Daniel Plack, MD

There’s not enough discussion on here about how hard it is to do residency with distance. I was told was it’ll be okay, you’ll make it work. Here we are on our “golden weekend” after not seeing each other for months. Post 28 hour call. Keep up this in mind for couples match.

100%. Remember PO:IV conversion is not straightforward, high variability in half life.

@rishikumarmd Do you have an example of implementing automation in work/MedEd?

Identify tasks that you regularly perform and learn how to automate them.

This video shows significant airway soiling. Suction was used continuously to provide a view in order to secure the airway (the SALAD technique) #AiRBlogVideos #FOAMed #Airway Find the password and more info here: sydneyhems.com/airway-registr…

You can nicely see the ICP waveform from the patients ( who was boarding ) ventriculostomy. Its very import to look and learn how to read all these different waveforms in the ICU, including doppler on echo and pocus.

Putting a 10cm needle through a rib to biopsy a lung mass next to the aorta, takes about 30-60min and pays us ~$90. Tell me again how physicians are overpaid? I paid a locksmith $155 to change my front door lock. It took 5min.

What people think I do in the ICU to help patients get better vs what I actually do in the ICU.

@seleniumdrive Totally agree. Rounds standardization should be unit specific.

Wait for it… Wait for it… Wait for it… I am the keeper of my own well-being.

Crazy that it has already been a year with this crew. I’m so thankful to be amongst them. Every critical care fellowship should be multidisciplinary.

Check out this video from current #RegionalAnesthesia fellow Dr. Rachel Douglas on gastric ultrasound. @RachelDouglasDO @MayoAnesRes youtu.be/hm-z75ds8-I

It’s pretty much a general rule of life that it doesn’t matter how great your circumstances are, there will always be those who find reason to complain. And conversely there will be those who don’t complain. Which do you want to be?

There is no such thing as a pulm-crit fellowship off of anesthesiology residency. If you want to do pulmonology, you need to do IM. Any anesthesiologist doing critical care is not a pulmonologist unless they are also boarded in IM and then did pulm-crit fellowship.

@DrCasteelEM Lots of people like to hate on this advice. Keep in mind it’s just that- advice. You can take it or leave it. It’s advice for how to build a strong financial future. If that’s not a priority to you, then the advice doesn’t apply to you.

“Live like a resident your first 3-5 years as an attending” …dang can I at least live like a decently paid fellow? I need something lol.

@PulmCrit Underlines the need for a high index of suspicion for mixed shock. @CGSNabzdykMD

phenylephrine & norepinephrine have more in common than most people realize 😛 (emcrit.org/pulmcrit/pheny…)

@EMARIANOMD @VAPaloAlto @stanfordanes @MayoAnesthesia @emilysharpe @asabcejo @rljohnsonmd @SLKoppMD @HansSviggum @SheelaPaiCole @daryloakes4 @MayoAnesRes Hey it brightened my day to run into you @EMARIANOMD! Looking forward to collab on truncal blocks for the CT surgery practice next year!

Look 👀 who I ran into at @VAPaloAlto today! @danielplackmd is an anesthesiologist and critical care medicine fellow at @stanfordanes and will be doing a cardiac anesthesiology fellowship with us next year!

@nikhilautar1 @FaguxMD @TPP_MD Respectfully, I disagree. All interns should be expected to place central lines with supervision.

@FaguxMD @TPP_MD Really? I thought it's pretty damn invasive, and for safety, only pgy2+ do it here (though some just hide it). I'm sure it's supervised, but it's still damn unsafe. I would not want interns doing it to me and I'm sure doctor colleagues here would agree, it's unsafe to expect it

When I was an intern I botched a central line on a septic patient with an INR > 4 As the large hematoma started to form my upper level - while putting on a gown - said, “Well, you’ll never do THAT again.” That’s when the self-judgement started to eat me alive… 1/

@BoyGeekDrone @TPP_MD It’s a problem in the US too. Some med schools have clerkship rotations (M3 and M4) that are largely shadowing with very little call experience.

@TPP_MD Mad how you'd rarely find an F1 or F2 having a chance at a central line in the UK. UK training is falling behind.

@80s_hairrocks @TPP_MD 💯

@TPP_MD One of my favorite sayings to med students and residents is “The most dangerous doctor is the one who knows everything.” After reading some of the arrogant responses from fellow MDs on this thread I’ll likely include “…the one who won’t admit they’ve ever made a mistake.’

@HappyDays_EM @nickmmark @ENirenberg @thehouseofpod Natural lung pressure is…. ((Inverse of driving pressure) x baseline NIF) / BSA ? Can we write this up @HappyDays_EM?!

@nickmmark @ENirenberg @thehouseofpod I mean in his defense it sounds pretty reasonable if you have no idea what you’re talking about. Who would ever be against going above “natural lung pressure”?

Remember when Elon promised ventilators and came back with BiPAPs and also had strong opinions about appropriate PEEP in COVID patients