Don't let the doctors do this!
This article provides information about some unnecessary, useless and even potentially dangerous medical procedures that patients should know.
1. Blood transfusion (if not necessary)There is no doubt that blood transfusion saves lives.
However, when carried out in the absence of an urgent need, it increases the risk of death.
According to the results of a recently published study that examined the probability of survival of patients with massive blood loss as a result of physical injuries, if the patient's risk of death exceeded 50% upon admission to the clinic, transfusion of red blood cells doubled the probability of his survival. However, if the risk of death was less than 6%, transfusion of red blood cells, on the contrary, increased the probability of death of the patient by five times.
Experts explain this by the fact that transfusion of red blood cells can lead to a moderate weakening of the body's immune defenses, and in more rare cases, cause pneumonia.
2. Scheduled surgery on FridayUndoubtedly, emergency surgical operations should be carried out as soon as possible.
However, if it is possible to choose the day of appointment of a planned operation, the best option is the beginning of the week.
According to the results of last year's study, when performing surgery on Friday, the patient's risk of death is 44% higher than when choosing Monday as the "X-day". On weekends, the quality of postoperative care may decrease due to the insufficient number and qualifications of the staff on duty. At the same time, the first 48 hours after surgery are the most important for the patient's recovery.
On the other hand, the risk of death after elective surgery is very low and is less than 1%. Therefore, its increase by 44% only slightly increases the amount of risk in absolute numbers. However, when your life is at stake, every little thing is important.
3. Shaving the hair from the area of the operationThere may be dirt on the hair, so you should avoid their presence in the immediate vicinity of the surgical incision.
This gave rise to a long tradition of preoperative shaving of hair on any part of the body covered with them. Very often this procedure is carried out with the help of disposable machines and even without pre-wetting.
This approach can lead to the very problem that it is used to prevent – infection of the wound. The razor wounds the top layer of the skin, leaving tiny microscopic cuts that bacteria can penetrate.
According to official recommendations adopted in the USA and the UK, hair should not be removed unless it physically prevents surgery or dressing. Otherwise, an electric clipper should be used. However, in practice, cheap disposable machines are still used.
4. Hip joint prosthetics with the latest developmentsAs a rule, when it comes to technology, newer developments are the best.
However, this does not always apply to medical devices. Unlike in the USA, in Europe, before new medical devices are on the market, they do not have to undergo long-term randomized clinical trials. They only have to pass a series of safety tests.
In the UK, more than 200 types of hip prostheses are used and new models appear almost every year. However, it takes about 15 years to evaluate the effectiveness and stability of the model. As an example of failure, we can cite the situation with some metal prostheses that wear out too quickly and release metal into the bloodstream. Therefore, sensible doctors tend to search for a "golden mean" between innovative developments and safety.
5. General medical examinationRegular medical examinations seem to be a reasonable approach from the point of view of preventing serious diseases.
However, experts who adhere to the principles of evidence-based medicine often express a completely opposite opinion. Such an examination is a screening option – the search for diseases in people who do not have symptoms. At the same time, if the effectiveness of screening is not confirmed by the results of large clinical studies, it often does more harm than good.
Screening can cause excessive excitement, as well as give both false negative and false positive results. In the first case, a person may lose vigilance, while in the second he is often subjected to unnecessary diagnostic and therapeutic procedures. All these effects have been demonstrated for a number of popular screening procedures: prostate-specific antigen analysis, breast self-examination, and possibly mammography.
Clinical studies devoted to evaluating the effectiveness of general medical examinations have brought extremely negative results. The latest and one of the largest studies involved almost 60,000 Danes who underwent annual medical examinations for five years. It turned out that these examinations had no effect on the risk of myocardial infarction and overall mortality.
In general, the situation can be described as follows: any screening is harmful, but in some cases the benefit it brings is greater than the harm it causes, and in other cases – the opposite.
6. Resuscitation of hopeless patientsDoctors are periodically accused of refusing to carry out resuscitation measures.
However, in reality, they are much more likely to make the exact opposite mistake – they perform cardiopulmonary resuscitation for patients with virtually no chance of survival.
Cardiopulmonary resuscitation is far from the most pleasant thing that a person can experience in the last minutes of life. To achieve the effect, doctors have to put a lot of pressure on the patient's chest, which often leads to rib fractures and damage to the heart and lungs. This traumatic procedure can save the life of a generally healthy person who suddenly has a myocardial infarction, but it is often applied to patients dying in the terminal stages of diseases such as cancer.
7. Conducting an inspection with unwashed handsSometimes patients want the doctor to conduct a more thorough physical examination.
However, this is not always safe, since there is no guarantee that the doctor's hands are thoroughly washed.
In the UK, 1 out of 15 hospitalized patients becomes infected with an infectious disease during their stay in the clinic. One of the saddest options is infection with any of the multi-resistant nosocomial pathogens, which often leads to death. One of the main reasons for this is poor hand hygiene of medical personnel, often due to absent-mindedness and forgetfulness.
Evgeniya Ryabtseva
Portal "Eternal youth" http://vechnayamolodost.ru based on the materials of New Scientist:
Dr No: Seven things you shouldn't let your doctor do (there are links to articles,
published on each of the items in scientific journals).
18.08.2014