[Case report: a 65-year-old man loses consciousness after colonoscopy].
Following an uncomplicated outpatient colonoscopy, a patient was found unconscious with bradycardia in the waiting room of a practice of an internist. After a half an ampoule of atropine, the pulse quickened but the patient remained unconscious. Even flumazenil did not improve the situation. The now responding emergency physician was confronted with numerous, unspecific neurological symptoms and considered various differential diagnoses. The situation was aggravated by the rural infrastructure. In the course of the clinical investigation, the patient's condition deteriorated rapidly and intubation was necessary. The correct underlying diagnosis was finally made following a telephone call and disclosed an (almost) fatal chain of misunderstandings.
Oppitz
Francesca
F
Klinikfür Anästhesie, Intensivmedizin und Schmerztherapie, Schön Klinik Vogtareuth. foppitz@schoen-kliniken.de
D000368:Aged; D000553:Ambulatory Care; D018686:Anesthetics, Intravenous; D001285:Atropine / Q000627:therapeutic use; D001919:Bradycardia / Q000209:etiology / Q000628:therapy; D018680:Cholinergic Antagonists / Q000009:adverse effects; D003113:Colonoscopy / Q000009:adverse effects*; D016292:Procedural Sedation / Q000009:adverse effects*; D003937:Diagnosis, Differential; D004632:Emergency Medical Services; D005442:Flumazenil / Q000627:therapeutic use; D018757:GABA Modulators / Q000627:therapeutic use; D006780:Hospitals, Rural; D006801:Humans; D006993:Hypnotics and Sedatives; D008297:Male; D008874:Midazolam; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D015742:Propofol; D013689:Telephone; D014474:Unconsciousness / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy
D018686:Anesthetics, Intravenous; D018680:Cholinergic Antagonists; D018757:GABA Modulators; D006993:Hypnotics and Sedatives; D018727:Muscarinic Antagonists; D005442:Flumazenil; D001285:Atropine; D008874:Midazolam; D015742:Propofol