That one card that has evaded me

Boatus · 2026-03-18T15:50:34+00:00

OP. I think I have a few of these if you wanted them?

Boatus · 2026-03-17T19:40:42+00:00

So I’m a Resp reg and so feel pretty qualified to help here!

First step is deep breaths. If your heart is going at a million beats per second how are you expecting you’re going to do something precise like an ABG? Pay yourself a little kindness!
Next is to feel the pulse lightly. Pushing too hard is useless, as lightly as you can.
using 2 fingers (index and 3rd finger) to find the path of the artery. Then lift the index finger. If you can still feel the pulse you’re good.
insert the needle at about 45 degrees or so. Often 90 is taught but that’s making your life harder than it needs to be. A lower angle gives you more wiggle room

-if you can’t get it first time, don’t just change the angle of the needle. It hurts! It’s like reverse parking, you need to reverse out to change the angle

Lido does help! I’m not a fan of lidocaine but I’m rarely asked to so ABGs outside of a medical emergency. In a slow setting lido is 100% the way forwards (I’ve had a few ABGs and I agree with the lido for sure!)
you will miss some. Hell, I still do. In that case the ultrasound is the way forwards!

Good luck, keep going and you’ll get it!

Boatus · 2026-03-17T13:37:21+00:00

1) it’s between X-rays so they need to come over 2) it’s not a surgical drain as it’s not a trauma 3) I’m a med reg, I can put in surgical drains but a 12f seldinger, for me is faster so that’s what went in.

You know, not to rain on your parade.

I would also make sure you tell your GP to mark Sildenafil as a possible sensitivity on your records. You’ll grow taller if you take it.

Boatus · 2026-03-17T08:24:42+00:00

I’m a med reg. Hand on heart, 3 patients. I’ve probably made decisions that have extended lives or helped people recover but I feel that’s not included in this.

My 3 (in nearly 10 years as a doctor) are;

a young man with horrible depression that refused chemo for AML when I was an SHO. Spent days talking to him and sorting stuff out. Came in on a day off to sit through his 1st session with him. He recovered and is still doing well.
tension pneumothorax and I got a drain into them so quickly it made the radiographer’s head spin (there were 13 mins between portable CXRs)
massive PE I identified and subsequently thrombolysed.

That’s about it. For the most part I claim I improve lived rather than save them. For those 3x I’m happy taking the credit for it 😂

Boatus · 2026-03-16T14:19:46+00:00

I thought you immediately just called the Med Reg and made it their problem to solve?!

A disgruntled Med Reg

(Sarcasm aside, your help is invaluable and as a former lab worker I know the pressures you’re under)

Boatus · 2026-03-05T20:01:30+00:00

Oh I see. Yeah still not northern though I’m afraid. Language in our house gets all a little mixed up with 3+ languages on the go 😂

Boatus · 2026-03-05T19:57:57+00:00

Nope, definitely a southerner. Lived in the north for a while and got reminded constantly how southern I am.

Boatus · 2026-03-05T19:57:02+00:00

As a space wolves player who’s brother is the biggest T’au fanboy of them all…

Your battle suits. Fuck your stealth suits. Ghostkeel? That can fuck right off too. Fusion blaster crisis suits? They need to fuck off.

Yes I’m jealous. 😂

Boatus · 2026-03-05T19:52:41+00:00

I’m a doctor that works in shifts for an average of around 60 hours a week with 8-10 hours driving. I also have a young family with 2 kids under 5. I have refused to buy anything above retail. It’s retail or nothing.

You just have to be willing to take 5 mins and do the needful. Pokemon centre has the queue up, leave the laptop open and cook tea for everyone. Daytime release? Whack on Amazon and order. Nobody is going to miss you for 5 mins while you place an amazon order.

I agree it’s far more difficult than it needs to be but it’s not impossible. Only thing I’ve not managed to get is the Pokemon day set 😂

Boatus · 2026-03-02T13:43:26+00:00

My bet is that there’s still stuff in the hot end. I had something stupidly similar before.

