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Will this change your treatment of people who get bumped on the head but say that they are fine? Remember Natasha Richardson.
No. It will irritate the bejeesus out of me when I'm looking at a 13 yo girl who hasn't eaten anything in 8-10 hours, syncopes in the heat at the amusement park and is helped to the ground by her friends but bumps her head very slightly on a guard rail (no DCAP-BTLS), and after getting some fluids and crackers and 45 minutes of rest in the shade and AC and evaluation by a medic is totally fine and asymptomatic besides hunger, but her parents cry Natasha Richardson and demand an ambulance against the medic's advice when all she really needs is a freaking sandwich and some supervision.
If your medic is advising no transport for a 13 yo syncopal patient that has spent all day in the heat, then he needs to get a new job.
I will bet a buck that is was either a PE or underlying cardiac issue and yes im guessing.
Hypertensive heart disease, according to the M.E. (source)
A enlarged heart should show up on a 12 lead right? Can medics tell that or does it take a cardiologist?
Another thing to think about with hypertrophy is that people that exercise and have it, tend to actually drop blood pressure instead of increasing it, causing heart issues. Reminds me of those commercials about ask you doctor if it is safe for sexual activity.