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Flashcards in Surgical Care Deck (56)
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1

Causes for Post-op fever 6 W's

Wind (atelectasis), Water (UTI), Wound (post-op infection), Walking (DVT/PE), Wonder (drug), What did we do?

2

Wind POD

1-3

3

Water POD

3

4

Wound POD

5

5

Walking POD

7

6

Wonder POD

anytime

7

Virchows Triad

Stasis, vessel damage, hypercoaguable state

8

When there's a fever also consider

necrotizing infection (48hrs), malignant hyperthermia, anastomotic leak (POD3-5)

9

necrotizing infection TX

CBC resuscitation, Pen G, surgical debridement

10

Malignant hyperthermia TX

CBC, resuscitation, rapid cooling, IV dantrolene

11

Anastomotic leak TX

place a drain or return to OR

12

Four crucial assessments of Burns

Airway, evaluation of other injuries, estimation of burn size, diagnosis of CO and cyanide poisoning

13

First degree Burn

superficial- no blisters, blanching. 7 days to heal

14

second degree burn

partial thickness- blisters, pain. superficial- 14-21 days to heal. Deep- 3-8 wks to heal

15

third degree

full thickness, no pain, do not heal, need skin grafts. months to heal and leaves scar

16

Fourth degree

life threatening, may extend into tissue and fascia. Multiple surgeries needed.

17

Parkland Formula

LR 4cc x wt (kg) x %BSA= amount given in 24 hrs. half over the first 8 hrs the other half over 16 hrs.

18

Lactated ringers

maintain stable blood pH, contains less Na and Cl than NS

19

CO poisoning SX

HA, lightheadedness, dizziness, confusion, tachypnea, hypoxia

20

When to refer burns

partial thickness burns >10% TBSA, burns on face, hands, feet, genitalia, perineum, 3rd degree, electrical burns, chemical burns, inhalation injury, complicated comorbidity, circumferential burns, Peds, burns requiring special social, emotional or rehab

21

Net Stress response to surgery

1) water and sodium retention to maintain cardiovascular stability
2)increased catabolism to provide energy sources

22

Calorie need

30kcal/kg/day

23

protein need

1g/kg/day

24

Harris-Benedict equation

Weight in KG + Height in cm - age in years

25

phases of wound healing

1) hemostasis and inflammation 0-5
2) Proliferation 5 days-2 wks
3) Maturation 2 wks- several months

26

Local Factors that affect wound healing

edema, infection, mechanical injury, Ischemia, Necrotic Tissue, Radiation effects, Hypoxia, Foreign body

27

Systemic factors that affect wound healing

age, nutrition, obesity, trauma, metabolic disease, Immunosuppression connective tissue disease, smoking

28

Necrotizing Fasciitis organisms

GAS, Staph aureus, Clostridium perfringens, Baceroides fragilis, Aeromonas hydrophila

29

Allografts

transplant between same species

30

Autografts

transplant in same individual