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Sun Apr 16 07:03:13 BST 2006

On Sat, 15 Apr 2006 KMATTOX at aol.com wrote:

> I am very aware that patients with orthopedic and vascular procedures have
> always gotten prophylactic antibiotics.  Often if here is presumed logic  for
> ONE, THREE are given.   If 8 hours of antibiotics are accepted,  they are
> continued for 3 days.  If three days are acceptable, they are  sometimes continued
> for 7 days.
>
> Although this is common practice, much like the OLD practice of massive
> fluid resuscitation and cyclic hyperresuscitation, with all its complications,
> these urban legends continue.   The burden of proof falls on those who  continue
> to use something based on culture or blind faith.   We can do  better than
> that now.
>
> Issues such as MAST PANTS,   Renal Dose Dopamine, Interosseous  infusions,
> Rectal washout, Presacral drains,  Single shot IVP  for penetrating abdominal
> trauma, etc, etc, etc, are other examples of long held  doctrine, but
> subsequently shown to be urban legends only.
>
> I vote more with Rick than with blind urban legend.    As a  matter of fact,
> I would be more rigidly opposed to prophylactic antibiotics in  the case
> described, than was Dr. Frykberg.

Dear Dr. Mattox,

	The lucid and eloquent presentation of your position is really the
underlying issue here at the moment (putting the medical question aside
for the moent, as it has essentially ceased to exist for a few emails
now).

	What most people here are trying (VERY hard) to impart to Dr.
Frykberg is that his acerbic, arrogant, and condescending presentation is
interfering with his ability to interact with others - whether such
interaction is on a professional, medical, casual, or other basis.  He
presents all positions as an extremely hostile "participant" - actually,
participant is the wrong word... Perhaps "Oracle" would be more
appropriate.

	Nobody here is arguing with his medical positions (although some
have asked for citations, whether properly or improperly is irrelevent at
this point), but a large proportion of the list is arguing with his
gargantuan ego.

	Had he - at ANY point during this thread - taken the time to treat
his peers with the kind of respect, care for teaching, and all around
decentness that you have, his troubles would be over.

	In short Dr. Frykberg needs to learn to play in the sandbox with
others.  And taking a lesson from your fine examples would be a great
start!

> k

-- 
Yours,

J.A. Terranson
sysadmin at mfn.org
0xBD4A95BF

'The right of self defence is the first law of nature: in most governments
it has been the study of rulers to confine this right within the narrowest
limits possible. Wherever standing armies are kept up, and the right of
the people to keep and bear arms is, under any colour or pretext
whatsoever, prohibited, liberty, if not already annihilated, is on the
brink of destruction.'

St. George Tucker

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Prophylactic antibiotics