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In this case, no. Unless of course the pictures showed children actually being harmed and there was reason to believe the patient was responsible.

The search is kosher but only to look for dangerous items and to catalog contents. Since there is no probable cause, I would think that any evidence of criminal activity found during such a search couldn't be used legally against the patient. A note to the OP, HIPAA and other privacy...

You should understand that both myself and my colleagues in the field and the ER take a medical history and preform an appropriately thorough physical exam based on our patient's complaint. Some patients have medic alert bracelets, many do not. I have never been in a situation where I missed...

I do not examine patients for medical information tags that are not obviously located on their wrist. I also think you are putting too much mental energy into this and need to forget about it and live your life.

According to the OP, she was a poor historian. She may not have even had a valve surgery, maybe it was a different type. Did she forget to mention other heart problems? Admittedly, shunt reversal is rare in the US, but it happens. Also, I don't know if I trust the oximeter in this case. Where...

Simple. Something in the vein or surrounding tissue is reflecting back light at the wavelength perceived as blue. Other wavelengths are absorbed.

Bleeding disorders in these patients is usually from a clotting factor deficiency because of hepatic impairment. Not all of them present with bleeding problems though.

I am gonna disagree with a thromboembolic event and instead suggest she has eisenmenger syndrome. In these patients, long standing left to right shunting from a PDA, ASD, or VSD leads to increased RV volumes and pulmonary artery pressures. Without intervention, intimal scarring and...

Hypertension in the setting of stroke or bleed is a common finding but very nonspecific. It could be chronic hypertension (and may have been a contributing or at least concomitant factor in the stroke), acute hypertension from numerous causes including anxiety about stroke symptoms, or as Rob...

The most important drug in this instance would be ASA which has been shown to reduce mortality. Nitro is good for relieving pain and therefore some anxiety, but this patient wasn't in pain. I am personally unaware of any literature showing nitro reduces mortality or myocardial damage, but that...

What you are feeling is completely normal. You just went through an EMT class, which is at most 150 hours of education concentrating on only the very common life threatening medical problems (paramedic programs in Cal are 1100 hours, as a comparison. Still not enough). EMT training simply does...

I wouldn't treat his hypertension. As others have pointed out, it seems unlikely he is having a crisis. His delirium- what is causing it is another question. If he had a normal neuro exam, glucose, and electrolytes it may be something benign and temporary like transient global amnesia or a fugue...

What's wrong with getting high? Work in biological anthropology and neurotheology has been done on the co-evolution of religiosity and substances/practices that alter consciousness. The sheer amount of naturally occurring substances that produce altered states is staggering. It really seems...

And that is what makes this an interesting case. Bell's palsy frequently occurs in older folks with risk factors for CVA which can complicate the diagnosis.

The local hospital is basic and does have CT. Are we of a consensus that this is a facial nerve palsy? How would your local systems react to you skipping the stroke protocol/activation based on your exam findings?

Man, just rote memorization during school for the pharm quizzes. They will stay with you; we use relatively few meds on the rig and dosages are pretty easy. Keep an electronic version of your protocols on your phone or have a cheat sheet with you for some more esoteric peds stuff.

Absolutely. I regularly turn to emedicine for pathologies I am unfamiliar with or even for admission criteria and management information for things I am familiar with. Google scholar is also helpful when I want to see the science for myself behind a drug or procedure. It is also helpful to be...

My understanding is that they are equivalent on most accounts except for flight physiology in the FP-C.

Of note, there is a local hospital with ED 10 minutes away and a hospital in a nearby city that receives stroke patients that is 40 minutes away.

Sure. The glucose is measured at 110. Neuro exam CN 1 Smell intact during breakfast CN 2Vision is grossly intact in both eyes, but pt complains left eye is somewhat blurry. CN 3, 4, 6 EOM intact, pupils are equal and responsive to light. CN 5 Sensation is present in all branches of the...