carotid endarterectomy, head & neck surgery, intraperitoneal & intrathoracic surgery, orthopedic, prostate surgery
risk?
intermediate
aortic & other major vascular surgery risk
high
ambulatory surgery, endoscopic, superficial procedure, cataracts, breast surgery risk
low
Goldman criteria
high risk type of surgery, hx ischemic HD, hx HF, hx CVD, DM, preop Cr > 2.0
low VTE risk?
minor surgery in pts < 40 y/o w/ no risk factors
moderate VTE risk
minor surgery in pts w/ one risk factor
ages 40-60 w/o risk
high VTE risk
pts > 60
age 40-60 w/ 1 risk factor
highest VTE risk (3)
pts > 40 w/ multiple risk factors
hip or knee arthroplasty
major trauma or spinal cord
when to re-evaluate fluid & electrolytes?
every 4-6 hours POD1
every 24h POD2+
CT indications? (3)
abdomen
perfusion of bowel wall
evaluating solid organs
X-ray indications
stones, bones, gas, mass
visualization of hollow organs w/ X-ray?
contrast radiography
MRI w/ contrast use?
enhancement of blood vessels
cause of post op fever day 1-2?
wind- lungs. Pneumonia, aspiration, PE
postop fever days 3-5?
water- UTI
postop fever days 4-6?
Walking- DVT or PE
postop fever days 5-7
Wound- surgical site infection
postop fever days 7+
Wonder drugs- drug fever, infections from IV lines or blood products
