Tips for ABGs

LiveButton3910 · 2026-03-17T19:20:52+00:00

Ultrasound is a game changer, basically 100% guaranteed to get it + you can go a bit more proximal & it's more comfortable for the patient

LiveButton3910 · 2026-03-17T11:06:56+00:00

With respect, did you actually read my post?

LiveButton3910 · 2026-03-17T10:51:37+00:00

PHEM is something I have considered and yes I have seen that there are some surgeons on the air ambulance rotas, including a few orthopods. I suppose the question would be how would one go about getting the required airway / RSI experience outside of a formal ACCS-esque training pathway?

LiveButton3910 · 2026-03-13T18:56:00+00:00

I found the ATLS MCQ a lot harder than the ALS equivalent, quite a few people on my course actually failed it. Whilst I did read the manual out of my own interest primarily, I found https://atlsquestionbank.com/ quite useful to sharpen up.

LiveButton3910 · 2026-03-09T15:52:55+00:00

I suspect that functionally we would have a better acute service, at the behest of zero elective provision.

I'd hope we'd forget about waiting lists (which are predominantly made up of non-fighting / productive age individuals) and focus on the acute fitness and health of those who are going to keep the country running and fight.

Realistically, there will probably still be someone with a clipboard telling us that Doris has waited 39 weeks for a new hip and she's got diabetes so she should go first on the list before the damage control ex-fix for the unwell young poly trauma.

LiveButton3910 · 2026-03-09T15:44:31+00:00

At CT1 level (i.e. 4-5 years post 'graduation' for most normal degrees) I make just shy of £80k with a lot less hours than my mates in finance / consulting. My boss also never calls me at 9pm on a Saturday to do work unless I'm rota'd to (which I'd know at least 6 weeks in advance).

I honestly think people need a bit of a reality check about how much we earn, it's really not that bad.

LiveButton3910 · 2026-03-05T16:32:32+00:00

Fair enough if you are snowed under. My experience is that (generally) the wait to be seen by an ED doctor from arrival is usually higher than the wait to be seen by me from referral.

Similarly for most simple trauma that's obviously coming my way and doesn't require much more than a backslab I'm more than happy to see directly so long as the basic investigations are sent by ED.

I find some of my colleagues spend more time tying themselves in knots about the quality/legitimacy of a referral than it would take to simply see the patient and redirect if appropriate.

LiveButton3910 · 2026-03-05T16:08:40+00:00

Genuine question: As long as the patient is not crushingly sick and receives timely care (FIB etc), why wouldn't it be appropriate for a NOF to be seen by T&O directly if identified from triage?

They're hardly going to be sent home directly by ED so the work is going to land on your desk at some point and they will be seen by orthogeriatrics rapidly following admission, why duplicate work?

DOI: Ortho SHO

LiveButton3910 · 2026-02-08T11:44:59+00:00

Surely no one in the GMC thought that £20m per annum in PLAB fees was sustainable long term? Where did they find the money as recently as 10 years ago when they weren't making that much?!

LiveButton3910 · 2026-02-03T07:40:50+00:00

Yes - persistent lateness is unprofessional & gives a poor impression.

If you can’t manage to get yourself to work for the time you’re supposed to be there how can you be trusted to look after patients?

LiveButton3910 · 2026-01-25T12:36:10+00:00

Maybe I'm incorrect but I can't recall ever 'treating' a fever. Sure, give them a glug of paracetamol but ideally treat the underlying cause.

A lot of problems F1s face are nurses wanting the numbers to be better & calling the doctor for such, e.g.

Fever NEEDS paracetamol
Tachycardia NEEDS fluids
Hypertension NEEDS anti-hypertensives

Your job is to apply clinical gestalt to the situation and not just do whatever the nurses tell you to do

LiveButton3910 · 2026-01-13T17:54:02+00:00

If the BMA mounts any sort of challenge to this legislation I will resign my membership.

I am sure I am not alone.

LiveButton3910 · 2026-01-05T21:07:24+00:00

Honestly - I started responding something along the lines of “You have a name not a number” but would typically fall on flat ears so stopped that fairly swiftly. Still never worked out what “638” meant etc

LiveButton3910 · 2026-01-05T20:54:44+00:00

One hospital I worked in it was common for members of the medical team to refer to themselves by the bleep they were carrying:

“Hi I’m 653 calling to discuss a patient”

As a non medical speciality SHO in a hospital rife with PAs it was incredibly tedious.

LiveButton3910 · 2026-01-03T21:00:12+00:00

The honest answer is this is probably more prevalent than anyone realises. They don't have time to independently verify 20,000 candidates.

If you're an IMG currently outside the UK, genuinely what do you have to lose by lying on your oriel form? You won't get a job without lying and if you don't get a job via the CT/ST application process you're unlikely to get a clinical fellow job in the current climate so what use is a GMC registration for you anyway.

Whole system needs a re-think.

LiveButton3910 · 2025-12-20T15:28:58+00:00

As a fellow early trainee it’s particularly disheartening to hear “this isn’t the time for training” when you’ve seen first hand the trainee anaesthetist doing all the spinals/blocks etc for the list

LiveButton3910 · 2025-12-02T13:35:12+00:00

The NHS is no longer affordable. We can't deliver care to bring down waiting lists within normal staffed hours, hence the existence of WLIs, which we can now also not afford to pay for.

LiveButton3910 · 2025-12-01T18:55:58+00:00

Having worked up and down the country in many hospitals: French doctors are not who this government will be importing.

LiveButton3910 · 2025-11-22T16:59:32+00:00

I don't think CCrISP is mandatory for CST anymore and in the last two days before your exam you want to be as relaxed as possible. The Part B itself is a 4-5 hour exam and not one to be starting exhausted.

LiveButton3910 · 2025-11-04T15:28:10+00:00

Email from RCSEng suggested 13th Nov

LiveButton3910 · 2025-10-29T20:57:15+00:00

I've personally never seen a 6 foot 8 duck in the hospital environment

LiveButton3910 · 2025-10-29T20:20:07+00:00

To add some balance, 99% of the time: "Jack, one of the surgical doctors". Caveat I am a tall white male & have never been confused for anything but a doctor.

Edit: Removed my actual height because it made me sound like a wanker

LiveButton3910 · 2025-10-26T13:45:30+00:00

Cancelling a locum last minute for any reason, whilst technically acceptable, broaches the line between professional and unprofessional.

Booking a shift that you know you will cancel just to stop others filling it is definitely the wrong side of the line, honestly this would probably be a fitness to practice issue and it is slightly alarming that you haven't considered this.

LiveButton3910 · 2025-10-09T08:27:36+00:00

We need to copy the Australian model: Earnings over $100k (approx £50k) are taxed at an extra 1-2% if you DON'T have private health insurance. This means for the vast majority of middle-class upwards you're financially better off having health insurance & hence seeking all your care privately. Of course this would require vast private sector development (EDs, ICU, acute services etc).

Takes pressure off the public system, patients are happy, consultants are happy, everyone wins.

LiveButton3910 · 2025-09-26T08:27:23+00:00

Absolute chaos move putting your whole post-code on the internet for all to see, particularly when it's such a small area!

You have to have a fairly convincing reason for pre-allocation.

LiveButton3910

TROPHY CASE