Bit nervous about FY1

You've been on placement in hospital all year right? You should have been doing tons of bloods and cannulas, if you're not confident yet i'd advise you make sure you get some more done before you start. Everyone struggles sometimes, that's totally normal, but you should really be capable of doing it 9 times out 10 by the time you start. Same for ABGs and catheters.

It's perfectly normal to be nervous. You're meant to be nervous. It's good to be nervous because when things go right (as they will the majority of the time) and as you get through it you'll get a satisfaction higher than any part of your medical degree.

As for practical procedures all I can say is practise as much as you can before you start. Do a week or two of shadowing and do as many of the venflons etc. as you can.

Truthfully I'd never put a catheter in before starting F1 (except on models) and had to wake my SpR up at 4am to help me on my first night shift. I wasn't very good at cannulation but if you know the technique you'll get better very quickly. My hit rate certainly wasn't 9/10 before I started, no where near. If you find you are struggling tell your seniors and nurses who are capable on the ward to help you. By that I mean teaching you and giving you tips - NOT taking the piss and asking them to do all of your difficult venflons!

I've never put in a catheter either or done an abg. Will have to start practising.

This doesn't mean I will be happy if you call me at 3am with a difficult one though...

If you're unsure about ABGs, use some local anaesthetic. Only a tiny bit, and rub it in well, so the bleb doesn't get in your way. Makes a huge difference to patients.

If you're unsure about ABGs, use some local anaesthetic. Only a tiny bit, and rub it in well, so the bleb doesn't get in your way. Makes a huge difference to patients.

I would always use local for ABGs if nobody is looking, people do seem to get shouted at for using it though.

I've put two catheters in (both male) and they seem to be fine. In the hospitals I've been in they are never a doctor job so hopefully it won't be something I have to do in my next place.

I may be really thick for asking this. Does LA make any difference at all in terms of the pain level patients experience from an ABG compared to say, having blood taken or getting a cannula? Surely it's the penetration of the skin that's painful so in theory it should hurt just as much as the other procedures? (unless one hits the nerve in which case the LA may not work since it's so superficial anyway)I don't have years of experience under my belt compared to some of you but I have done 5-6 ABGs this year and none of the patients complained of pain, the most I got was a subtle wince, nothing more than what one would get when they take blood. I have always used an orange needle though.

I think its that the area you're going for it more sensitive.

Regardless - a few of my colleagues have volunteered for having ABGs done on them. They all say its much, much worse than venepuncture.

Were the people you did it on old? Old people are just tough as nails. Or have relative neuropathy. Same difference.

No, they weren't elderly but they were definitely unwell enough to warrant an ABG to be performed. I guess the area where it's done could be more sensitive as you said but I'm not sure if I'm convinced that LA is required. But I guess everyone has their preferences, I once saw an anaesthetist using LA prior to putting a grey cannula in a housman's vein, as in the cephalic vein not an FY1's.

Have one yourself if its not too bad then get back to us.

LAs are not without risk and it stings bad too.

I'd be more unsure about how to use LA! Do you have to prescribe it beforehand? How much do you draw up/what strength? This is something we've never been taught (and I've never seen it done either).

Applicable even if you're not unsure?

Every med student i know who has had an ABG swears that they will never do one without local again!