J Emerg Med
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Syncope in the pediatric population is a common and mostly benign event. There is a subset of patients, however, in whom exertional syncope is the manifestation of a life-threatening cardiac abnormality. ⋯ As a potential precursor of sudden death, exertional syncope in pediatric patients should prompt a thorough evaluation for a cardiac etiology.
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Olanzapine (Eli Lilly and Company, Indianapolis, IN) is starting to be used with more frequency in emergency departments (EDs) for agitated patients. The potential complications of the use of olanzapine in combination with a benzodiazepine have not been well characterized in ED patients with undifferentiated agitation. ⋯ In this relatively small sample, olanzapine plus benzodiazepines seems to be safe in patients who have not ingested alcohol, but may produce potentially significant oxygen desaturations in patients who have. Future, prospective studies should explore the benefits vs. potential risks of adding a benzodiazepine to olanzapine for agitated patients in the ED.
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There are risks to ordering computed tomography (CT) scans. ⋯ After education about the risks of CT utilization, emergency physicians were more likely to believe that patients should give informed consent before CT scan and predicted that they would be more likely to discuss the risks and benefits of CT with their patients.
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Pharyngeal pain alone due to acute myocardial infarction is rare. ⋯ A misdiagnosis of acute myocardial infarction can lead to unfavorable outcomes; therefore, physicians or emergency medical technicians should be aware of this disease even when a patient complains of sudden pharyngeal pain alone.
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Guillain-Barré syndrome has been regarded as a spectrum of diseases with many variants. ⋯ Although extremely rare, Guillain-Barré syndrome can present initially as isolated ptosis with subsequent descending paralysis.