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Podcast for your consideration

  • 1.  Podcast for your consideration

    Posted 06-21-2021 17:57

    As some of you know, I host a podcast called Annals on Call.  The most recent episode describes the challenge of diagnosing sepsis and the dangers of overdiagnosis.  I look forward to any comments on this topic.


    Annals On Call - Does the Sepsis Bundle Improve Outcomes? | Annals of Internal Medicine https://www.acpjournals.org/doi/10.7326/A20-0015

    In this episode of Annals On Call, Dr. Centor discusses the Severe Sepsis and Septic Shock Early Management Bundle with Drs. Klompas and Rhee.




    ======================
    Robert M Centor, MD, MACP
     
    Chair-Emeritus, ACP Board of Regents
     
    Professor-Emeritus, General Internal Medicine
    UAB
    FOT 720
    1530 3rd Ave S
    Birmingham, AL 35294-3407
     
    Phone: 205-934-7997
    Fax    : 205-975-7797
    -- 



  • 2.  RE: Podcast for your consideration

    Posted 06-21-2021 18:19
    Hot button topic for me.
    I come from decades in aeromedical: There is a concept of "sterile cockpit." (https://asrs.arc.nasa.gov/publications/directline/dl4_sterile.htm) When I am accessing a chart to interact with a specific patient's care, I would argue that I am in a "sterile cockpit" environment. In that circumstance, any interruptions better be right (sepsis alerts should alert me to a septic patient) and any non-firing flag (shop talk for no alert) better not have sepsis.
    This study makes clear what we have long known but, due to "non-disparagement clauses" and other reasons, have said little.
    It is time we subject these electronic systems to FDA review, to ensure they do what they propose to do.
    Like, don't miss sepsis and find it where it exists.

    tom benzoni






  • 3.  RE: Podcast for your consideration

    Posted 06-21-2021 18:22

    As you listen to the podcast, the problem comes from the automatic steps that the bundle initiates. Over use of antibiotics and missed alternate diagnoses abound when we over diagnose sepsis.  That is the dilemma - how to increase recognition of sepsis without harming too many patients who do not have sepsis.  This is what makes medicine so difficult.


    ======================
    Robert M Centor, MD, MACP
     
    Chair-Emeritus, ACP Board of Regents
     
    Professor-Emeritus, General Internal Medicine
    UAB
    FOT 720
    1530 3rd Ave S
    Birmingham, AL 35294-3407
     
    Phone: 205-934-7997
    Fax    : 205-975-7797
    --