Workup: CBC with differential, CXR, 2 blood cultures, UA, Urine Cx
1) Atelectasis (POD 1-2)
a. Most common cause of post-op fever
b. Risk factors: prolonged immobilization, smoking hx, lung dz
c. Sx: low grade fever, rales on auscultation, tachycardia, tachypnea
d. Tx: bronchoscopy
2) Pneumonia (POD 1-2)
a. Risk factors:
i. Respirator use (Pseudomonas, Klebsiella)
1. Tx: aminoglycosides + penicillin
ii. Aspiration
1. Tx: NGT for decompression, oxygenation
b. Sx: cough, sputum production; Vitals: fever, ↑ RR
c. Findings: CXR infiltrate, Leukocytes on CBC
3) UTI (POD3+)
a. 5% chance per each day foley is in
b. Sx: burning sensation upon urination; no pain if Foley still in
c. Risk factors: prostate hypertrophy, Diabetes, catheters, urinary retention
d. Microorganisms: Pseudomonas, Serratia, Enterococcus, E.Coli, Proteus, Klebsiella
e. Findings: leukocyte esterase and nitrite changes on UA; growth on Urine Cx, leukocytes on CBC
f. Tx: remove foley, increase fluids, Abx
4) Wound (POD 5+)
a. Sx: >2cm erythema, swelling, warmth, pain around incision site
b. Microorganisms: Staph most common
c. GI infections: E. coli, Bacteroides, Enterococcus
d. GU infections: Pseudomonas, Proteus
e. Tx: drain and wet-to-dry dressings twice daily
f. Other complications: hematoma, seroma, dehiscence (fascial opening)
5) DVTs (POD7+)
a. Sx: leg edema, tender superficial veins, chest pain, tachycardia, tachypnea, SOB
b. Studies: Doppler, venogram, CT (look for occlusion in pulmonary arteries)
c. Tx: ambulate, SCDs, systemic heparin, consult cardio
6) Medications - drug rxn can occur anytime
7) Line infections
a. IV lines need to come out after 72hrs
b. Sx: fever, leukocytosis on CBC, bacteremia on blood Cx, (+) culture from line tip
c. Micro: S. aureus, S. epidermidis
d. Tx: removal of line and +/- IV Abx
8) Peritonitis
a. Perforation of GI tract à abdominal pain, fever, sepsis
b. Studies: KUB (check for free air)
c. Tx: NPO with NGT, Abx, IVF, operate to irrigate abdomen
d. Complications: abscess formation
i. Tx: localize with CT scan or Gallium study (xrays while injecting radioactive gallium into bloodstream), drain, Abx
Fever occurring during operation
1) Transfusion rxn
a. Sx: fever, excess bleeding, urticaria, red urine
b. Tx: stop transfusion, hydrate with NS, mannitol for osmotic diuresis
2) Intraoperative Septicemia
a. Release of abscess
b. Tx: copious irrigation
3) Malignant hyperthermia
a. Sx: fever, tachycardia, tachypnea, acidosis with hyperkalemia, shock
b. Causes: halothane, succinylcholine, MAOi + meperidine
c. Tx:
i. stop surgery/anesthesia
ii. dantrolene (muscle relaxant)
iii. cool patient
iv. hyperventilate to ¯ acidosis
v. bicarb + insulin to ¯ hyperkalemia and ¯ acidosis
vi. mannitol for diuresis
d. mortality 60%
Fever occurring few hours post-op
1) Thyroid storm
2) Addisonian crisis
a. Tx: resume steriod therapy for Addison's dz
3) EtOH withdrawal
a. Sx: low grade fever, tremors, seizures
b. Wernicke's encephalopathy: confusion, nystagmus, ataxia
c. Korsakoff's: confabulation, amnesia caused by damage to mamillary bodies
d. Tx: thiamine
4) Anastomotic leak
5) Clostridium perfringens wound infection
Peritonitis is a frequent cause of death from typhoid fever.
fever
The most common prenatal surgeries are for conditions in which the newborn will not be able to breathe on its own.
Poor hemostasis during surgery
Yes, surgery can kill. Intraoperative causes of death include hemorrhage, sepsis and cardiorespiratory failure. Posoperatively, infection is the most common cause of death following surgery.
In this day and age the most common type of surgery would probably be plastic surgery.
Arthroscopy is the most common surgical alternative to knee revision surgery.
i don't think so but I'm just trying to help no a fever does not cause sleepwalking a fever would most likey cause sickness
Cataract surgery is still the most common type of eye surgery and is also one of the most unnecessary. LASIK is currently number two and is becoming more common.
what is the most common victims to prey upon for scarlet fever
No. Most fevers are not caused by cancers. You can have a fever and not have a cancer, this is the most common case. You can also have cancer and not have a fever, and you can have cancer and a fever.
The most common type of plastic surgery on the jaw is corrective jaw surgery. This type of surgery is done to improve appearance, and the ability to chew better. This surgery is called Orthognathic surgery.