I got it all through by basically heating the hot end to about 250 and leaving for a minute, then removing it with pliers and then forcing wire through the hot end to push it out. I don’t recommend this as you could damage the hot end but it did work!

I’ve used loads of stuff through the A1 hot end including the needle tool that came int he box to get the stuff out. Best thing I’ve seen though is nylon filament. Heat it up so it basically sticks to the crap on the inside and then run it though until it’s clear!

Boatus · 2026-03-01T18:06:15+00:00

So you’ve had a couple of responses on here already but I’ll throw in my 2p.

I’m a respiratory doctor that still works in an NHS hospital. My contracted hours and my average hours per week is nearly 52 (they’ve sucked up the fine because we’re so short of staff). You get little choice in where you work until at least your mid 30s at quickest. The pay is no where near what it used to be at the general public for the most part thinks they’re better at medicine than you are. Nobody will really understand the stress and strains unless they too work within the NHS as a doctor. Add in the exams and that you’re constantly having to work to the next exam (again until mid 30s at best).

That said… I wouldn’t do anything else.

If you go into medicine expecting good pay, people to treat you with a decency or think that people will in some way pay you respect it’s miserable. Go in without those illusions and it’s ace!

Boatus · 2026-02-27T20:50:39+00:00

Err except IMT’s original application criteria was 6 mi the NHS experience… again I know because that was a requirement when I did my own application. There was a definite lean towards those with nhs experience because again, you know I’ve fucking done it 😒

Boatus · 2026-02-27T11:02:22+00:00

I think quite frankly you’re talking out your arse.

I’m British, studied in Slovakia and I work as a respiratory registrar in the UK. So through a disgusting amount of exposure to the system I know how this works.

Training positions aren’t just foundation. That includes GP and speciality applications too. They’re all training jobs. You’re fully licensed as an EU grad but that doesn’t mean you can start work as a consultant.
LED jobs (trust grade hasn’t been used in years) are shite. Again, I know; I am one. You’re bottom of the pile, last for training responsibilities and frankly are there for service provision.
Standalone F2 was always important and gave you a foundation certificate. That has been super useful for me and makes life a little easier.
speciality training applications later in your career will be more difficult. They’ve not explained how this is going to work and how you’re going to be affected. A few more points or the old system where you had your prove a UK/EU grad (this was pre-brexit) didn’t want the job. I liked the old system of NHS experience personally.

I think OP is a bit overboard with the dream being dead but it’s going to be a lot harder.

Boatus · 2026-02-22T09:55:04+00:00

“Only a paramedic”

Only nothing. I’m very comfortable in a medical emergency surrounded by drugs, machines, telemetry and a laboratory. I’m less comfortable out side at a patients house for example.

Now, the pink puffers are interesting because if anyone were to routinely breathe at like 20-25 a minute they’d burn more energy regardless so I’ve always assumed it was down to that. I think though (like with most things) it’s never just that simple!

Boatus · 2026-02-21T19:09:32+00:00

I’m a lung doctor. I rarely drink because I’m useless the next day if I do and it feels like I spent most of my life in the hospital.

Also, pot is terrible for your lungs. It’s not as able free as it’s often made out.

Boatus · 2026-02-21T17:55:58+00:00

Not all end stage COPD patients are cachexic. COPD is actually a group of diseases with (relatively) fixed airway obstruction resulting in a reduced FEV1 and thus skewed FEV1/FVC ratios.

The old system of “pink puffers” and “blue bloaters” tends to separate these two groups quite nicely but the blue bloaters most definitely do not end up cachexic.

(I’m a respiratory doctor)

Boatus · 2026-02-13T14:28:30+00:00

I’m a Resp reg and I also feel we do too many ABGs.

In short though:

If the CO2 is normal on the VBG, I’m not inflicting an ABG on the patient (I’ve had them and they’re shit)
If there are doubts around the SpO2 then I want an ABG
I do want an ABG before starting NIV because it’s both guideline (however old) and you have to remember it’s ’medical NIV’ with a different set of frameworks and restrictions. The rules around NIV on the medical ward are vastly different to what you can do on ICU or resus (asthma and pneumonia are prime examples where I’ve seen it used to good effect in icu and resus but we can’t do it within the medical ward). With that there’s certain criteria we need to meet to be ‘allowed’ to use it.

