PACU troponins

[MoMoGesiologist]

I think we have to be careful with the argument about limiting testing. Ordering all the tests for no reason is clearly not beneficial and meaninglessly increases the cost of care. However risk stratification may well be a good reason to order a test. It's even better when the course after the test is modifiable; but we test for all kinds of diseases that we don't have a treatment for so we can appropriately council patients even when it doesn't necessarily alter their clinical course. e.g. Huntington's and Alzheimer's.

Do we really need more tests for "risk stratification"? Isn't taking a history and ASA class enough? You shouldn't need a preop troponin to tell you not to slam 200mg propofol for induction for an 80yo CAD, DM, CKD, etc. Then again, maybe some of my attendings from residency would have benefitted from the hard data and a study telling them not to do that...

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[fakin' the funk]

For example, a 75 year old man with several medical problems including IDDM, CAD (no stents), HTN gets lipoma excision under sedation. No major problems in surgery and patient goes to PACU. Would you immediately order troponins? What if the patient had a couple episodes of hypotension that responded well to phenylephrine boluses and has since had stable vitals with no support?

Haha wtf???

Dude is this a personal medical question because this smells like BS. Are you cop?

You're asking about the validity of ordering troponins on asymptomatic patients going home in 45 minutes? Wth?

 

[Southpaw]

yeah, the discussion that resulted was all fantastic and academic and such, but the OP sounded very malpractice lawyeresque.