Worsening of Primary Raynaud's Phenomenon During Episodes of Pyrexia and Rigors in SARS-CoV-2 Infection.

Acute SARS-CoV-2 infection is associated with several cutaneous manifestations, including vasculitic digital ischemia. The reversal of digital ischemia in the primary Raynaud phenomenon (RP) arises from endothelial hypersensitivity to circulating adrenaline and noradrenaline and diminished vasodilatory innervation. SARS-CoV-2 can infect endothelial cells and be associated with raised adrenaline levels, reduced microvascular dilatory responses, and exaggerated clotting mechanisms. We report worsened RP in a patient with previously mild winter-time primary RP during the periods of fever and rigors from an acute SARS-CoV-2 infection contracted in a warm summer period. This reverted to the mild phenotype after recovery, and we discussed possible mechanisms for the brief exacerbation.

Clinical Issues: The Official Voice of Perioperative Nursing

Removal of used flammable skin antisepsis materials Key words: flammable liquid antiseptics, National Fire Protection Association (NFPA), fire prevention, fire risk, patient care vicinity. According to the Food and Drug Administration, a surgical smoke precipitator device "is a prescription device intended for clearance of the visual field by precipitation of surgical smoke and other aerosolized particulate matter created during laparoscopic surgery. "1 Surgical smoke precipitators use electrostatic precipitation (ESP) technology to negatively charge surgical smoke particles inside the patient's peritoneal space, allowing the smoke particulate matter to precipitate (ie, deposit) on the inner surface of the abdominal wall.2'3 In addition to the application of ESP during laparoscopic surgery, ESP technology has various other air-cleaning applications, such as pollution control for industrial sites (eg, coal-burning plants, incineration facilities)4 and in-duct air filtration in buildings.5 When the surgeon uses a surgical smoke precipitator during laparoscopic surgery, he or she introduces a specialized electrode wand into the abdomen under direct visualization and according to the manufacturer's instructions for use (IFU).2,3 The activated wand emits anions (ie, negatively charged ions) that are attracted to the grounded patient (ie, the patient with a dispersive electrode in place) when connected to the device's powered electrical generator. Medical device event-reporting may include both an internal reporting process at the facility11 and an external reporting process to the Food and Drug Administration using the Manufacturer and User Facility Device Experience database.12 Emily Jones, MSN, RN, CNOR, NPD-BC, is a perioperative practice specialist in the Nursing Department at AORN, Inc, Denver, CO.