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2 This requirement was ultimately removed in 2003, however iron related exposures and deaths have stayed low. 6 Can see subsequent electrolyte disturbances and dehydration related to severity of GI symptoms. The oral bioavailability of inorganic iron is < 10%; ferrous iron (Fe 2+ ) is better absorbed than ferric iron (Fe 3+ ).
Emergency providers only see the “tip of the iceberg” of this huge number of AFib episodes — which consists of patients who call EMS or present to the ED with new-onset palpitations, heart failure exacerbation, acute stroke ( or other symptom related to their AFib ).
It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chest pain, weakness and nausea. En route, EMS administered aspirin 325mg by mouth, but withheld nitroglycerin due to initial hypotension. N Engl J Med 2003; 348:1756-1763, 5/1/2013.
Also consider non-hemorrhagic volume depletion, dehydration : orthostatic vitals may uncover this [see Mendu et al. (3)]. Premonitory symptoms (Nausea, pallor, diaphoresis, flushing), or triggers (Valsalva, Pain, Emotion, Prolonged Standing, Dehydration) are very useful in making the diagnosis. Eur Heart J 2003 May; 24:811-19.
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