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Chest Pain in a Patient With Coronary Artery Disease – II

Case Study A rapid response event was initiated by the bedside nurse for sudden onset chest pain. On prompt arrival of the rapid response team (RRT), it was noted that the patient was a 59-year-old male with a known history of bronchial asthma, coronary artery disease who had a coronary artery bypass graft eight years ago, and coronary stent placement five years ago. The patient was…

Chest Pain in a Patient With Coronary Artery Disease – I

Case Study A rapid response event was initiated by the bedside nurse for acute onset hypotension. On prompt arrival of the rapid response team, it was noted that the patient was a 66-year-old female with a known history of ST-elevation myocardial infarction (STEMI) status post coronary artery bypass grafting a year ago, hypertension, and type 2 diabetes. She initially presented to the hospital for right flank…

Simulation in Pediatric Anesthesia

THE FIELD OF PEDIATRIC anesthesia has become increasingly subspecialized, with unique challenges that demand high-quality teaching and training. Pediatric anesthesia is focused in detail, diverse in surgical and technical complexity, and tolerates an exceedingly small margin for error. With the advancement of technology in radiology, the rise of procedural sedation and pediatric intensive care unit (ICU) requirements for bedside surgery, there is an increased challenge to…

Pediatric Equipment

Heating and Cooling Systems Consider for a moment the design of the surgical gown. It is designed to be a sterile barrier to protect the patient, yet it also must be a barrier to body fluids to protect the wearer. Because it is waterproof, it exchanges air poorly and in turn prevents dissipation of body heat. The surgeon wants to turn down the temperature in the…

Pediatric Anesthesia in Developing Countries

THE POPULATION IN THE DEVELOPING WORLD CONTINUES TO GROW while world demographics trend toward an aging population in an urbanized, developed world. Children, many orphaned by the ravages of war, human immunodeficiency virus (HIV) infection, and famine, constitute more than one-half of the population in many of these countries. Eighty-five percent will require surgery before their 15th birthday. The burden of surgical disease requires safe anesthesia,…

Infectious Disease Considerations for the Operating Room

THE RABBIT HOLE THAT IS THE PERIOPERATIVE ENVIRONMENT is not well understood by the majority of our general pediatric colleagues. Similarly, the rabbit hole of the primary care clinic or the pediatric inpatient ward is not well understood by the majority of our anesthesiology colleagues. A pediatric patient may repeatedly enter the rabbit hole over the course of a hospital admission, a journey fraught with dangers…