The bloodletting knife, pictured above, was a sure sign of a competent physician in its day. It is also a symbol of evidence based medicine, one of the first stories in our history of how the scientific method eventually dispelled the myth that bloodletting cured all. Today, a physician would be considered a quack for suggesting such an intervention. Not that long ago, however, to argue against it was medical heresy. We so much different today?
ACEP Now - The Official Voice of Emergency Medicine is a publication of the American College of Emergency Physicians. In recent months, author Kevin Klauer, DO, EJD, FACEP published a 2 part series on Myths in the Emergency Department: rooted in culture, based on tradition Part 1 & Part 2 (click red link to see original article and references). Below is a summary of some of the key points discussed in the article.
- Tramadol is less effective at 8 hours than ibuprofen for pain
- "Banana bags" are expensive and not superior to oral vitamins in most cases for alcohol intoxicated or malnourished patients
- Glucagon is no better than placebo for esophageal obstructions
- Patients with syncope and wi ECG changes or chest pain do not benefit from cardiac enzymes
- Dilution should not be an explanation for your patient's anemia
- Penicillin allergy is actually very rare, and there is only a 1% cross-reaction to cephalosporins (first and second generation with R chains)
- Iodine is not an allergen, and shellfish allergy is not a contraindication to IV contrast for a CT scan
- There is no evidence supporting the use of empiric antibiotics with nasal packing
- Tap water is likely the best irrigation solution for wounds
- CT brain is not routinely indicated prior to lumbar puncture
Read something intriguing or controversial? Want to read more or find the original references? Link to Myths in the Emergency Department: rooted in culture, based on tradition Part 1 & Part 2 to find out more.