SR 29 - Surgical Prohpylaxis

Question 1

What medications provide protection from postop GI bleed?

Answer 1

H2 blockers

PPI

Question 2

What measures provide protection from postop atelectasis/pneumonia?

Answer 2

Incentive spirometry
Coughing
Smoking cessation
Ambulation

Question 3

What treatments provide proteection from postoperative DVT?

Answer 3

Low-molecular-weight heparin
SubQ low-dose unfractionated heparin
Sequential compression device for lower extremities
Early ambulation

Question 4

What measures provide protection from wound infection?

Answer 4

Shower the night before surgery with chlorhexidine scrub
NEver use a razor for hair removal - electric shavers only
Ensure adequate skin prep in OR
Do not close the skin in a contaminated case
Ensure preoperative antibiotics in the bloodstream before incision
Ensure no excess Bovie (necrotic tissue)

Question 5

What measures prevent ventilator-associated pneumonia?

Answer 5

Head of bed >30o
Handwashing
Patient oral hygiene
Avoidance of gastric overdistention

Question 6

What treatment provides protection after splenectomy?

Answer 6

Immunization - H. influenzae, Streptococcus, Menigococcus

Give penicillin when fever/illness occur

Question 7

What treatment provides protection for Wrnicke’s encephalopathy?

Answer 7

Rally pack - AKA banana bag

Includes thiamine, folate and magnesium

Question 8

What is Wernicke’s encephalopathy?

Answer 8

Thiamine deficiency
Triad of symptoms:
- Confusion
- Ophthalmoplegia
- Ataxia