Sunday, August 24, 2008

Surgery Mnemonics

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


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


Post-operative complications (immediate) "Post-op PROBS":
Pain
Primary haemorrhage
Reactionary haemorrhage
Oliguria
Basal atelectasis
Shock/ Sepsis


Fistulas: conditions preventing closure FETID:
Foreign body
Epithelialization
Tumor
Infection
Distal obstruction


Oedema causes: localised ALIVE:
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


Compartment syndrome: signs and symptoms · 5 P's:
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


F PURE:
Flat (eg venous)
Punched-out (eg trophic, arterial)
Undetermined (eg pressure, TB)
Rolled (eg BCC)
Everted (eg SCC)


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


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.


Post operative order list check-up FLAVOR:
Fluids
Laboratories
Activity
Vital signs
Oral allowances
Rx [medications]







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2 comments:

samuel pontoh said...

nice share brother.....

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