Abstract Body

Background/ Purpose: Physicians are limited in their ability to treat because it is guided by the information they are provided from their patients. Internet searches of patients raise multiple ethical considerations and are generally unadvised in the management of care. In this case, we describe a patient for whom an internet search proved vital in her medical treatment.

Case Report: A woman with no identifying information was found obtunded by EMS and transported to our emergency department. The patient was sedated for uncooperative and aggressive behavior and was unable to provide any meaningful information. A limited physical exam revealed a disheveled appearing patient with constricted (2mm) pupils, and spontaneous movement of all 4 limbs elicited by a sternal rub. Basic metabolic panel was significant for hypokalemia, urine drug screen was negative, and alcohol levels were undetectable. The patient remained altered for the for multiple days. On the fifth day of hospitalization the patient was able to state her name and a Google search was conducted that identified the patient as a missing person from her adult foster care home. We were then able to find her hospital records that revealed an extensive psychiatric history and multiple psychiatric inpatient admissions for psychosis secondary to schizophrenia. Antipsychotics were initiated and the patient was transferred to an inpatient psychiatric hospital for further management.

Conclusions: This case demonstrates the benefits of using the internet to help with patient care. Patient-targeted internet searches raise ethical considerations but should be contemplated for patients with this presentation.