Sudden onset of weakness in a 24-year-old.

Hypokalemic periodic paralysis is characterized by episodic weakness, the presence of precipitating factors, and the tendency to resolve spontaneously. Physical examination of the patient between attacks often shows no abnormalities. Potassium replacement therapy may be needed for severe episodes.

Nearly fatal partial obstruction of the upper airway.

The dangers of taking antihistamines while reactive small-airway disease is present are theoretically valid. In this case, an episode of coughing in a 33-year-old woman mobilized a thickened plug of mucus from the peripheral to the central bronchial region, which created a nearly fatal, partial upper airway obstruction. The mucous plug was discovered during an emergency bronchoscopy and quickly removed by suction.

Emergency medical services: teamwork to fight sudden death.

It is estimated that upwards of 20% of accidental highway and prehospital coronary deaths could be averted by the availability of prompt, effective prehospital care; this implies that approximately 35,000 deaths from myocardial infarctions and 12,000 deaths from vehicular trauma are preventable. So, statistically, are 13,000 deaths from cerebrovascular accidents, poisonings, drowning, and other accidents. There are nearly 12 million nonfatal injuries each year, the suffering, cost and disabilities of which are incalculable. It is clear that these statistics demand some type of unified multi-professional response. Although not perfect, Emergency Medical Services is clearly the most effective available means of reversing the present rates of sudden death and disability.