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 sarcoma skin lesions, pain-fully 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+?

Answer 1

Total hip arthroplasty means that the damaged bone & cartilage of the ball & socket joint is removed and replaced with artificial prosthesis.

1. Lateral position wherein the pelvis can be flexed and can be adducted.

Axillary padding can be postioned at the level of the nipples. Bottom legs & arms need to be padded.  Padded Mayo stand to be kept at the foot of the table which allows the leg to be internally rotated
  
2. Disposable grounding pads

Disposable grounding pads otherwise called as single use pads or sticky pads, can be used for this patient as he is HIV positive Single use will ensure sterility throughout the procedure and also cleaning can be done immediately after the surgery

4. Standard precautions during a Biohazard patient handling:
Position the OR lights properly before the start of the surgery. All bodily fluids of all patients should be regarded as hazardous substances. Personnel protective equipments such as eyewear, gloves, gowns etc usage is mandatory. 2 layer of gloves must be used. outside gloves should be bigger than the inner gloves with index finger area need to be thickened to prevent needle stick injury during the suturing procedures.Disposable equipment should be used as far as possible