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Flashcards in Surgical Prophylaxis Deck (17):
1

What medications provide protection from postoperative GI bleeding?

H2 blockers, PPI

2

What measures provide protection from postoperative atelectasis and pneumonia

Incentive spirometry, coughing, smoking cessation, ambulation

3

What treatments provide protection from postoperative DVT?

LMWH; subcutaneous low-dose unfractionated heparin; sequential compression device for lower extremities; early ambulation

4

What measures provide protection from wound infection?

Shower the night before surgery with chlorhexidine scrub; no razors for hair removal; ensure adequate skin prep in OR; do not close the skin in a contaminated case; ensure preoperative antibiotics in the bloodstream before incision; ensure no excess Bovie

5

Why not use a razor to remove hair preoperatively?

Micro-cuts are a nidus for bacteria and subsequent wound infections

6

How long should prophylactic antibiotics be given?

< 24 hours

7

What treatment provides protection from oral or esophageal fungal infection during IV antibiotic treatment?

PO nystatin

8

What measures prevent ventilator-associated pneumonia (VAP)?

Head of bed > 30 degrees; hand-washing; patient oral hygiene; avoidance of gastric overdistention

9

What is the classic preoperative bowel prep?

1. Lower bacterial count in colon by catharsis (GoLYTELY or Fleets)
2. PO antibiotics (neomycin, erythromycin) preoperatively
3. Preoperative IV antibiotics with spectrum against anaerobes (e.g. Cefoxitin)

10

Is there any evidence that a bowel prep decreases infections?

No

11

What treatment provides protection from OPSS after splenectomy?

Immunization against H. flu, Streptococcus, Meningococcus, and penicillin when illness/fever occurs

12

What treatment provides protection from endocarditis with faulty heart valve or prosthetic heart valve?

Antibiotics prior to dental procedure or any surgery

13

What treatment provides protection from tetanus infection?

Tetanus toxoid (and tetanus immunoglobulins, if one or no previous toxoid with dirty wound)

14

What treatment provides protection from alcohol withdrawal?

Chlordiazepoxide (Librium), also give Rally pack

15

What treatment provides protection from Wernicke's encephalopathy?

Rally pack (contains thiamine, folate, and magnesium)

16

What is Wernicke's encephalopathy?

Condition resulting from thiamine deficiency in patients with alcoholism, causing a triad of symptoms:
1. Confusion
2. Ophthalmoplegia
3. Ataxia

17

What treatment decreases the risk of perioperative adrenal crisis in a patient on chronic steroids?

Stress-dose steroids (100 mg hydrocortisone administered preoperatively, continued postoperatively q8h, and then tapered off)