I'm going to start with my general Twitter disclaimer. I mean it.
And, off to the lectures:
Referencing a European paper citing very very few went to the OR emergently from the ER to the OR, recommended calling TSS when the ER doc needs them, not a routine event.
(Will not catch on for a long time, Trauma needs their Activation Fee).
This following one had to do with ?whatever to do with those very tiny occult pneumothoraces we're finding on trauma CT's of the chest. Long, meandering discussion; sizes of the PTX weren't defined, no criteria for getting a thoracostomy tube were made, just 'did they get a chest tube or not'.
Not much was gotten from that article. Perhaps I missed the point.
This next one tried to determine, in a 'pan-scan' for trauma ED, if there were some agreement on what trauma scans the ED attending and the Trauma Surgery attending could prospectively agree they didn't need.
All the scans trauma wanted were gotten with a prospective form filled out by both about which scans they didn't want. In the end the ED...
They found a bunch of incidental things, and in the end couldn't reconcile whether finding completely incidental things that didn't affect management was worth the CT.
The first CT is a gateway study to more, apparently.
Doctors will err on the side of survival in recommendations to patients, when they themselves often look at the data and decide they'd rather forgo some or all treatments and skip the unpleasant effects. Interesting.
Bukata felt sending things like ankle sprains to PCP's as a routine thing was ethically bad, as 'it's self limiting' and costs the pt more for no benefit.
I disagree, many needs some Physical Therapy to have a more stable ankle that doesn't recurrently sprain.
Also not a fan of these 9 page DC instructions we're printing out.
treating pedi fever is about patient comfort, not treating disease. making a big deal out of fever treatment tells mom it's very important, when it's for comfort only.