https://newphysician.org/evidence-and-action/The Shit List and $0 Fixes, personally approved by Sonny Saggar, MD.https://newphysician.org/the-shit-list/calcium-in-cardiac-arrest/https://newphysician.org/the-shit-list/calcium-in-cardiac-arrest/The trolley is well stocked. The evidence is rather less enthusiastic.https://newphysician.org/zero-fixes/oral-phenylephrine/https://newphysician.org/zero-fixes/oral-phenylephrine/The nose is blocked. The wallet is open. The evidence has a small objection.https://newphysician.org/the-shit-list/routine-oxygen-in-normoxemic-acs/https://newphysician.org/the-shit-list/routine-oxygen-in-normoxemic-acs/A heart attack feels like an oxygen problem. So we put oxygen on the patient. It is tidy, visible and emotionally satisfying. It is also usually the wrong reflex when the patient’s oxygen saturation is already 90% or higher.https://newphysician.org/zero-fixes/stay-active-with-uncomplicated-back-pain/https://newphysician.org/zero-fixes/stay-active-with-uncomplicated-back-pain/When uncomplicated low-back pain arrives, the marketplace offers a comforting plot: lie down, immobilize the problem, buy a belt, and wait for the spine to apologize.https://newphysician.org/zero-fixes/early-loading-uncomplicated-ankle-sprain/https://newphysician.org/zero-fixes/early-loading-uncomplicated-ankle-sprain/A sprained ankle arrives with swelling, pain, and a powerful urge to put the whole foot into witness protection.https://newphysician.org/the-shit-list/npo-after-midnight-healthy-elective-surgery/https://newphysician.org/the-shit-list/npo-after-midnight-healthy-elective-surgery/A hospital can perform microsurgery through a keyhole, map a beating heart in three dimensions, and still tell every afternoon patient to stop drinking at midnight.https://newphysician.org/the-shit-list/positive-urine-culture-without-symptoms/https://newphysician.org/the-shit-list/positive-urine-culture-without-symptoms/In nonpregnant adults who have no urinary symptoms or systemic signs of infection, a positive urine culture is usually a finding to understand, not an antibiotic order wearing a lab coat.https://newphysician.org/zero-fixes/epley-for-confirmed-posterior-canal-bppv/https://newphysician.org/zero-fixes/epley-for-confirmed-posterior-canal-bppv/For adults with clinician-confirmed posterior-canal BPPV and no neurological red flags, a canalith-repositioning manoeuvre is first-line treatment that can outperform routine pills and scans without buying a device.https://newphysician.org/zero-fixes/postmeal-walking-type-2-diabetes/https://newphysician.org/zero-fixes/postmeal-walking-type-2-diabetes/For ambulatory adults with type 2 diabetes, a brief walk after meals can blunt the immediate glucose rise more than putting the same thirty minutes of walking somewhere else in the day.https://newphysician.org/the-shit-list/antibiotics-uncomplicated-acute-bronchitis/https://newphysician.org/the-shit-list/antibiotics-uncomplicated-acute-bronchitis/In otherwise healthy adults with an acute cough and no evidence of pneumonia, COPD exacerbation, pertussis, or another bacterial syndrome, an antibiotic usually buys about half a day and a fresh opportunity for diarrhoea.https://newphysician.org/the-shit-list/routine-aspirin-first-heart-attack-prevention/https://newphysician.org/the-shit-list/routine-aspirin-first-heart-attack-prevention/In people trying to prevent a first heart attack, a protective ritual may purchase bleeding without buying much protection. The exception is the entire point.https://newphysician.org/zero-fixes/spit-dont-rinse-after-fluoride-toothpaste/https://newphysician.org/zero-fixes/spit-dont-rinse-after-fluoride-toothpaste/One tiny change in the bathroom keeps fluoride where it can help. No new gadgets, miracle paste, or heroic personality required.https://newphysician.org/zero-fixes/honey-acute-cough-children-over-one/https://newphysician.org/zero-fixes/honey-acute-cough-children-over-one/For children older than one with a short, uncomplicated viral cough, honey may modestly ease the night. It is a comfort measure, not a diagnosis and certainly not a miracle.https://newphysician.org/the-shit-list/routine-vitamin-d-testing-healthy-adults/https://newphysician.org/the-shit-list/routine-vitamin-d-testing-healthy-adults/For generally healthy, asymptomatic adults, routine 25-hydroxyvitamin D screening has no established record of improving health outcomes. A useful test became a cultural reflex.