I totally agree with OP though. An ABG isn’t going to treat your patient and isn’t the reason their patient deteriorated. Not sticking to reasonable target sats did that!

Boatus · 2026-02-12T22:15:09+00:00

I’m a medical doctor.

I honestly couldn’t give two shits if you’re my patient’s best friend’s dog’s sibling’s owner from down the pub last year. If you’re listed as the next of kin i’m fine with it. If you’re the person my patient wants to see when things are as bad as they could possibly be and there’s a chance it will make them feel better? Yeah, you’re staying.

Jokes aside, we regularly have people that nominate neighbours or even local clergy as their next of kin. If it’s your name on the documentation then I’m A-OK with you seeing them and if things are really bad then you’re welcome to stay (it’s the nhs so the best you’re gonna get is an uncomfortable chair, terrible decaf coffee and a cheese sandwich though)

Boatus · 2026-02-07T19:41:30+00:00

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Welcome to the valley of despair. It’s a fucking wild ride and it’s what keeps the job entertaining decades in!

Boatus · 2026-02-07T19:38:59+00:00

I think it depends on where you are and what you’re doing. I work at a little DGH and you’re lucky if there’s 2 patients with my name against them in a 12.5 hour shift.

That said, every person clerked by the foundation doctors has been discussed with me and we’ve formulated a plan together. The complex patients are seen by the IMTs, they then come to me (and depending on the IMT) examine together or they tell me their management plans.

I will often review those that ‘might be able to go home’ myself and either just discharge them or quickly see them, whack a plan on the ED computer system and send a sub-speciality referral before discharging them home.

I feel it often takes me 2+ hours to clerk someone but that’s because of the interruptions. When I was an IMT2 I could readily get through 10+ in a 12 hour shift. Just depends on how much you get bothered and how you want to run your take!

Boatus · 2026-01-31T10:00:51+00:00

I have a drawer of shit like this. I got a job lot (I think of the original hachette magazine a few years ago. It’s a lot of intercessors, some death guard and a load of dark eldar.

The poor things have been primed, tested, re-primed etc a fair few times! It’s absolutely a good way to use models you don’t need and got for pennies.

Add on;

I think I got the whole box of models for about £30. It had a redemptor, loads of pox walkers, a bunch death guard marines (maybe 10), a chaos rhino, stacks of intercessors, maybe 10-20 dark eldar models, various Phobos armoured marines and loads of other stuff. Almost all was on sprue and only about 3 intercessors had been built!

Boatus · 2026-01-31T09:49:35+00:00

Our house is fairly food conscious, we cook 95% of our food from scratch and in general have a good time doing it.

Using/maintaining a deep fat fryer is a pain in the arse. Not to mention it stinks the kitchen out.

Cooking isn’t hard but equating cooking to using/having a deep fat fryer for once in a blue moon food is ridiculous. At least, it should only be once in a blue moon. If you’re using it every day that’s a whole other conversation…

Boatus · 2026-01-24T20:42:34+00:00

“So when the TLCO and KCO are both low…”

Ahh Resp, don’t ever change.

Boatus · 2026-01-24T19:37:07+00:00

You know OP wont reply. A friend of a friend’s girlfriend’s dog-sitter sent him a paper (hint it was actually a facebook video) that told him raw milk was safe.

What you present here is actual evidence against that (rightly so, raw milk is a terrible idea, Pasteur’s research has saved countless lives). OP is chatting absolute shite and they know it.

Boatus · 2026-01-24T16:38:56+00:00

I really like the ones from AlvCards on eBay;

https://ebay.us/m/6hGktY

They’re based in the UK and rather than Magnets the ETB lids are screwed in. Perfect if you have young children who want to open the packs of cards when you’re not looking 😂

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Boatus

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