The Phlegmfighter
The Phlegmfighter

@phlegmfighter

8 Tweets 24 reads May 06, 2020
Just throwing this out there. My beloved Hall, Schmidt and Wood textbook from 1998, meticulously underlined and taken to heart as a sr medical student. #breakingtherules as regards #extubation and #mechanicalventilation in general.
Little did I know that I would forget this passage and rediscover it more than 20 years hence after blog posts such as this: medicalevidenceblog.com
I did not endeavor to become an iconoclast for its own sake, I just became one. Passages such as this probably guided me, I now realize.
The #zentensivist does not mechanically follow #therules. S/he rather takes a deep understanding of pathophysiology, combines it with experience, and applies it to individual patients whom s/he sees and feels with his own eyes and hands
And the s/he makes #rational decisions for *that* patient and responds iteratively to #feedback to tailor care to *that* patient. The rules be damned. They were made for non-experts, seeking general, not specific guidance.
That is how you achieve the best outcomes for your patients. The end. @ogi_gajic @msiuba @PulmCrit @footyDoc #zentisivist
PS - it amazes me that, so many years after underlining those passages, I thought that my iconoclastic tendencies were revelations. Others, many year past, made the same "revelations" about automatic, mechanical rules and following the numbers. We are not the first #zentensivist

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