Following an uncomplicated outpatient colonoscopy, a patient was found unconscious with brad-ycardia in the waiting room of a practice of an internist. After a half an ampoule of atropine, the pulse quickened but the patient remained unconscious. Even flumazenil did not improve the situation. The responding emergency physician was confronted with numerous, unspecific neurological symptoms and considered various differential diagnoses. The situation was aggravated by the rural infrastructure. In the course of the clinical investigation, the patient's condition deteriorated rapidly and intubation was necessary. The correct underlying diagnosis was finally made following a telephone call and disclosed an (almost) fatal chain of misunderstandings.
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