Preoperative measures
Preoperative treatment in the patient with generalised peritonitis is as important as surgery:
- correct fluid balance due to lost extracellular fluid:
- give a rapid IV infusion of Hartmann's solution, 2.5-3.0 litres over 3 hours in a 70kg adult
- monitor central venous pressure in elderly patients to ensure that infusion is not given too quickly
- insert a urinary catheter to monitor urinary output
- give additional colloid if there is evidence of hypovolaemia
- remove blood for culture, then give parenteral antibacterial treatment, e.g. metronidazole for anaerobes and cephalexin for aerobes
- give analgesic, preferably IV slowly, after consulting with the anaesthetist
- give oxygen via a face mask as diaphragmatic movements are likely to be reduced
- before inducing anaesthesia, pass a 16F nasogastric tube to keep the stomach empty
Create an account to add page annotations
Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.