AANA journal
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Case Reports
Airway management in a child with penetrating pharyngeal wall foreign body injury: a case report.
Penetrating foreign bodies of the oropharynx are encountered in children of all ages, although more frequently between the ages of 3 to 5 years. A thorough preanesthetic evaluation of these patients, including type and extent of injury, must be performed if time allows. As a result of the often emergent nature of these cases, poor patient cooperation, and great potential for airway compromise, special considerations are given to management of the airway. The use of nontraditional equipment may greatly facilitate laryngoscopy and intubation.
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Comparative Study Controlled Clinical Trial
A study comparing chloroprocaine with lidocaine for skin infiltration before intravenous catheter insertion.
A prospective, double-blind, mixed, crossover study was conducted to determine the perception of pain associated with intradermal lidocaine and chloroprocaine for insertion of an 18-gauge intravenous catheter. A convenience sample of 64 healthy, adult volunteers was used. Each participant received an intradermal injection of lidocaine or chloroprocaine on the dorsum of one hand followed by insertion of an 18-gauge intravenous catheter. ⋯ A repeated analysis of variance was used to determine whether there was significant difference in pain associated with the injections and with the insertion of the catheters. There was no significant difference in the amount of pain associated with the intradermal injections (P = .955) or with insertion of an 18-gauge needle (P = .977). Both local anesthetics were effective in reducing pain from the initial injection of the local anesthetics to the insertion of the 18-gauge needle (P = .000).
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Historically, closed malpractice claims have been used to identify and examine potential causes for adverse anesthesia outcomes. In the United States, the American Association of Nurse Anesthetists and the American Society of Anesthesiologists have compiled and analyzed such data. ⋯ Although some researchers have cited closed claims studies as evidence of anesthesia risk trends, the nature of the data makes it inappropriate for calculation or comparison of risk. Further work is needed to elucidate some mechanisms of injury and to develop interventions to maximize patient safety.
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Review Case Reports
Use of heliox for intraoperative bronchospasm: a case report.
Bronchospasm is an anesthetic emergency that can lead to disastrous outcomes if treatment is irresolvable. An anesthesia provider must immediately initiate treatment if bronchospasm is suspected in order to avoid negative sequelae. ⋯ Although heliox has been used foryears to treat patients with various respiratory complications, it is not currently a common treatment instituted by anesthesia practitioners for the treatment of bronchospasm. Consideration of the use of heliox may provide another option for the treatment of a patient suffering from refractory bronchospasm.