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MSNA student encounters rare epidural complication

05.12.2015 | By:
MSNA student Nora Pulford

Nora Pulford, CRNA, MSNA, was presented with an extremely rare anesthesia case resulting from an epidural complication during her clinical training at Texas Wesleyan University. Pulford based her case report on the patient’s diagnosis, and it was published in the International Student Journal of Nurse Anesthesia in the spring. Only a small number of students get published during their nurse anesthesia residency.

This is an example of the scholarly work our students do to contribute to the field of anesthesia practice.  “Nora is an exemplary student that reveals that Texas Wesleyan University is developing future anesthesia leaders, scholars and clinicians,” said Dion Gabaldon, CRNA, DHA, assistant professor, GPNA.

About the Case

Two clinical techniques are commonly used to find the epidural space that hosts an epidural catheter providing medications for pain relief during childbirth. One clinical technique uses air and the other saline; both techniques can have complication.

A rare complication with the use of air is that the air doesn’t dissipate and can travel to the brain causing severe headaches and neck pain. This complication is hard to diagnose, and is often unreported. Pulford’s clinical anesthesia team was able to correctly diagnose their patient’s problem, and, in doing so, helped add to the literature necessary for others to make the same accurate diagnosis.

As more cases are recorded, the technique that is safer for the patient, air or saline, is more likely to come to light. As of now, there is no statistically significant study that would promote one technique over the other. The good news is, while this complication is painful, it is rarely life threatening. 

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