The surgical junior doctor is the first person called. Rasheed Zakaria and Ashok Handa explain how to manage eight common presentations
- By: Rasheed Zakaria, Ashok Handa
One of your first responsibilities as a junior doctor is the care of surgical patients in the wards. Surgical and clinical commitments may mean that your seniors are not immediately available, and in an emergency you will invariably be the first person to be called.
This article covers situations encountered commonly in patients who have had operations—shortness of breath, venous thromboembolism, pain, wound problems, confusion, transfusion reactions, nausea, and pyrexia. We hope to highlight the diagnoses you should have at the forefront of your mind, why they occur in surgical patients, how to avoid them, and how to initiate management before advice is available. As always, if in doubt, call for help.
Respiratory complications are common after surgery, especially in older patients (box 1). Be particularly vigilant for patients with pre-existing cardiac or respiratory disease, smokers, immobile patients, patients who have had a general anaesthetic, and patients who have had