A&A practice
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Case Reports
Fetus-in-Fetu Airway Teratoma Management of a Newborn in a Low-Resource Country: A Case Report.
A term baby was delivered by cesarean and found to have an unexpected large teratoma attached to its mouth. Surgical excision was planned within 24 hours. Anesthesia concern of airway control required multidisciplinary team consultation, airway and patient preparation, and anticipation for failure. Challenging airway cases in low-resource countries can be successfully managed with deliberate attention to detail, preparation, and experience.
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We report a case of subcutaneous implantable cardioverter-defibrillator implantation in a morbidly obese pediatric patient with hypertrophic cardiomyopathy for the primary prevention of sudden cardiac death. During routine defibrillator threshold testing of the newly placed subcutaneous implantable cardioverter defibrillator, normal sinus rhythm could not be restored despite repeated attempts at defibrillation using the subcutaneous implantable cardioverter defibrillator and transcutaneous pads. Here, we describe the successful intraoperative resuscitation and management after failure to restore normal sinus rhythm using the newly placed subcutaneous implantable cardioverter defibrillator and repeated transcutaneous defibrillation attempts.
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Harvesting of iliac crest bone graft for alveolar cleft repair in children is associated with significant postoperative pain. Transversalis fascia plane block has emerged as an alternative to local wound infiltration for iliac crest bone graft harvesting and has been used with good effect in adult patients requiring bone graft for orthopedic surgery. Little is known about the use of the transversalis fascia plane block in children or the feasibility of placing a continuous infusion catheter. In this report, we describe our experience using a continuous transversalis fascia plane infusion catheter in the management of a 6-year-old girl undergoing alveolar cleft repair with iliac crest bone graft.
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The Accreditation Council for Graduate Medical Education (ACGME) is moving toward competency-based medical education. This educational framework requires the description of educational outcomes based on the knowledge, skills, and behaviors expected of competent trainees. An assessment program is essential to provide formative feedback to trainees as they progress to competency in each outcome. This article describes the development of 2 model curricula for airway management training (basic and advanced) using a competency-based framework.
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Review Case Reports
Bilateral Sciatic Neuropathies as a Complication of Positioning During Neuraxial Anesthesia for Cesarean Delivery: A Case Report.
Neurologic complications following neuraxial anesthesia for cesarean delivery are rare. We present a 33-year-old parturient who developed prolonged lower extremity weakness following a single-shot subarachnoid block for cesarean delivery. ⋯ We review the incidence of nerve injury associated with neuraxial anesthesia and risk factors for developing peripheral nerve injury in this context. We offer a solution to prevent this complication from occurring.