Haider Warraich
speaker
683 appearances
3 recordings
1 series
first heard Oct 2020
last heard Dec 2021
Haider Warraich’s voice in public audio — every appearance, attributed to the second.
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Appearances
And what you see there is that patients that, you know, I think there's a lot of confidence amongst nurses.
And I think it's probably well earned that there is comfort.
If you ask them, are they comfortable with diuretics?
The answer is usually yes.
But I think all of us have anecdotally seen that perhaps a lot of times we're just not that aggressive.
And I would say not even aggressive even in the inpatient setting.
Here's an interesting tidbit.
If you look at all patients in the hospital, so this is national registry data.
If you look at all comers with heart failure who are in the hospital in the United States, only about 1% to 2% of them are discharged with unchanged or worsening symptoms, which means that during the hospitalization, we help them get better.
or before they were discharged.
But when you look at folks going to hospice, 37% have unchanged or worsening symptoms.
So what that tells me is that it's not just that they're not, that hospice might not be being very aggressive diuretics.
We on our end in the inpatient setting might not be, you know, we might feel like, oh, this patient is hospice bound and we maybe don't have to be that aggressive about managing their symptoms.
So I agree.
I mean, I've written a couple of papers, top 10 tips for heart failure.
And one of them is if diuretics don't work, double them.
Don't mess around with them in a patient who's volume overloaded.
You cannot hurt them with diuretics.
And so I think that mentality is as important in the inpatient side, but also definitely in the outpatient side.
I've seen that once.
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