Kaleb Lachenicht

“We don’t learn from experience. We learn from reflecting on experience.” - John Dewey

Peri-op cardiac arrest - how can we do better? • team briefings • in situ multidisciplinary simulation • teaching generic cardiac arrest team competencies • mandatory training for rare anaesthetic events @jpenketh39 @JerryPNolan buff.ly/3Zgrypy

The Sepsis Guidelines emphasize on early administering broad-spectrum antibiotics, appropriate fluid resuscitation, measuring lactate, and initiating vasopressors if clinically indicated within the first hour of sepsis recognition. See more teaching at: @jackcfchong" target="_blank" rel="nofollow noopener">youtube.com/@jackcfchong

Our latest case report - another instance of bougie familiarity and skills leading to safer airway management. @kmconnel78 @BritFltdoc @mack99301 @Trev074Trevor @UWMedFlight @UWEmerMed @MadtownEM @cliffreid @AMPAdocs @ATACCFaculty @DipRTM @UCAirCareDoc sciencedirect.com/science/articl…

Adrenaline VS Noradrenaline

🧵 1/8 Excited to share a win! Our ICU is launching a positive reporting system where staff can recognise each other's excellence. Already works brilliantly in our ED & retrieval service - now expanding thanks to amazing colleagues running with the idea! #HealthcareExcellence #PositiveCulture

Extubation Readiness: A to L Checklist We're obsessed with safe intubation, but what about taking the tube out? How do we assess extubation readiness? Here's my simple, alphabet-based A to L checklist: 1/17

Before DCing Pts From the ED…I Have a Checklist of 6 Things (Like a Procedure Checklist): -Stable VS -Clinical sobriety -Ability to care for oneself -No new complaints -Complete eval of all triage complaints -Review all labs/imaging one more time #MedEd #AvoidingMalpractice

I'm reposting this again because it's so important as a trainee, attendings with different styles can be frustrating (you just learned one style and want to do that!) but learning diverse approaches to a single problem will serve you well later on, by teaching flexibility

Non-invasive BP measurement in prehospital critical care is less reliable the sicker you are Thanks @stemlyns & @EMManchester for this post on a great prehospital paper by @DrYaniPerera and colleagues from @TVAirAmb

Emergency Department Pericardiocentesis Great video with many practical tips youtu.be/0aoQdhfCX2A?si…

Psychological safety is not just a ‘tick box’ exercise in simulation & just to say ‘this is a safe space’. It is a fundamental concept that needs nurtured & built on trust. It can be fragile-therefore needs to be maintained throughout the simulation #PsychologySafeContainer

He laughs. “Beer and Skittles, doc.” He shakes my hand, we say our goodbyes, and I sit down in my office to chart. Name. Date of birth. Diagnoses. Data. Forms. Structure. None of it conjures the image. A dog, a car, a way home. Three wishes. Ships in a harbor. Harbour.

Let’s mention some tips: 1. Very few intubations are really “crash” ones. Use the time to optimize yourself, the patient and the environment 2. Pre-oxygenate almost everybody with NIV. Use common sense and the PREOXI trial findings 3. Use waveform capnography (not colorimetric)

nice reminder that epinephrine is a banger for patients on the verge of dying norepi: improve the Bp epi: improve the Bp, improve cardiac output, treat anaphylaxis, treat status asthmaticus, treat bradycardia look at this list of pts who survived with a dirty epinephrine gtt:

Follow on from previous post. The plastic star foreign body was retrieved from the larynx. The granulation tissue then removed. The toddler made good recovery. What a star! #ENT #entsurgery #surgeon #airway #larynx #airwayhealth

Recording tomorrow, last chance to get some horribly complex questions in for @heli_med_james & @robfenwick …

Intubation for hypoxaemia and septic shock Emergency medicine specialists in black scrubs One on haemodynamics, one on oxygenation Art line in, Peripheral norepi, epi 1:100000 ready to push Ramped, preox via NIV-ST mode on Hamilton, allowing supported ventilation during induction Intubated first pass over bougie using VL by emergency medicine trainee. No desaturation. Resus nurses all over it Calm, smooth, safe. Just like we train No random ideas or drug combos introduced by a clinician that you've never met before A shared mental model in a cohesive trained team leads to effective resuscitation

We just published a pediatric distal femur IO study in #PrehospitalEmergencyCareJournal. This is the first publication demonstrating the success of this site in the pediatric population. A huge thanks to my team at @PBCFR for promoting and encouraging high quality EMS research. 🙏

#Fluids 💧& #Sepsis: Less is More? 1️⃣💧hemodynamic effects are fleeting 2️⃣ Coin-toss probability in 💧responsiveness assessment; 3️⃣💧responders rapidly become non-responders 4️⃣💧responsiveness tools: limited applicability in #ICU #PedsICU 5️⃣💧=drugs w/serious adverse effects