Clinical methods are taught to all medical students everywhere, and if not, they learn them from reading books. Unfortunately they do not retain the knowledge at all times. They tend to sometimes believe their immediate seniors, like a first year resident believes what he/she is told by a second year resident rather than what he/she had learned before qualifying. The following example should make this point clear.
I had sent a patient to the Anesthesiology clinic to see if she was fit for receiving anesthesia for a surgical procedure I had planned for her. She came back certified fit for receiving anesthesia. Something caught my eye in her case record form. In front of the findings of examination of her respiratory system, a first year resident anesthesiologist had written only the word 'AEBE'. I got curious and decided to call him.
"You have just seen a patient of mine" I said after identifying myself and wishing him a good morning. "I want to know what the word 'AEBE' means. It is written as the finding of examination of her respiratory system."
"AEBE is short for 'Air Entry Bilaterally Equal'" he said.
"Ah!" I said. "I appreciate you have certified she is fit and thank you for that. But may I point out something?"
"Yes" he said (tentatively or encouragingly, I was not sure which).
"Air entry is equal on both sides. But what if it is reduced on both sides? If so, she would not be OK. There can be a lot of foreign sounds on auscultation, such as rhonchi and rales. If any of these are present, bilaterally equal air entry would not at all be reassuring. Do you agree with me?"
"Yes, yes" he said hurriedly.
"It could be a lot more meaningful and easier to just write 'normal' instead of AEBE."
"Of course" he said.
"May I ask where you learned this AEBE?"
"My senior told me to write like that" he said.
"Well, I hope you will refrain from doing so in future and will advise your juniors correctly" I said.
"Yes, yes, I will" he said.
"Great" I said and put the phone down, happy in the knowledge that I had made a change for better by correcting this trend.
I had sent a patient to the Anesthesiology clinic to see if she was fit for receiving anesthesia for a surgical procedure I had planned for her. She came back certified fit for receiving anesthesia. Something caught my eye in her case record form. In front of the findings of examination of her respiratory system, a first year resident anesthesiologist had written only the word 'AEBE'. I got curious and decided to call him.
"You have just seen a patient of mine" I said after identifying myself and wishing him a good morning. "I want to know what the word 'AEBE' means. It is written as the finding of examination of her respiratory system."
"AEBE is short for 'Air Entry Bilaterally Equal'" he said.
"Ah!" I said. "I appreciate you have certified she is fit and thank you for that. But may I point out something?"
"Yes" he said (tentatively or encouragingly, I was not sure which).
"Air entry is equal on both sides. But what if it is reduced on both sides? If so, she would not be OK. There can be a lot of foreign sounds on auscultation, such as rhonchi and rales. If any of these are present, bilaterally equal air entry would not at all be reassuring. Do you agree with me?"
"Yes, yes" he said hurriedly.
"It could be a lot more meaningful and easier to just write 'normal' instead of AEBE."
"Of course" he said.
"May I ask where you learned this AEBE?"
"My senior told me to write like that" he said.
"Well, I hope you will refrain from doing so in future and will advise your juniors correctly" I said.
"Yes, yes, I will" he said.
"Great" I said and put the phone down, happy in the knowledge that I had made a change for better by correcting this trend.
