Post-operative pyrexia

The timing of the pyrexia may give an indication as to the possible cause:

Day 0-3                Transfusion reactions

                          Drug reaction eg Halothane

                          Septicaemia

 

Day 1-3                Respiratory collapse or infection

 

Day 3-5                Wound infection / UTI

 

Day 6 -10             Deep vein thrombosis

                          Pulmonary embolus

 

If a patient develops a pyrexia, an infection screen should be performed:

1. Examine the chest +/- CXR, sputum for culture

2. Examine the wound—swab for culture and sensitivity

3. Enquire as the urinary symptoms—urine sample for culture

4. Examine for signs of deep venous thrombosis

5. Look in the ears and mouth of a child

6. If no obvious cause, then perform a FBC to check the white cell count and blood cultures.

 

 

The patient’s temperature should be recorded 4 hourly as part of the routine post-operative observations, augmented with inspection of the chest and wound. The upper limit of normal is taken as 37 C.

Post-op care

 

The Ward Round