Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgical prep and care > Prophylaxis > Flashcards

Prophylaxis Flashcards

1
Q

What preoperative drugs are prescribed?

A

Thromboprophylaxis

Prophylactic antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the indication for prophylactic subcutaneous LMWH?

A

Reduce risk of DVT and fatal PE in:

-All patients over 20y undergoing abdominal surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the dose of prophylactic Dalteparin? When should it be given?

A

2,500 units subcutaneously OD

Started at least 2hr preoperatively

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name 1 contraindication of preoperative LWMH

A

Patients having neck surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Name 3 high risk patients for preoperative DVT or PE

A 
Oral contraceptive pill
Previous DVT or PE
Obese patients
Intra-abdominal malignancy
Pelvic or lower limb surgery patients
Pregnant
Amputees
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How should the dosage of prophylactic LMWH be changed in high risk patients?

A

Larger prophylactic dose of subcutaneous LMWH

e.g. Dalteparin 2,500 ➔ 5,000 units

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name the 3 types of thromboprophylaxis

A

Mechanical devices: TEDS and pneumatic compression boots
Unfractionated heparin
LMWH SC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the mechanism of action of Heparin

A

Irreversibly binds to ATIII ➔ increases inactivation of factors IIa and Xa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the dosage of unfractionated heparin for thromboprophylaxis in surgical patients?

A

5000 units taken 2hr pre-operatively

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the mechanism of action of LMWH

A

Irreversibly binds to ATIII ➔ increases inactivation of factor Xa (preferential) and IIa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What blood monitoring is required if thromboprophylactic unfractionated heparin is used?

A

APTT - maintain between 50-70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Name 2 LMWH drugs

A

Dalteparin

Enoxaparin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is DVT risk assessed for VTE prophylaxis?

A

All patients are assessed for risk factors on admission and after 24hr in hospital.

Risk according to procedure factors and patient factors.

These are balanced against bleeding risks and risks of compression devices.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Name 2 procedure factors that increase DVT risk

A

Prolonged anaesthetic time

Lower limb or pelvic surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name 3 patient factors that increase DVT risk

A 
Immobility
Malignancy
Age
Dehydration
Obesity
Diabetes
Cardiorespiratory disease
Inflammatory pathology
OCP or HRT
PMH or FHx of thromboembolic disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name 3 bleeding risks that should be considered when assessing need for prophylactic heparin or LMWH

A

Active bleeding
Stroke
Invasive procedure
Bleeding disorders

17
Q

Name a risk of compression devices for thromboprophylaxis

A

Peripheral vascular disease

18
Q

What are the indications for prophylactic antibiotics?

A

To minimise wound or prosthesis infection

To minimise subacute bacterial endocarditis

19
Q

Which antibiotics are used for prophylaxis?

A

Depends on nature of surgery, countering the effect of potential spillage from colonised organs once opened.

Consult trust policy for antibiotics for specific surgeries and patients.

20
Q

What are the main wound contaminants in colonic surgery? Which antibiotics are used?

A

Anaerobes: Bacillus fragilis
Gram -ve bacilli: E. coli, Pseudomonas, Klebseilla
Skin: Staph aureus

Cefuroxime and Metronidazole
Augmentin (penicillin)

21
Q

What are the principles of antibiotic prophylaxis?

A

High circulating serum level of ABX at time of potential contamination
Rarely needed to be continued post-op
Many clean wounds do not require prophylactic ABX
High risk patients may require extended or specific prophylaxis

22
Q

What is the average length of prophylactic antibiotic courses?

A

1-3 days

23
Q

Name 2 causative agents of bacterial endocarditis

A

Staph aureus

Strep viridans

24
Q

How does subacute endocarditis differ to acute endocarditis?

A

Subacute usually occurs on damaged valves.

25
Q

Name 2 risk factors for subacute endocarditis

A

Prosthetic heart valve

Rheumatic heart disease (rare)

26
Q

Outline thromboprophylaxis for patients with low risk of DVT

A

TEDS stockings only

27
Q

Outline thromboprophylaxis for patients with medium risk of DVT

A

TEDS stockings
+
Enoxaparin 30mg SC OD or Dalteparin 2500U SC OD

28
Q

Outline thromboprophylaxis for patients with high risk of DVT

A

TEDS stockings
+
Enoxaparin 30mg SC BD or
Dalteparin 5000U SC OD

29
Q

Name 3 patient factors that affect the need for post-op thromboprophylaxis

A

Age
BMI
Personal or FHx of VTE
Personal or FHx of thrombophilia (increased clotting)

30
Q

Name 3 procedural factors that affect the need for post-op thromboprophylaxis

A 
Orthopaedic operations
Plaster cast immobilisation
Spinal surgery
Pelvic operations
Prolonged anaethesia
Malignancy operations

Surgical prep and care (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions