Medical Urban Legends

March 26, 2008

Excellent rebuttal !! Thanks for the well explained and accurate reasoning.

I doubt if it will make much impression on some Neanderthal xenophobes we have

seen on this site, but then thats OK.

Re: Medical Urban Legends

Barbara I highly doubt either of our careers are in jeopardy.

,

Wow. Jeez. Where do I even begin. Okay here goes.

Thus Begineth the lesson

While empiric studies are the gold standard, anecdotal reports are a

valid, recognized source of information when they come first hand

from a knowledgable, reliable source and are taken in context with

appropriate reservation.

Studies are only as foolproof as the fools who wrote them.

Remember Rescue ny flipping the caps off his " Amp of Bicarb "

BristaJet? Studies showed Bicarb as a first line cardiac arrest

drug. Right up to when more studies showed that it was ensuring a

dying heart would become a dead heart. What about the routine

practice of high volume crystaloid fluid resuscitation that is now

shown to be exactly the WRONG thing to do? Research that came about

from a retrospectives analysis done because of ANECDOTAL reports of

high survivability rates in British wounded during the Falklands

war. There was once an excellent study that recommended prophylactic

thalidimide to pregnant women, and then anecdotal reports of birth

defects. Can I get a round of applause from the flipper babies for

Anecdotal Evidence? Anecdotally people on Rogaine for high blood

pressure grew hair. Anecdotally Wellbutrin aided in smoking

cessation. They were both studied to find out...Tadaah! The

anecdotes reported by experienced clinicians were validated by

analysis.

Okay, so lets look at the other side of the coin. If it hasn't been

studied it must be VooDoo? Let's see. The Mayans taught their

children to chew a certain kind of tree bark to releive pain. I doubt

the Mayans ever did a study on it. The acid refined from this bark

is commonly called aspirin...The cardiac benefits would be realized

much later...Andean indians were certain that chewing coca leaves

gave them energy. They must have had a paper on the subject...The

Nightclubbing benefits would be realized much later...(Leatitia in

case you didn't catch it that was a joke) The Chitosan dressings that

are all the rage are made from ground up seashells. Maggots are used

to debride wounds just as they were in ancient times. Leeches were

reviled by medics of the " scientific age " right up to when they

realized ...oooh that works to stimulate blood flow to vascularly

compromised tissue...In asia medics would make potions from poppies

to releive pain. I wonder how they designed their double blind

clinical trials? Nightshade elixers were used to treat cardiac

conditions long before anyone refined digitalis, or even really knew

how the heart worked. They just knew the nightshade worked. No

anabolic steroid has never been formally studied for the promotion of

hypertrophic muscle growth. Better cancel the next Arnold Classic.

None of those biceps are really there. How many times in your 20

years have you injected Lidocaine into a cardiac arrest patient? Now

try and find the original human clinical trials that put Lidocaine

into the ACLS protocols. You will be looking for a long time. Should

I keep going?

So grandma was wrong about the butter. Let it go. Are all home

remedies valid? No, of course not. That is why we consult..TRAINED

PROVIDERS as to what has worked for them instead of the old women at

the sewing circle...Hi Aunt Emma! I am eating my potato skins!..

(Aunt Emma who incidentally was a physician, BU Med class of '39 the

only woman in her class)

If nothing else, what happened to the placebo effect? The efficacy

of placebos have been well studied. If the patient beleives it will

work, and it will not do harm then why not?

Studies are a nice boat to float in, but sometimes we find ourselves

in situations where there is no choice but to swim. When the shit

really hits the fan who would you rather have with you, a quick

thinker, or an accurate citation quoter?

Also remember your shore/offshore background, and truly remote work

are two different animals. On remotes you may not always have

helicopters on call, fancy burn dressings, or even a nice roll of

cling film. The hallmark of a good practitioner is to always be

questioning and refining your methods, keeping your mind open to all

the possibilities of the world, and if possible backing them up with

a well designed study.

Every single treatment you use in the ER or on the Oil Rig started

out as one guy saying to another... " you know what I found works well

for that? "

So spake Sumo

Thus endeth the lesson-

In the future try to use the bathroom before we leave the house.

These stops are really taking the joy out of the trip.

God forgives all of your mitakes

Society forgives some of your mistake

Evolution forgives none of your mistakes

-???

Something useful!!!! Potato skins on burnsâ€¦.

Does anyone else out there want to seriously reduce their chances of

future employment by posting one of these nuggets of research based

clinical efficacy that I somehow missed in my 20 odd years in

healthcare positions?

Working in U.K A/E departments and in the oil and gas industry

internationally I've seen lots of patients present with `alternative'

dressings and first aid measures ( including the already mentioned

butter on burns; it's a pity those fats do like to retain heatâ€¦ shame

it seemed such a lovely idea) which have included toothpaste on

burns, tobacco, curry powder, flour, dried herbs and numerous other

everyday items in wounds and I've spent many an hour having to clean

them out of burns and open wounds and trying to re- educate the

patients. I really don't expect to find people recommending them on

a site like this. Anyone got a research paper on the use of horse

s**t poultices handy ...there seems to be a lot of it about?

