Ultrasound-guided Stellate Ganglion Block As Rescue Therapy For Refractory Ventricular Tachycardia - A Case Report

Refractory ventricular arrhythmia or electrical storm is a dangerous cardiac condition that entails three or more episodes of ventricular arrhythmia that are resistant to treatment within 24 hours. Providers must consider more novel techniques to abate these threatening dysrhythmias when traditional measures fail to return patients to a controlled and perfusable rhythm. One approach to this emergency is a stellate ganglion block to inhibit the sympathetic pathway leading to ventricular arrhythmia. This case report details a 66-year-old male with refractory ventricular tachycardia overnight in the intensive care unit that persists despite pharmacotherapy and cardioversion after catheter ablation. Literature on the efficacy of the stellate ganglion block as a rescue therapy in refractory ventricular arrhythmia or electrical storms is examined and applied to the presented case

Environmental Review of CFCs and their Replacements; the Montreal Protocol Plan

Research paper written by University of Scranton undergraduate student Charles Sylvester. Sylvester was selected by a panel of faculty and staff as the winner of the University's 2024 Bonnie W. Oldham Library Research Prize, in the Undergraduate Upper-Level category

Unanticipated Difficult Airway in a Patient Undergoing Double Lumen Tube Placement: A Case Study

For patients undergoing thoracic procedures extending into the chest wall, placement of double-lumen endotracheal tubes is necessary to provide one-lung ventilation to maintain an optimum surgical field. Technical difficulty increases with double-lumen endotracheal tube (DLT) placement. Standard of practice dictates that the Macintosh (Mac) laryngoscope increases first pass success. Newer video laryngoscopy devices such as the GlideScope, C-MAC, or Airtraq may provide an enhanced glottic view leading to successful DLT placement. This case study presents a patient undergoing a chest wall mass removal who presented with an unanticipated difficult airway during DLT intubation. The purpose of this case study was to review and evaluate the use of video laryngoscopy for first pass success during DLT placement compared to the Mac laryngoscope and provide evidence to support a superior laryngoscopy tool

Multimodal Pain Management in Total Knee Arthroplasty

Total knee arthroplasty (TKA) surgeries have become very frequent and common procedures. What differs the most is the make up of the multimodal pain cocktails that are administrated in the preoperative and intraoperative period. Depending on what medications are used can impact the use of opioid and patient reported pain levels. This paper reports the case of a 67-year-old female undergoing a right total knee arthroplasty. The surgeon preforming the surgery wanted all his patients under general anesthesia and was against any regional anesthesia. Furthermore, the hospital pharmacy did not provide any premade intravenous pain cocktails, so anesthesia providers had to make their own. There were no preoperative non-opioid pain medications administered and the specific pain cocktail that was used intraoperatively consisted of lidocaine, ketamine, dexamethasone, and magnesium sulfate. These medications were examined and compared to the latest literature on ideal multimodal pain cocktails. Practice recommendations were identified to establish where further research is still needed

Case Management During Power Failure in the Operating Room

Operating room power failure causes an immediate threat to patient safety yet remains a neglected topic in medical training and research. Almost all medical equipment within an operating room replies on a power source to function properly, therefore power failure can result in nonfunctional critical surgical and anesthetic equipment. It is important to emphasize the importance of being knowledgeable about the battery life and capabilities of all equipment, having sources of back-up lighting and monitoring immediately available, and having a disaster plan in place that engages the entire OR operating room staff. This paper reports the case study of a 48-year-old female undergoing a robotic, laparoscopic total hysterectomy when total power failure occurs in the operating room, how it was handled, and what improvements can be made to be as prepared as possible if this situation is encountered in the future. Practice recommendations were made based on the review of literature, and they included disaster planning, checklist preparation, and emergency monitoring kits. Being prepared and having a plan in place helps OR staff maintain a calm composure and provide better communication among each other, resulting in better situation handling and best patient outcomes

Intraoperative Fluid Resuscitation Techniques During an Exploratory Laparotomy with Intraoperative Bleeding: A Case Report

Perioperative fluid management is a crucial part of anesthesia. Adequate fluid management is involved in maintaining intravascular volumes, tissue perfusion, and electrolyte balance, while facilitating oxygen and nutrition delivery and removal metabolic wastes at the tissue level. Research has failed to establish a superiority of crystalloids over colloid administration perioperatively. There are still questions about the use and administration of albumin during fluid resuscitation. This case study focuses on fluid selection during an emergent abdominal laparotomy in which the patient experienced significant interoperative blood loss

GroupFly: the Application to Revive Social Interactions

This paper introduces the problem that was brought about by the pandemic in 2020. The proposed solution is GroupFly, a thesis project developed over the course of the 23/24 academic year. A section of major features is described, which includes groups as the main feature of the application. After describing users as the stakeholders, both functional and nonfunctional requirements are also provided. From these requirements and the business logic, the domain model is created. The third and fourth chapters explain the design of the system and implementation of that design, which incorporates Flutter and Firebase as the backend. The security of the system is then talked about in the fifth chapter, which includes input validation and security rules in Firebase's database. The sixth chapter discusses the lack of deployment, while the seventh chapter summarizes the concluding thoughts of the project

The Alphaproteobacterium, Hirschia baltica, Produces a Secondary Prosthecae at The Old Pole

Bacteria produced many cell shapes, but it is unclear how they do this or how different shapes are related evolutionarily. An example would be prosthecate, or appendaged, morphologies in the Caulobacterales order of the Alphaproteobacteria. This order contains genera that produce nonreproductive prosthecae as well as others that reproduce by tip-budding progeny from the tips of their prosthecae. In this work we report on our investigation of Hirschia baltica, a tip-budding member that also produces a secondary prosthecae at the opposite cell pole. We hypothesized that because the location of H. baltica's secondary prostheca parallels the primary unreproductive prosthecae of Caulobacter crescentus, the secondary stalk of H. baltica might evolutionarily linked to C. crescentus and share similar regulatory and biosynthetic networks. We investigated when secondary prosthecae were produced during batch culture growth in two types of media. We show that secondary prosthecae are not exclusively produced in a specific growth phase. However, marine broth increased the frequency of secondary prosthecae along with cellular defects in stationary phase. Finally, we determined that while secondary prosthecae can produce daughter buds, this occurs very rarely in the population, and most cells with secondary prosthecae appear to reproduce through the primary reproductive prostheca