Pharmacology for Rapid Sequence Intubation (RSI) Airway Management in Trauma Patients
UChicago Medicine
Laura Celmins, PharmD, BCPS, BCCCP
Clinical Pharmacy Specialist
Emergency Medicine
In this video, Laura Celmins, a clinical pharmacist in the emergency department at UChicago Medicine, discusses rapid sequence intubation (RSI) medications as part of the airway management for trauma patients.
Microscope Drape for Aerosol-Generating Procedures During COVID-19 Pandemic
Bascom Palmer Eye Institute
C. Scott Brown, MD
Neurotology and Lateral Skull Base Surgery Fellow
University of Miami Miller School of Medicine
Fred F. Telischi, MEE, MD, FACS
James R. Chandler Chair in Otolaryngology
Chairman of Otolaryngology and Professor, Neurological Surgery and Biomedical Engineering
University of Miami Miller School of Medicine
During the COVID-19 pandemic, viral transmission via aerosolized particles poses the risk of infecting operating room staff. In this video, Dr. Telischi at the University of Miami demonstrates one of several techniques for draping the microscope during cochlear implant surgery.
Pancreatic Debridement via Sinus Tract Endoscopy
Massachusetts General Hospital
Peter Fagenholz, MD
Assistant Professor of Surgery
Massachusetts General Hospital
Harvard Medical School
This patient is a 58-year-old male who was in a motor vehicle accident and developed a persistent necrotic collection adjacent to the pancreatic tail that did not improve with percutaneous drainage. Here, Dr. Peter Fagenholz at MGH performs a pancreatic debridement using sinus tract endoscopy (STE), a minimally-invasive technique for debridement of dead or infected tissue.
STE and other minimally-invasive techniques have significantly decreased morbidity and mortality for patients undergoing intervention for infected pancreatic necrosis. Common management principles include early non-interventional management to allow the necrosis to wall off, initial intervention with minimally-invasive drainage, and minimally-invasive necrosectomy addressing clearly demarcated necrosis.
STE involves the placement of a percutaneous drain followed by fluoroscopically-guided dilation of the drain tract to allow for placement of a working sheath, through which an endoscope can be introduced to debride the peripancreatic necrosis. After debridement, a drain is then replaced through the same tract.
JOMI is partnering with InciSioN (https://incisionetwork.org/).
InciSioN is a nonprofit organization representing over 5000 students, trainees, and early career physicians around the world, who are passionate about Global Surgery. We work towards the common goal of access to safe, timely and affordable surgical healthcare for all. Our work rests on three pillars of Advocacy, Education, and Research.
Prophylactic Laparoscopic Bilateral Gonadectomy for Complete Androgen Insensitivity Syndrome
University of Arkansas for Medical Sciences
J. Corbin Norton, MD
Department of Urology
University of Arkansas for Medical Sciences
Stephen J. Canon, MD
Department of Pediatric Urology
Arkansas Children’s Hospital
Amrit Singh, MD
Department of Pathology
University of Arkansas for Medical Sciences / Arkansas Children’s Hospital
Laura L. Hollenbach, MD
Department of Obstetrics and Gynecology
University of Arkansas for Medical Sciences
Georgia Gamble, MD
Department of Obstetrics and Gynecology
University of Arkansas for Medical Sciences
Laura A. Gonzalez-Krellwitz, MD
Department of Pathology
University of Arkansas for Medical Sciences / Arkansas Children’s Hospital
The patient, in this case, is a 15-year-old female who presented with primary amenorrhea and who on work-up was found to have complete androgen insensitivity syndrome. Here, Dr. Canon at the University of Arkansas for Medical Sciences performs a prophylactic laparoscopic bilateral gonadectomy to reduce her future risk for intra-abdominal testicular malignancies. Final pathology results showed a rare case of bilateral germ cell neoplasia in situ and bilateral paratesticular leiomyomas and reinforced the decision to intervene early allowing for the removal of the gonads prior to their conversion to formal germ cell tumors.
Less Invasive Stabilization System (LISS) for Distal Femur Fracture Repair
Brigham and Women’s Hospital
Michael J. Weaver, MD
Associate Orthopaedic Surgeon, Brigham and Women’s Hospital
Assistant Professor of Orthopedic Surgery, Harvard Medical School
Brigham and Women’s Hospital
The patient in this case is an 81-year-old male with dementia who sustained an unwitnessed fall that resulted in a displaced intra-articular distal femur fracture. Here, Dr. Weaver at Brigham and Women’s Hospital repairs the fracture by performing an open reduction and internal fixation with a LISS plate. An anterolateral approach was used to visualize the joint surface and obtain an anatomic reduction of the articular surface, and a percutaneously-placed lateral lock plate was used to bridge the area of comminution while restoring length, alignment, and rotation to hopefully allow for biologic fixation that permits the bone to heal well.