Two quick stories about Kyle. I was an intern. He PGY3.
A. 6/25/2011. Kyle saw my orders. “Don’t use docusate. It doesn’t work.” He was don’tcusating before it was cool.
B. 3/2012. Kyle came to the bedside of my hypotensive patient. “MAP is cardiac output times SVR...
1/3
A. 6/25/2011. Kyle saw my orders. “Don’t use docusate. It doesn’t work.” He was don’tcusating before it was cool.
B. 3/2012. Kyle came to the bedside of my hypotensive patient. “MAP is cardiac output times SVR...
1/3
... His shins are cool. Means SVR is high. So CO must be low. CO is heart rate times stroke volume. Pulse is high. So SV must be low. Now let’s look at his JVP. If preload was low, it would be flat. But look it’s elevated. This is cardiogenic, tamponade, pneumothorax...”
2/3
2/3
I’d probably had several opportunities before that to learn that approach. But that’s when it stuck. Something about the way he thought outloud, made sure I was listening, was calm but focused.
I’ve used and taught that framework many times since then. All him.
3/3
I’ve used and taught that framework many times since then. All him.
3/3
