BACKGROUND
The incidence of reactions to epinephrine-containing local anesthetics in Mohs micrographic surgery (MMS) has not been established.
OBJECTIVE
To estimate the incidence of epinephrine-induced reactions from local anesthetics in patients who undergo MMS for the removal of cutaneous malignancies.
METHODS
From 2016 to 2018, 200 MMS patients were recruited from the authors' surgical center. Assessments were obtained throughout the entirety of the Mohs cases during a single visit.
RESULTS
This study estimated the incidence of epinephrine reactions in patients who undergo MMS to be 2.0% (95% confidence interval: 0.1%–3.9%). No relationship between epinephrine dose and incidence of adverse effects was found. Patient age was a significant risk factor for the development of an epinephrine reaction.
CONCLUSION
Systemic reactions to epinephrine from local anesthetics are an infrequent adverse event in MMS cases. The data suggest that the absolute dose of local anesthetic with epinephrine does not correlate with the risk of developing an epinephrine reaction. Older age seems to have a protective effect.
This article describes a kindergarten teacher's incorporation of children's literature for dynamic learning frame, growth mind‐set, and social justice development into her classroom literacy instruction. The authors first compare a dynamic learning frame with a growth mind‐set, explaining their use of the former because of its consideration for social justice and civic engagement. The authors then argue that the language in certain children's literature, as well as the language that teachers use to prompt students’ responses to the books, can spark young children's development of a dynamic learning frame. Toward this aim, the authors share three examples from read‐aloud sessions over the course of a year that illustrate how the kindergarten teacher helped her students develop a dynamic learning framework through the selection of children's literature that supported that goal in both theme and language as well as the language that she used to discuss those books with her class.
In this column, we highlight books for grades K-8 in which characters defy stereotypes, straddle the borders of multiple identities, and live unique intersections of identity.
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