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Very Good, but is PE the only possible cause of RV strain in a previously and largely asymptomatic individual?

Aren't AED's considered a fundamental BLS skill these days? Would expect everyone to have 'em pretty much.

What about trauma? That sounds alot like bruised ribs. Conversely, it Could also be the beginnings of a Hiatial.

Pain isn't the reason we give aspirin in chest pain cases. We give aspirin mainly as a low-risk anti-platelet in chest pain cases, as it prevents clots from getting bigger in cases of MI and PE.

As the OP said, the history bears no peculiarities. (meaning there is no applicable history.)

This is where they need to be transferring stable patients to other facilities with capability to treat. It's also an area where they need to discharge those ER cases that should be "urgent care" cases- Way too many people clog up the ER with non-life threatening conditions because they can't...

Government funded and government- run are the same thing for purposes of 1983 complaints and civil rights law. Plus most "County" hospitals are owened in part by the government. eighth amendment law is also not necessarily restricted to criminal punishment- it has been expanded over the years...

A 38-year-old male patient presents with palpitations and SOB. He is not suffering from syncope or dizziness and has no other complaints. The history bears no peculiarities. Auscultation is normal and there are no signs of left or right heart failure. The ecg is depicted here...

My source would be the appropriate federal statutes. Since most of the facilities that accept incoming adult mental health cases are government run (most usually a county hospital) they become subject to not only the patient dumping statutes, but the statutes under 28 U.S.C. 1983, 18 U.S.C. 241...

I'd agree with that- which is why, personally, I think the policy is poorly written. But I suspect political influence goes into these things. I've given my opinion, and I'm sorry you didn't like it. I've said pretty much all I have to say on the subject, and hence that point of...

hrmnn, how do you figure- paroxysmal cardiac arrest isn't all that common in the grand scheme of things, as compared to the significant chance that a psych pt. is probably going to become combative. (usually because things like significant EtOH intoxication, etc. tend to be co-morbid in these...

I am a jackass when it comes to that kind of thing, because it most usually means that someone, somewhere, isn't getting up off their can and doing their job, and consequently making my job more difficult than it really needs to be. I take personal offense to that kind of work ethic. Oh, but...

This sort of thing is WHY our MC is separate and distinct from the receiving facility. Our system doesn't allow the receiving facility to dictate treatment UNTIL they have formal custody of the patient. We give them the heads up on what they have coming, but thats about it. Issues involving...

What I'm not clear about in the first place is how a suicidal pt. is a BLS pt. in the first place- Our local protocol and scope of practice designates suicidal / homicidal pts. as ALS pts because of the increased chance of needing chemical restraint, which requires both an EMT-P and also...

Yeah... This seriously makes inquiring minds want to know exactly what drug they were passing around before they shot that video. Some people have WAY too much time on their hands...

Yep. They all pretty much hate me, because I don't do red tape well. In fact I'm deathly allergic to it. Babysitting a psych patient does NOT fall under the job description of Emergency Medicine. Thats what RNs are for. Now, if they want to pay me RN pay, I'm not going to complain so much, but...

I'm sure you would right up until you had federal agents in the facility over it within a week or two. Patient Dumping is a federal criminal offense that the FBI investigates, and last time I checked hospital administrators don't like people seeing federal agents walking up and down the halls of...

That is true... BUT you still have that public perception stigma that you have to overcome- People (especially juries, whom do not have our education) will sometimes overlook expert opinion and protocol, looking more to public perception, which is resistant to change, because of the fact that...

This is a valid point. C-spine isn't without it's issues- however, there's also the public stigma about NOT using it (regardless of the empirical data in support of not using it.) Lawyers love public perception when it works for them, regardless of how detrimental it is in reality. Mind you...

meh, in my mind, if I'm using the collar, I'm probably using the backboard- I just can't plausibly see a situation where c-spine is appropriate where we'd KNOW for the fact (without XR) that suspected trauma is confined above the T and L vertebra - and these things have an interesting way of...