Background: Hip fracture (HP) involves bleeding that often requires blood transfusion and it can be life-threatening. Jehovah’s witnesses (JW) refuse blood products (BP) administration because of religious beliefs. Recombinant Human Erythropoietin (rHuEPO) has become an alternative but there are still no guidelines on its use in these situations. Methods: JW patients with HP admitted to [...]

Background: Background: As healthcare systems evolve to provide more efficient and patient-centered care, the utilization of ambulatory surgery centers (ASCs) has become increasingly common. These centers offer a convenient and cost-effective alternative to traditional inpatient hospitalization for a wide range of surgical procedures. However, proper preoperative evaluation and decision-making are critical to ensure patients are [...]

Background: At Thomas Jefferson University Hospital (TJUH) in Philadelphia, Pennsylvania, 4th year medical students can complete an elective in Perioperative and Consultative Medicine. The Farber Hospitalist Division is a unique Hospital Medicine Division in the Department of Neurosurgery that runs the medicine consult service and specializes in neurosurgical co-management at both TJUH Main Campus and [...]

Case Presentation: A 66-year old woman with a history of obesity and hypertension presented with a right femoral neck fracture after a mechanical fall. She underwent a right total hip arthroplasty and the anesthesiologist reported transient intraoperative hypoxia during cement placement. In the recovery room, the patient was hypotensive, tachycardic and hypoxic requiring up to [...]

Case Presentation: An 87yo woman with dementia presented with a large right adrenal mass consistent with pheochromocytoma with lymph node metastases based on biochemical testing and MIBG scan. Non-operative management with iobenguane-131 (Azedra) was considered because of her surgical risk. However, given her underlying dementia, comorbid conditions, and frailty, she was appropriately identified as high [...]

Case Presentation: A 69yo man was seen in preop clinic before cystoprostatectomy for a very large bladder tumor that had excellent radiographic response to pembrolizumab. His recent history was notable for an episode of witnessed syncope 5 weeks prior attributed to dehydration in the setting of baseline, long-standing intermittent episodes of SVT. Outpatient ECHO and [...]

Case Presentation: A 63-year-old man with polycystic kidney disease and bilateral renal masses was seen in our dedicated Pre-Operative clinic before a bilateral nephrectomy for renal cell carcinoma. In preparation for this surgery his nephrologist had placed a referral for community hemodialysis. However, regional wait times for community dialysis chairs averaged 2-3 months necessitating prolonged [...]