Thank you. I hope you realize the "yelling" is intended to be humorous. It is to remind docs to speak so they can be heard. But I appreiae your comment because no one enjoys listening to screaming. Paul
Great list! One thing to point out about #5- is that bacterial and viral pneumonia are associated with significant increases in cardiovascular dysfunction including HF ( DOI: 10.1016/S0140-6736(12)61266-5.) In Europe, NT-pro- BNP is frequently used as a severity marker especially in those with severe CAP.
Dr. Breithardt - one more thing. Can i use your comment in another post? If so how should i refer to you, name and affilitation. No worries if you don’t want you name used. Thx. Paul
Dr. Breithardt - You are absolutely correct. I often will say something like that, not because I do actually yell at people, but just because I want the point to stick in readers’ minds and also to make the writing somewhat entertaining. I appreciate your sensitivity. I also think a deep voice helps convey being in control, so I think it’s a great point. Thank you for reading. Please pass on the address to others who might be interested in my Rules. Paul
Thanks for reading the rules. I really should do one about simply acknowledging that the patient is there. Some of my doctors only talk to the screen. Paul
Dr. Koontz - Excellent point. ONe of the most frequent complaints from patients is that the doctor did not look at them. Can I use your comment in a future post. How would you like your name and title presented? Paul
LOL. I am amazed when the fellows almost whisper to the patients, who are in their 80's. My wife says I yell at everybody, but she has a biased sample! P
Love it especially #6, especially in a noisy urban ER. Took me 1/2 of my career to figure this out so I was yelling at pts for the 2nd 1/2. People kept telling me to pipe down so I knew I had it about right.
Also, Luis, please encourage others who may benefit from these to subscribe to Substack. Since it's free, I always say that, "It's worth every nickel." Paul
Very good points. I use to joke residents are allowed to prescribe up to 400 mg furosemide without even telling me. However, I was challenged by the febrile CHF patient… it deserves a deeper dive.
Oh another comment: I loved the “diuresed” verb. I miss this verb in my native language.
Thank you for writing. I am glad you like the posts. AT your suggestion I have added fever in CHF to address in the future. Where do you practice, Dr. Leite. My wife and I, despite our 77 years, are trying to learn Spanish. Please pass along the blog site to others who might enjoy it. Paul
Thank you. I hope you realize the "yelling" is intended to be humorous. It is to remind docs to speak so they can be heard. But I appreiae your comment because no one enjoys listening to screaming. Paul
Great list! One thing to point out about #5- is that bacterial and viral pneumonia are associated with significant increases in cardiovascular dysfunction including HF ( DOI: 10.1016/S0140-6736(12)61266-5.) In Europe, NT-pro- BNP is frequently used as a severity marker especially in those with severe CAP.
Eric - That is a great comment. Sorry to be slow in responding. I am slow at social media! Paul
Don't YELL at deaf patients - try to speak with a "deep voice" @ low frequency!
Dr. Breithardt - one more thing. Can i use your comment in another post? If so how should i refer to you, name and affilitation. No worries if you don’t want you name used. Thx. Paul
Dr. Breithardt - You are absolutely correct. I often will say something like that, not because I do actually yell at people, but just because I want the point to stick in readers’ minds and also to make the writing somewhat entertaining. I appreciate your sensitivity. I also think a deep voice helps convey being in control, so I think it’s a great point. Thank you for reading. Please pass on the address to others who might be interested in my Rules. Paul
Thanks for reading the rules. I really should do one about simply acknowledging that the patient is there. Some of my doctors only talk to the screen. Paul
as a patient please do yell. dent speak softly and have your head turned towards PC screen!!!!
Dr. Koontz - Excellent point. ONe of the most frequent complaints from patients is that the doctor did not look at them. Can I use your comment in a future post. How would you like your name and title presented? Paul
LOL. I am amazed when the fellows almost whisper to the patients, who are in their 80's. My wife says I yell at everybody, but she has a biased sample! P
Love it especially #6, especially in a noisy urban ER. Took me 1/2 of my career to figure this out so I was yelling at pts for the 2nd 1/2. People kept telling me to pipe down so I knew I had it about right.
Thank you. Paul
Excellent refresher Dr. Thompson. Thank you
Also, Luis, please encourage others who may benefit from these to subscribe to Substack. Since it's free, I always say that, "It's worth every nickel." Paul
Luis - Thank you for the kind comment and also for pointing out the incorrect reference. I will try to fix that. Paul
Very good points. I use to joke residents are allowed to prescribe up to 400 mg furosemide without even telling me. However, I was challenged by the febrile CHF patient… it deserves a deeper dive.
Oh another comment: I loved the “diuresed” verb. I miss this verb in my native language.
Thank you for writing. I am glad you like the posts. AT your suggestion I have added fever in CHF to address in the future. Where do you practice, Dr. Leite. My wife and I, despite our 77 years, are trying to learn Spanish. Please pass along the blog site to others who might enjoy it. Paul
Hi Dr Paul I am a Brazilian intensivist. I am glad to see you are learning Spanish. A beautiful language. Yes I will pass the blog. Great work.
Thank you for these pearls that have the effect of making me feel like a fellow again 10+ yrs later. Haha. Truly grateful.
By the way, reference (3) takes me to a post about fever and not the chloride level post it suggests in your writing. Reference (2) is correct.