Alternatives to if

• In advanced medical writing and clinical discussions, we often use alternatives to 'if' to make conditions more precise, formal, or concise.
• Structure
• Function
• Example
• otherwise / or else
• presents a negative consequence
• Administer the antidote immediately; otherwise, the patient will deteriorate.
• supposing / assuming (that)
• introduces a hypothesis or condition
• Assuming that the serum level rises, we must increase the monitoring.
• but for / if it weren't / hadn't been for
• introduces a counterfactual rescue
• But for the quick toxicology screen, the child would have died.
• Remember
• Use 'otherwise' and 'or else' to warn about the result of not doing an action.
• Use 'supposing' or 'assuming (that)' to build a conditional scenario.
• Use 'but for' followed directly by a noun phrase for third-conditional meanings.
• Use 'if it hadn't been for' before a noun phrase in past counterfactuals.
• Examples
• Assuming that the hospital in London has naloxone, the ambulance will divert there.
• Or else the patient would have suffered irreversible hepatic failure.
• If it hadn't been for the senior resident at St Thomas' Hospital, the error wouldn't have been caught.
• Common mistakes
• Unless for the antidote, she would have died.
• But for the antidote, she would have died.
• Assuming the test will be positive, we started treatment.
• Assuming that the test is positive, we start treatment.

Complete the sentences

• We must intubate the patient early; (otherwise) ____ the airway will close.
• (supposing) ____ that the antidote arrives from Manchester, what should we do next?
• (but for) ____ the activated charcoal administered in Birmingham, the overdose would have been fatal.
• The toxicologist must check the labs; (or else) ____ we will miss the poisoning case.
• (assuming) ____ that the serum level drops, we can discharge the patient tomorrow.
• (if it hadn't been for) ____ the quick intervention in Edinburgh, the child wouldn't have survived.

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