Avendano John P, Monica James, Varghese Bobby
Department of Orthopaedic Surgery, Robert Wood Johnson University Hospital, New Brunswick, New Jersey.
J Orthop Case Rep. 2023 Jul;13(7):52-55. doi: 10.13107/jocr.2023.v13.i07.3750.
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.
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.
This case emphasizes the importance of a thorough history and physical update and pre-operative assessment before operating.
现有文献强调了通过术前检查表优化手术结果的重要性,该检查表包括病历和近期检查结果回顾、病史变化以及心血管系统、肺部系统和气道的体格检查。
我们报告一例47岁男性病例,该患者在门诊手腕手术过程中出现失代偿,需要继续插管并转至医院。对患者进行随访时,实验室检查显示HIV检测呈阳性,CD4细胞计数为11个/立方毫米,同时伴有与肺孢子菌肺炎相符的肺炎,而手术团队在手术前对此并不知情。
该病例强调了手术前全面更新病史、体格检查和术前评估的重要性。