Which of the following statements about the postoperative period is false?
|
Department of Anesthesiology, Washington University School of Medicine, Saint Louis, Missouri, US Show
Find articles by Michael S. Avidan Hannah R. MaybrierDepartment of Anesthesiology, Washington University School of Medicine, Saint Louis, Missouri, US Find articles by Hannah R. Maybrier Arbi Ben AbdallahDepartment of Anesthesiology, Washington University School of Medicine, Saint Louis, Missouri, US Find articles by Arbi Ben Abdallah Eric JacobsohnDepartment of Anesthesiology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, CA Find articles by Eric Jacobsohn Phillip E. VlisidesDepartment of Anesthesiology, University of Michigan, Ann Arbor, Michigan, US Find articles by Phillip E. Vlisides Kane O. PryorDepartment of Anesthesiology, Weill Cornell Medicine, New York City, New York, US Find articles by Kane O. Pryor Robert A. VeselisDepartment of Neuroanesthesiology, Memorial Sloan Kettering Cancer Center, New York City, New York, US Find articles by Robert A. Veselis Hillary P. GrocottDepartment of Anesthesia & Perioperative Medicine, University of Manitoba, Winnipeg, Manitoba, CA Find articles by Hillary P. Grocott Daniel A. EmmertDepartment of Anesthesiology, Washington University School of Medicine, Saint Louis, Missouri, US Find articles by Daniel A. Emmert Emma M. RogersDepartment of Anesthesiology, Weill Cornell Medicine, New York City, New York, US Find articles by Emma M. Rogers Robert J. DowneyDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, US Find articles by Robert J. Downey Heidi YulicoDepartment of Anesthesiology, Memorial Sloan Kettering Cancer Center, New York City, New York, US Find articles by Heidi Yulico Gyu-Jeong NohDepartment of Anesthesiology, Asan Medical Center, Seoul, South Korea Find articles by Gyu-Jeong Noh Yonghun LeeDepartment of Anesthesiology, Asan Medical Center, Seoul, South Korea Find articles by Yonghun Lee Christine M. WaszynskiDepartment of Medicine, Hartford Hospital, Hartford, Connecticut, US Find articles by Christine M. Waszynski Virendra K. AryaDepartment of Anaesthesiology and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India Find articles by Virendra K. Arya Paul S. PagelDepartment of Anesthesiology, Medical College of Wisconsin, Madison, Wisconsin, US Find articles by Paul S. Pagel Judith A. HudetzDepartment of Anesthesiology, Medical College of Wisconsin, Madison, Wisconsin, US Find articles by Judith A. Hudetz Maxwell R. MuenchDepartment of Anesthesiology, Washington University School of Medicine, Saint Louis, Missouri, US Find articles by Maxwell R. Muench Bradley A. FritzDepartment of Anesthesiology, Washington University School of Medicine, Saint Louis, Missouri, US Find articles by Bradley A. Fritz Witold WaberskiDepartment of Anesthesiology, Hartford Hospital, Hartford, Connecticut, US Find articles by Witold Waberski Sharon K. InouyeDepartment of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School; and Institute for Aging Research, Hebrew SeniorLife, Boston, Massachussetts, US. The choice of the antibiotic for prophylaxis is based on several factors. Always ask the patient about a prior history of antibiotic allergy, as beta-lactams are the commonest type of antibiotics used in prophylaxis. A history of severe penicillin allergy (anaphylaxis, angioedema) means that cephalosporins are also contraindicated, as there is a small but significant risk of cross-reaction. Most importantly, the antibiotic should be active against the bacteria most likely to cause an infection . Most postoperative infections are due to the patient's own bacterial flora. Prophylaxis does not need to cover all bacterial species found in the patient's flora, as some species are either not particularly pathogenic or are low in numbers or both. It is important to select an antibiotic with the narrowest antibacterial spectrum required, to reduce the emergence of multi-resistant pathogens and also because broad spectrum antibiotics may be required later if the patient develops serious sepsis. The use of 'third generation' cephalosporins such as ceftriaxone and cefotaxime should therefore be avoided in surgical prophylaxis. Often several antibiotics are equal in terms of antibacterial spectrum, efficacy, toxicity, and ease of administration. If so, the least expensive drug should be chosen, as antibiotics for surgical prophylaxis comprise a large portion of hospital pharmacy budgets. Commonly used surgical prophylactic antibiotics include:
Parenteral 'second generation' cephalosporins such as cefotetan have improved anaerobic and aerobic Gram-negative cover compared to first generation cephalosporins. They are sometimes used as a more convenient, but more expensive, alternative to the combination of metronidazole plus either first generation cephalosporin or gentamicin for abdominal surgical prophylaxis. The bacterial flora in some hospitalised patients may include multi-resistant bacteria such as methicillin-resistant staphylococci. An assessment then needs to be made for each surgical procedure about whether or not prophylaxis with parenteral vancomycin is indicated. Unnecessary use of vancomycin selects for vancomycin-resistant enterococci (VRE), vancomycin-intermediate Staphylococcus aureus (VISA), and vancomycin-resistant Staphylococcus aureus (VRSA), the first two of which already occur in Australian hospitals. Which of the following is true regarding the animal welfare regulations and duplication of experiments?Which of the following is TRUE regarding the Animal Welfare Regulations and duplication of experiments? Unnecessary duplication of animal experiments is not allowed. Non-USDA regulated species are never required to be placed in a pain/distress category.
When must personnel receive training to perform animal procedures?Every three years, all personnel working with live animals must complete the “Working With Animals in Biomedical Research – Refresher” course from Citiprogram (www.citiprogram.org).
Which statement is true about a reduced food intake in rodents 4 days after a vascular cannulation surgery?Which statement is TRUE about a reduced food intake in rodents 4 days after a vascular cannulation surgery? Reduced food intake may indicate the animals are in pain and distress.
Which of the following are the responsibility of the IACUC?Responsibilities. The IACUC is responsible for oversight of the animal care and use program and its components as described in the Public Health Service (PHS) Policy on Humane Care and Use of Laboratory Animals (Policy) and the Guide for the Care and Use of Laboratory Animals (Guide ).
|
