Category: TWDFNR
Hey team! I am writing to share a high-value care pearl this week from the Things We Do For No Reason (TWDFNR) series! For those who haven’t read before, the Journal of Hospital Medicine’s TWDFNR series was inspired by ABIM’s Choosing Wisely Campaign and highlights practices that have become common in medicine but don’t necessarily
Antimicrobial Stewardship An elderly patient presents with fevers and new oxygen requirement. Labs reveal a leukocytosis and chest x-ray reveals a lower right lung consolidation. You are concerned about an aspiration pneumonia and instinctively choose a regimen with anaerobic coverage, but is anaerobic coverage necessary? A recent article by Dr. Vedamurthy and others published in the Journal of Hospital Medicine attempts to answer this question. Highlights
On Monday’s morning report, we discussed the case of an elderly female presenting with hemoptysis and AKI. Part of our discussion focused on FeNa and FeUrea. These tests are commonly ordered reflexively during evaluation of AKI, but are they the best use of hospital resources. A 2016 article by Dr. Pahwa and Dr. Sperati attempted to address this question. Key Points : The initial studies investigating FeNa and FeUrea focused on select
Things We Do For No Reason (TWDFNR) Supplemental oxygen for normoxemic patients! Multiple studies have shown no benefit and potentially harm when administering oxygen routinely to patients whose SpO2 is >94-96% or in those with 88-92% but underlying risk of respiratory failure (eg COPD patients) Do NOT give supplemental oxygen to acute MI patients unless