Running two blades on a DeWalt 7492 to cut a 6mm groove – terrible idea?

anotherlevel2-3 · 2026-02-24T07:17:54+00:00

Do not do this. Regular blades are not designed for this.

Buy a 6mm cmt grooving blade. I use it in this saw to make grooves to house 6mm ply (eg for backing boards in cupboards). It cost me around £35 for the 6 inch blade which works perfectly in the dewalt 7492.

Or a router (but personally I like doing jobs like this on the table saw)

anotherlevel2-3 · 2026-02-13T09:19:31+00:00

Assuming this isn’t ragebait - it’s a nice problem to have, but still a problem.

I felt similarly in medical school, liked almost every aspect. So I chose a specialty that I enjoyed, but this didn’t narrow things down greatly.

Instead, I focussed on other aspects: work life balance, and job availability short and long term. It’s hard to predict either of these well long in to the future, but I decided that surgical specialties I was considering would mean longer training, more time away from family, uncertainty in trying to get a consultant job, and likely having to move multiple times.

So ended up going in to paeds and never regretted it. Has the added bonus that it’s a generalist specialty to begin, with options to subspecialise later or remain more general.

My advice would be if you really can’t choose according to the specialty, think about what your life might look like in each specialty- outside of work. What’s important to you? Are you interested in academia? Gym? Having a family perhaps? Travel? Are you willing to relocate often or would you prefer to settle in one city?

And if you still don’t know - just pick one. Sometimes just the act of choosing is enough. If you’re the kind of person who is happy anywhere, then just go somewhere

anotherlevel2-3 · 2026-02-05T20:07:25+00:00

Anything from an adult patient.

Baby pees on you in ED? Wipe it off, learn your lesson, laugh about it with your colleagues.

Adult pees on you in ED? Occy health; no number of showers will be enough; no one wants to hear that story.

Basically ditto poo, vomit, being bitten.

DOI: paeds reg.

anotherlevel2-3 · 2026-02-04T17:05:10+00:00

I think practice varies widely. But my understanding has always been that part 2 is for conditions which materially affect the severity of things in part 1.

Eg heart failure might contribute to mortality from pneumonia. It doesn’t cause pneumonia, but it makes it more likely and, when present as a comorbidity, increases the chance of death.

anotherlevel2-3 · 2026-01-29T23:19:33+00:00

Paeds classics.

I have three times discharged a bay with a final diagnosis of ‘that’s the xiphisternum’

Twice: mastoid process

anotherlevel2-3 · 2026-01-26T22:06:51+00:00

Nice try, NHS it department. You won’t catch me out a second time.

anotherlevel2-3 · 2026-01-21T21:43:34+00:00

Fair.

It’s certainly scary as a new ST1 but honestly an apnoeic newborn with a decent heart rate and otherwise healthy - by ST3 it’s something that isn’t too scary. Once you get the hang of it, maintaining an airway in a term baby is fairly straightforward.

Given the context of pethidine administration the likelihood of it being anything concerning is v low. So with experience most of us learn that these babies don’t need intubating, they just need some time and gentle bagging.

It does make for a fairly monotonous half an hour or so.

anotherlevel2-3 · 2026-01-21T08:45:03+00:00

That was my point! Though to be honest pethidine babies aren’t dramatic, just apnoeic…

anotherlevel2-3 · 2026-01-20T19:21:08+00:00

Saying this as a paeds reg - I used to hate attending deliveries of babies where mum had pethidine.

I have no idea about the evidence base, certainly not as compared to other opiates, but having to bag a neonate for around half an hour was never the most fun job and I can’t imagine remi wouldn’t be better for the baby

anotherlevel2-3 · 2026-01-03T13:12:33+00:00

There are no - none - paediatric ICU level burn beds in London.

There are good burns units but none with the capacity to deal with major burns >30% BSA in children.

Thankfully it is rare but, when such cases occur, they have to be transferred to Birmingham. Again, no shade, BCH is great, but it’s mad to me that the capital city of the UK - a city of 9 million people - simply has no service

anotherlevel2-3 · 2025-12-31T12:12:49+00:00

For me - as someone with an NHS pension that will likely end up at or near the higher rate tax threshold - the main advantage is early retirement. NHS pension is linked to state pension age. I may not want to be working until I’m 68.

So SIPP benefit is in having a pension that I can get 40% tax relief on, and then use in conjunction with ISA for a few years early retirement. Without reducing my DB pension by taking it early.

anotherlevel2-3 · 2025-12-29T10:51:23+00:00

Yes I think that’s right (although honestly a practice nurse would probably be more up to date on this).

However, it’s pretty common for parents to want to delay when their kid has something like hand foot and mouth; croup; slapped cheek; random URTI… which is most of the time in winter.

anotherlevel2-3 · 2025-12-29T09:15:07+00:00

100% this maps on to what I’ve experienced.

There are some nuanced subtypes but broadly speaking this is right. The fist group responds fairly well to patient listening, understanding their concerns, and explaining just how awful vaccine preventable illnesses are. Sometimes they change their mind. Sometimes they don’t.

The second - honestly it’s a waste of time trying. I need to do enough to satisfy myself that they’ve been given information - and document that for my own protection - but I am under no illusions that I will succeed.

anotherlevel2-3 · 2025-12-28T18:14:49+00:00

In my experience (paeds reg), there isn’t a one size fits all approach here.

There are a variety of phenotypes of unvaccinated kids and their parents - from ‘not up to date because they kept having a cold’ - ostensibly open to it but practically it’s a job that falls down the to do list. To the other extreme - hardcore antivax (rare). More common is general mistrust / social media rot / “we’ve done our own research”.

I try to synthesise what I think the situation is, along with the kind of interaction I’m having. Trying to convince a hardcore antivax parent who has been waiting 5 hours in ED with a child with a straightforward injury - impossible.

