2 prison guards, 1 patient, 1 pair of handcuffs, 1 nurse, 1 cannula, NO PRESSURE

2 prison guards, 1 patient, 1 pair of handcuffs, 1 nurse, 1 cannula, NO PRESSURE

I've come along a lot in the last few weeks at my clinical procedures.  I've improved from wanting to hide in the nearest supply closet at the suggestion of cannulating a patient to actually feeling pretty confident I can pop it in provided the patient is not completely shut down/ older than time itself (for those non medical personnel not in the know, a cannula is basically a tube you put into a vein so that you can give IV drugs/fluids through it, it usually stays in there a few days).

Those of you who are observant and have been following my blog regularly  might have realised I have only ever blogged about successfully getting a cannula in ONCE, that would be because until a few weeks ago I had in fact only got a cannula in ONCE (yes, I am a final year and yes I realise this is bad) which was on my elective over a year ago and then only under guidance from a midwife.  Still after a few weeks on surgery and 1 in ITU I'm finally more at the level a fifth year should be at and have now done quite a few, but heres the story of my first two sucessful patients.....

1 week old with a MELONoma (sorry I doctored the word a bit...) he was a bit fruity... (yes yes brother, I stole your joke, I'd vancouver reference you but this blogs anon so tough luck :P)

Ok, this patient was a mango.  The nurses mango to be precise (I think she ate it afterwards and all :S).  He made good practise for how to hold and insert cannulas though, very forgiving and very patient, so I think I owe my first actual successful unassisted cannula to him.  Here he is in all his cannulated glory:

Incidentally don't try and flush saline into a cannulated mango, it WILL squirt out and hit your reg in the face. Opps :/.

The patient in handcuffs
So off I went to cannulate my first actual patient here at the suggestion of mango-nurse, and she came with me so she could sign off my cannulation skill box if I managed / take over if I did not. All fine so far, till I get the patient who turns out to be handcuffed to a prison guard with another one watching... So my cannulation attempt will in fact have 8 eyes on it, excellent, no pressure... IS IT ME OR IS IT SUDDENLY REALLY HOT IN HERE?!

Furthermore the vein I like the look of is partially being covered by the handcuff, I try to pull the handcuff down a bit (wondering as I do if thats even allowed or if a prison guard is about to yell at me) but it gets caught on the wrist bone so I assume its meant to not go any further and give up tugging and try to work around the handcuff when the patient impatiently tugs it down for me, opps, good start.

But anyway long story short, I did get the cannula in first time (yay) but I did also give the bed a bit of a blood splattering which mango-nurse was less keen about, never mind, win some lose some.

But yes, not the first unassisted cannulation experience I was expecting!

Halfadoc x

Things can only get bettttter....

October 2012:  This last week and a bit started off so badly, with everything seeming to go wrong leaving me very fed up with medicine and my own disorganisation, fortunately I'm glad to say a week on and everything is already seeming a lot less stressful!  The main two items of stress are below, not the only ones by far, but the straws that broke the camels back I suppose because without them it all seems so much more manageable again :).

I've gone from having fits of rage that someone had taken my stethoscope from SAU where I had accidently left it over night (my stethoscope is by no means top of the range but its still £60 that I really can't afford to waste right now) to having my faith in humanity restored by someone responding to my "MISSING STETHOSCOPE" posters and getting it back to me.  It had been missing for 3 weeks and I leave this hospital in a week so I thought it was a gonna but had been paranoidly eying up all stethoscopes of the same colour to try and see if my name was engraved on them.  Its probably for the best that its turned up now, because staring at all those doctors' chests was probably a little creepy....

Furthermore I was having a major fit of rage at myself and a big panic about the fact I could not find my intercalated degree certificate and it is foundation job application time - if I couldn't get a replacement one by the 19th then my intercalated year would be a waste of time in the sense that I wouldn't get any points for it on my job application - I couldn't believe that I had successfully put things such as my Duckling Swimming Award certificate in a well organised folder but had no idea where the most important certificate I currently had was! Major fail!  I organised to get a replacement (another £26.50) and begged the admin lady to push it through faster than the 3 weeks quoted when sods law, 2 hrs after I had paid, my parents find my certificate at home. Doh!!  However the very kind admin lady arranged a refund for me even though my certificate had already been printed - what a gem! So once again faith in humanity restored :)

But at least I alway know where my duckling awards are, I mean WHO knows when someone may ask me to show proof of having earnt that...

Its also been a good week in that I've spent it in ITU which has been VERY interesting, plus I'm finally getting good at blood taking and cannulating - the doctors on this ward have actually commented that I'm very good! Now thats a change! 

The best FREE medical finals revision sources

Right, so this is going to be an ongoing resource that I will add to as I go along , but I figure finals are a problem that is best shared so it would be nice to have a list that all students can look at and add to in order to save us all doing the same research.  Please comment if you know of other sources and I will add them to the list :) (and steal your suggests for my own revision as well ;D).

Free Podcasts - good for revising on the go

• http://saran.podomatic.com/ - easy to download, work straight away with windows media player.  I've not listened to them yet so I'll let you know what they are like soon (downloaded them for a long car drive!).
• http://www.podmedics.com/ - not free but you can get a free 7 day trial.  So I guess you can liberate as many resources as possible during that time....And of course then sign up for the website if you like them...
• There is a free podmedics podcast app with quite a few downloadable podcasts which are pretty good if you have an iphone

Non downloadable presentations/ podcasts (streaming only)

• "Feather does finals"- Meant to be really really good, been recommended by lots of people.

Youtube videos! (for those all important examinations you never learnt to do!):

• Series of OCSE videos by manchester uni -  v. useful! (and thats as a non biased non Manchester student ;D) 
• Another ocse video series - not as many as above one, but good for thyroid!
• Varicose veins ocse video - this one is great for varicose veins examination, finally made sense to me! (There is also a few more ocse videos if you click on the uploader name)

Websites

• geekymedics.com - looks really good from what I have looked at so far :)
• http://almostadoctor.co.uk - really useful notes and sectioned in a very easy to use way.
• www.askdoctorclarke.com - the courses and that aren't free but you can sign up to the website for free and theres a fair bit of revision material there 
• http://passmed.co.uk/index.html - bit variable, has links to other free sites but lots of them are out of date (have been looking through for working ones!).  Some info on the site itself though.

....More to come!