Fever and abdominal pain after bowel surgery
AMC Clinical practice station
Acute management · 2 min to read · 8 min to perform
Assess Mrs Pritchard and start management.
Joan PritchardOh doctor, I feel awful. I've been shaking and my tummy hurts so much.
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Open the full station (charts, voice, result letter) →The task
You are a doctor in an emergency department. Mrs Joan Pritchard, aged 71, had a laparoscopic right hemicolectomy for bowel cancer eight days ago and went home on day four. She has arrived by ambulance with fever and abdominal pain. A nurse is with you and the on-call surgical registrar can be reached by telephone. Assess Mrs Pritchard and start management. Then explain to her what you suspect and what will happen next. You can ask for any examination findings and results you need.
What this station tests
- Sepsis after major surgery needs resuscitation, cultures and antibiotics within the first hour, then source control.
- Check for drug allergy before antibiotics and use eTG to choose an alternative.
- Paracetamol and opioids can mask fever and pain; do not be falsely reassured.
- Use ISBAR to hand over to the surgical team and read back the plan.
- Explain in plain words what you suspect and acknowledge the fear of another operation.
Sources for the clinical content
- Australian Commission on Safety and Quality in Health Care: Sepsis Clinical Care Standard
- Australian Commission on Safety and Quality in Health Care: Recognising and Responding to Acute Deterioration Standard
- Australian Commission on Safety and Quality in Health Care: Communicating for Safety Standard
- Australian Commission on Safety and Quality in Health Care: Antimicrobial Stewardship Clinical Care Standard
An original practice scenario with invented patients. Not an exam question.