Anonymous #1
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What sort of procedures should I know?
**Sorry if this sounds a bit lame**
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seaholme
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#2
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Every F2 will have had to pass F1 or equivalent. These are the F1 core procedures you're expected to be able to perform:

1. Venepuncture
2. IV cannulation
3. Prepare and administer IV medications and injections
4. Arterial puncture in an adult
5. Blood culture from peripheral sites
6. Intravenous infusion including the prescription of fluids
7. Intravenous infusion of blood and blood products
8. Injection of local anaesthetic to skin
9. Injection – subcutaneous (e.g. insulin or LMW heparin)
10. Injection – intramuscular
11. Perform and interpret an ECG
12. Perform and interpret peak flow
13. Urethral catheterisation (male)
14.Urethral catheterisation (female)
15. Airway care including simple adjuncts (e.g. Guedal airway or laryngeal masks
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Etomidate
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In reality, a good FY2 should be able to do bloods, cannulate, do ABGs from radial and femoral, catheterise, use a non-automated defib during an arrest, and confidently shove an oral/nasal airway in.

Skills to be learnt in that year would be suturing, lumbar puncture, difficult cannulas and maybe fascia iliaca blocks (specialty depending: A&E/ortho), cardioversion.

Anything else would be a bonus.
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Ghotay
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(Original post by Etomidate)
In reality, a good FY2 should be able to do bloods, cannulate, do ABGs from radial and femoral, catheterise, use a non-automated defib during an arrest, and confidently shove an oral/nasal airway in.

Skills to be learnt in that year would be suturing, lumbar puncture, difficult cannulas and maybe fascia iliaca blocks (specialty depending: A&E/ortho), cardioversion.

Anything else would be a bonus.
Have literally never seen anyone do a femoral stab in my life, let alone done one myself. Would you really consider that an F2 skill?
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Etomidate
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(Original post by Ghotay)
Have literally never seen anyone do a femoral stab in my life, let alone done one myself. Would you really consider that an F2 skill?
Really? That's quite surprising. It's a pretty handy skill for getting arterial or venous blood in an emergency, or a patient who requires essential bloods where all else has failed. It's a fairly straight forward with similar risks as other sampling. Helpful in an arrest/ROSC when you just want 20mLs of blood and an ABG. Also they seem to be less painful for the patient, in my experience (even with/without local).

Are you an FY2 yourself?
Last edited by Etomidate; 1 year ago
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nexttime
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(Original post by Ghotay)
Have literally never seen anyone do a femoral stab in my life, let alone done one myself. Would you really consider that an F2 skill?
I wouldn't expect every F2 to be able to do it. But I definitely would expect an F2 to be willing to give it a go under supervision (whether they've seen one or not), and subsequently be considered independent.

Its really quite easy!
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Ghotay
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(Original post by Etomidate)
Really? That's quite surprising. It's a pretty handy skill for getting arterial or venous blood in an emergency, or a patient who requires essential bloods where all else has failed. It's a fairly straight forward with similar risks as other sampling. Helpful in an arrest/ROSC when you just want 20mLs of blood and an ABG. Also they seem to be less painful for the patient, in my experience (even with/without local).

Are you an FY2 yourself?
Yeah I'm an F2. In the kind of situations you're describing I've generally seen people whip out the ultrasound to go vein/radial hunting, or they just straight up cannulate the jugular vein.

(Original post by nexttime)
I wouldn't expect every F2 to be able to do it. But I definitely would expect an F2 to be willing to give it a go under supervision (whether they've seen one or not), and subsequently be considered independent.

Its really quite easy!
To be fair I wouldn't be afraid of trying. Just surprised to see it viewed as a core F2 skill
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nexttime
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(Original post by Ghotay)
To be fair I wouldn't be afraid of trying. Just surprised to see it viewed as a core F2 skill
Its mainly for emergencies when faffing for an USS isn't an option. I guess you're right in that US is probably taking over in non-emergency settings.

I personally couldn't call it core - just common. More common than US guided cannulas among F2s I'd say? Perhaps your experience is different though.
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Etomidate
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(Original post by Ghotay)
Yeah I'm an F2. In the kind of situations you're describing I've generally seen people whip out the ultrasound to go vein/radial hunting, or they just straight up cannulate the jugular vein.


To be fair I wouldn't be afraid of trying. Just surprised to see it viewed as a core F2 skill
I think I would fall out of my chair if I ever saw a non-anaesthetist use an ultrasound or cannulate the EJ. It would certainly make my life much easier.
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Ghotay
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(Original post by Etomidate)
I think I would fall out of my chair if I ever saw a non-anaesthetist use an ultrasound or cannulate the EJ. It would certainly make my life much easier.
All of the juniors in my A&E received ultrasound for vascular access training. I only had reason to use it once myself, but it was great. Cannulated the basilic vein in an IVDU; quite satisfying.

One of out consultants was ****-hot on ultrasound and really encouraged it though, and one of our specialty doctors too. Seen it used for art lines, assisting with fascia-iliacas (when they're too obese for you to find a femoral pulse), all sorts. Even did a cardiac ECHO on someone while CPR was ongoing, though that was mostly for educational purposes. I think I'm a bit of a US convert actually.

Saw the same consultant cannulate the EJ a few times too. Maybe he's just ahead of the curve?
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nexttime
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(Original post by Etomidate)
I think I would fall out of my chair if I ever saw a non-anaesthetist use an ultrasound or cannulate the EJ. It would certainly make my life much easier.
Only anaesthetists use ultrasound? That does sound quite behind! Its a core CMT/A&E skill as far as I'm concerned, even if the Powers that Be still seem to think ascitic drains are more important.

We have never received any training at all but you can phone a number and they will bring you a machine then you can mess around with it. Failing more peripheral access the basilic is always easy to find as Ghotay says.
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Helenia
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I would also be pleasantly surprised, but it's no bad thing if it saves me getting out of bed!
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girl_in_black
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(Original post by Ghotay)
Yeah I'm an F2. In the kind of situations you're describing I've generally seen people whip out the ultrasound to go vein/radial hunting, or they just straight up cannulate the jugular vein.
This is very, very uncommon - I only ever saw it done in the hospital I trained in. My reg was seriously impressed when I said I could do US-guided cannulas when I started F1.
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belis
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(Original post by Etomidate)
I think I would fall out of my chair if I ever saw a non-anaesthetist use an ultrasound or cannulate the EJ. It would certainly make my life much easier.
I have almost given on call med reg a stroke by doing just that as an FY1 one memorable weekend. I thought I was being helpful by sorting it all myself. They have fast bleeped ITU consultant as felt EJ cannula needed removing immediately by an expert. Boss was able to reassure them that they have seen me put enough central lines during my ITU/anaesthetic rotation to be confident that 'my reckless intervention' won't cause an immediate demise of the patient and in fact was a sensible thing to do under the circumstances.
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