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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
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Arteries of the Upper Limbs01:12

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The subclavian artery transitions into the axillary artery as it exits the chest and enters the axillary region. This artery is critical for supplying blood to the shoulder area, including the head of the humerus, through the humeral circumflex arteries. As the vessel continues into the upper arm or brachium, it becomes the brachial artery. This artery plays a key role in vascularizing the brachial region and bifurcates at the elbow into several branches. These branches include the deep...
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One-Compartment Model: IV Infusion01:09

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Intravenous (IV) infusion is often utilized when continuous and controlled drug delivery is necessary, such as during surgery or in the treatment of chronic diseases. This method offers numerous advantages, including immediate drug action, precise control over dosage, and bypassing the first-pass metabolism.
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Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
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The human circulatory system, a marvel of biological engineering, is a complex network of vessels that transport blood throughout the body. Among these, the veins responsible for carrying blood from the upper limbs are divided into two categories: deep and superficial.
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A two-compartment model is a vital tool in pharmacokinetics, providing an essential understanding of drug behavior, especially for those administered via zero-order intravenous infusion. This model outlines two compartments: the central compartment, where elimination occurs, and the peripheral compartment.
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Hand and Forearm Compartment Syndrome Secondary to Intravenous Infiltration.

Joseph Vyskocil1, Jonathan Sheu2, Paul Telehowski2

  • 1Central Michigan University School of Medicine, 1632 Stone St, Saginaw, MI 48602.

Journal of Orthopaedic Case Reports
|November 11, 2024
PubMed
Summary

Acute compartment syndrome (ACS) from IV catheter infiltration is rare but serious. Early recognition and fasciotomy are crucial for limb salvage in patients unable to communicate.

Keywords:
Acute compartment syndromeemergent fasciotomiesiatrogenic fluid extravasation

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Area of Science:

  • Orthopedic Surgery
  • Vascular Surgery
  • Emergency Medicine

Background:

  • Acute compartment syndrome (ACS) is a critical orthopedic emergency.
  • Iatrogenic fluid extravasation from intravenous (IV) catheters is a rare cause of ACS.
  • Clinical diagnosis can be challenging in anesthetized or obtunded patients.

Observation:

  • A 64-year-old female developed ACS in the hand and forearm post-carotid endarterectomy.
  • Swelling and signs of ischemia were noted due to an infiltrated IV catheter.
  • Diagnosis relied solely on physical examination due to the patient being under anesthesia.

Findings:

  • The patient presented with significant hand and forearm swelling and tissue tension.
  • Physical findings suggested early ischemia, necessitating immediate intervention.
  • Emergent fasciotomies were performed to relieve compartment pressures.

Implications:

  • Prompt diagnosis and surgical decompression are vital for managing ACS from iatrogenic fluid extravasation.
  • Heightened clinical awareness is crucial for identifying this rare etiology in non-communicative patients.
  • Early fasciotomy can prevent severe morbidity and mortality associated with compartment syndrome.