tag:blogger.com,1999:blog-1406547525301395071.post3700635779617009250..comments2023-09-19T04:20:38.429-07:00Comments on Status Iatrogenicus: Miffed at the Myth of MIVF and nonplussed by nil per os (NPO)Scott K. Aberegg, M.D., M.P.H.http://www.blogger.com/profile/17564774546019869201noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-1406547525301395071.post-25272730784154555412013-06-02T17:33:48.429-07:002013-06-02T17:33:48.429-07:00I have always been confused about the NPO thing. P...I have always been confused about the NPO thing. Patient is NPO, getting dehydrating nasal O2 and is dry. Like tongue sticking to roof of mouth dry. I have had my hand slapped away if I approached with the relief of an ice chip, hearing "He/she's NPO!!!" Ok, gotcha for food and impending O.R., and certain medical conditions. But he/she weren't so compromised they'd be making saliva, right? And...swallowing it, perhaps? Can't I offer the relief of a cold ice chip to drip backwards into the throat? Do we really have to wait for someone to find a disgusting glycerine swab? I mean, really. <br />P.S. : read your blog as a marathon today. A link came to me by way of a suspicious power. And I think I'm in love with you:)<br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-1406547525301395071.post-7761355173067775092012-05-26T08:27:18.551-07:002012-05-26T08:27:18.551-07:00I agree with all of this, particularly the differe...I agree with all of this, particularly the differences between surgical and medical patients, with my focus on the latter.<br /><br />To quote Franklin, "A foolish consistency is the hobgoblin of little minds." The status quo is often the status quo for a reason - but on many other occasions, it serves no purpose and should be reconsidered or challenged. That was the main point of this post.Scott K. Aberegg, M.D., M.P.H.https://www.blogger.com/profile/17564774546019869201noreply@blogger.comtag:blogger.com,1999:blog-1406547525301395071.post-51613396892548638032012-05-25T13:47:03.825-07:002012-05-25T13:47:03.825-07:00Enjoy your blog very much and agree with most of y...Enjoy your blog very much and agree with most of your musings. In defense of continuous IVF, if one is attentive enough to be able to give a fluid repletion bolus 1-2x a day one should surely be as attentive with a continuous drip. (The question of intravascular vs total body water can be argued another day.) Regarding mobility, if the pt can get out of bed he/she probably doesn't need IVF and can take PO. Strict I/O's do help with fluid balance. And surely you don't disagree that there is a baseline (if unknown) fluid requirement - pts who are NPO should probably be getting some sort of intake, the content of which can be debated. And many criticall ill patients do, in fact, fall into that category - those in extremis, with bowel ischemia, immediately post-op, etc.Anonymousnoreply@blogger.com