Pituitary Perioperative Care Management Survey EmailThis field is for validation purposes and should be left unchanged.Do you use IV antibiotics at time of surgery and if so which type (assuming no allergies)? No antibiotics 1st generation cephalosporin (e.g. cefazolin) 3rd/4th gen cephalosporin and/or vancomycin Other IV antibiotic How do you routinely use post-op antibiotics after any IV antibiotics? No postop oral antibiotics Oral antibiotics only if we place any packing (absorbable or non-absorbable) Oral antibiotics only if we place non-absorbable packing Oral antibiotics in all patients Do you use packing and how long do you leave it in place: 1. Highflow >1cm dura effect No packing Absorbable packing Nonabsorbable packing less than 3 days Nonabsorbable packing 3-5 days Nonabsorbable packing 7 days or more Do you use packing and how long do you leave it in place: 2. Highflow or </+ 1cm dura effect No packing Absorbable packing Nonabsorbable packing less than 3 days Nonabsorbable packing 3-5 days Nonabsorbable packing 7 days or more Do you use packing and how long do you leave it in place: 3. Lowflow leak No packing Absorbable packing Nonabsorbable packing less than 3 days Nonabsorbable packing 3-5 days Nonabsorbable packing 7 days or more Do you routinely use a Foley urinary catheter? No, not routinely placed Yes, placed in OR to monitor fluid balance, removed in OR Yes, placed in OR and maintained <24hr postop to monitor fluid balance Yes, placed in OR and maintained >24hr or when patient mobilizes to monitor fluid balance Do you send patients to the ICU post-op? Always If there is a CSF leak If they are high risk or medically complex Never DI management and sodium monitoring: 1. Do you routinely discharge patients with fluid restriction? Yes No DI management and sodium monitoring: 2. Do you routinely check a BMP in follow-up postop? No specific algorithm Ask patient to call with symptoms of delayed hyponatremia Clinical team routinely calls patient to inquire about symptoms of delayed hyponatremia Routine short-term follow-up at 1 week by surgical team or endocrinology to decide Routine BMP drawn around POD7 DI management and sodium monitoring: 3. Use of salt tablets at discharge? Never use salt tablets Routinely use salt tablets in patients post-op Please describe your routine post-operative activity progression – No CSF leak intraop: No bedrest, mobilize ad lib Bedrest for 24 hours or less and then mobilize ad lib Bedrest >24hr, then mobilize ad lib Please describe your routine post-operative activity progression – Low flow CSF leak intraop: No bedrest, mobilize ad lib Bedrest for 24 hours or less and then mobilize ad lib Bedrest >24hr, then mobilize ad lib Please describe your routine post-operative activity progression – High flow CSF leak intraop: No bedrest, mobilize ad lib Bedrest for 24 hours or less and then mobilize ad lib Bedrest >24hr, then mobilize ad lib Duration off CPAP if no CSF leak intraop: Start right way <1 week 1-2 weeks 2-4 weeks >4 weeks Duration off CPAP if CSF leak intraop: Start right way <1 week 1-2 weeks 2-4 weeks >4 weeks Non- Cushing hydrocortisone management for patients with NORMAL preop cortisol: Provide replacement for everyone immediately postop Assess patient cortisol POD 1 and replace accordingly Assess patient cortisol POD 1 and/or 2 and replace accordingly No replacement unless symptoms develop
