Inadvertent Intra-Arterial Administration of Rocuronium During Anesthetic Care in a Sixteen-Year-Old Patient
Bibliographic record
Abstract
The inadvertent intra-arterial (IA) injection of medications can result in significant clinical sequelae, including paresthesia, pain, loss of motor function, compartment syndrome, gangrene, and loss of digits or limb. We present the inadvertent IA administration of rocuronium during intraoperative anesthetic care of a 16-year-old patient. Following the inhalation of incremental concentrations of sevoflurane in nitrous oxide and oxygen, an intravenous (IV) cannula was placed in the left antecubital fossa. Rocuronium was administered through an IV cannula to facilitate endotracheal intubation. The forearm and hand became mottled and it was determined that the cannula was in the brachial artery. During the ensuring 2 h, there was a gradual return of the extremity to its baseline appearance. The patient was discharged home and no further sequelae were noted. Previous reports of the IA injection of neuromuscular blocking agents are reviewed, techniques to prevent such problems discussed, and a pathway for treatment outlined.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".