A & A case reports
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A 44-year-old man undergoing ambulatory surgery sustained a 5% total body surface first-degree burn on his lower and lateral torso and upper thigh during routine use of a new forced-air warming Bair Paws™ flex gown system. We describe the likely mechanism of injury, intraoperative events suggesting special variation in the warming process, and a brief review of adverse events associated with forced-air warming systems.
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We report a case of succinylcholine-induced hyperkalemia in a patient with a mediastinal triton tumor, which is characterized by a rhabdomyosarcomatous differentiation. Caution should be taken with succinylcholine use in patients presenting with a rhabdomyosarcomatous tumor or with a tumor of unknown cell type when histopathological diagnosis is not available.
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In this report, we describe the case of a 7-year-old girl presenting to Queen Elizabeth Central Hospital, Blantyre, Malawi, with hypoxia and respiratory distress. Investigations demonstrated an endobronchial tumor, and she underwent a radical left-sided pneumonectomy. This case highlights the challenges of anesthesia in a resource-depleted setting.
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This case report documents the inadvertent placement of an arterial cannula despite using realtime ultrasound to insert a peripheral venous cannula in a child with difficult venous access. The resultant limb ischemia was treated with an infraclavicular ultrasound-guided brachial plexus block as sympatholytic treatment.
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An elderly male with a history of argyria caused by chronic ingestion of colloidal silver presented for elective colonoscopy. The patient's skin was a profound blue-gray color that caused concern among staff until his condition was identified through his medical and medication history. ⋯ The anesthetic management concerns include differentiating argyria from hypoxemia and other pathologies with similar appearance and clearly communicating the patient's history of argyria to follow-on caregivers to prevent unneeded diagnostic or interventional procedures. It is also important for caregivers to understand that the altered skin pigmentation of argyria does not interfere with pulse oximetry.