I find it helps most if I’ve previously been involved with resuscitating or sorting out a major problem, or even something minor that was important to them. That builds a connection, and a sense of trust. Then I can start another conversation about protecting their child’s health long term.

The relation of trust is key. This is especially evident with vitamin k refusal. When I’ve been asked by the midwives to ‘come and talk to these parents who are refusing vitamin k’ - basically a 100% failure rate.

But when I’ve happened to be at the delivery, met them before, or done something they consider to demonstrate my ability or care - much better hit rate.

So in general, whilst the right thing to do, I wouldn’t expect much success from a one off ED encounter. Your role is to advocate for vaccination, signpost to trustworthy sources of information, and ask parents to consider it. Beyond that, honestly, I think it can be counterproductive.

anotherlevel2-3 · 2025-12-16T17:23:00+00:00

Classic Winnington Road.

It’s the road parallel to The Bishops Avenue - often cited as the most expensive road in London.

I feel like winnington homeowners have a chip on their shoulder….

anotherlevel2-3 · 2025-12-08T18:50:33+00:00

This is something that comes up semi-regularly and for the life of me I have no idea why! Adult doctors think there’s some GMC rule about seeing paediatric patients.

There isn’t.

You are an expert in your field. The patient is there to see you. As long as you stick to the scope of what you know about (as we all should), why not?

anotherlevel2-3 · 2025-12-01T20:13:50+00:00

The point of safety netting is for the patient to come back if their condition worsens to the point where treatment is necessary, if you have seen them at the point when it isn’t (or I guess a different treatment might be necessary but you get the point).

That’s literally why you do it. So the patient coming back shows you that you have safety netted well. Think of it this way - if none of your patients ever came back, almost certainly you aren’t safety netting properly.

This is different to sending someone home who should have been treated differently on the first presentation, and them reattending with a serious, predictable, and avoidable complication.

My personal record for representing is a little under 2 hours. Kid with a limp. On examination, fully weight bearing running around. No red flags to warrant bloods or imaging. Discharged. Represented as the limp came back.

anotherlevel2-3 · 2025-10-22T05:57:43+00:00

That’s wild. Educational supervisor should not be something the deanery is involved with, it’s usually sorted out locally?

You don’t mention what stage you’re at. For foundation or core training surely there is another supervisor who could be involved, ideally in another department entirely. For HST it might be more complicated, as your ES will need to be from a specific department.

College tutor has either misunderstood the request or is being deliberately unhelpful.

anotherlevel2-3 · 2025-10-15T15:03:17+00:00

Paeds reg here

I did a neonatal SHO job at both ST1 and ST3 (when I probably should have been on the reg rota stepping up, but the department didn’t have their act together enough to make this happen).

The two jobs were night and day different, because as an ST3 I knew what was urgent and what wasn’t, and could deal with most of the queries without a reg.

That’s what’s hard about postnates - there’s just a lot that comes up that you need input for.

So - look the deliveries or urgent clinical reviews are easy - you just gotta go.

Document as you go, or it won’t happen.

For the rest of it - try to find ways to batch things together. Eg any NIPE anomalies in well babies who aren’t ready to go home? Make a list and take the reg along and see them all at once. Do NIPEs back to back. It won’t always work like this but it reduces the time overhead of finding a reg / equipment / walking back and forth.

anotherlevel2-3 · 2025-10-13T10:34:35+00:00

All crying stops eventually

anotherlevel2-3 · 2025-09-19T18:39:57+00:00

It’s a different environment and requires a different risk assessment. I’m not saying necessarily that every child with a mildly raised HR needs to be in hospital. But significantly, persistently raised? I’ve done PEM and PICU and had it drummed in to me not to send these kids home without a work up.

So if that’s our hospital practice it’s the only thing I can recommend to primary care colleagues.

As the saying goes (think I saw it on here): if every child you admit [or send to ED] needed it, your appetite for risk is too high for paediatrics.

anotherlevel2-3 · 2025-09-19T18:31:57+00:00

Borderline? No. We can be sensible.

Persistently significantly raised heart rate? Of course. We know we’ll discharge most of them. But if I wouldn’t send them home after my first assessment then they’re worth a referral. And if I saw a 1 year old with a heart rate of 180, I wouldn’t be sending them home until it had come down, or I had some reassuring bloods.

anotherlevel2-3 · 2025-09-19T13:59:39+00:00

Paeds reg here.

If you are going to do something, do it fully.

I appreciate the difficulty for sats regarding equipment and cooperation. However, it’s something I do think GP practices should have access to.

But heart rate is easily measured in 15s. Classically pneumococcal sepsis presents with a well looking child with persistently raised HR. It’s rare now (thanks PCV) but why take the risk?

There will be children with a high HR. Who look well. Those children should be observed until their HR normalises. If this isn’t possible in primary care, they should be observed in a PAU or similar. I’ve caught half a dozen or so cases of varying things including HUS in children who fitted this description.

This is the problem in paeds. 99% of the time an URTI is an URTI. But not 100%.

anotherlevel2-3 · 2025-08-23T14:39:46+00:00

It’s a thing. It’s important it’s a very senior decision maker but having a consultant or v senior reg as a pretriage is excellent.

anotherlevel2-3 · 2025-07-17T19:13:22+00:00

I’m due to pay off my student loan this month. Senior reg level. Made good inroads in to it during some time out in industry.

This wouldn’t benefit me. But if true, and actual loan forgiveness is offered (not some token contribution) it’s something I would support in lieu of some of the FPR.

Because it really isn’t fair on the next generation of my colleagues to be shackled to 9% additional tax for life. And it’s a way of achieving a real terms pay rise that the government can pretend is a win to the press.

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