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UNNECESSARY ROUTINE ORDERS

Samuel P. Harbison, M.D.
JAMA. 1953;152(5):396-399. doi:10.1001/jama.1953.03690050020007.
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Even in this age of science and reason it would appear that we as surgeons carry out certain time-honored practices that have no true rational basis. If these practices were harmless as well as ineffective, it would be less important to discuss them; some are harmful, however, and some contribute significantly to the discomfort of the patient. There seems to be no reason to continue certain ones, and others should be studied and reevaluated by scientific means. For the most part such practices survive because they have for a long time been incorporated in "routine" preoperative and postoperative orders and hence have not been subjected often enough to close scrutiny. I refer to such routine matters as use of morphine, enemas, deprivation of fluids, and shaving preoperatively, and to the use of morphine, hypodermic medication, enemas, and diet postoperatively. The operative procedure itself should not be omitted from consideration, since

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