Journal of clinical anesthesia
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In the axillary fossa, the musculocutaneous nerve (MC) is generally distant from the axillary artery and from the other brachial plexus nerves. In that way, MC requires a specific block. ⋯ Abduction of the shoulder significantly reduced the distance between the MC and the axillary artery. This change in the location of the MC is probably due to the moving of the nerve because of muscle rearrangements and the ability to achieve better proximity of the probe in the axillary fossae.
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An 18-month-old male patient, classified as American Society of Anesthesiologists I, with bilateral inguinal hernia was scheduled for operation. Preanesthetic evaluation revealed history of completed medical treatment of acute bronchitis 10 days ago, and his respiratory examination was recorded as normal. He was successfully operated under general anesthesia with a laryngeal mask. ⋯ The patient's hemodynamic and respiratory parameters recovered quickly after foreign body removal, and the patient was transferred to intensive care unit. His parents were questioned for persistent respiratory symptoms and they gave information about repeating respiratory tract infections in the last 3 months. We predict that displaced foreign body in lobar bronchus due to mechanical ventilation can cause this condition.
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Observational Study
Assessing student usage, perception, and the utility of a Web-based simulation in a third-year medical school clerkship.
The goals of this study were to assess students' usage data of Web-based simulation (WBS), to determine if it can fill gaps in clinical experience-based medical education, and to determine students' perceived value of this kind of simulation during a clinical clerkship. ⋯ WBS in medical school clerkships is accepted by students and can fill gaps in clinical medical school education, without negatively affecting students' workloads or clerkship experiences.
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Obstetric anesthesiologists commonly care for high-risk obstetric patients. However, it is unclear how obstetricians refer these patients for anesthetic evaluation and whether obstetric anesthesia clinics (OACs) are used. Our study aims were to determine the availability and characteristics of OACs at US academic obstetric centers and to evaluate how high-risk patients are referred for anesthetic evaluation. ⋯ Our findings suggest that, among US academic centers, OACs are uncommon and the referral of high-risk patients for antenatal anesthetic evaluation is inconsistent. These findings suggest that more structured referral processes are needed to ensure that high-risk women receive anesthetic evaluation before labor or delivery.