A&A practice
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Case Reports
Cerebral Venous Sinus Thrombosis After Lumbar Epidural Steroid Injection: A Case Report.
Cerebral venous sinus thrombosis (CVST) is an exceedingly rare complication of epidural anesthesia, with only a handful of known cases after epidural steroid injection (ESI). We report a case of CVST in a 33-year-old male patient that presented with headache after lumbar ESI. ⋯ Ultimately, the patient was pronounced dead by neurologic criteria. This case highlights the importance of keeping this rare but potentially fatal diagnosis in the differential even in lower-risk patient populations.
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Case Reports
Life-Threatening Tracheal Tube Obstruction by Vernix Caseosa in a Newborn: A Case Report.
Accurate diagnosis and optimal management of sudden intraoperative ventilatory failure is crucial in children. Herein, we report the case of a newborn who underwent pacemaker implantation immediately after birth via cesarean delivery. ⋯ Diagnosis of tracheal tube obstruction was challenging because the obstruction occurred immediately after airway suctioning, which is performed to rule out tracheal tube obstruction. Anesthesiologists must consider airway obstruction from high-viscosity vernix caseosa as a possibility immediately after airway suctioning in newborns.
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Case Reports
Lumbar Sympathetic Block for Treatment of Knee Pain From Synovial Plica Syndrome: A Case Report.
Lumbar sympathetic blocks (LSBs) are used to treat sympathetically mediated pain in the lower extremities, kidneys, ureters, and genitals. LSBs use local anesthetic to block the sympathetic system to modulate pain response. ⋯ He received 3 rounds of LSB resulting in significant and sustained pain relief. This case suggests that LSB successfully treated knee pain from synovial plica syndrome and there may be a sympathetic component to this disease state.
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Mastery learning with fixed end points and variable training time leads to more consistent expertise but is difficult to implement. Here we piloted mastery learning of laryngoscopy with independent practice. 35 learners participated in independent mastery learning on a manikin that provides automated performance feedback. ⋯ After an average of 21 minutes of open practice, the percentage of subjects that met mastery criteria improved from 24% to 89% (P < .05). Independent intubation practice with manikin feedback facilitated mastery learning, enhanced procedural education, and may impact clinical care.
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Fewer than 30% of all medical schools have programs that encourage medical design innovation or entrepreneurship at the trainee level. This is particularly evident in the fields of anesthesiology and pain medicine, where utilizing medical devices constitutes a significant part of a clinician's daily practice. To fix this gap, our institution has developed an incubator club where trainees can learn about medical devices and entrepreneurship. Our goal is to present how this can be incorporated at other institutions because these clubs are a low resource utilization investment that can teach trainees valuable skills in innovation and entrepreneurship.