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Surgical Foundations Seminar Series SF 10.1 – 2 Sepsis & Surgical Infections 1 - Assessment and Prophylaxis Session Objectives After this session you will be able to: 1. Discuss prophylactic measures for the prevention of surgical site infections, catheter sepsis and pneumonia. 2. Differentiate various susceptibility to infection in patients with immunosuppression from HIV/AIDs, Chronic disease states, drug induced and post-transplantation and explain how these patients can be evaluated and optimized preoperatively. 3. Discuss risks and management of needle stick injuries, body fluid exposure, and smoke plume inhalation. 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 Page 1 of 3 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 Page 2 of 3 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: Page 3 of 3