Post-operative fever
Introduction
Few topics overlap so well with the surgery shelf exam and the daily clinical duties of a core clerkship student on their surgery rotation as well as post-operative fever.
What is post-operative fever?
Post-operative fever is defined as a temperature exceeding 38C on 2 consecutive post-operative days or a temperature greater than 39 C on any single day [1]. The diferential for post-operative fever may appear broad but it can be broken down based on the timeline of the fever. A potentially helpful mneomnic is “wind, water, walking, wound and wounder drugs”
POD 1-3 :Wind
Common causes of post-operative fever during this time are atelectasis (is often debated but is tested on the shelf) and pneumonia. These are complications of being intubated and the lack of deep breathing immediately after surgery due to pain and drug side effects.
POD 3-5: Water
A very common cause of fever that appears during this time is a UTI, especially a catheter associated UTI (CAUTI). Patients may have catheters for extended periods of time after surgery depending on their acuity and the specific procedure they had done. Every day with a catheter is increased risk of developing an infection. Because of this it is best-practice to get rid of foley catheters as soon as possible after surgery. You as a student should re-evaluate the need for the foley each day and include either keeping it or discontinuing it in your plan.