A&A practice
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Point-of-care ultrasound (POCUS) has established its role as a "third eye of a clinician" by virtue of its ability to provide real-time visual information. The present case highlights the role of POCUS in an 11-year-old girl with a misplaced hemodialysis catheter scheduled for surgical exploration with the removal of the catheter and direct arterial repair.
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Transporting spontaneously ventilating adults with tracheostomies from the operating room (OR) or other anesthetizing locations to the intensive care unit (ICU) or other recovery locations presents significant challenges, as traditional T-pieces may not be readily available. This article describes a novel modification to the Ayre's T-piece, designed to address this gap by using readily available equipment. The modification integrates a 3-mL syringe, a size 7.0 endotracheal tube (ETT) connector, and oxygen tubing from an adult under-the-chin style facemask while adapting the expiratory and inspiratory limbs of the anesthesia circuit.
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Spread of drugs in the epidural space may be unpredictable. The differential diagnosis of unilateral hemiparesis could be due to the unilateral spread of the drug, spinal epidural hematoma, intraspinal hematoma, and spinal cord injury. ⋯ We present a case of atypical spread of epidural local anesthetic causing hemiparesis. It emphasizes the need for careful monitoring of sensory levels on both sides and provides insight into the causes of unilateral drug spread in the epidural space.