I had a nice FaceTime call with a childhood friend of mine yesterday. She is about to complete her didactic year and enter her clinical year of PA school (way to go, you!). After chatting with her, she mentioned that it might be a good idea to write a post about some of the tips I offered her. So here it is — let’s get into it, shall we?

  1. Bring a notebook: My manager hilariously added this to her email out to our PA students that they should “bring a notebook to take notes especially if working with Darren.” So…

I’m not sure when PRVC started being so widely used but it definitely snuck up on me and our unit. Perhaps it’s an old friend from COVID days (but I remember using tons of PC during that time). 4/5 intubated patients on my floor are usually on PRVC but why? When did we start navigating away from our old friend VC, an almost standard of care ventilator mode?#nonewfriends. Most of my colleagues also choose PRVC nowadays. Well, this is the perfect topic to go over on this post.

What is my practice now? When I see PRVC, I’ll switch back…


Another day off means another post! Let’s make this a quick one on something I pretended to understand but really don’t:

Pulmonary artery catheter waveforms! Don’t you always hate it when the heart failure attending or fellow starts saying yeah the CVP isn’t the one projected in the parenthesis and then starts staring at the screen and says A-wave, V-wave, etc?

Here are the basics first as a reminder. 10–15cm to the subclavian. I like the rule of 6’s; you can use the dimes one too. Up to you. This is all derived from the manufacturer, Edwards, page.

RA: 6


Who would ever have thought that Darren would write a book review? And for fun? The last time I wrote something like that was in ELA or my AP English class back in high school. Actually I’m not sure if you’d find it surprising since I’m writing all these posts about medicine. Anyways, I’m so happy I finished a book; it took me about four months to finish because I’m not a good reader. And this is the first book I likely finished front to end since the days of my reading Harry Potter and Tuesday’s With Morrie.


It has been 10 days since my last story. That must mean I’ve been working a lot of shifts in the CCU because I enjoy this newfound writing and reading during my mornings. But then again, inspiration for writing content has been harder to discover recently. The purpose of this blog wasn’t to rediscover the wheel but to really touch upon things I do in the ICU constantly that I personally didn’t deeply understand and find evidence behind the practice. Again, it was to challenge myself to take what people say with a grain of salt (not because they’re wrong…


Prescribing albumin is just one of those things that causes controversy in the ICU. Well, maybe more so in my mind. I was first introduced to the concept of albumin during my per diem shifts in the CTICU at Cornell — the cardiac surgery fellow would always say “just give him (or her) a SPA.” After further inquiry and “research” I learned that a “SPA” was the acronym for “salt poor albumin” or 25% albumin (vs 5% albumin). Anyways, that’s how I learned about albumin.

Albumin is a colloid (a type of fluid or substance that contain macromolecules or large…


Ah the famous words: “You can sous vide everything!” So, I just bought a sous vide. A sous vide is a fancy, well…doesn’t have to be, kitchen gadget that circulates and heats a water bath to the temperature of your desire and maintains it. It’s great for internal food temperature control so you can avoid overcooking. I bought an Anova Nano Sous Vide (recommended by an internal medicine resident at work) with an Anova Vacuum Sealer.

So here is my salmon recipe.

Ziplock or vacuum sealed bag with salmon (salt, pepper, aromatics like rosemary or thyme to taste, and lemon)…


Good morning. Let’s get into it shall we?

Inari FlowTriever

This catheter made by Inari Medical is used for mechanical thrombectomy and was the first FDA approved mechanical thrombectomy catheter for pulmonary embolism. It’s important to note that this is a non-thrombolytic catheter (not injecting tPA). The FlowTriever removes thrombo-emboli via two methods. The first is aspiration where a syringe is attached to a three-way stopcock. When closed, the syringe is pulled back creating a negative pressure. When the catheter tip is proximal to the clot, the valve is opened and the clot is sucked into the negative pressure syringe…


Sometimes I like looking back at where I have been to get to where I am today. I’ve worked at five hospitals within five years and doing this has allowed to me to understand that I like where I am now. Of course, I did not purposefully pursue having so many workplaces under my belt — it was a combination of opportunity, timing, graciousness, difficulty, and patience.

Teaching Hospital #1

After I graduated from my physician assistant program back in 2016, I was blessed with working at one of the greatest medical institutions in the world. It was a cardiology…


This morning I used the 25 to 300 grams recipe. It’s good. Have to use really coarse grounds though. I used 45 on my Niche burr grinder today. I suppose I need to go to 48.

RINSE

I quickly wanted to touch upon a comment I made on yesterday’s post regarding central line cold infusion catheters. It sounds cool and I believe the city hospital adjacent to mine still does it. But cooling pads with Arctic Sun is probably the way to go. The RINSE trial (Rapid Infusion of Cold Normal Saline) came out in 2016 and the results showed…

Darren Kang, PA

Darren is a physician assistant specializing in Cardiac Critical Care in New York City. Passionate about resus, shock, PE, cooking & coffee.

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