that's exactly the point. we are physicians too, you know. our knowledge doesn't stop with what-you-believe-you-are-the-only-one-to-realize is the obvious. the devil is in the details.
yes, this mantra is repeated often early in people's training. it is based on the oncotic gradient difference between most commonly used rescuscitative fluids... 1:1 for colloids and 3:1 for crystalloids. i don't think that it's meant to be a strict rule to follow so much as pearl for people to remember that there are different gross effects concerning what happens to those fluids once they are put in the bloodstream. but, after all, it's not as simple as that, is it? are you surprised that you aren't the only one who knows that?
at some point, we all learn that there is a huge controversy in this particular topic, resuscitation. there is data that shows that giving colloid can worsen peripheral edema after injury. conversely, there is other data that shows that giving crystalloid, namely LR, activates the immune system and can worsen peripheral edema as well. there is even data that shows that people are horrible at estimating actual blood loss. the point is, there is always a better, more detailed, sometimes even more controversial and confusing story when you put a finer point on things. this is the difference between the lesson, the pearl, and what we do in actual practice, which the vast majority of us are, despite your belief, capable of understanding.
so, what's the point of worrying about the origin of this "mantra" and chuckling when you hear it? is it just another way you prop your own ego up and prove to yourself how superior you think you are to everyone else? that we actually follow pearls by rote and never think twice about it?
what's the point of this thread?
