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Doctor insights on: Management Of Dic In Post Cesarean Patient

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Management of dic in post cesarean patient ?

Management of dic in post cesarean patient ?

Emergently: Dic (disseminated intravascular coagulation) is an emergency in any situation. The patient with dic has, for one of several reasons, consumed elements in her blood which are needed to cause blood to clot. Without the ability to clot, she will bleed continuously until something is done to replace the "clotting factors" or otherwise arrest the bleeding, e.g., hysterectomy. ...Read more

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Dr. Nikolaos Zacharias
1,453 doctors shared insights

Cesarean Section (Definition)

Cesarean delivery is the most commonly performed life-saving surgery in obstetrics; it involves safe delivery of the fetus(es) via an incision on the lower abdomen of the pregnant woman, thus ...Read more


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What is the management for a client with post-partum hemorrhage and hypovolemic shock?

What is the management for a client with post-partum hemorrhage and hypovolemic shock?

Fluids, then blood.: Post-partum hemorrhage is the loss of morethan 500 ml of blood after vaginal delivery, or 1000 ml of blood after cesarean section. It is the most common cause of perinatal maternal death in the modern world. The management is similar to shock since fluid loss occurs. First crystalloid solution, then blood units if loss is >2000 ml or shock progresses despite aggressive replacement. ...Read more

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What is surgical management of patient having diaphragmatic hernia?

What is surgical management of patient having diaphragmatic hernia?

Repair: Usually it requires surgic repair with pt's own tissue or a mesh. www.drlugo.com. ...Read more

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What is the best type of anesthesia for csection in a patient with borderline chiari malformation?

What is the best type of anesthesia for csection in a patient with borderline chiari malformation?

Straightforwards: You can safely use any anesthetic your doctors feel is appropriate, but key issue might be safe positioning of head relative to neck, so, let them know of your Chiari. But if this is a low grade, "borderline" issue, really no significant risk of any kind. ...Read more

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Post surgery pain manage for patient woken up from GA. Which is considered better Fentanyl or Morphine for a patient who is opiate resistant?

Post surgery pain manage for patient woken up from GA. Which is considered better Fentanyl or Morphine for a patient who is opiate resistant?

Comments: Would prefer NOT to use either for post-operative pain as each very potent, and could cause apnea in a relatively naive patient. Fentanyl is the most potent narcotic we have available on the market at this time. ...Read more

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What is the normal post-op nursing wound and drain management in mastectomy patient?

What is the normal post-op nursing wound and drain management in mastectomy patient?

Varies: Some persons have very good tissue, and others may not. If fluid is expected, drains of closed system variety are placed and removed when volume of drainage decreases or stops. The incision(s) may be sutured, stapled or glued and have needs of management or removal at 10- 14 days based on surgeon preference and tissue appearance. ...Read more

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What is the typical stay in the hospital for a stage 4 cancer patient with pneumonia? IV antibiotics. No complications to severe complications.

What is the typical stay in the hospital for a stage 4 cancer patient with pneumonia? IV antibiotics. No complications to severe complications.

Widely variable: Pneumonia comes in many shapes and sizes, and how an individual responds to pneumonia is widely variable. Adding in advanced cancer usually makes everything more complex. A hospital stay could vary from 1 day for a milder case to weeks for the most severe cases. ...Read more

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What are the risks associated with a repeat c-section after laboring in attemp of vbac?

What are the risks associated with a repeat c-section after laboring in attemp of vbac?

Infection, bleeding.: An urgent or emergent repeat cesarean section after failed trial of labor in women with a prior cesarean section can be a very morbid procedure with high risk for infection, fever, bleeding, transfusion, injury to the bladder, ureters, bowel, possible hysterectomy and infertility. A prelabor repeat c-section is infinitely safer and more controlled - and is a much preferable choice. ...Read more

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Please explain why is a post operative patient under sub arachnoid block anesthesia positioned flat on bed for 8 hours?

Please explain why is a post operative patient under sub arachnoid block anesthesia positioned flat on bed for 8 hours?

Spinal headache: The reason why patients are kept in the lying down position after subarachnoid block or spinal anesthesia is to decrease the chance of developing a post dural puncture headache or commonly known as a spinal headache. There is a hole made from the introduction of the spinal needle through the dura and into the subarachnoid space to deposit the medication there to accomplish a spinal block. ...Read more

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After what kind of surgeries would patient controlled analgesia be used for post-operative recovery versus traditional physician-controlled pain mgmt?

After what kind of surgeries would patient controlled analgesia be used for post-operative recovery versus traditional physician-controlled pain mgmt?

Most inpatient : surgeries can use PCA, it's more personal preference and patient must be able to understand and push button ...Read more

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What is the survival rate of glioblastoma IV patients post surgery?

What is the survival rate of  glioblastoma IV patients post surgery?

Life expectancy: Prognosis depends on patient age, location of the tumor and extent of resection. This is a tumor with close to 100% death rate. Expected length of survival (3months, 6months, about 1 year) is often used to describe what to expect. ...Read more

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Can the general anaesthesia administered for a d and c procedure (to investigate post menopausal bleeding) cause death?

