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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.
Introduction:
The available literature underscores the importance of optimizing surgical outcomes through a pre-operative checklist, which includes a review of the medical records and recent test results, changes in medical history, and a physical examination of the cardiovascular system, pulmonary system, and airway.
Case Report:
We report a case of a 47-year-old man who decompensated during an outpatient wrist procedure and needed to remain intubated requiring transfer to a hospital. On follow-up with the patient, laboratory work revealed a positive HIV test and CD4 count of 11 cells/mm3, along with a pneumonia consistent with pneumocystis pneumonia, which was unbeknownst to the surgical team before the procedure.
Conclusion:
This case emphasizes the importance of a thorough history and physical update and pre-operative assessment before operating.
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