By Geno J. Merli MD FACP, Howard H. Weitz MD FACC FACP
This functional guide offers entire, to-the-point, evidence-based assistance at the preoperative, perioperative, and post-operative therapy of surgical sufferers. every one bankruptcy makes a speciality of a specific sector of scientific hindrance, with concise displays of pathophysiology, overview and administration ideas, the newest drug therapy details, and crucial info on threat stratification and caliber development. the result's a useful resource at the administration of surgical sufferers with co-existing scientific difficulties which may be suffering from surgical procedure, in addition to the right way to procedure clinical issues that could ensue in the course of or following surgical procedures.Comprehensive discussions first and foremost of every bankruptcy emphasize session in surgical sufferer management.A concise, bulleted structure permits you to take up key info at a look. broadly up to date chapters.Easy-to-read tables current key info on every one ailment, together with class, motives, hazard elements and indexes, drug remedy details, mortality charges, laboratory findings, and postoperative complications.Recommendations observed via an overview of the standard of supportive proof, together with randomized managed trials, inhabitants dependent reports, and consensus guidelines.A topical index takes you instantly to the solutions you need.A new, smaller layout makes the publication effortless to hold with you anyplace.
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Additional info for Medical Management of the Surgical Patient
Example text
Pregnancy Testing Because of the risks to the fetus from exposure to anesthetic agents, antibiotics, and radiographs, it may be prudent to test women of childbearing age for pregnancy. Serum Albumin Serum albumin has not traditionally been used as a routine preoperative test. There is no evidence for its use in a healthy population. However, the national VA surgical risk study showed that low serum albumin was a better predictor of surgical outcomes than many other preoperative patient characteristics when used in patients with comorbidities.
Whitacre, Sprotte) construction (Fig. 4-2). This newer design further reduces dural trauma during lumbar puncture, with an additional reduction in CSF leakage. Numerous clinical and in vitro studies with these needles have yielded overwhelmingly favorable results. Indeed, many anesthesiologists have, with occasional A Figure 4-2 • B C D Array of needles used for neuraxial anesthesia (A–C are used for spinal anesthesia). A, Traditional beveled (Quincke) needle, with orifice within the diagonal cutting tip.
Common devices include penile implants, artificial sphincters, synthetic pubovaginal slings, and bone anchors for pelvic floor reconstruction. Gynecologic Surgery Perioperative antimicrobials can prevent infection after cesarean section in high-risk situations (premature rupture of membranes). In these cases, most obstetricians administer cefazolin after the umbilical cord is clamped because of concern about masking septic manifestations in the newborn. Antimicrobials are not recommended in uncomplicated cases.