Post-operative fever causes Six W's:
Wind: pulmonary system is primary source of fever first 48 hours, may have pneumonia
Wound: infection at surgical site
Water: check IV for phlebitis
Walk: deep venous thrombosis, due to pelvic pooling or restricted mobility related to pain and fatigue
Whiz: urinary tract infection if urinary catheterization
Wonder drugs: drug-induced fever
Wind: pulmonary system is primary source of fever first 48 hours, may have pneumonia
Wound: infection at surgical site
Water: check IV for phlebitis
Walk: deep venous thrombosis, due to pelvic pooling or restricted mobility related to pain and fatigue
Whiz: urinary tract infection if urinary catheterization
Wonder drugs: drug-induced fever
Scrotum: scrotum swelling differential THE THEATRES:
Torsion
Hernia
Epididymytis, orchitis
Trauma
Hydrocoele, varicocele, hematoma
Edema
Appendix testes (torsion, hemorrhage)
Tumour
Recurrent leukemia
Epididymal cyst
Syphilis, TB
Torsion
Hernia
Epididymytis, orchitis
Trauma
Hydrocoele, varicocele, hematoma
Edema
Appendix testes (torsion, hemorrhage)
Tumour
Recurrent leukemia
Epididymal cyst
Syphilis, TB
Post-operative complications (immediate) "Post-op PROBS":
Pain
Primary haemorrhage
Reactionary haemorrhage
Oliguria
Basal atelectasis
Shock/ Sepsis
Pain
Primary haemorrhage
Reactionary haemorrhage
Oliguria
Basal atelectasis
Shock/ Sepsis
Fistulas: conditions preventing closure FETID:
Foreign body
Epithelialization
Tumor
Infection
Distal obstruction
Foreign body
Epithelialization
Tumor
Infection
Distal obstruction
Oedema causes: localised ALIVE:
Allergic (angio-oedema)
Lymphatic (elephantiasis)
Inflammatory (infection, injury)
VEnous (DVT, chronic venous insufficiency)
Allergic (angio-oedema)
Lymphatic (elephantiasis)
Inflammatory (infection, injury)
VEnous (DVT, chronic venous insufficiency)
GI bleeding: causes ABCDEFGHI:
Angiodysplasia
Bowel cancer
Colitis
Diverticulitis/ Duodenal ulcer
Epitaxis/ Esophageal (cancer, esophagitis, varices)
Fistula (anal, aortaenteric)
Gastric (cancer, ulcer, gastritis)
Hemorrhoids
Infectious diarrhoea/ IBD/ Ischemic bowel
Angiodysplasia
Bowel cancer
Colitis
Diverticulitis/ Duodenal ulcer
Epitaxis/ Esophageal (cancer, esophagitis, varices)
Fistula (anal, aortaenteric)
Gastric (cancer, ulcer, gastritis)
Hemorrhoids
Infectious diarrhoea/ IBD/ Ischemic bowel
Compartment syndrome: signs and symptoms · 5 P's:
Pain
Palor
P ulseless
Paresethesia
Pressure (increased)
Pain
Palor
P ulseless
Paresethesia
Pressure (increased)
Swollen leg: unilateral swelling causes TV BAIL:
Trauma
Venous (varicose veins, DVT, venous insufficiency)
Baker's cyst
Allergy
Inflammation (cellulitis)
Lymphoedema
Trauma
Venous (varicose veins, DVT, venous insufficiency)
Baker's cyst
Allergy
Inflammation (cellulitis)
Lymphoedema
Pancreatitis: treatment MACHINES:
Monitor vital signs
Analgesia/ Antibiotics
Calcium gluconate (if deemed necessary)
H2 receptor antagonist
IV access/ IV fluids
Nil by mouth
Empty gastric contents
Surgery if required/ Senior review
Monitor vital signs
Analgesia/ Antibiotics
Calcium gluconate (if deemed necessary)
H2 receptor antagonist
IV access/ IV fluids
Nil by mouth
Empty gastric contents
Surgery if required/ Senior review
Appendicitis: Alvarado's scoring system for diagnosis MANTRELS:
Migratory pain (1)
Anorexia (1)
Nausea (1)
Tenderness (2)
Rebound tenderness (1)
Elevated temperature (1)
Leucocytosis (2)
Shift to left (1)
· Score 3-4 = no appendicitis. Score 5-6 = doubtful. Score 7 or more = appendicitis is confirmed.
Migratory pain (1)
Anorexia (1)
Nausea (1)
Tenderness (2)
Rebound tenderness (1)
Elevated temperature (1)
Leucocytosis (2)
Shift to left (1)
· Score 3-4 = no appendicitis. Score 5-6 = doubtful. Score 7 or more = appendicitis is confirmed.
Post operative order list check-up FLAVOR:
Fluids
Laboratories
Activity
Vital signs
Oral allowances
Rx [medications]
Fluids
Laboratories
Activity
Vital signs
Oral allowances
Rx [medications]
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