Commandments
Thou shalt treat according to level of risk rather than level of risk factor. Thou shalt exercise caution when adding drugs to existing polypharmacy. Thou shalt consider benefits of drugs as proven only by hard endpoint studies. Thou shalt not bow down to surrogate endpoints, for these are but graven images. Thou shalt not worship Treatment Targets, […]
THE Rules
Apologies to the Fat Man and the Velominati: We are the keepers of the house of medicine. Others have fallen by the wayside, but we are the salaried employees with no skin in the game, slaves to the shift schedule, acolytes of the Suk school, Sisyphean laborers who take care of anyone, for anything, at […]
Hypertensive Emergucation – Part II
To continue on the ranty but too lengthy exposition of IV blood pressure lowering… Where else does hypertensive emergency get invoked, in my opinion, inappropriately? Let’s continue and go through our top 4 sources of end organ damage so we can see what therapies are indicated: Heart! In association with angina and ACS, the […]
Hypertensive Emergucation – Part I
Overhead: “Level 1 triage coming in to Trauma-B” Me: “Who’s in triage? What are they sending?” Charge RN: “It’s a tachycardic emergency.” Me: “Um, but what is it? What are they here for?” Charge RN: “I just told you! HR was 146. EMS gave Lopressor x 2 with no relief.” Me: “…” (head explodes- triaged as […]
