Download SF 10.2-2 Sepsis & Surgical Infections 2 - Postsurgical Infection Session Objectives

Surgical Foundations Seminar Series
SF 10.2-2 Sepsis & Surgical Infections 2
- Postsurgical Infection
Session Objectives
After this session you will be able to:
1. Discuss the approach to fever in the postoperative patient.
2. Outline the presentation, diagnosis, management and common
pathogens for common post-surgical infections including hospital
acquired pneumonia, catheter sepsis, urinary tract infections,
surgical site infections, necrotizing soft tissue infections, bacteremia
and pseudomembranous colitis.
3. Discuss pathogenesis and treatment of common antibiotic resistant
pathogens including MRSA, VRE and ESBL organisms.
Relevant RCPSC Objectives
Medical Expert
2. Establish and maintain clinical knowledge appropriate to surgical
practice
PRE-OPERATIVE ASSESSMENT
 2.1 Apply knowledge of the clinical, socio-behavioural, and
fundamental biomedical sciences relevant to surgical practice during
assessment of a patient including:
• 2.1.2 Physiology (as it relates to risk assessment, postoperative care and the acute care setting)
 2.1.2.7 Immunology of sepsis and transplantation
• 2.1.14 Common infection
 2.1.14.1 Community and hospital acquired bacteria,
fungi and viruses
 2.1.14.2 Impact of blood borne pathogens, including HIV,
Hepatitis B and Hepatitis C
CONDUCTING A PROCEDURE
 2.2 Demonstrate an understanding of the conduct of a surgical
procedure
• 2.2.2 Principles of management of patient and surgical team
with respect to blood borne pathogens
 2.2.2.1 Needle stick injury
 2.2.2.2 Mucosal exposure
 2.2.2.3 Smoke plume inhalation
• 2.2.5 Principles of prophylaxis
 2.2.5.1 Wound and systemic infection
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Surgical Foundations Seminar Series
COMPLICATED POST-OPERATIVE CARE
• 2.4 Demonstrate an understanding of the pathophysiology and
complications in the post-operative surgical patient related to the
following systems:
o 2.4.13 Common postsurgical infections
 2.4.13.1 Pulmonary
 2.4.13.2 Vascular catheter
 2.4.13.3 Urinary
 2.4.13.4 Surgical site infection, including incisional and
organ/space
 2.4.13.5 Spreading and necrotizing infections
 2.4.13.6 Hematogenous infections
 2.4.13.7 Types of bacteria:
• 2.4.13.7.1 Clostridium difficile
• 2.4.13.7.2 Multi antibiotic-resistant pathogens
• 2.4.13.7.3 Common pathogens in the specific
surgical site
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Surgical Foundations Seminar Series
o 4.2.2
Complicated
postoperative course:
 4.2.2.3 Pulmonary disease
• 4.2.2.3.1 Aspiration
pneumonia
• 4.2.2.3.2
Hospitalacquired pneumonia
 4.2.2.7 Sepsis
• 4.2.2.7.1
Catheter
sepsis
• 4.2.2.7.2 Superficial
surgical
site
infection
• 4.2.2.7.3
Deep
surgical
site
infection
4. Use preventive and therapeutic interventions effectively
•
•
4.1 Formulate and implement a comprehensive management plan in
collaboration with patients,their families and other health care
professionals as required for the following clinical situations
o 4.1.1 Preoperative evaluation and optimization of the patient
with the following conditions:
 4.1.1.10 Patient with immunosuppression:
• 4.1.1.10.1 HIV
• 4.1.1.10.2 Secondary to drugs
• 4.1.1.10.3 Chronic disease states
• 4.1.1.10.4 Post-transplant
 4.1.1.13 Infections
o 4.1.3 Prophylaxis:
 4.1.3.1 Antibiotic
 4.1.3.3 Immunization, including tetanus
4.2 Demonstrate effective, appropriate and timely application of
preventive and therapeutic interventions for post-operative
management of patients with:
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