Improving Adherence to Practice Guidelines for Anticoagulation in Patients Receiving Neuraxial Anesthesia Using an Electronic Order Entry Alert System

Conclusion Unapproved antithrombotic administration was significantly reduced after initiation of the alert system. This simple electronic alert was found to have a protective effect for patients receiving both anticoagulation and epidural analgesia.
Source: Journal of Patient Safety - Category: Health Management Tags: Original Articles Source Type: research

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We report a case of a parturient with intense central poststroke pain after an ischemic cerebrovascular incident at 15 weeks of gestation, attributed to cerebral venous thrombosis. After a multidisciplinary team consultation, she was scheduled for cesarean delivery at 35 weeks of gestation, under combined spinal-epidural anesthesia. Due to severe left-sided neurological deficits and ipsilateral intense neuropathic pain, the neuraxial technique was successfully performed using the paramedian approach.
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports Source Type: research
​BY JENNIFER TUONG; IVAN KHARCHENKO; JEAN LUC AGARD; &AHMED RAZIUDDIN, MDA 65-year-old man who had HIV well-controlled with highly active antiretroviral therapy, hypertension, sciatica, and restless leg syndrome presented to the emergency department with left leg pain. He also had had chemotherapy and radiation for anal cancer. The patient said the pain had started 45 minutes earlier when he was sitting on the toilet.He described the pain as sore in quality and 10/10 on the pain scale. He reported that it had started in his lower back and radiated to his left leg. He said he had had no trauma or weakness to the regio...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
Conclusion: Quadratus lumborum block and intrathecal morphine are effective analgesic regimens after cesarean section. However, quadratus lumborum block provides better long lasting analgesia together with reduction of total postoperative morphine consumption. PMID: 30852882 [PubMed - as supplied by publisher]
Source: Korean Journal of Anesthesiology - Category: Anesthesiology Tags: Korean J Anesthesiol Source Type: research
ConclusionsAdrenal vein thromboses are rare events requiring curative anticoagulant therapy and labor management to minimize the risk of hemorrhage. Patients should receive thromboprophylaxis for subsequent pregnancies and a full thrombophilia investigation.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
ConclusionsThe HerniaSurge Group has developed these extensive and inclusive guidelines for the management of adult groin hernia patients. It is hoped that they will lead to better outcomes for groin hernia patients wherever they live. More knowledge, better training, national audit and specialization in groin hernia management will standardize care for these patients, lead to more effective and efficient healthcare and provide direction for future research.
Source: Hernia - Category: Sports Medicine Source Type: research
(Reg Anesth Pain Med. 2016;41(6):773–775) This case report described the challenges posed by parturients with Fontan circulation, including the treatment for congenital heart disease and anticoagulation management during cesarean delivery performed under neuraxial anesthesia. Pregnancy, in general, increases the risk of venous thromboembolism and this is a common complication in patients with Fontan circulation. In this case, the 30-year-old parturient with Fontan circulation developed a neuraxial hematoma four days after her cesarean delivery performed with continuous spinal anesthesia. Morbid obesity and superfici...
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Case Reports Source Type: research
Publication date: Available online 5 July 2016 Source:Anaesthesia Critical Care & Pain Medicine Author(s): A.G.M. Aya, B. Ondze, J. Ripart, P. Cuvillon The occurrence of seizures in the peripartum period is a rare but particularly challenging situation. Seizures in the peripartum period could result from three categories of conditions: first and most frequent is the exacerbation of a known pre-existing seizure disorder, mainly epilepsy. A therapeutic evaluation is needed; second is the new onset of seizures due to a non-pregnancy-related problem. An accurate diagnosis and a specific treatment are required; third is ra...
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
[Chest pain at 32 weeks' gestation: pregnancy-related spontaneous coronary artery dissection]. Anaesthesist. 2016 Aug 2; Authors: Schmutz A, Quaas P, Grundmann S Abstract A 32-year-old woman at 32 weeks gestation presented with cardiac arrest due to ventricular tachycardia following acute chest pain at home. After immediate defibrillation with return of spontaneous circulation (ROSC), an ST segment elevation myocardial infarction due to coronary artery dissection was confirmed. Two drug-eluting stents were implanted and she was placed on dual antiplatelet therapy (DAPT). The echocardiog...
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research
We are going to get up close and personal this month to talk about hemorrhoids. You should be familiar with these painful offenders because half to two-thirds of people between 45 and 65 will suffer from their cruelty. (Am Surg 2009;75[8]:635.) Patients may seek emergency department care if they experience bleeding or severe pain from hemorrhoids.Hemorrhoids are highly vascular structures that are round or oval in shape. They arise from the rectal and anal canal, and sometimes appear around the anus itself. It is important to note that hemorrhoids do not have arteries and veins but special blood vessels called sinusoids, c...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Publication date: Available online 5 July 2016 Source:Anaesthesia Critical Care & Pain Medicine Author(s): Anne-Sophie Ducloy-Bouthors, Max Gonzalez-Estevez, Benjamin Constans, Alexandre Turbelin, Catherine Barre-Drouard Points essentiels Any dyspnoea, chest pain, syncope or collapsus must alert women health care providers to engage rapidly the diagnosis process and emergent treatment of the cardio-circulatory failure. The larger competence of the obstetric anaesthetists to perform echographic diagnosis at the parturient bedside helps to a more rapid management than previously. Symptomatic and etiologic treatmen...
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
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