Patients get discharged from the hospital when they are STABLE. This is such a fundamental principle that many of us have the word “stable” templated into our discharge notes.
Stable means that their vital signs are acceptable over time and that their clinical trajectory is not dynamic. Put plainly, the patient needs to be boring, without new and changing stuff happening, to send them out of the hospital.
A patient who has vital signs changing / fluctuating in a concerning direction, new test results, new treatments all happening over a short amount of time IS NOT STABLE and IS NOT GOING HOME
Even considering it is completely contrary to the “out of an abundance of caution” we heard the other day
Even with an advanced WH med unit (would love to hear more about this), if can’t flex to ICU level care, leave him where he is

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More from @choo_ek

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As an ER doc, I’m used to working off partial and sometimes conflicting information. But this is confusing on a different level.
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Is it odd that I don’t believe it?
Look, I thought October was going to come with a huge ramp up of reassurances about Covid to begin with
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27 Sep
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I wish more health disparities research would move beyond describing the problems to understanding and solving them.
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When COVID is long over, people will still be writing papers like "Observed racial disparities in COVID mortality across 17 counties with cold weather"
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All my papers are late. All my emails go unanswered until a second poke, except a tiny random sample that I answer within one hot second. All birthday wishes are belated. My grants go in late or not at all. Workouts have gone out the window. So have quotas on chocolate.
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