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Phase 2 - General Surgery Placement > Antibiotic Prophylaxis and Sepsis > Flashcards

Antibiotic Prophylaxis and Sepsis Flashcards

1
Q

what does a superficial incisional infection affect?

A

the skin and subcutaneous tissue of the surgical incision

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2
Q

what does the onset tend to be for a superficial incisional infection?

A

within 30 days after surgery

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3
Q

what are the signs and symptoms of a superficial incisional infection?

A

5 signs of swelling +/- purulent fluid at the site of incision

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4
Q

what does a deep incisional infection affect?

A

skin, subcutaneous tissue, and deep soft tissue (fascial and muscle)

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5
Q

what does the onset tend to be for a deep soft incisional infection or an organ/space infection?

A

within 30 days after surgery or within a year if an implant is in place

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6
Q

what are the signs and symptoms of a deep incisional infection?

A
  • purulent fluid at site of infection
  • fever and localised tenderness
  • abscess formation
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7
Q

what does an organ/space infection affect?

A

skin, subcutaneous tissue, deep soft tissue, any organ or anatomy that was manipulated in the procedure

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8
Q

what are the signs and symptoms of an organ/space infection?

A
  • purulent fluid at site of infection
  • systemic signs of infection
  • abscess formation
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9
Q

what are the two most common infectious organisms for an incisional infections?

A
  • staphylococcus aureus

- e. coli

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10
Q

what are patient risk factors for a surgical site infection?

A
  • extreme age
  • obese or malnourished
  • diabetic
  • smoking
  • immunosuppression
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11
Q

what are surgical risk factors for a surgical site infection?

A
  • preoperative skin preparation
  • length of operation
  • antibiotic prophylaxis
  • instrument sterilisation
  • surgical drains
  • post-operative hypothermia
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12
Q

what key measures are taken in the pre-operative phase to prevent surgical site infections?

A
  • pre-operative showering and hair removal

- antibiotic prophylaxis or treatment if patient had prior infection

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13
Q

what measures are taken in the intra-operative phase to prevent surgical site infections?

A
  • surgical scrubbing
  • sterile equipment including clothing
  • antiseptic skin prep
  • oxygenation and laminar airflow in theatre
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14
Q

what measures are taken in the post-operative phase to prevent surgical site infections?

A
  • regular dressing changes using an aseptic technique
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15
Q

what patients are considered high risk for MRSA infections?

A
  • surgical patients
  • ITU patients
  • patients with a central venous catheter
  • patients with known MRSA carriage
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16
Q

what patients are considered medium risk for MRSA infections?

A

all adults are considered medium risk

17
Q

what patients are considered low risk for MRSA infection?

A

all children are considered low risk

18
Q

what treatment is given to high risk MRSA patients?

A
  • screen for MRSA on admission

- give nasal mupirocin and disinfectant body wash throughout stay

19
Q

what treatment is given to medium risk MRSA patients?

A

disinfectant body wash throughout their stay

20
Q

what is the treatment for low risk MRSA patients?

A

no specific action is given

21
Q

what is the standard antibiotic prophylaxis treatment given before lower abdominal and hepatobiliary surgery?

A

metronidazole 500mg IV

gentamicin 120mg IV

22
Q

what is the standard antibiotic prophylaxis treatment given before upper abdominal surgery?

A

co-amoxiclav 1.2g IV

23
Q

what other drug is given in antibiotic prophylaxis if the patient is MRSA positive?

A

teicoplanin 400mg IV

24
Q

true or false: co-amoxiclav is safe to give to patients with a penicillin allergy

A

false.

patients should instead be treated with gentamicin 120mg IV and metronidazole 500mg IV

25
Q

what is the antibiotic prophylaxis treatment before orthopaedic surgery?

A

co-amoxiclav 1.2g IV

26
Q

what is sepsis?

A

a life-threatening organ dysfunction caused by an abnormal and uncontrolled host response to an infection

27
Q

what is a SOFA score?

A

a way for clinicians to identify the extent of organ dysfunction

28
Q

what SOFA score would indicate sepsis?

A

a score equal or more than 2

29
Q

what levels are looked at to determine a qSOFA score?

A
  • respiratory rate >22/min
  • altered mental state
  • systolic BP <100mmHg
30
Q

what is involved in the sepsis 6 bundle?

A 
mnemonic: BUFALO or 'Give 3 Take 3'
Bloods (culture)
Urine output
Fluids
Antibiotics
Lactate
Oxygen
31
Q

what are the common sources of sepsis on the wards?

A

‘The 7 Cs’:

Chest infection, Cut, Catheter, Collections (abdomen/pelvis), Calves (DVT), Cannula, Central line

32
Q

what is classified as septic shock?

A

sepsis with hypotension despite adequate fluid resuscitation

Phase 2 - General Surgery Placement (14 decks)

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