A&A practice
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Neuraxial analgesia has been established as the standard of care for labor analgesia. However, patients presenting with coagulopathy require anesthesiologists to explore alternate analgesic techniques. Systemic opioids may result in neonatal respiratory depression, and inhaled nitrous oxide may lead to nausea, vomiting, and over sedation and may not be readily available in all labor and delivery units. In this case report, we describe a case where posterior quadratus lumborum blocks provided effective analgesia in a parturient with Hemophilia A during the first stage of labor.
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A 17-year-old healthy girl underwent an uneventful esthetic septorhinoplasty. She was easily extubated and transferred to the postanesthesia care unit (PACU) with oxygen saturation (SpO2) of 96%. ⋯ The subsequent chest computed tomography (CT) revealed bilateral patchy infiltrates similar to the radiologic findings of Coronavirus Disease 2019 (COVID-19). Finally, a reverse transcriptase polymerase chain reaction (RT-PCR) of a pharyngeal specimen confirmed the diagnosis of COVID-19.
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Case Reports
Two Case Reports of Upper Extremity Venous Thrombosis From Midline Catheter Placement in Pregnancy.
Midline catheters are often inserted in pregnant women for whom a prolonged hospital stay is anticipated to facilitate the administration of medications and for blood sampling. Midline catheters compared with peripheral intravenous catheters are associated with fewer venipunctures and scheduled line changes. We present 2 cases of pregnant women with no personal or family history of thrombosis who underwent midline catheter insertion and developed venous thromboembolism of the upper extremity requiring anticoagulation therapy. Studies are needed to evaluate the safety profile of midline catheters in pregnancy.
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We evaluated a full-face snorkel mask with an airway circuit filter to protect health care providers against airborne pathogens. First, a quantified N95 fit test was performed using aerosolized saline. ⋯ Neither hypercapnia nor hypoxemia occurred. This modified mask has the potential to protect providers who care for patients with coronavirus disease 2019 (COVID-19).