title: Death by Disimpaction: A Bradycardic Arrest Secondary to Rectal Manipulation.
abstract: Rectal examination and fecal disimpaction are common procedures performed in the Emergency Department on a daily basis. Here, we report a rare case of a patient suffering a cardiac arrest and ultimately death likely due to rectal manipulation. A 66-year-old male presented to the Emergency Department (ED) with a complaint of abdominal distention and constipation. A rectal exam was performed. During the examination the patient became apneic. On the cardiac monitor the patient was found to be in pulseless electrical activity with a bradycardic rate. Our recommendation would be to provide adequate analgesia and close patient monitoring of those undergoing this procedure especially patients with significant stool burdens.
authors.affiliation: Department of Emergency Medicine, University of Missouri-Columbia, One Hospital Drive, DC 029.1, Columbia, MO 65212, USA.
authors.forename: Christopher S
authors.identifier: 0000-0002-3254-4569
authors.initials: CS
authors.lastname: Sampson
authors.affiliation: Department of Emergency Medicine, University of Missouri-Columbia, One Hospital Drive, DC 029.1, Columbia, MO 65212, USA.
authors.forename: Cory M
authors.initials: CM
authors.lastname: Shea