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Green Oaks had the benefit of examining Routh without preconceptions. The VA did not. A spokesman for the hospital says the knife episode was triggered by a “recent binge on alcohol and marijuana and being off his psychiatric medications”—issues the VA had previously blamed for Routh’s psychotic behavior. Green Oaks’s records, however, state that he was not intoxicated when he arrived at the facility. A psychotic break caused by substance abuse, not schizophrenia, may require a less aggressive medication regimen and a shorter period of hospitalization, according to Saleh.

Some that I picked up from working in Canada and Large Urban facilities in the US.
LOL,Squared ->Little old Lady Lying on Linoleum – Elderly female found on floor by EMS.
CD-> Celestrial Discharge: Person who has died.
WBC-> Well Baby Check. Parents who bring baby/child in to ED after minor incident “Just to be checked out”
OBECALP-> For drug seekers – Give 20mg of Obecalp IM/IV stat: Placebo backwards (usually 5 mls of a saline flush IV to see if they “need something stronger” since they are allergic to EVERYTHING but Demerol. I have even had patients return to the ED and ASK for OBECALP “because it worked last time”
BOTTLED -> A Canadian classic. EMS has just brought in someone that has been BOTTLED (hit in the head with a bottle, most cases a beer bottle)
Z-PACK-> NOT WHAT YOU THINK. This case is a group/family from a particular State/Province that are on Medi-Care/Welfare and their health card starts with a “Z” and use the ED and EMS for minor health issues “We have a Z-Pac of 4 in Room 5” Translation we have 4 family members in room 5 that need / health care check by a doctor.
CHURCH SYNDROME -> Often goes along with LOLSquared, occurs most often with Little old Catholic Ladies, that get dizzy from standing and kneeing in church
MALL WALKER-> Most often a LOL, that takes her B/P on the drug store machine in the Mall after doing the “Mall Loop” and finds her B/P “Higher than normal” and her friends tell her to go to the ED for a
HC-> Health Check – similar to a WBC but an adult.

The common procedure of invasive cardiac intervention and intravenous magnesium administration before reperfusion should without question become the gold standard in treatment of acute myocardial infarction. [4] Two meta-analyses studied the impact of magnesium treatment on reduction of the death rate and rhythm disorders in the acute phase of myocardial infarction before initiation of reperfusion treatments. Both reports found a 54% reduction of the death rate, and one noted a decreased incidence (49% less) of ventricular fibrillation or tachycardia in the population treated by magnesium. [5] The most important action of MgSO4 in AMI is to open up collateral circulation and relieve ischaemia thus reducing infarct size and mortality rates. [6]

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