A&A practice
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We report a case of massive engorgement of an asymptomatic tongue hemangioma with the use of a supraglottic airway device (SGA) during general anesthesia for transurethral resection of a tumor on the lateral wall of the urinary bladder. This was probably a result of obstruction of the venous drainage of the hemangioma due to the pressure exerted by the inflated cuff of the SGA. The SGA was removed and the trachea was intubated and the engorgement resolved completely in a few hours.
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Case Reports
Facial and Oral Cross-Contamination of a 3-Year-Old Child With High Concentration Capsaicin: A Case Report.
High-concentration topical capsaicin is used to treat different neuropathic pain states. We present a case in which a 3-year-old child orally ingested capsaicin after touching her mother's arm that had been treated with a high-concentration capsaicin patch 3 hours earlier. ⋯ After the use of cleansing gel, external cooling, and drinking milk, the pain lessened over half an hour and subsided after 2 hours. This report aims to raise awareness for this formerly unreported mode of oral contamination.
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Case Reports
Management of Tracheoesophageal Fistula Repair With Cardiac Dextroposition and Right Lung Agenesis: A Case Report.
Tracheoesophageal fistulae (TEF) commonly occur as part of the vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal, and limb abnormalities (VACTERL) association. However, pulmonary agenesis is not typically seen with TEF. We report the anesthetic management of a TEF repair in a 33-week-old, 1.6-kg, monochorionic diamniotic twin with right lung agenesis, intrauterine growth restriction, and cardiac dextroposition. Due to the unique position of the heart, the patient periodically lost complete cardiac output during the exposure and repair of the esophagus.
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In January 2020, a global pandemic was declared by the World Health Organization authorities for coronavirus disease 2019 (COVID-19). Since then, we have looked for ways to avoid transmission with mitigation measures and social distancing. ⋯ Many innovations have been proposed to assist providers including barriers to use during airway management. We present adaptations to previously described intubation or "aerosol" boxes.
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Methemoglobinemia is a rare disorder of the blood in which there is an increase in methemoglobin, which occurs when hemoglobin is present in the oxidized form. Methemoglobin impairs hemoglobin's ability to transport oxygen, produces functional anemia, and leads to tissue hypoxia. ⋯ The cause of methemoglobinemia in this patient remains unknown. Hypoxia and methemoglobinemia did not respond to methylene blue and required administration of packed red blood cell transfusions.