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Revisiting the Importance of the Pre-Operative Assessment - A Case Report
John P Avendano1, James Monica1, Bobby Varghese1
1Department of Orthopaedic Surgery, Robert Wood Johnson University Hospital, New Brunswick, New Jersey.
Journal of Orthopaedic Case Reports
|July 31, 2023
Summary
A thorough pre-operative assessment is crucial for patient safety. This case highlights how a missed HIV diagnosis and Pneumocystis pneumonia led to intraoperative complications, emphasizing the need for updated medical histories.
Area of Science:
- Medicine
- Surgery
- Infectious Diseases
Background:
- Optimizing surgical outcomes relies on comprehensive pre-operative checklists.
- These checklists involve reviewing medical records, recent test results, and performing physical examinations of cardiovascular, pulmonary, and airway systems.
Observation:
- A 47-year-old male patient decompensated during an outpatient wrist procedure.
- The patient required intubation and transfer to a hospital.
Findings:
- Post-procedure laboratory tests revealed a positive HIV diagnosis with a CD4 count of 11 cells/mm3.
- The patient also had Pneumocystis pneumonia, which was undiagnosed prior to the surgery.
Implications:
- This case underscores the critical importance of a thorough and updated pre-operative history and physical examination.
- Incomplete pre-operative assessments can lead to unexpected intraoperative complications and adverse patient outcomes.
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