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  • Juri Katchanov 10:28 pm on March 15, 2020 Permalink | Reply  

    Principles 

    General

    1. Every moment of your shift A.S.K. YOURSELF: Right Attitude-Skills-Knowledge
    2. Ego is your enemy
    3. AVK Aufrichtigkeit-Verantwortung-Kompetenz
    4. You are in a high-risk situation for error if you act without love and joy. Act with love & joy.
    5. Never be re-assured by success. Success is a lousy teacher
    6. Pain is the best teacher.
    7. Always reflect on all your actions. Experience without reflection is a waste of time
    8. Not all things are as they originally appear- do not jump to a conclusion.
    9. Successful doctors are those with successful habits
    10. The biggest faliure is not to move
    11. Anticipate! Document your anticipation. Prepare for anticipated events
    12. Focus!
    13. Achtung: Лучше перебздеть, чем недобздеть
    14. Never jump! If you jump, you skip, you miss. Go the full circus!
    15. Trau Deinen eigenen Augen mehr als fremden Lippen (J.W. v.Goethe)
    16. Seek first to understand, then to be understood (Stephen R. Corey)
    17. Growth-oriented vs Goal-oriented (John C. Maxwell)
    18. Never say something that can be misunderstood or misinterpreted (Scott Adams)
    19. Qui gladio ferit, gladio perit
    20. Peace is more precious than triumph
    21. Always make people feel good. (People will never forget how you made them feel. Maya Angelou).
    22. Express gratitude (Steve Philpot). Feel solidarity … resound with gratitude (Joseph Brodsky).
    23. Practise compassion (Dalai Lama, Barbara Tatham).
    24. Do not pre-dict, pre-pare!
    25. Be the standard and others will raise their standards (James Clear). (Never tell people to be/ act differently).
    
    
    
    
    

    Diagnostic

    1. Failure to diagnose is often failure to consider
    2. Atypical presentation of a common disease > typical presentation of an uncommon disease
    3. Stick always to your validated checklists, algorithms, and pathways
    4. Actively fight the desire to be re-assured by negative tests/ normal labs

    Management

    1. DR ABCDE: Danger-Response-Airway-Breathing-Disability-Environement
    2. CPR-crash card w defi-IV-POCUS-> 2 algorithms (VFib-pVT vs PEA-asystole)- 2 min
    3. S.A.M.P.L.E.: symptoms & signs, allergies, medication, PMHx, last meal, events
    4. ABCDEFG: Don’t Ever Forget Glucose
    5. Pregnancy test in women of child-bearing age
    6. Document all relevant anticipated events and make arrangements accordingly.

    Educational

    1. Clinical case presentation: Do not just memorize the case (this will lead to availability bias) but incorporate it into your diagnostic scheme (this will ensure an appropriate retrieval)
    2. A pathway/checklist/algorithm is never finished; it is only abandoned.
     
  • Juri Katchanov 8:20 pm on December 18, 2019 Permalink | Reply  

    stay vigilant! 

    https://vigilant.school.blog/

    vigilant.school.blog
     
  • Juri Katchanov 8:12 am on January 15, 2021 Permalink | Reply  

    the rules of good leadership by James Clear 

     
  • Juri Katchanov 8:11 am on January 15, 2021 Permalink | Reply  

    the rules of good leadership by James Clear 

     
  • Juri Katchanov 7:44 am on January 15, 2021 Permalink | Reply  

    clinical assessment of peripheral tissue perfusion in septic shock 

    https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-019-0511-1

     
  • Juri Katchanov 7:02 pm on January 14, 2021 Permalink | Reply  

    intramuskuläre Injektion 

     
  • Juri Katchanov 7:00 pm on January 14, 2021 Permalink | Reply  

    Impfen mit BioNTec 

     
  • Juri Katchanov 5:18 pm on January 10, 2021 Permalink | Reply  

    decompensated hypothyroidism 

     
  • Juri Katchanov 10:23 am on January 10, 2021 Permalink | Reply  

    10 ways to improve nurse-physician communication 

    https://journalfeed.org/article-a-day/2020/ten-ways-to-improve-physician-nurse-communication

    10 commandments of physician – nurse communication:

    1. Communicate diagnostic assessment, plan of care and disposition plan to other team members as early as possible. Update the team of any changes to the plan.
    2. Communicate pending tasks in the patient’s care as well as information regarding changes or holdups to tasks or orders.
    3. Communicate details regarding proactive diagnostic testing and therapeutic interventions (e.g. placing IV and drawing bloodwork prior the physician evaluation in patients with abdominal pain, obtaining urine HCG in women of childbearing age).
    4. Don’t assume everyone has a shared understanding: recognize that you might have unique access to information and make sure that it is shared in a timely manner.
    5. Notify providers of any critical or unexpected changes in vital signs or patient status. Did the patient develop new tachycardia, fever, or hypotension? Is the patient more somnolent or getting more agitated?
    6. Do not assume electronic orders substitute for verbal communication.
    7. Use asynchronous communication for lower priority items to aid in prioritization (e.g. leaving a note for a physician requesting they sign-off on non-urgent orders).
    8. Adapt communication strategies based on team members’ experience level and existing relationships. For example, a new nurse may need extra time and guidance while orienting.
    9. Adapt communication strategies to the physical layout of the ED, especially in those facilities where nurses and physicians may have workstations out of sight from one another or where it is not obvious which staff members are on different care teams.
    10. Use strategies that exploit provider experience level regardless of role hierarchy. Perhaps we all remember being a fresh resident physician (finally a doctor!) and realizing that we knew very little compared to the seasoned charge nurse.

    Source
    Ten Best Practices for Improving Emergency Medicine Provider-Nurse Communication. J Emerg Med. 2020 Mar 4. pii: S0736-4679(19)30939-4. doi: 10.1016/j.jemermed.2019.10.035. [Epub ahead of print]

     
  • Juri Katchanov 8:36 am on January 4, 2021 Permalink | Reply  

    Patient Safety Net 

    https://psnet.ahrq.gov/

     
  • Juri Katchanov 8:32 am on January 4, 2021 Permalink | Reply  

    In Conversation with Pat Croskerry 

    https://psnet.ahrq.gov/perspective/conversation-withpat-croskerry-md-phd

     
  • Juri Katchanov 7:42 am on January 1, 2021 Permalink | Reply  

    vaccine safety by NEJM 

    https://www.nejm.org/doi/full/10.1056/NEJMra2035343?fbclid=IwAR06zhBOekmOrwVVxtEhpqgXLBuX9gOsh9KwZqBZxaIN5A-oNNGlpXr7eoM

     
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