Article Flashcards
when are abx given prior to surgery
30min- 1hr
when is a fluoroquinolone or vancomycin given before surgery? why?
120 minutes to avoid an adverse reaction associated with rapid infusion.
the professional consensus supports using narrow-spectrum, first and second generation cephalosporins. why?
inexpensive, safe to use and bactericidal and have long half lifes
if a patient is hypothermic, how many times higher is their rate of infection
3 times higher and stayed in the hospital nearly 1 week longer than normothermic patients.
what percent of surgical infections are considered preventable
60%
how often is temperature measured
q15 minutes
when does the greatest decline in patient temperature occur
during the first hour of surgery
how do we keep the patient warm
forced warm air- bair hugger
HAI occur at what percent in hospitalized patients
10%
what is the failure rate of anesthesia providers not washing their hands
64-93%
The CDC and the National Nosocomial Infection System define SSIs by the following clinical criteria
4 things
A purulent exudate draining from a surgical site
A positive culture obtained from a surgical site that
was closed initially
A surgeon’s diagnosis of infection
A surgical site that requires reopening due to at
least one of the following signs or symptoms: tenderness, swelling, redness, or heat
what 3 things can CRNA’s do to prevent infection
normothermia
timely abx
handwashing
surgical site infections are how common
2nd most common hai
how many days since surgery is considered a SSI
30days
The infection risk associated with primary hip and knee arthroplasty is approximately 1% and increases to 2% to 5% for arthroplasty revision. Explain why orthopedic infections are a grave concern
infection in the bones and joints is very difficult to treat and is associated with a lifelong recurrence risk of 10% to 20% When multi-resistant pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) infect a prosthetic joint, the treatment failure rate is 20% to 40%.
It is costly, and requires a new joint replacement, prolonged abx and rehab.
what do volatile and IV anesthetics and opioids do to thermoregulation
mpair thermoregulatory control by decreasing heat production and increasing cu- taneous heat loss through vasodilation
how does muscle relaxants impair thermoregulation
Muscle relaxants also compromise thermoregulatory control by preventing shivering
name the various adverse outcomes to a patient being hypothermic
increased blood loss (transfusion requirement)
prolonged postoperative recovery times
heightened post op pain
impaired neutrophil function
vasoconstriction leading to hypoxia
INCREASED INCIDENCE OF SSI
what precent of colorectal surgeries develop SSI
20%
how much longer did patients with hypothermia stay in the hospital
nearly 1 week longer
name some various risk factors for developing hypothermia
extremes of age female length and type of procedure general and spinal anesthesia ambient temp of OR preexisting condition (BURNS, ENDOCRINE disorder, PREGNANCY, Large open wound)
what is deemed the gold standard for measuring temperature
no gold standard exist
what is the most reliable method to measure temperature
distal esophagus
what is the issue with using rectal temperature
it lags behind temperature measured in the esophagus and pulmonary artery.
fails to rip during MH!!
