November 23rd, 2010 by GruntDoc in Better Health Network, Opinion, Research
No Comments »
I think I blogged this before, but didn’t describe it much. Allow me to rectify that mistake.
The NNT.com (“Number Needed To Treat”) is an ever-expanding website which boils down high-quality reviews of medications and interventions and presents its recommendations in a much more approachable green-yellow-red “warning triangle” format rather than some ratio.
While I won’t use this as a single source to change my practice, I’m going to have to do some more research on some of the [questionables] of our age (i.e. Octreotide for variceal bleeding, PPI infusions for upper GI bleeding, etc.) — just two of the studies that fly in the face of current practice.
An aside: While inhaled corticosteroids for asthma aren’t beneficial in the review, what it doesn’t tell you is that the Feds think they are, and will grade your asthma care on how many of your asthma patients get a prescription for them, so be aware.
Graham Walker, M.D. is behind this, and good for him.
*This blog post was originally published at GruntDoc*
May 14th, 2009 by GruntDoc in Better Health Network
No Comments »
So typical a colleague remarked on it.
*This blog post was originally published at GruntDoc*
April 11th, 2009 by GruntDoc in Better Health Network
No Comments »
Other night, two dudes were rather unceremoniously dumped on our ambulance ramp. They were, reportedly, not breathing very effectively, thought to be due to ingestion of some substance or another.
Dude who ‘dropped off’ his fellows walked into the ER waiting room, went to the vending machines, got a snack, and left. Didn’t talk to anyone.
With friends like these…
March 24th, 2009 by GruntDoc in Better Health Network
No Comments »
I’ve never cooked lobsters but was reminded of the trick to the recipe today: if you try to put lobsters into boiling water you’ll have a big fight and it won’t go well, but put them in cool water and slowly turn up the heat, by the time they realize there’s a problem they’re cooked.
I thought about this while turning sideways between gurneys in the hall to get through to the next patient of many.
The temperature in my ED continues to climb, but I’ve been here so long it just seems like it’s getting a little warm.
ED’s everywhere have rising census, increasing demands, physical plants that aren’t keeping up with the crush.
Coal mines have canaries. Medicine has lobsters.
It’s getting warm, but there’s plenty of time.
Right?
