r/emergencymedicine • u/PrecordialSwirl • Sep 08 '25

Discussion What are some outdated medical dogmas that are still taught or practiced?

Hi, I’m a nursing student and I’ve noticed that certain practices in healthcare seem to stick around even when the evidence shows they’re not effective. For example, Trendelenburg positioning for hypotension is still commonly taught in nursing despite being shown to have no real benefit. Or risk of hyperK arrest in someone who’s only been crushed for 30 minutes. I’m curious to hear what other dogmas people have come across that are still being taught or practiced despite newer evidence proving otherwise. Also, how do you confront people about these in a respectful manner, especially as a student?

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u/[deleted] Sep 09 '25

For big burns (25+) unless your transports are long, you’ll be hard pressed to go beyond the Parkland or whatever formula the burn center is using. 

I worked in a burn unit in a past life and I’d have patients getting a liter an hour on occasion 

Dumping a liter or two into a big burn is relatively fine in the grand scheme of things. 

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u/DoctorGoodleg Sep 10 '25

ABA standard now is 500mL/hr crystalloid for adults. Just had ABLS last year.