Post Operation Complications/Fever

There's some main factors tat cause complication/fever postoperatively and we can use this mnemonic to easily remember the source of complications/fever.

"5 W's"

1. Wind - complication from respiratory system, usually segmental atelectasis occurs, as patient usually not breathing well after op and this lead to reduce mucous secretion and will form mucous plug in the alveolar which will cause collapse of the alveolar, known as segmental atelectasis. Tis can further lead to pneumonia if the mucous plug get infected.
TO PREVENT THIS - encourage chest physio , encourage incentive spirometry, prop up patient to about 30 degree and also to give adequate anlgesic if needed so that, patient can breath and expand the lungs pain free.
** One way to check if the analgesic is adequate or patient is improving with chest physio is to ask patient to cough, if the patient is able to cough and with increasing trend, it means patient is recovering well with our treatments** (told to me by my MO)

2. Water - urinary tract infection, usually happen cause of CBD, to remove asap.

3. Wein @ Vein - thrombophlebitis , DVT, PE

4. Wound - surgical side infection ( infection at the operation site, wound breakdown, etc)

5. What else - to check for other cause other than the 4 above, usually like drug fever, blood tranfusion reaction, etc)

* Atelectasis happens in 48 hours
* UTI happens in 3-4 days post Op
* SSI and thrombophlebitis also 3-4 days post Op

What to look if patient develop fever postoperatively:
1. check lungs
2. check surgical wound side
3. check cathether side ( CBD, Branullas, CVL)
4. skin for rashes
5. joint for inflammations.

Non-infectious cause of Postoperative fever:
1. Drug fever will have increase Eosinophilia
2. Hematoma with increase temperature and leukocytosis
3. Gout
4. Transfusion reaction
5. DVT @ PE