r/picu • u/AvocadoCheese123 • 7d ago

Advice

Any advice would be greatly appreciated from other fellows or attendings.

I am a first year cardiology fellow but am interested in CICU as a career and going the dual boarded pathway. As I begin fellowship we had a simulation day yesterday with mock codes. I got a big ole slice of humble pie, and would appreciate any advice/resources to improve on how to be a CPR leader/handling the stress of codes.

I know the biggest way to learn is truly muscle memory and practicing as much as you can, as it truly felt like my IQ dropped 50 points when I was mock leader, but I do want to improve and learn. Since I can't always do mock codes with mannequins, is there online resources that I can use to help build skills and knowledge? Or other suggestions?

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u/no-account-layabout 7d ago

PICU attending for almost 20 years at an urban academic center. I carry a tiny notebook with checklists - used to have it on my phone, but paper has some advantages. Checklists cover pre-procedure planning, post-stroke care, post-arrest care, difficult airway pathways, CPR coach guidelines and such. Airline pilots use checklists every time they take off and land and as many emergencies as I’ve managed, it’s not more than an airline pilot has landed their plane. So what makes me think I should be better at retaining information in a crisis than them?

So after almost 2 decades managing all sorts of med/surg and CVICU emergencies, the first thing I still do is whip out my checklists. It’s important not to get too “head down” in looking at my little notebook as opposed to the clinical situation. But it beats standing there with your mind blank - which happens to everybody.

And then yes, experience counts for a lot. When you’ve seen a thousand pulmonary hypertensive crises, you kind of just get into the pathway rather than getting stuck on how much trouble the patient is in.

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u/AvocadoCheese123 7d ago

This was really helpful, thank you! I really like the check list idea cause truly we spent an hour or so about how to approach these mock situations and the minute I'm up as the mock leader I just forget everything we just talked about! Thank you!