Surgical Emergencies

Question 1

What is infection control

Answer 1

The prevention of any harm from your patient by reducing the risk of infection

Question 2

What is an SSI

Answer 2

Surgical site infection caused by microbial flora on the skin (required within 30days)

Question 3

Define a surgical infection

Answer 3

an infection developed within 30 days of surgery (or 1 year if there is an implant)

Question 4

Define sepsis

Answer 4

The presence of pathogens and their toxin products in the tissues of a patient

Question 5

Define asepsis

Answer 5

The absence of pathogenic microbes in living tissues

Question 6

Antiseptic

Answer 6

A patient that either inhibits pathogenic microbes or inhibits their growth

Question 7

Disinfectant

Answer 7

A chemical that kills micro-organisms on objects

Question 8

Disinfection

Answer 8

the removal of micro-organisms but not necessarily their spores

Question 9

Sterilisation

Answer 9

the complete elimination of microbial viability. Including bacteria and spores.

Question 10

What is a clean surgical area/site

Answer 10

Does not enter GI tract, urogenital tract or resp tract. No inflammation or prior infection

Question 11

What is a clean contaminated surgical area/site

Answer 11

Can enter the GI tract, urogenital tract or resp tract.

No inflammation or prior infection

Question 12

What is a contaminated surgical area/site

Answer 12

open, fresh and accidental wounds

Question 13

What is a dirty surgical area/site

Answer 13

Anal, oral or infected areas.

Question 14

What does chlorhexidine provide?

Answer 14

long lasting inhibition or bacterial growth

Question 15

What does alcohol provide?

Answer 15

It kills bacteria quickly but doesn’t remove organic matter

Question 16

What is a GDV - Gastric dilation and volvulus

Answer 16

GDV is the dilation of the stomach causing it to expand, misposition and rotate

Question 17

What can a GDV cause on the body

Answer 17

inadequate blood flow to the heart
rupture of the stomach wall
pressure on the diaphragm - abnormal respiratory pattern

Question 18

3 treatment stages of a GDV

Answer 18

stabilise and decompress stomach
surgical exploration
gastropexy

Question 19

What is meant by septic peritonitis?

Answer 19

An inflammatory condition of the peritoneum that occurs secondary to microbial contamination
bacteria in the peritoneum - inflammatory

Question 20

What are some causes of septic peritonitis?

Answer 20

FB rupture 
ruptured uterus 
penetrating object (stick injury)
bile leakage 
uroabdomen

Question 21

What is the treatment for a patient presenting with septic peritonitis?

Answer 21

Stabilisation (prior to surgery) = IVFT and ABs

Surgery - removal of cause of infection

Question 22

What are the clinical signs for a patient presenting with septic peritonitis?

Answer 22

Acute abdominal pain
dehydration
fever/pyrexia
shock (hypovolemic, septic and distributive)

Question 23

What is a haemabdomen

Answer 23

a condition where an accumulation of blood occurs in the peritoneal space

Question 24

What are the clinical signs of a patient presenting with a haemabdomen

Answer 24

Tachycardia 
Tachypnoea 
Pale MM pronged CRT 
Hypovolemia 
Perfusion issues

Question 25

What are some reasons for a haemabdo

Answer 25

Trauma
Neoplasia
Splenic torsion
Toxicity

Question 26

What is the aim when treating a haemabdo

Answer 26

Re-establish circulating volume (fluid therapy)

Question 27

What are some pre op considerations for a patient to undergo a caesarian

Answer 27

Pre Op IVFT
Clip awake
Reduce GA time
O2 therapy

Question 28

What are some intra op considerations for a patient to undergo a caesarian

Answer 28

Induction - propofol
Little to no pre - med
IVFT to prevent hypotension
Tilt surgery table to reduce pressure on chest

Question 29

What are some post op considerations for a patient to undergo a caesarian

Answer 29

Supervise
IVFT
Warmth
Get puppies feeding

Question 30

What is normal gestation period of a dog

Answer 30

57-72 days (average 65)

Question 31

What is considered a prolonged gestation

Answer 31

Without a temperature drop or signs of labour

65+1 day after peak of luteinizing hormone or 65+3 days after ovulation

Question 32

What is the most common cause of dystocia

Answer 32

uterine inertia - lack of contractions ( primary too weak, secondary start of strong then get weak)

Question 33

what is the recommended dose of oxytocin

Answer 33

1.1-2.2 IU/kg IM or SC

Question 34

What are some steps for medical management for a patient in dystocia

Answer 34

1. vaginal examination
2. IV access
3. Radiographs
4. Low dose oxytocin 1-3 IU wait 30-45 mins
5. if no delivery administer calcium gluconate 0.5-1.5mg/kg over 20 mins
6. if still no pups administer more oxytocin 1.1-2.2 IU/kg
7. wait 30-45 mins if still no pups 3rd dose of oxytocin
8. if no pups surgery