Specialists are always awake at 3 am. Remember to call them for consultations . Patients who return to the ER after visiting earlier in the day usually have something seriously wrong. Always talk to everyone - nurses, paramedics, family. They're great information sources in the search for the truth about what occurred or why the patient's there.
Patients are usually quite smart about their own diseases.
Give them the benefit of the doubt - and believe what they say. When in doubt, admit the patient. Senior citizens are always sicker than they appear or state. Teenagers are always pregnant and usually will deny it until asked three times . If you think of doing a particular test - Do It .