Dr Ivor Popovich presents examples of evidence-based decision making during ward calls. We also highlight some recommendations from Choosing Wisely and give an update on death certification.

• The Intern Suppository – Ivor’s EBM blog

• The Rational Clinical Examination – JAMA

• Plain film in small bowel obstruction

• The gas-less abdomen

• Paucity of gas

• Non-specific bowel gas pattern

• Read more in the blog post here

• Plasmalyte in renal failure

• Not contra-indicated

• Actually alkalinises plasma, driving potassium into cells

• The chloride in NaCl acidifies plasma, drawing potassium into the extracellular space

• Read more in the blog post here

• Asthma admission

• Tachycardia is not explained by salbutamol administration alone

• A large diurnal variation in peak flow (e.g. >50%) is a major risk factor for in-hospital cardiac arrest (not severity of asthma exacerbation at admission).

• Severity of wheeze does not correlate with severity of exacerbation

• Read more in the blog post here

• Choosing wisely

• New Death Documents website

• MOH Completing the Medical Certificate Cause of Death form (March 2018)

• MOH Examples of incorrect and correct cause of death certification (March 2018)