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My experience with the precautionary principle/ A 
A young lady attended ED on Friday with a confirmed unruptured ectopic pregnancy on US.
She was haemodynamically well & fitted the criteria for use of methotrexate & this was administered with consent /1
https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.14189
A young lady attended ED on Friday with a confirmed unruptured ectopic pregnancy on US.
She was haemodynamically well & fitted the criteria for use of methotrexate & this was administered with consent /1
https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.14189
The young lady was readmitted on Sunday with abdominal pain. She continued to remain well apart from pain. I was concerned that she may have a ruptured ectopic pregnancy, a known possibility following methotrexate. An urgent scan showed fluid in the pelvis. She stayed fasted /2
I was faced with 2 options:
-Operate on Sunday night
-Wait until Monday morning
That night I made the decision to wait until Monday morning.
Uncomplicated surgery was performed on Monday morning, patient recovered well, discharged Tuesday morning, the end.
But was it the end /3
-Operate on Sunday night
-Wait until Monday morning
That night I made the decision to wait until Monday morning.
Uncomplicated surgery was performed on Monday morning, patient recovered well, discharged Tuesday morning, the end.
But was it the end /3
No, Reader, it was not the end.
A complaint was made about my decision to wait until Monday morning.
I was declared incompetent & dangerous. Too dangerous to continue working because I had endangered the patientâs life.
Did I not know that ectopic pregnancy could be lethal? /4
A complaint was made about my decision to wait until Monday morning.
I was declared incompetent & dangerous. Too dangerous to continue working because I had endangered the patientâs life.
Did I not know that ectopic pregnancy could be lethal? /4
I had not applied the âprecautionary principleâ of the potential for a life threatening outcome for my patient.
A full investigation followed during which I was stood down from clinical work. I wonât describe the mental trauma of standing âaccusedâ of negligence. /5
A full investigation followed during which I was stood down from clinical work. I wonât describe the mental trauma of standing âaccusedâ of negligence. /5
So, my question Reader is this:
Are those in decision making positions currently using the same precautionary principle when they make
PPE decisions?
And if they are not, what disciplinary actions will they face for the actual harm caused to thousands of HCW affected? /Fin
Are those in decision making positions currently using the same precautionary principle when they make
PPE decisions?And if they are not, what disciplinary actions will they face for the actual harm caused to thousands of HCW affected? /Fin
Addendum: This happened a long time ago. Thank you for your supportive messages. I made a full recovery.
The reason for this thread is to to ensure that the same rules apply across the board to everyone who makes decisions in healthcare
The reason for this thread is to to ensure that the same rules apply across the board to everyone who makes decisions in healthcare
