Re Asprin/Jels reply. Perhaps "easy" was too glib. We all rely on intuition
and yes I agree that sometimes that intuition is wrong. This was about
whether or not asprin should be given in a suspected MI when there could be
underlying, or a primary oesophageal/gastric problem. It does not resolve the
dilemma of administration based on having to make a diagnosis sometimes.
Perhaps its the old dilemma of diagnostic pre hospital care vs. assessment
based medicine. Do you treat the symptoms or the cause? or both. Personaly I
do both. An example was last week. 45 year old lying among boulders with
"sore ribs" and some mild left sided chest pain after a stumble. The
assessment based syptoms were painful ribs and much burping. The burping of
suggested something else and a little bell rang in my head, and after a look
at the rythmn he was in AF @ 150/min. The diagnosis suggested an infarct may
have ocured so he was given asprin. I felt no dillema with this at the time
but in light of what is being discussed maybe I should have withheld it? A
later 12 confirmed an infarct and he was given Strep. Ribs were fine.
I no its never "easy" but shouldn't we avoid always putting wood in the way of
the trees
Davy Gunn
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