tag:blogger.com,1999:blog-1406547525301395071.post4400790176322900134..comments2023-09-19T04:20:38.429-07:00Comments on Status Iatrogenicus: Screening in Disguise: You Can't "Unknow" that Troponin, But You Can Dismiss It After Careful ThoughtScott K. Aberegg, M.D., M.P.H.http://www.blogger.com/profile/17564774546019869201noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-1406547525301395071.post-41349422875743835842017-11-09T19:44:40.789-08:002017-11-09T19:44:40.789-08:00Rafael, who are you? I think we would get along. ...Rafael, who are you? I think we would get along. We appear to be cut from the same clothScott K. Aberegg, M.D., M.P.H.https://www.blogger.com/profile/17564774546019869201noreply@blogger.comtag:blogger.com,1999:blog-1406547525301395071.post-3236430903258497962017-11-09T18:11:34.793-08:002017-11-09T18:11:34.793-08:00Please DON'T:
- Order troponin to everyone
- S...Please DON'T:<br />- Order troponin to everyone<br />- Sedate everyone, especially with benzodiazepines<br />- Infuse fluids to elevate blood pressure<br />- Forget that anamnesis can't be replaced by POCUS<br />- Anticoagulate chronic AF in an ICU setting<br />- Prescribe omeprazole or the likes for everyone<br />- Apply deliriant hypernatremia correction formulas<br />- Assume that a collapsible vena cava is something to be corrected <br />- Give statins to a mechanical ventilated patient to "treat" or prevent stroke, MI etc<br />- Ask a patient if a stone floats or something like that<br /><br />... this list goes on. I will only suggest one DO:<br /><br />- Extubate patients BEFORE the morning round. Aggressively. That's important.Rafaelnoreply@blogger.comtag:blogger.com,1999:blog-1406547525301395071.post-79639296264887064702017-07-19T13:43:49.878-07:002017-07-19T13:43:49.878-07:00An afterthought: I am aware of cases where CAD/MI...An afterthought: I am aware of cases where CAD/MI was incidentally discovered in the ICU with unguided troponin testing. But that is looking at the problem a posteriori. It's like saying your neighbor Mr. Jones won the lottery, so everybody should play the lottery as an a priori decision.Scott K. Aberegg, M.D., M.P.H.https://www.blogger.com/profile/17564774546019869201noreply@blogger.com