A & A case reports
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Labels and medications with similar appearances have the potential to harm patients and cause delays in hospital services. We report a problem involving the Maxtec MAX-1 and MAX-11 oxygen sensors which are commonly used on anesthesia machines. ⋯ The incident required the replacement of a MAX-11 sensor with a MAX-1 sensor to ensure proper functioning of the anesthesia machine. Identification of these cases can educate health care professionals of potential sources of labeling errors and safety issues and can also bring about Food and Drug Administration policy changes.
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A 3-year-old girl suffering from Stevens-Johnsons Syndrome with severe sloughing of the oropharyngeal mucosa was brought to the operating room for an emergent tracheostomy after multiple failed attempts to intubate the trachea in the pediatric intensive care unit. However, a retrograde tracheal intubation was successfully performed in the operating room to secure her airway, after which a tracheostomy was performed. Retrograde intubation can be a quick and effective method for securing the difficult airway.
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Ethylene oxide (EO) is a highly reactive gas widely used for sterilization of medical devices, for example, plastic materials and ventriculoperitoneal shunts. Allergic reactions to EO are rare and have been observed mainly in patients during hemodialysis and myelomeningocele patients. ⋯ Also, pretreatment with omalizumab was implemented for the first time in such a case. With these measures, further surgeries in our patient were uneventful.
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Minimally invasive mitral valve surgery has been increasingly performed because of its presumed advantages over traditional surgery performed through median sternotomy. Cardiac herniation is an extremely rare complication initially reported by Bettman and Tannenbaum in 1948. ⋯ In this case report, we present 2 cases of cardiac herniation occurring after minimally invasive mitral valve surgery; the 2 cases had different surgical exposures and clinical presentations. Early diagnosis is crucial for a timely lifesaving definitive management.
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Hypoglycemia is a frequent problem encountered with diabetics and hospitalized patients. Although point-of-care glucose meters have revolutionized management, there are circumstances wherein glucose meter readings are inaccurate. ⋯ After surgery, the patient's laboratory testing reflected hypoglycemia, while point-of-care glucose meter testing indicated hyperglycemia. It is important to remember that the "gold standard" is the laboratory serum glucose test, and if a discrepancy from point-of-care results occurs, an investigation should be made to ascertain the reason.