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When making critical treatment decisions, shared decision-making (SDM) between healthcare providers and patients is essential. SDM involves discussing care options, considering patient preferences, and ensuring decisions align with patient values and medical conditions. This process becomes challenging in life-threatening emergencies, where time constraints hinder thorough discussions and coordination among healthcare providers, potentially leading to inappropriate care. Two cases highlight these challenges. Patient A, a 76-year-old man with acute aortic dissection, underwent surgery without comprehensive SDM, resulting in unsuccessful outcomes and questioning the appropriateness of the intervention. Patient B, an 84-year-old man with heart failure and COPD, received palliative care following thorough SDM and multidisciplinary consultation, leading to a dignified end-of-life experience. We conclude that effective communication and multidisciplinary collaboration are crucial for SDM, even in acute settings. Recommendations include creating space for thorough discussions, involving all relevant healthcare providers, and integrating palliative care as a serious treatment option. This approach ensures patient-centered care and aligns medical interventions with the patient's values and needs.

In mechanically ventilated patients with ARDS, prone positioning has demonstrated improvement, not only in oxygenation but also in survival. Whether early prone positioning of patients with mild hypoxemia and ARDS due to covid-19 improves outcome in terms of survival and prevention of the need for invasive ventilation was recently investigated in a RCT. Physiological reasoning would suggest a potential benefit. But no advantages of prone positioning were found in the study population of 250 patients. However, compliance to the intervention was very low in the intervention group making it practically impossible to assess the effects of the intervention. Therefore, clinicians should still rely on physiological reasoning and individual effects of prone positioning in deemed suitable patients.

This commentary discusses the increasingly observed managerilisation of healthcare. Managerilisation frequently results in a framework of rules, regulations and accompanying time-consuming forms and procedures to guide decision-making. Although likely developed with the best of intentions in mind, this framework may be of limited value and tends to leave healthcare professionals feeling frustrated and distrusted. In addition, overzealous bureaucracy and rigid adherence to protocols may be disadvantageous to patient care and outcomes. Instead, we advocate a renewed focus on common sense and in particular on a renewed trust in healthcare professionals. Their professional judgement is based on many years of education and bedside experience. Hospital management should once again seek to embrace their expertise, while healthcare professionals should actively seek to regain the reins when it comes to delivering healthcare.

Abbreviations are used more and more in physician common parlance and it seems they are on the way to becoming a new jargon. However, identical abbreviations may have different meanings, especially in different medical specialties. Moreover, many physicians do not know the meaning of specific abbreviations or are attributing the wrong meaning to the abbreviation. This will lead to misunderstanding and therefore danger to the patient. The authors are calling for a stop on the use of spoken abbreviations and for minimising the use of abbreviations in clinical notes and medical prescriptions.