Pre-op Flashcards
Indications for prophylactic antibiotics
Appendicectomy Colorectal resections Open biliary surgery Oesophageal or gastric surgery Vascular surgery
What is used as prophylactic antibiotics
Coamoxiclav
Or vascular: piperacillin and tazobactam
Wells score for DVT
Active cancer Entire leg swollen Calf swelling >3cm Deep vein tenderness Leg immobilisation Immobility - surgery, bedridden Pitting oedema Collateral superficial veins History of DVT -2 if another diagnosis more likely
Prevention of DVT
TEDS
Intermittent pneumatic compression device
DVT treatment
LMWH treatment dose
Switch to DOAC for 3 months
Methods of nutrition
Enteral (preferable)
Parenteral
Indications for NJ tube
Gastric outlet obstruction
Pancreatitis
Delayed gastric emptying
Post gastrectomy
How to administer TPN
Dedicated central venous line
Dedicated PICC line
Dedicated lumen of multilumen catheter
Management for sepsis following parenteral nutrition
If insertion site infection - stop nutrition, take line and peripheral cultures, give ABx via line
If venous line infection - take line cultures, remove line, give ABx
Monitoring in TPN
Weight Fluid balance Glucose Creatinine Electrolytes (+Ca+PO4)
Who’s at risk of refeeding syndrome
Prolonged starvation
Initiating artificial feeding
Anorexia nervosa
Alcoholism
Symptoms of refeeding syndrome
Rhabdomyolysis
Arrhythmia
Cardiogenic shock
Seizures
Prevention and treatment for refeeding syndrome
Prevention - pabrinex during refeeding window, monitor closely (especially look for low phosphate)
Treatment - parenteral phosphate
