A&A practice
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Despite advancements in gender representation, female anesthesiologists continue to encounter challenges in career advancement that may be further impacted by motherhood. This scoping review examines personal and systemic barriers and facilitators to career advancement for anesthesiologists facing infertility, pregnancy, and childcare. ⋯ Recommendations from these studies include establishing clear parental leave policies, providing adequate lactation spaces and protected break times, addressing gender disparities in leadership roles, and prioritizing physician well-being. To implement these recommendations effectively, institutions and departments should develop and disseminate role-specific policies that promote career advancement and satisfaction through equitable support of pregnant and parent anesthesiologists.
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Case Reports
An Unusual Incident of "Cannot Ventilate" Situation Due to a Broken Soda Lime Canister: A Case Report.
The circle breathing system enables rebreathing using a carbon dioxide absorbent. This case report presents a rare incident of ventilation failure in a 30-year-old male patient due to a broken unidirectional valve in a soda lime canister. Despite the anesthesia machine passing automated checks, a mechanical blockage from caked soda lime in the inner inspiratory chamber led to insufficient tidal volume delivery. The incident underscores the importance of performing manual breathing circuit checks after replacing the soda lime canister, as well as the need for heightened vigilance in detecting equipment malfunctions to maintain patient safety during anesthesia.
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Case Reports
Anesthesia for Cesarean Delivery in a Patient With Spondylocostal Dysostosis: A Case Report.
Spondylocostal dysostosis (SCD) is an inherited skeleton growth disorder characterized by abnormalities of the vertebrae and ribs. Individuals are susceptible to kyphoscoliosis and pulmonary complications, which may be exacerbated by respiratory physiologic changes in pregnancy. We present a case of a parturient with severe kyphoscoliosis and restrictive lung disease who received a modified rapid sequence induction and transabdominal plane blocks for cesarean delivery. Our case describes the safe administration of general anesthesia for cesarean delivery and reviews the anesthetic considerations for managing patients with SCD.
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Malignant hyperthermia (MH) is a potentially fatal disorder triggered by volatile anesthetics or succinylcholine, inducing a hypermetabolic crisis in susceptible patients. The caffeine-halothane contracture test (CHCT) remains a gold standard for MH detection. ⋯ This anesthetic plan allowed for an in utero myelomeningocele repair for a 24-week-old fetus. A multi-institutional team coordinated the urgent CHCT and repair with a favorable outcome.