Post Op Fever

Question 1

What are the 5 W’s of post op fever?

Answer 1

Wind, water, walking, wound, and wonder drugs

Question 2

What is the diagnosis if pt has a fever during surgery and what are 3 things we can do to treat it?

Answer 2

Malignant hyperthermia due to anesthesia

Dantrolene, O2, and IV fluids to cool them off.

Question 3

What is usually the diagnosis when pt has fever right after surgery, how to make the diagnosis, and how to treat?

Answer 3

Bacteremia from the surgery
Blood culture
Broad spectrum abx like vancomycin and pip tazo

Question 4

What is most likely causing fever post op day 1 and what to do to confirm it?

Answer 4

Atelectasis

CXR

Question 5

What is the most common cause of post op fever day 2?
How to make the diagnosis?
Treatment?

Answer 5

PNA
Fever, cough, consolidation on CXR
Broad spectrum abx

Question 6

What is the most common cause of fever post op day 3?
How to make the diagnosis?
Treatment?
How could we have prevented it?

Answer 6

UTI
UA and urine culture
Abx
Take the foley cath out as soon as possible

Question 7

What is something we can do to try to prevent “wind” post op fevers?

Answer 7

Out of bed

Question 8

What is the most common cause of fever on post op day 5?
How to make the diagnosis?
Treatment?
How could we have prevented it?

Answer 8

DVT/PE
US of legs
Heparin to warfarin
Out of bed and low molecular weight heparin after surgery

Question 9

What is the most common cause of fever on post op day 7?
How to make the diagnosis?
Treatment?

Answer 9

Wound infection, so usually cellulitis
US to rule out abscess
Abx

Question 10

What is the most common cause of fever post op day 10-14?
How to make the diagnosis?
Treatment?

Answer 10

Wound abscess
US
Abx, incision and drainage