A&A practice
-
Case Reports
Takotsubo Cardiomyopathy in a Coronavirus Disease-2019-Positive Patient: A Case Report.
Coronavirus disease 2019 (COVID-19) has a high incidence of cardiac involvement, commonly described as a new-onset cardiomyopathy. In this report, we describe a patient with a new manifestation of cardiac involvement in the setting of a COVID-19 diagnosis: that of takotsubo cardiomyopathy.
-
Case Reports
First Case Report of Intubation With a Total Control Introducer and a Hyperangulated Video Laryngoscope.
We describe the first use of an articulating Total Control Introducer (TCI) and video laryngoscope (VL) to guide intubation of a patient with known difficult airway. The patient was an 84-year-old woman with a Mallampati IV airway assessment, small mouth opening, limited neck extension, and micrognathia. ⋯ Anteflexion and retroflexion of the introducer tip allowed dynamic navigation through the upper airway and into the trachea. Intubation was performed on first attempt without complications.
-
This survey study evaluates the user experience of an electronic maternal early warning system that generates automated pages. Survey domains included the system's effect on patient care, alarm fatigue, and continued use of the system. ⋯ A majority, 83%, felt that the system should remain in use, and 64.5% felt it improved patient safety. Of those who believed that they had received a page, 51.4% felt that they received pages "too frequently." Although alarm fatigue was not fully evaluated, providers on our unit support the continued use of this automated maternal electronic surveillance system.
-
Neuraxial catheters are typically removed without complications. In rare cases, however, breakage of the catheter may lead to a retained catheter fragment. ⋯ The computed tomography scan of the lumbar spine revealed hypertrophic spinous processes (Baastrup disease) and a retained catheter fragment located in the thecal sac at L3-L4, terminating at the anterior portion of the interspinous ligament at L4-L5. Proper precautions should be taken when removing neuraxial catheters to prevent this complication.
-
During surgery, cardiac implantable electronic device (CIED) function may be disrupted by electromagnetic interference (EMI) from monopolar electrosurgery and cause adverse sequelae. Monopolar electrosurgery requires a dispersive electrode. ⋯ We present a case in which an underbody electrode was used, and EMI occurred even though the surgical site was inferior to the umbilicus. Since little is known about EMI risk with underbody electrodes, practitioners should be wary of their use in CIED patients undergoing surgery until more information is available.