From the Editor
The June 1, 2016 issue offers 6 clinical care case reports and 3 education case reports. Turner and colleagues present a noteworthy clinical case report about a patient who sustained a head injury that resulted in a subarachnoid hemorrhage. After surgical treatment of the CNS traumatic event, an epidural abscess developed requiring a cranioplasty that produced an associated open skull deformity. Sinking skin flap syndrome (SSFS) resulted and the patient’s mental status deteriorated. Conventional treatment with fluids and patient positioning was ineffective and an unusual treatment, an epidural blood patch, was employed. Manometry guided the epidural blood patch and facilitated an increase in epidural and CSF pressures with improvement in the patient’s deteriorating mental status. This case report provides an opportunity to ponder how SSFS secondary to a decompressive craniectomy may alter intracranial pressure dynamics and CNS function by changing the cranium from a “closed-box” to an “open-box.” The educational lesson from this case report deals with the Monro-Kellie doctrine. This case provides a chance to brush up on this physiology.
The June 15, 2016 issue offers 5 clinical care case reports, 1 education case report and 3 additional case reports, one on patient safety and the other 2 on perioperative services. In addition, a most current global health case report by Enright and colleagues updates us on the current status of the Lifebox patient safety initiative. Sprouting from the 2007 World Health Organization Surgical Safety Checklist campaign, Lifebox has grown to have delivered almost 11,000 Lifeboxes/pulse oximeters to anesthetizing locations in 90 low- and middle income countries with educational programs implemented for its use in more than 50 of those countries. Drum has written an Editorial that accompanies Enright et al.’s global health case report. Read both of these articles and decide for yourself what priority oximetry deserves in the history of anesthesia patient care and its impact on patient safety. Do these articles blend well with the notion that 2 of the most important seminal contributions to medical care are the clinical introduction of anesthesia and the standardized use of pulse oximetry?
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