xijin

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in a TV show, <grey's anatomy>,

MEREDITH said: Wind, water, wound, walking, wonder drugs. The 5Ws.

so, who can give an explanation?

than you very much!!
 

nutcancer

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errr, i think:

wind = atelactasis/pneumonia
water = uti
wound = incisional infection
walking = dvt
wonder drug = allergy
 

GATC

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errr, i think:

wind = atelactasis/pneumonia
water = uti
wound = incisional infection
walking = dvt
wonder drug = allergy



Yeap...that is also the order they occur in...unless you have fasciitis with clostridium, etc.
 
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msl2007

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The ob folks will have you add a 6th W: womb (= basically anything in it but PID and pregnancy esp or perimenopause that happens to hit right after surgery :) )

also, for wonder drug, it isn't just allergy, but "drug fever"- a somewhat random fever in response to a drug or drug combo, esp the heavy hitting abx.
 

bcoak

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As a future surgery resident, I know it's surgical dogma that atelectasis causes fever, but evidence has been shown for at least 30 years that this simply is not true. Take a look at the following reference:

"Lack of Association Between Atelectasis and Fever" Chest 1995, 107: 81-84.
 

RichL025

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I agree, I've looked at those studies myself.

Then again, I've seen time & time again, a temp drops a degree or more less than a half hour after the nurses start nagging about IS use... not even tylenol would work that quick...
 

bcoak

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Agreed Rich. And as a resident, I'm sure when the nurse bugs me about post-op fever, I'll throw out the IS or have them cough or anything else to get the nurse off my back. But it's b/c I am just trying to pacify the nurse, not b/c I actually think that the atelectasis is causing fever. You and I both know that the fever is likely benign, but since we have to come up with a response for hte nurse, I don't mind pacifying her for the time being, even though I know IS is a futile exercise and uneeded expense.
 

Surgeon24

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Just the inflammatory response of surgery Post-op #1-2 explains the benign fever. But still, I tell the patient and nurses to start pumping the spiro.
 

gerickson03m

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Atelectasis does not cause fever, otherwise you would have fever every morning. post op fever like D1 is from the surgery and cytokines.
 
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