Orthotic and Prosthetic Management of the AIDS or Infectious Patient
Carey A. Glass, C.P. *
INTRODUCTION
Over the past two years the problem of Acquired Immune Deficiency Syndrome (AIDS) has become an ever increasing concern to the health care professional. Until now, articles and reports written by health care professionals have dealt with how to protect yourself from direct contact by controlling the work environment. As health care professionals and specialists, we are called upon to supply prosthetic and orthotic services to these patients, allowing them to lead as normal a life as possible. Considering the confusion over how to handle AIDS patients, let's first review some basic facts about the disease.
A REVIEW
What is AIDS?
Acquired Immune Deficiency Syndrome is a disease that effects the immune system of the body and its ability to fight infection.
What Causes AIDS?
The cause has been identified as a virus referred to as HIV Positive (HIV+), or Human Immunodeficiency Virus. HIV+ attacks the white blood cells that protect the body from infection. By destroying the white blood cells, the virus reduces the body's resistence to infection. Eventually a simple flu virus or other infections cannot be controlled by the body's immune system, causing the patient to become seriously ill and eventually die.
What are the Symptoms of AIDS?
The HIV+ virus can be latent and, while remaining infectious, some people do not have any symptoms at all. In some cases, it could be months or even years before any true symptoms are noticed. Some of these are white spots on the mouth and tongue, chronic diarrhea, swollen glands, excessive weight loss, fever with night sweating, Karposi's Sarcoma, or purplish sores on the skin.
How Can AIDS Be Spread?
The AIDS virus has been found in blood, breast milk, saliva, urine, semen, and tears. It can be passed on by intravenous drug use, direct contact with contaminated blood or blood products, as well as sexually.
What Procedures Should be Taken to Protect the Prosthetist and Orthotist?
Over the last eight months, with cooperation of doctors and staff of both hospital and health care facilities, we have developed a procedure to follow when handling infectious patients in the hospital. First, vinyl or latex gloves should be worn when examining, casting, or measuring a patient as well as when working with garments or devices in intimate contact with the patient. It is suggested that when dealing with open wounds during cast removals, double gloves should be worn. Second, respiratory masks and goggles should be worn when removing casts, for protection from airborne debris. All open wounds should be covered, and all instruments that are used in measuring the patient should either be sterilized or disposable. It is very important to wash your hands with an approved soap before and after seeing the patient. The use of a balloon or plastic bag as an interface during casting is quite protective, and following useage it should be discarded with infectious waste. The HIV+ virus is very sensitive to basic sterilizing procedures such as Cidex baths, germicide, alcohol washes, or gas sterilization.
CONCLUSION
Acquired Immune Deficiency Syndrome is a health problem that must be dealt with in a common sense manner. When seeing patients as we do in our offices, as well as in hospitals, we must not forget to protect ourselves adequately. The estimates of the number of HIV+ carriers are high enough that certain procedures should be the rule, and not the exception. The health hazards to the prosthetic and orthotic professional are such that these precautions should be taken in handling all patients with open wounds.
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