A&A practice
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Chronic abdominal pain in the pediatric population has the potential to interfere with all aspects of life and daily functioning. Pain may originate from various sites including the viscera, fascial layers, muscles, or peripheral nerves. ⋯ We report a case highlighting the use of pulsed radiofrequency in the treatment of lower abdominal pain secondary to ilioinguinal and iliohypogastric neuralgia. In carefully selected patients, as part of a multimodal regimen, pulsed radiofrequency can aid recovery by providing effective and long-lasting pain relief, thus allowing time for effective rehabilitation.
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Case Reports
Nebulized Nitroglycerin for Coronavirus Disease 2019-Associated Acute Respiratory Distress Syndrome: A Case Report.
We present a case where nitroglycerin tablets dissolved in saline and intravenous nitroglycerin solution were nebulized as surrogates for inhaled nitric oxide (iNO) after our iNO supply was depleted during the coronavirus disease 2019 (COVID-19) surge in New York. We gave this treatment to a COVID-19 patient with severe acute respiratory distress syndrome (ARDS) and hypercarbia. In response, the patient had immediate and clinically meaningful improvement in multiple organ systems despite no other interventions or ventilator changes.
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Despite efforts by medical and social activists, transgender parturients encounter barriers to adequate and gender-inclusive health care, resources, and support. We present a case of a 38-year-old transgender man presenting for induction of labor at term. Our case highlights the importance of multidisciplinary planning, appropriate gender-related language, and interventions that may ameliorate gender dysphoria during childbirth. Because some transgender men may desire childbirth, we recommend that health care providers become familiar with and respectful of the unique considerations for this patient population in the peripartum setting.
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Case Reports
Use of Airway Ultrasound in Infants With Unexpected Subglottic Stenosis During Anesthesia Induction: A Case Report.
Point-of-care ultrasound has been integrated into airway management because it allows for rapid and noninvasive assessments. We present 2 cases of unexpected subglottic stenosis in infants during induction of anesthesia. ⋯ The severity of subglottic stenosis in the first case was grade III, requiring emergent tracheostomy. In conclusion, airway ultrasound helps to assess possibility of intubation and plan further airway management in children with unexpected difficult airway.
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Burnout is a serious problem that anesthesiologists face during training and in practice. To mitigate it, experts advocate for strategies focused on enhancing individual resilience in addition to organizational change in health care systems. To catalyze this change, wellness-focused education must incorporate foundational knowledge about the science of well-being and impart skills to empower trainees to lead change in the future. We developed and implemented a longitudinal, developmental 3-year curriculum in a large anesthesiology residency program that included strategies to strengthen community-building, enhance meaning from a career in medicine, and incorporated topics focused on career and leadership development.