TO>In your message dated Monday 15, July 1996 Jon Wilcox wrote :
TO>> With all this blatant honesty and rationalising of clinical
TO>shortcuts,
TO>> who will be totally honest and say they do not do PR's on suspected
TO>> appendicitis.
Toby Lipman replied:
TO>I will. I NEVER do a PR on a suspected case of appendicitis. It's a
TO>waste of time and unnecessary humiliation for the patient. A much
TO>better test (in addition to the history and RIF tenderness +/-
TO>guarding) is whether or not the patient can climb on to the
TO>examination couch or sit up without pain or discomfort. If that sign
TO>is positive I always admit the patient.
And I almost never take the temperature either......
The decision to admit (or not) is usually obvious and if not,
more likely to be revealed by seeing the patient again in a
few hours.
And don't you just love those hosp docs who want to know over
the phone the temp and PR findings .....!
______________________________________________________________
Dr. David Jobson
The Surgery, Main St Surgery Tel +44 (0)1728 830526
Leiston Surgery Fax 832029
Suffolk Home Tel 831100
IP16 4JG email [log in to unmask]
* SLMR 2.1a *
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