Comments for RAEducation

Comment on Epidural Catheter Disconnects by BlueNeedle

BlueNeedle — Sat, 06 Mar 2010 17:52:08 +0000

How did you come up with the length of catheter to remove?

Comment on Epidural Catheter Disconnects by Sajit Paul

Sajit Paul — Thu, 04 Mar 2010 20:29:45 +0000

It is clear that the epidural catheter cannot be used. Also there is a great risk of epidural haematoma with removal. Considering the risks and benefit it seems appropriate to remove a length of the distal end of the catheter(10-15 cm) under aseptic precautions, usig sterile blade and dress up the the catheter in sterile manner. When appropriate interval has passed the catheter can be removed and next dose of enoxaparin given after six hours.

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myozpamuk — Tue, 22 Dec 2009 07:04:09 +0000

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Comment on Clinical Cases and Images – Blog: Interesting Articles: A Weekly Review of the "Big Five" Medical Journals by Noel Loans

Noel Loans — Mon, 21 Dec 2009 08:01:26 +0000

Great post and a very informative blog overall. Thanks

Comment on Clinical Cases and Images – Blog: Interesting Articles: A Weekly Review of the "Big Five" Medical Journals by Darren

Darren — Sun, 20 Dec 2009 20:36:28 +0000

Thank you for generating RSS feeds. As well, what options are provided to the public in terms of clinical materials and journals which are otherwise off limits to non paying individuals?

Comment on Clinical Cases and Images – Blog: Interesting Articles: A Weekly Review of the "Big Five" Medical Journals by inurl:viewerframe?mode=

inurl:viewerframe?mode= — Fri, 18 Dec 2009 09:14:12 +0000

Great point. Google is providing excellent resource for the medical industry. The responsibility is ours to figure out how to best utilize them.This was actually very helpful.

Comment on Thoracic Paravertebral Catheters in Cadavers by Veerandra Koyyalamudi

Veerandra Koyyalamudi — Thu, 17 Dec 2009 22:29:13 +0000

Again this brings up the point as to whether we should just move towards epidurals for the management of rib fracture and thoracotomy pain. There is no definitive end point and many a time I find myself not sure if the paravertebral catheter was in the right place.

Comment on Thoracic Paravertebral Catheters in Cadavers by Steve L

Steve L — Thu, 17 Dec 2009 18:07:03 +0000

I would be intersted to know more specifics. We have only the ultrasound spread noted by the original proceduralist to confirm needle position in the space. Before we conclude that all of these needles were in the right place, but only 55% of the catheters ended up in the right place, I would like to see some type of confirmation(i.e. U/S picture confirmed by a seperate ultrasonographer)Second, what kind of catheter were they using? Was it stiff? How much catheter did they thread into the space?
So I would say cautionary, but not disheartening.

Comment on Thoracic Paravertebral Catheters in Cadavers by Myles Conroy

Myles Conroy — Thu, 17 Dec 2009 04:04:56 +0000

I have tried this approach in anaesthetised patients on >10 occasions. In contrast to comments above, I have found the needle difficult to identify, let alone the tip, despite some experience with paravertebral imaging and inplane blocks in general.

Needle localisation is best demonstrated by injections of saline as the needle is advanced. Expansion of the paravertebral space is visualised as the pleura is pushed deep above and below the level of insertion and correlates with success. The catheter still tends to be difficult to feed, so depositing it at the end of the needle seems to suffice. The last time I followed this approach I managed to deliver excellent analgesia for 12 unilateral fractured ribs that lasted for 1/52 before the block failed!

Comment on Clinical Cases and Images – Blog: Interesting Articles: A Weekly Review of the "Big Five" Medical Journals by china university

china university — Thu, 26 Nov 2009 12:54:12 +0000

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