Removal of orthostatics in abdominal pain

[Iowa Medic]

Orthostatics have been removed from the abdominal pain protocols and I'm curious as to the reason.

I am in no way dependent on the results of said test but I'm curious as to the thought process behind the removal. I've done a couple google searches as well as a search on this site and don't see any research behind the removal or research that would suggest that orthostatics are some how harmful/irrelevant etc.

I'm sitting here talking to my girlfriend who is an ICU nurse and short of a serious AAA (which I would assume you would identify) I'm a bit lost as to why they would remove the orthostatics.

Thank you in advance

[paramedicmike]

From which protocols? Iowa's?

[Iowa Medic]

My bad.

Yes the new Iowa protocols released for 2012.

[cwilliams17]

Do you really need a protocol to perform orthostatics?

[Kiwiology]

Should you really have even been performing orthostatics? What on earth of benefit is it going to tell you in a patient with abdominal pain?

[paramedicmike]

Do you really need a protocol to perform orthostatics?

This was going to be my next question.

Do you assess and treat your patients based on protocols? Or do you assess and treat your patient by what you think is medically necessary using your protocols as a guide to stay within the good graces of your medical director?

If you need a protocol to outline your assessment and treatment I think I see the problem (specifically an inability to think for yourself). Based on other posts you have made I'm inclined to think that this is not the case. So you'll forgive my confusion over why this would be of concern to you.

[DwayneEMTP]

Do we really need to know the motivation to answer the questions?

Seems like you either know why they might remove them, or you don't. The other stuff is fine and interesting, but maybe should be added to your answer to the question instead of as an attempt to make is sound as if the question is stupid to begin with.

I don't have an answer Brother, but I thought that it was a really interesting question...I'll have to think on it for a bit...My knee jerk reaction would be that it has something to do with manipulating patients with possible acute abs. But not sure if that makes sense or not...

[m0nster986]

Do you have a link to the specific protocol?

[Iowa Medic]

Perhaps it was worded poorly...

They are removing RSI from the scope in some places due to the piss poor % of intubations and/or the inability of some to recognize appropriate indications or dosages.

My question was more to the rationale behind removal than the necessity of having the procedure in the protocol. I don't need a cook book to treat nor do I regularly refer to said protocol other than when new versions comes out and feel it's appropriate review for changes.

I'm now unsure if the original post was unclear or there are some that are just so anxious to bash a newbie over the head with "cook book medic" or "I can't believe you look at Protocols". Considering I do indeed work under a physicians license I suppose the least I can do is look at the changes made and attempt to understand the logic or data that caused said changes.

Thank you in advance

[paramedicmike]

You can couple a unclear initial post with an unclear reading of the initial post. Thus the confusion I later referenced.

Have you asked the docs in your system the reason for the change? It seems if you're looking for the rationale behind such a decision going directly to the people who made the decision would be your best bet for a direct answer.

I'm curious as to their answer as well.