Best Reasons to Visit an Emergency Room

Case 4: I need a lumbar puncture!
A 16 year old teen age girl presented to the emergency ward with her mother. Her complaint? Really bad back pain. Prior to coming in, the mom and daughter team had visited their Primary Care Physician, who was so impressed with the back pain that he thought the patient needed a spinal tap to "rule out" meningitis. Well, a pregnancy test in the Emergency Ward was positive, and a proper exam by a real doctor in the E.D. revealed a rather large mass in the belly, with a fast heart beat. The patient insists that she just finished her menstrual period, and denies ever being sexually active. No...it's not ALIEN; The mother was demanding that her daughter get some strong pain medications. at this point. What do you do now? Any strong pain medication could be dangerous to give to a pregnant patient, plus now, it's becoming obvious that the patient is probably in LABOR! The ethical dilemma is this; state law defines a pregnant teen as emancipated; therefore "competent" to decide her own healthcare, and federal laws (HIPPA) states that a patient's personal medical information is private, and only with consent by the patient, can medical information be given to someone else. It was obvious that the patient didn't want mom to find out she is pregnant, but knowing that it's just a matter of time before mom finds out anyway...heck I told mom the truth. "No medications for pain except Tylenol...you are being sent to Labor and Deliver to deliver a baby!" Two hours later, baby was delivered. Sorry no lumbar punture, (to rule out meningitis), and no epidural needed either!
Diagnosis: Back pain, resolved by labor and delivery.