BMJ  2007;334 (23 June), doi:10.1136/bmj.39253.656134.3A

Editor's Choice

US editor's choice

Changing what we do

The first 150 words of the full text of this article appear below.

One way to measure whether a medical journal is of use to you is whether anything you read leads to changes (presumably improvements) in what you do. Sometimes new ideas are evidence-based and seem required once you know about them. Other times they are just good ideas, worth a try. This week's BMJ has some of each type.

If there is anyone out there still using lactated Ringer's solution for initial treatment of patients with diabetic ketoacidosis, it's probably time to stop. In an editorial, Ketan Dhatariya claims that some UK emergency room doctors and intensivists are still using Hartmann's solution (similar but not identical to the Lactated Ringer's used in the US), and explains all the reasons that favor normal saline instead (doi: 10.1136/bmj.39237.661111.80). Although no randomized controlled trials back up his statements, the logic is reasonably sound for the benefits of normal saline over a lactated solution.

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