Discover and read the best of Twitter Threads about #complicatedppe
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Write this down: “The purpose of daily rounds & presentation (& progress note) is to *document the behavior of the disease under observation and treatment*.” This is the paramount philosophical purpose. You can include superfluous and redundant boilerplate (eg RRR no MGR no CCE)
But your presentation MUST contain all the data from the patient/exam/labs etc which allow an assessment (explicit or intuitive) of whether the patient is getting better or worse or not progressing, whether the expected is happening or not, & whether there r unexpected findings
Ideally, these rspecific to the pt & the disease rather than routine claptrap; if your patient has #complicatedPPE, the output of the chest tube will have a central position in the presentation; if it’s asthma, wheezing, RR, acc mm use. Tailor ur assessment to the disease….
Do you know all of these nuances of #pleuraldisease? Why is an #empyema distinct from a complicated #parapneumoniceffusion? What is #contarinisyndrome #explosivepleuritis #chyliform #pseudochylous? Are all #chylothorax milky? #pccm #pulmcrit #pulmonary 
#pleuraldisease is fascinating and nuanced. First step is #lightscriteria which give favor to finding #exudates which tend to be more urgent. You only need one criterion, which maximizes #sensitivity. Meaningless statement: "It's an exudate only by protein." One criterion=exudate
(Like on Tinder, the more criteria you require, the more you narrow your pool, compromising sensitivity for specificity.) Transudates I will skip over. Most common #exudate is #parapneumoniceffusion #PPE. If there is or is likely to be #pneumonia, it's PPE. Next task is to...
