A & A case reports
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In this report, we describe the case of a young female with Down syndrome who presented to the anesthesia service after pulseless electrical activity arrest with a King LT(S)-D extraglottic airway device in situ. She had multiple predictors of difficult intubation, including what appeared to be a submental mass consistent with Ludwig's angina. She went on to receive an urgent tracheotomy because of those predictors but had full resolution of the submental mass on removal of the extraglottic airway device, which had been overinflated at the time of insertion. We outline the various techniques to establish a definitive airway with an extraglottic device in place.
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Plagiarism by residency applicants in their personal statements, as well as sites that sell personal statements, have been described, and led in 2011 to advice to avoid plagiarism and the caution that plagiarism detection software was available. We screened personal statements of 467 anesthesiology residency applicants from 2013-2014 using Viper Plagiarism Scanner software, and studied them for plagiarism. ⋯ Plagiarized content ranged up to 58%. Plagiarism continues to occur in anesthesiology residency personal statements, with a higher incidence among graduates of non-United States medical schools.
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Vocal fold injection is used for the management of glottal incompetence from various causes. The procedure is well tolerated and has few reported complications. ⋯ His blood glucose value was measured at 24 mg/dL, and plasmatic insulin level was 246 mU/L. To our knowledge, this is the first reported case of a systemic side effect after vocal fold lipoinjection.
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Case Reports
Emergent Airway Management of an Uncooperative Child with a Large Retropharyngeal and Posterior Mediastinal Abscess.
Retropharyngeal abscesses are deep neck space infections that can lead to life-threatening airway emergencies and other catastrophic complications. Retropharyngeal abscesses demand prompt diagnosis and early establishment of a definitive airway when there is airway compromise. ⋯ We present the case of a 12-year-old girl with mediastinitis and tracheal compression and anterior displacement from a large retropharyngeal and posterior mediastinal abscess secondary to traumatic esophageal perforation, who received successful awake nasal fiberoptic intubation. Anesthesiologists must be prepared for airway emergencies in uncooperative patients, especially children, but there is controversy concerning the use of sedation.