Question

A 43-year-old male patient is brought to the OR for a total hip arthroplasty. His chart shows that he is HIV+; he is in the early stages of AIDS. He has Kaposi’s sarcoma skin lesions, painfully swollen lymph nodes in the groin and axilla, and is underweight.

1. What important principles should you consider while positioning the patient to protect him from pain and injury?

2. What are some special considerations concerning an AIDS patient when placing the ESU grounding pad?

3. What complications could be encountered during the case that the CST should be prepared to assist the OR team in resolving?

4. Discuss the concept of standard precautions. Do you treat this patient any differently because he is HIV+?

5. What exactly is Kaposi’s sarcoma?

Answer 1

1. The prime consideration for this case while positionng the patient to protect him from pain and injury is to diagnose for internal kaposi sarcoma.The fecal occult blood test and endoscopy also considered.

2. The  ESU grounding padshould be placed carefully to avoid any pain due to skin lesions while both keeping and removing. Those grounding pads should be ensured single use pads or sticky pads to provide sterility throughout the procedure and also cleaning can be done immediately after the surgery.

3. CST must be well enough to provide special need for HIV population and should know how to respond. HIV population might be presented with unique physical and psychological needs. The complicaions of ethical commitment to provide the best quality of care and empathy for all cases.

4. Standard precautions are mandatory and any type of bodily fluids of all patients should be regarded as hazardous substances. PPEs like as eyewear, 2 layer gloves, gowns etc are mandatory. Disposable equipment should be used as far as possible. Safe injection practices and respiratory hygiene are important.

5. Kaposi's sarcoma is a kind of cancer characterized bypresence of tissueor patches in red or purple color usually occur in mouth, nose, throat, and sometimes esophagus. It is caused by a virus called the human herpesvirus 8 especially in AIDS patient when immune system is compromised.