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I'm going to agree it's kidney related. Could also explain the high BP. Pulse and MAP seem to be too high for cushings.

when was his last dialysis?

Delayed cap refill, mild cyanosis and lethargy. From my understanding of TOF the onset is usually between 1 and 3 years old but who knows.

Supportive care and drive. I'm thinking a very early Tet Spell or some undetected aspiration.

I put the "ish" in Jewish. Shana Tova all.

Does that mean they do not have to have any bedside manor? Do they always follow the rules or do they know when they can bend them in the best interest of the pt?

"One who gives his patients the best possible care with the tools he has available, I would hope. " What if the tools they have available are either limited or wrong? Not because of some systemic problem but because of a lack of training or CME? I have worked with plenty of other medics who...

I always here people talking about medics being "good." In your opinion what makes a good medic? It seems to me these "good" medics are not necessarily the best clinicians.

Our service also has the Ferno Rescue Aid. Basically a big strong tarp with handles.

I am more than impressed.

If the edeme was as gerealized as the OP states it could be Cardiac Asthma.

Any changes in urination frequency?

Here it seems like anyone who even mentions nausea gets gravol prior to transport. I feel like people push it just because they can.

How often do you push gravol? I find in my area IM gravol is pushed out like candy.

I have other stips which show a much more prolonged run of the spikes. Just chose that one because it shows the underlying rhtythm as well.

Nope

What could cause interference on two different machines and in several different locations? The hospital 12 lead should have been clean. The pt and the family both denied any pacemaker, nurse looked for scars, bumps etc and couldn't find any evidence of one.

I don't have a clue with what is going on in these rhythms. At first glance it looked like a pace maker had gone haywire. The problem, the Pt does not have a pace maker. The "pacer spikes" were intermittent and observed on scene, during transport, at the ER and were confirmed with the ERs...

Link?

Some sort of spasm?