Resuscitation
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Review Case Reports
Acute respiratory failure leading to emergency intubation: an unusual manifestation of Munchausen's syndrome.
Munchausen's syndrome is a contrived psychiatric disorder, in which patients present with an intentionally produced or feigned illness with the aim to assume the sick role and to gain medical attention. Patients may even seek the application of invasive procedures, sometimes with serious risk to life. ⋯ This case report may contribute to the awareness among emergency physicians of Munchausen's syndrome as a differential diagnosis of respiratory failure. Recognition of this psychiatric disease is not only important for correct medical diagnosis and treatment, but also essential in protecting the patients from unnecessary invasive and aggressive medical procedures.
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More than 160,000 people suffer sudden cardiac death each year in the US. It is estimated that ventricular fibrillation (VF) is the initial rhythm in approximately 30% of these cases. Ventricular fibrillation that does not respond to the first few defibrillation attempts is associated with mortality rates of up to 97%. ⋯ While no significant detrimental effects directly related to low dose beta-blockade during VF have been reported in the studies reviewed, concerns relating to possible loss of myocardial contractility and hypotension remain. To this day, high quality human trials are lacking. Preliminary human studies are needed to assess the effects of beta-blockers in the treatment of cardiac arrest from ventricular fibrillation or pulseless VT further.