Miscellaneous

Question 1

What are the first questions you always ask when someone presents with post-operative complications?

Answer 1

1. What was the surgery?
2. When was the surgery?
3. What are their vital signs?

Question 2

What are some common post-operative complications?

Answer 2

Fever
Respiratory distress
Hypotension
Low urine output
Nausea, emesis
Wound issues
Pain

Question 3

If someone presents with fever post-op, what causes are you considering?

Answer 3

The likely causes differ depending on POD#:
POD0-1:
- aspiration pneumonitis
- Clostridial wound infection (unlikely)
- pre-existing infection
- malignant hyperthermia 
- transfusion reactions
POD2+:
- pneumonia
- urinary tract infection
- line sepsis from IV
- drug allergies or reactions
- anastomotic leaks
- wound infections (more likely)

Question 4

If someone present with respiratory distress post-op, what causes are you considering?

Answer 4

Pneumonia
Aspiration
Atelectasis
Pneumothorax
Pleural effusions
ARDS: non-cardiogenic, pulmonary oedema
Pulmonary embolus (rare)
Cardiac: ischaemia
Acute pulmonary embolism

Question 5

If someone present with hypotension post-op, what causes are you considering?

Answer 5

Remember SHOCK N Awe causes of hypotension
Sepsis 
Hypovolaemia
Obstructive e.g. tamponade or PE
Cardiogenic e.g. pump failure
Neurogenic e.g. epidural
Anaphylactic shock

Question 6

If someone present with low urine output post-op, what causes are you considering?

Answer 6

Post-renal causes first:
- epidurals, spinals
- pain
- catheter obstructions
- UTI
Pre-renal:
- hypovolaemia
Intra-renal (i.e. ATN):
- drugs
- hypotension
- surgery