Emergency medicine journal : EMJ
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PresentationAn 83-year-old man presented for headache and altered mental status. Four days prior, he underwent endoscopic sinus surgery for nasal polyps. Over the two previous days, he gradually developed a headache and was brought to the emergency department when his wife noted mild confusion and generalised weakness. ⋯ Administer broad-spectrum antibiotics, including pseudomonal coverage. Consult otolaryngology to arrange functional endoscopic sinus surgery for CSF leak closure. Consult neurosurgery for surgical decompression of mass lesion(s).
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A short cut review was conducted to assess if the use of rocuronium in the ED was associated with a decrease in the provision of postintubation sedation. Four papers were identified that presented the best evidence to answer the question. ⋯ All the identified studies were retrospective and there was a plethora of outcome measures used. When compared with suxamethonium, rocuronium was associated with a delayed initiation and reduced dose of postintubation sedation.