Case

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AMS with hx of head injury and LOC.  Sounds like classic set up for a 
possible bleed(not even considering age of pt.).  By the time you decide this might 
be a bleed via observation, you will probably be in a very deep hole.  ER is 
not the realistic place to observe neuro vitals q one hour.  ICU will refuse 
this patient in a heartbeat.  YOU MUST SCAN!!!  You will not be able to scan 
without heavy sedation.  The presence of ETOH requires airway protection.  Level 1 
I work at does not make it a habit do this, but it is not unusual either.

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