A&A practice
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Case Reports
Case Report of Accelerated Idioventricular Rhythm in the Interventional Radiology Suite: A Sticky Situation.
Embolization is a well-established method of treatment of arteriovenous malformations. Most procedures are performed under general anesthesia due to the painful nature of some sclerosing agents, procedure duration, and need for immobilization to allow precise injection. Familiarity with the possible side effects of these agents is important for the anesthesiologist to facilitate timely and successful management of intra- and postprocedural complications. This case report describes an unusual presentation of systemic migration of glue-lipiodol mixture during embolization of a calf arteriovenous malformation in an adolescent that resulted in accelerated idioventricular rhythm and its successful management leading to complete resolution.
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Intraoperative cell salvage (ICS) became commercially available in 1968 and has enjoyed wide uptake. However, its use in transurethral resection of prostate (TURP) remains rare. We describe a 71-year-old man who underwent TURP with incomplete blood cross-matching. ⋯ ICS was used to retrieve blood present in bladder irrigation. This is the first Australian report of ICS use during TURP. This case led to a change in our practice and serves to demonstrate the potential of this technology during emergencies.
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Patients who are Jehovah's Witnesses are known to the medical community for frequently declining blood products, even at times of life-threatening anemia. Alternatives to red blood cell transfusion are being developed, including hemoglobin (Hb)-based oxygen carriers. We present the case of a 77-year-old male Jehovah's Witness who underwent a cystoprostatectomy and radical nephrectomy with a postoperative Hb nadir of 4.5 g/dL. He received an Hb-based oxygen carrier, PEGylated carboxyhemoglobin bovine (Sanguinate), with gradual improvement in anemia symptoms and eventual discharge to a short-term rehabilitation facility.
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The role of the anesthesiologist in the perioperative environment requires facility in leadership; however, leadership education is not part of the traditional curriculum for anesthesiology trainees. To address this educational gap, we developed a leadership program for anesthesiology residents at an academic medical center to build competency in the areas of teamwork, emotional intelligence, integrity, selfless service, critical thinking, and patient-centeredness, constructs that correlate with the Accreditation Council for Graduate Medical Education competencies of interpersonal and communication skills and professionalism. This report describes the design and implementation of the program, including the curriculum, and offers recommendations for implementation at other institutions.