The world is currently facing an unprecedented healthcare crisis caused by a pandemic novel beta coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The pathogen is spread by human-to-human transmission via droplets exposure and contact transfer, causing mild symptoms in the majority of cases, but critical illness, bilateral viral pneumonia, and acute respiratory distress syndrome (ARDS) in a minority. Currently, controlling infection to prevent the spread of SARS-CoV-2 is the primary public healthcare intervention used. The pace of transmission and global scale of SARS-CoV-2 infections has implications for strategic oversight, resource management, and responsiveness in infection control. This article presents a summary of learning points in epidemiological infection control from the SARS epidemic, alongside a review of evidence connecting current understanding of the virologic and environmental contamination properties of SARS-CoV-2. We present suggestions for how personal protective equipment policies relate to the viral pandemic context and how the risk of transmission by and to anaesthetists, intensivists, and other healthcare workers can be minimised.
Laryngeal tuberculosis (TB) is a rare condition, occurring in less than 1% of patients infected with pulmonary TB. We present a case of a 57-year-old male patient, who presented in extremis with audible stridor, increased work of breathing and cyanosis. In addition, the patient had a complex medical history, including a recent diagnosis of congenital malformation of the epiglottis. Emergency intervention was required to secure the airway, and after initial attempts at intubation were unsuccessful, an emergency tracheostomy was performed. Four days after initial presentation, his sputum tested positive for acid-fast bacilli, and a subsequent CT chest revealed pulmonary as well as laryngeal TB, which was confirmed on biopsy of the larynx. The patient was commenced on a 24-week course of anti-tuberculous treatment and was successfully decannulated 6 months after the emergency airway was established.
Background: Green discoloration of urine following propofol use is a rare yet benign side effect. While rare with propofol infusions, it is even less recognized following single doses of propofol and can cause anxiety for both patients and healthcare professionals. Case Presentation: This paper presents the case of a patient with alcohol-induced liver cirrhosis who transiently produced green urine following a single dose of propofol at the induction of anesthesia. The exact incidence and mechanism are not known; however, it is thought to be due to the extrahepatic pharmacokinetics associated with propofol metabolism and clearance. Due to its rarity, it can propagate anxiety and lead to unnecessary investigations. Conclusion: Propofol is a very commonly used anesthetic drug. The case highlights that the prompt recognition of this rare adverse effect can prevent unnecessary investigations and provide reassurance to the patient and healthcare providers.
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