dont stress about the etCO2 81 - hypercapnia wont kill the patient. trying to achieve a normal pCO2 might 💀 (dynamic hyperinflation causes obstructive shock) . #StoweEM20 by @mattroginski
autoPEEP can be measured, but this requires a passive patient. waveforms provide qualitative information even if not passive #StoweEM20 by @mattroginski
the primary driver of autoPeep is respiratory rate (*not* tinkering with the inspiratory time). shoot for resp rate around 10-14 #StoweEM20 by @mattroginski
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how to place a consult: you MUST understand the five stages of consultant grief.
once you can understand this painful and natural process, requesting consults will make a LOT more sense
buckle up, it can be a little rough…
🧵 1/6…
stage 1: denial
- You dont need a consult.
- You called the wrong service.
- 18 years old? consult pediatrics
- I’m not actually on call now
- Everything’s fine, just walk it off…
stage 2: anger
- you should have consulted us earlier/later
- you should have checked this test before calling us
- you’re a terrible doctor/student/human being