D&C and death: Unfortunately any anesthetic carries the possibility of death. Modern techniques are much safer then even 20 years ago. In fact. Anesthesia is one of the best examples of safety improvements in medicine. The chances of death, with an anesthetic such as a d&c, if you are relatively healthy is extremely low. You are probably more likely to be struck by lightning on the way to the hospital. ...Read more

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What is the average duration of a laparotomy with removal of adhesions and endo lesions including a presacral neurectomy in a stage 3 endo patient?

What is the average duration of a laparotomy with removal of adhesions and endo lesions including a presacral neurectomy in a stage 3 endo patient?

Varies: Endometriosis is a chronic condition. Most manage the syndrome medically. If surgery is required, most prefer laparoscopy over an open laparotomy. Lysis of adhesions may be brief or extensive. Pre sacral neurectomy is a complicated procedure which should be done as a last resort, by common opinion. Talk with your provider. Ask about recurrence, complications and success rates. Hang in there. ...Read more

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What would be the pre and post op requirments on rxs for a patient about to have major 6 level fusion back surg. This patient currently taking zanax x 20 yrs and aterol. What would be the pre and post op requirments regarding these medications due to the

What would be the pre and post op requirments on rxs for a patient about to have major 6 level fusion back surg. This patient currently taking zanax x 20 yrs and aterol. What would be the pre and post op requirments regarding these medications due to the

Shouldn't be any: If you are on usual therapeutic doses of both adderal and xanax, (alprazolam) they will generally continue your medication pre-op, and begin it again as soon as you are eating. If you are going to not be eating for any prolonged period of time, an equivalent amount of another benzodiazepine (like ativan) can be given as a shot (0.5 mg of Ativan im is equivalent to 1 mg of xanax). The adderal can be skipped. ...Read more

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Has anyone undergone emergency surgery for delivery and rupture of the uterus?

Has anyone undergone emergency surgery for delivery and rupture of the uterus?

Yes: I had a patient in 1992 that had a ruptured uterus and required an emergency delivery and repair of the uterus. The baby developed CP and died a few years later. ...Read more

Dr. John Fung Dr. Fung
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80yr.Has a cerebrovascular event in the early perioperative stage of an open heart surgery operation. Abort operation or go on ? The surgeon choose not to abort the operation to assess for the severity of injuries to the brain. The outcome of the operatio

Dr. John Fung Dr. Fung
4 doctors agreed:
80yr.Has a cerebrovascular event in the early perioperative stage of an open heart surgery operation. Abort operation or go on ? The surgeon choose not to abort the operation to assess for the severity of injuries to the brain. The outcome of the operatio

I : I do not believe any physician reviewing this comment will be able to appreciate the condition of this patient going into surgery to assess the risk factors, rationale and options for treatment. I doubt that the surgeon would have known the patient was having a stroke during the cardiac procedure. It is not the usual practice of monitoring brain activity during cardiopulmonary bypass. Clearly there was significant cardiac problems, if indeed this patient required two valve repair/replacement, coronary artery bypass grafting and thromboendarterectomy. The fact that the patient suffered multiorgan system failure (as you suggest with the comment that there was "sustained irreversible vital organs damage"), suggests that the pump time was perhaps longer than usual, but understanding also that the organs of an 80 year old patient are fragile to start with. The finding of bilateral strokes on post-op day 3 would be consistent with events that occurred during or shortly after surgery, but likely not known during surgery. So unless there were other indications for the surgeon to abort, then continuing with the operation was understandable. I suggest you make an appointment with the surgeon to discuss your concerns and questions personally, to iron out any confusion or misunderstandings that exist and to bring closure to this case. ...Read more

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Can a person(female, 26) suffering from Hereditary motor and sensory neuropathy be given general anesthesia for the treatment of Diaphragmatic hernia?

Can a person(female, 26) suffering from Hereditary motor and sensory neuropathy be given general anesthesia for the treatment of Diaphragmatic hernia?

Depends: The severity of the neuropathy and the specific type of anesthetic are both important factors. This condition needs collaboration between your neurologistr and anesthesiologist ( not anesthetist). ...Read more

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Whipple/Oncology: What is the likelihood of a persons demise during or directly after a Whipple IRE intensive operation for pc? Are there any numbers?

Whipple/Oncology: What is the likelihood of a persons demise during or directly after a Whipple IRE intensive operation for pc? Are there any numbers?

Unusual: Experience is the most important part of the procedure. Knowing how to find the SMV helps and creating the tunnel under the pancreatic neck is important so that it extends to where the gastroduodenal artery is ligated at the hepatic artery. Because of many anastomosis, drains should be used I employ a T-tube in the CD anastomosis. If all is performed properly, very low mortality.less than 1% ...Read more

Dr. Gerald Mandell
38 doctors shared insights

Disseminated Intravascular Coagulation (Definition)

A condition in which the body's normal blood clotting mechanisms are disrupted and small blood clots form in the small blood vessels, then causing excessive bleeding by using up ...Read more