>

Explore your hobbies and interests. Go to

http://in.promos./groups

March 26, 2008

and follow the money.

who did the studies,and why?

to find out what happened?

to prove a hypothesis?

to disprove one?

who paid?

why did they pay?

My personal fave is that in the 70s,over 95% of

airline crash victims had eaten pickle in the previous

6 hours prior to fatal crash.

so avoid pickle and live!

of course the fact that all airline meals contained

pickle kind of junks that theory-but its where the

evidence leads,if you don't contextualise.

and hermeneutics is always a valid technique.

meaning of evidence is not always agreed on.

consider the statement that 49.9 per cent of a

population are unwell.

the statment that the majority of folk in that country

are well is true.

but misleading-spin,veiwpoint,opinion?

seeing something work or a valid source seeing it work

can be expanded on by experimentation or examination.

but beware the effect of " I danced with a man, who

danced with a girl, who danced with the prince of

wales " effect!

rumour control can sometimes have quality control

issues.

Had a car crash outside the plant yesterday-some minor

injuries- scrapes and bruises.

On the bus home many informed sources were explaining

all the critical injuries/deaths they knew had

happened.

as they say in Glasgow-aye,right!(2 positives here

means a negative).

Fraser

<sumoparamedic@...> wrote:

> Barbara I highly doubt either of our careers are in

> jeopardy.

>

> ,

>

> Wow. Jeez. Where do I even begin. Okay here

> goes.

>

> Thus Begineth the lesson

>

> While empiric studies are the gold standard,

> anecdotal reports are a

> valid, recognized source of information when they

> come first hand

> from a knowledgable, reliable source and are taken

> in context with

> appropriate reservation.

>

> Studies are only as foolproof as the fools who wrote

> them.

>

> Remember Rescue ny flipping the caps off his

> " Amp of Bicarb "

> BristaJet? Studies showed Bicarb as a first line

> cardiac arrest

> drug. Right up to when more studies showed that it

> was ensuring a

> dying heart would become a dead heart. What about

> the routine

> practice of high volume crystaloid fluid

> resuscitation that is now

> shown to be exactly the WRONG thing to do? Research

> that came about

> from a retrospectives analysis done because of

> ANECDOTAL reports of

> high survivability rates in British wounded during

> the Falklands

> war. There was once an excellent study that

> recommended prophylactic

> thalidimide to pregnant women, and then anecdotal

> reports of birth

> defects. Can I get a round of applause from the

> flipper babies for

> Anecdotal Evidence? Anecdotally people on Rogaine

> for high blood

> pressure grew hair. Anecdotally Wellbutrin aided in

> smoking

> cessation. They were both studied to find

> out...Tadaah! The

> anecdotes reported by experienced clinicians were

> validated by

> analysis.

>

> Okay, so lets look at the other side of the coin.

> If it hasn't been

> studied it must be VooDoo? Let's see. The Mayans

> taught their

> children to chew a certain kind of tree bark to

> releive pain. I doubt

> the Mayans ever did a study on it. The acid refined

> from this bark

> is commonly called aspirin...The cardiac benefits

> would be realized

> much later...Andean indians were certain that

> chewing coca leaves

> gave them energy. They must have had a paper on the

> subject...The

> Nightclubbing benefits would be realized much

> later...(Leatitia in

> case you didn't catch it that was a joke) The

> Chitosan dressings that

> are all the rage are made from ground up seashells.

> Maggots are used

> to debride wounds just as they were in ancient

> times. Leeches were

> reviled by medics of the " scientific age " right up

> to when they

> realized ...oooh that works to stimulate blood flow

> to vascularly

> compromised tissue...In asia medics would make

> potions from poppies

> to releive pain. I wonder how they designed their

> double blind

> clinical trials? Nightshade elixers were used to

> treat cardiac

> conditions long before anyone refined digitalis, or

> even really knew

> how the heart worked. They just knew the nightshade

> worked. No

> anabolic steroid has never been formally studied for

> the promotion of

> hypertrophic muscle growth. Better cancel the next

> Arnold Classic.

> None of those biceps are really there. How many

> times in your 20

> years have you injected Lidocaine into a cardiac

> arrest patient? Now

> try and find the original human clinical trials that

> put Lidocaine

> into the ACLS protocols. You will be looking for a

> long time. Should

> I keep going?

>

> So grandma was wrong about the butter. Let it go.

> Are all home

> remedies valid? No, of course not. That is why we

> consult..TRAINED

> PROVIDERS as to what has worked for them instead of

> the old women at

> the sewing circle...Hi Aunt Emma! I am eating my

> potato skins!..

> (Aunt Emma who incidentally was a physician, BU Med

> class of '39 the

> only woman in her class)

>

> If nothing else, what happened to the placebo

> effect? The efficacy

> of placebos have been well studied. If the patient

> beleives it will

> work, and it will not do harm then why not?

