Two points, one from each story:
1) Atrial fibrillation with chest pain is unstable by definition. If the facts are as presented, and the patient suitable, it sounds like a CCU admission with urgent treatment at the very least, and possible transfer for cardiac catheterization depending on response. Hard to believe it was 22 hours to just get MSO4. Experience tells me there is more to the story.
2) Why would they do an MRI for a kidney stone? The test of choice would be a spiral CT with "stone protocol", assuming there was nothing diagnostic on a plain film. It is an easy diagnosis on clinical grounds in most cases---flank pain, CVA tenderness, hematuria and possible radiation to the groin---about the level of a third year med student. I can't understand withholding analgesics for an imaging procedure. Again, I suspect more to the story.
|