Browsing by Author "Salmon, Chase"

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    A case of postpartum hypothermia
    (2023-03-24) Salmon, Chase; Hartman, Jennifer; Cook, Myanna; Venkatesh Shantharam, Rajalakshmi
    A 22 y/o G2P1 at 39+5 presented for a scheduled repeat cesarean section. Pt. had reassuring fetal heart rate tracings and no history of complications during her pregnancy. Her only past medical history included one prior full term cesarean section and morbid obesity. She had no known drug allergies and her only known allergy is to contrast dye. Pt. underwent a repeat low-transverse C-section with a spinal epidural containing Ropivacaine 0.5% 30mL. She had no immediate complications and had an estimated blood loss of 500 ml. Approximately 2 hours postpartum, anesthesia was called to the bedside for a pt. temp of 93.5 ℉, diaphoresis, SBP 140, HR 65, and O2 Sat 95%. Pt. was given 2L O2 via nasal cannula, warm blankets, a bair hugger, and 2mg ativan IV. One hour later, the patient’s temp had improved to 97.1 ℉ and the patient was taken off the bair hugger at 8 hours postpartum. Cesarean sections with spinal anesthesia come with the risk of adverse side effects, such as hypothermic reactions. In this patient, post-op multimodal warming therapies were successful within eight hours of deployment. Core temperature monitoring post-op could serve to catch downward trending body temperatures earlier. Proactive warming measures could be utilized preoperatively and intraoperatively, such as continued forced-air warming and administering warmed IV fluids, to lower the risk of post-cesarean spinal anesthesia-related hypothermia. Hypothermic reactions are a common adverse reaction seen in cesarean sections with spinal anesthesia. Furthermore, this reaction has been associated with additional complications such as wound infection, shock, and maternal mortality. Clinically, this case highlights the efficacy of forced-air and warm blanket warming in treating post-op hypothermia, but it also highlights a potential need for more consistent monitoring of temperature post-op and further research into post-op hypothermia in obese patients, as minimal research on this topic exists.
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    Student and Faculty Collaboration in Student Affairs
    (2023-04-28) Crowley, Evelyn; Salmon, Chase; Walvoord, Emily; Dafoe, Erin
    How does an institution increase student engagement when delivering co-curricular content that students sometimes view as unnecessary? Over the years, co-curricular topics such as, professional identity formation, policy awareness, academic success, awareness of institutional resources, cultivating a sense of well-being, etc. have become increasingly important. Indiana University School of Medicine (IUSM) has developed a novel approach to delivering co-curricular content that incorporates students into the creation and delivery of this content. In this session, we will discuss ways that students partner with Student Affairs in co-curricular educational programming, with a focus on personal & professional development (PPD) sessions and first-year orientation. These collaborations have fostered a greater degree of student engagement, higher levels of satisfaction with programs, and the ability to deliver content better connected to the student experience. Intentional personal and professional development education is just as vital on the path to becoming a physician as is traditional coursework. Collaborations begin during our first-year orientation, where rising M2s serve as content creators and are responsible for executing orientation in tandem with student affairs and regional campus faculty and staff. Throughout the academic year, students serve on the PPD planning committee to crowdsource topics from peers, listen to class chatter and concerns, and then work with student affairs to develop just in time sessions. These sessions focus heavily on M1 and M2 students who are in the very beginning stages of forming their professional identity. Examples include panels with upper-class students and residents, sessions with Mental Health Services, information about summer opportunities following the M1 year, creating a Step 1 study routine, and determining the right specialty. For our upper-class students, the focus shifts towards career development, residency application and Match preparation, financial security, and more. During this presentation, IUSM’s Associate Dean for Student Affairs and student panelists will discuss the evolution of these student-led initiatives at their nine-campus institution, review topics built in the curriculum, lessons learned and lead attendees in activities to develop and/or refine their own models. The session will include an interactive PowerPoint presentation, table discussions augmented with worksheets and a pair & share activity. We will conclude with an open Q & A with student panelists.