>

> Studies are a nice boat to float in, but sometimes

> we find ourselves

> in situations where there is no choice but to swim.

> When the shit

> really hits the fan who would you rather have with

> you, a quick

> thinker, or an accurate citation quoter?

>

> Also remember your shore/offshore background, and

> truly remote work

> are two different animals. On remotes you may not

> always have

> helicopters on call, fancy burn dressings, or even a

> nice roll of

> cling film. The hallmark of a good practitioner is

> to always be

> questioning and refining your methods, keeping your

> mind open to all

> the possibilities of the world, and if possible

> backing them up with

> a well designed study.

>

> Every single treatment you use in the ER or on the

> Oil Rig started

> out as one guy saying to another... " you know what I

> found works well

> for that? "

>

> So spake Sumo

> Thus endeth the lesson-

>

> In the future try to use the bathroom before we

> leave the house.

> These stops are really taking the joy out of the

> trip.

>

> God forgives all of your mitakes

> Society forgives some of your mistake

> Evolution forgives none of your mistakes

> -???

>

> Something useful!!!! Potato skins on burns….

>

> Does anyone else out there want to seriously reduce

> their chances of

> future employment by posting one of these nuggets of

> research based

> clinical efficacy that I somehow missed in my 20 odd

> years in

> healthcare positions?

> Working in U.K A/E departments and in the oil and

> gas industry

> internationally I've seen lots of patients present

> with `alternative'

> dressings and first aid measures ( including the

> already mentioned

> butter on burns; it's a pity those fats do like to

> retain heat… shame

> it seemed such a lovely idea) which have included

> toothpaste on

> burns, tobacco, curry powder, flour, dried herbs and

> numerous other

> everyday items in wounds and I've spent many an hour

> having to clean

> them out of burns and open wounds and trying to re-

> educate the

> patients. I really don't expect to find people

> recommending them on

> a site like this. Anyone got a research paper on

> the use of horse

> s**t poultices handy ...there seems to be a lot of

> it about?

>

> >

>

=== message truncated ===

__________________________________________________________

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More Ways to Keep in Touch. http://uk.docs./nowyoucan.html

March 26, 2008

A very eloquent response but we've moved a long way from potato

skins on burns.

A useful point to remember when considering treatment options is to

add the words " Your honour " at the end of any explanation you come up

with...just as you would when you find yourself in court trying to

defend your actions.

Barbara originally asserted that her treatment 'reduced pain and

scarring'...as opposed to what exactly? By all means say I've used

something and it and it worked for me personally but lets not try and

dress it up and give it validity by implying it goes beyond that.

I personally can't imagine any scenario in which I'd find myself in

a 'truly remote' location armed with the ability to boil water, have

a potato handy, possibly have a microwave and clingfilm at hand and

then chose this as a treatment option.

Barbara, by the way I have a have a 20cm x10cm scar from sustaining a

deep dermal burn. I know something of burn dressings.

Something useful!!!! Potato skins on burns….

>

> Does anyone else out there want to seriously reduce their chances

of

> future employment by posting one of these nuggets of research based

> clinical efficacy that I somehow missed in my 20 odd years in

> healthcare positions?

> Working in U.K A/E departments and in the oil and gas industry

> internationally I've seen lots of patients present with

`alternative'

> dressings and first aid measures ( including the already mentioned

> butter on burns; it's a pity those fats do like to retain heat…

shame

> it seemed such a lovely idea) which have included toothpaste on

> burns, tobacco, curry powder, flour, dried herbs and numerous other

> everyday items in wounds and I've spent many an hour having to

clean

> them out of burns and open wounds and trying to re- educate the

> patients. I really don't expect to find people recommending them

on

> a site like this. Anyone got a research paper on the use of horse

> s**t poultices handy ...there seems to be a lot of it about?

>

> >

>

March 26, 2008

No worries .

Some people are explorers, some are shopkeepers. Both are equally

important, both are certain they are right, and neither can get the

other to understand his way of thinking.

You have obviously found your niche in the ER. More power to you.

For my part I am not satisfied to wallow in the status quo. I have

been led to beleive the world is round, and I am going to see for

myself. If I fall off the edge you are welcome to say " I told you so "

I heard pickles cause plane crashes. Be careful.

" You have to risk going too far to discover just how far you can really

go "

T.S. Eliot

March 26, 2008

Thanks for that . Not just a pretty face I see...(oops, forgot about the

photo debacle!!) Much appreciated. Now have you heard about the wonders of Aloe

crystals...?

, Now if you had a huge potato, that wound would've healed quicker, and the

scarring would've been less....... just pulling your leg, seriously. Come-on,

give us a smile!! Guess you won't look at a potato chip again hey? The truth

here is, I didn't DO any research, just followed a myth, and it worked for me

and everybody I passed it on to that used it, and it worked better than any

over-the-counter-creams or dressings for us. No hard feelings?

Barbara