Absence of Adverse Neurological Outcomes in a Non-Neurologically Injured Polytrauma Patient Despite Extreme and Prolonged Treatment-Resistant Hypotension: A Case Report.

Temporary hypotension after severe trauma might help achieve hemostasis and increase the chances of survival. However, excessive hypotension can lead to adverse neurological sequelae or be fatal. The relationship between the degree of hypotension and neurological prognosis after trauma is not fully understood.

Ultrasound-guided para-umbilical block: a pediatric case.

Background: Rectus sheath block is a common peripheral nerve block for patients undergoing umbilical hernia repair surgery. However, rectus sheath block alone can affect only anterior branches of intercostal nerves and, therefore, is incomplete for postoperative analgesia for the anterior abdomen, which is innervated by both anterior and lateral branches. We describe a successful perioperative analgesia with ultrasound-guided para-umbilical block after pediatric umbilical hernia surgery.

Learning curve for paramedic endotracheal intubation and complications.

Background: Pre-hospital laryngoscopic endotracheal intubation (ETI) is potentially a life-saving procedure but is a technique difficult to acquire. This study aimed to obtain a recommendation for the number of times ETI should be practiced by constructing the learning curve for endotracheal intubation by paramedics, as well as to report the change in the frequency of complications possibly associated with intubation over the training period.

Methods: Under training conditions, 32 paramedics performed a total of 1,045 ETIs in an operating room.

[Intraoperative cardiac arrest due to coronary vasospasm after tourniquet release--a case report].

A 55-year-old man with no past history of ischemic heart disease underwent open reduction and internal fixation of the right arm because of an open fracture. Under general anesthesia with brachial plexus block, the operation was started after the upper arm had been pressurized at 280 mmHg by tourniquet. The patient had cardiac arrest 15 min after the tourniquet release, and was resuscitated by CPR.

[A case of Guillain-Barré Syndrome complicated with Fat Embolism syndrome].

A 22-year-old man was admitted to our ICU for treatment of fat embolism syndrome complicated with multiple bone fractures. Acute respiratory distress syndrome developed, and the patient received steroid therapy. During the steroid therapy, symmetrical proximal muscle weakness of all four limbs without sensory abnormalities and autonomic nervous system dysfunction developed.