Sunday, June 1, 2014

If there was any need for a reminder of the dangers of procedures compared with conservative management first:

"The intensive care unit (ICU) at Holy Cross Hospital is ecstatic to receive an upcoming patient from the operating room who should have multiple lines and monitors to untangle.
Very shortly the team will be receiving a multiple level spinal fusion patient who has 2 peripheral IVs, a central line, multiple drips without any labels, an arterial line, a foley, JP drains, some leftover SSEP wires, and normal monitors.
Given that the patient was prone intraoperatively and will be rotated 180 degrees should ensure maximal line tangling.  As an added bonus, it is reported that the ICU bed that the patient is arriving on has a broken steer mechanism and no IV pole."
http://www.gomerblog.com/2013/11/icu-patient/
David

Saturday, May 3, 2014

COURAGE results
In the COURAGE trial, angioplasty was no better than medical therapy for preventing later cardiovascular problems.
OutcomeAngioplasty plus stentMedical therapy
Death or nonfatal heart attack19.0%18.5%
Death, nonfatal heart attack, or stroke20.0%19.5%
Heart attack13.2%12.3%
Subsequent angioplasty or bypass surgery19.8%30.6%