In this guest post, we share a powerful real-life story from Dr. Jitendra Bapat, an anesthesiologist. Dr Bapat had used the PubMed search skills he learned from QMed to find a crucial answer to treat his patient. He describes this as an invaluable experience. Incidentally this also led to his resident presenting this case study at a conference, and winning a prize
I am Dr. Jitu Bapat, an anesthesiologist, and I would like to share how QMed’s training directly helped me in patient care.
During an emergency duty, I received a call from the recovery unit about a patient who had undergone an awake craniotomy. The patient was otherwise comfortable, breathing well, but one arm showed desaturation (82–85%) and visible cyanosis. The other arm had normal oxygen saturation (100%).
On reviewing the case, I noted that intravenous medications—including antibiotics and phenytoin sodium—had been administered through the affected arm. A non-invasive BP cuff had also been placed on the same arm for 3–4 hours, cycling every 10 minutes. Despite this, the arterial pulse was intact, so arterial occlusion seemed unlikely.
We performed a Doppler study, which revealed a thrombus in the basilic-cephalic venous compartment. This left me uncertain about the exact diagnosis. At this point, I turned to PubMed and applied the focused search skills I had learned from QMed.
Within minutes, I came across references to a rare complication—Purple Glove Syndrome—linked to intravenous phenytoin, especially when combined with compression from an NIBP cuff. This explained the situation perfectly. With this knowledge, we immediately initiated the correct treatment protocol and successfully saved the patient’s limb.
The key takeaway was that prolonged IV infusion of phenytoin sodium, especially with repeated NIBP cuff inflation, can precipitate thrombophlebitis leading to Purple Glove Syndrome. Importantly, this complication can be avoided by using fosphenytoin, a safer prodrug.
We later documented this case as an e-poster for a conference, where my resident won the first prize!
But the most important outcome was preventing a potentially devastating complication—something made possible because I could perform a precise PubMed search at the right time.
I am deeply grateful to QMed and Dr. Vasumathi for their training, which enabled me to find the right evidence in minutes. It has been invaluable not only in saving a patient’s limb but also in contributing to academic learning and awareness among colleagues.
#Literaturesearch #Searchskills #Clinicalpractice
