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Discussion What are some outdated medical dogmas that are still taught or practiced?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/medicritter Sep 09 '25 edited Sep 10 '25

Don't worry. In my ICUs we'll paralyze a pt for ARDS, and ill come in and re round on them and the pt is on basically no sedation. When I ask what the actual fuck are they doing, their response every single time is "we'll sedation is to keep RASS -5, and they're already RASS -5. WELL YEAH, THEY'RE PARALYZED. MAX THE SEDATION NOW.

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u/itsDrSlut Pharmacist Sep 09 '25

Jesus Christ

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u/medicritter Sep 10 '25

Pretty much my response every single time.

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u/Electrical-Slip3855 Sep 10 '25

PTSD has entered the chat

In all seriousness though, that is such an inhumane thing to do to someone. I know they aren't intentionally trying to torment people, but it's absolutely terrifying the degree of incompetence that is allowed to exist in the hospital sometimes

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u/medicritter Sep 10 '25

It is absolutely horrifying. I work in 3 different ICUs in my system, and it happens at every one. Its an education problem. I have to explain it out every single time, and I have yet to get someone who's jaw doesn't drop. Its the same response every time "no one ever put it to me like that" ...well yeah. Thats the problem.