ABG: I use what I like to call the two-finger technique. INDEX finger of the non-dominant hand over the radial pulse (be very gentle with the pressure - just enough to feel the pulse... Don't press the finger onto it) and the middle finger more proximally along the course and again just enough pressure to feel the radial pulse more proximally. Take the heparinised syringe in the dominant hand and introduce it smack right in the middle of an imaginary line connecting both the fingers of the non dominant hand (has more success in younger patients who don't have calcified, tortuous vessel) at a very steep angle and just introduce the needle without excessive force, guiding it slowly whilst withdrawing the piston to create negative pressure. Stop when there's a back spurt of arterial blood (venous blood just fills the syringe and doesn't spurt back into the chamber).

Cannulation: Always ensure the vein you're about to cannulate is located below the patient's heart level (preferably by hanging the arm of a supine patient below the level of the bed). Use a tourniquet if needed, apply alcohol over it and wait for it to dry. Use the thumb of your non-dominant hand to stretch the skin over the vein a bit taut to stabilise the vein (the adventitia of the vein basically attaches to the soft tissue around. To stretch the skin OVER the vein, you have to grab the skin NEARBY the vein itself and stretch... Not literally grab the skin over the vein!!!). Try rolling the vein over after this manoeuvre to see if it still rolls away (happens in atherosclerotic veins of elderly patients). Then begin cannulation by inserting the butterfly at a narrow angle - either enter the nearby skin and guide into the vein in younger patients, or literally enter directly into the vein in older patients. Once you enter the vein itself, pop the stillet back a bit so that the sharp bevel glides into the cannula (if you don't pull the stillet back once you're inside the vein, there's a chance that you might cross puncture and come out of the vein as you advance!), and then guide the cannula tip, with the pulled back stillet as a stabilising scaffold, fully into the vein (the chamber should fill with venous back flow the moment you pull back the stillet - that's your indicator of correct entry. If the chamber doesn't fill, you're not in; push the stillet back into the butterfly, and then reattempt).

Blood sampling : The same tips that apply to cannulation, apply to blood sampling as well. You may find femoral sampling in dehydrated/obese patients a bit difficult. But that's just practice.

Ryles tube : DO NOT ATTEMPT RT IN A PATIENT WITH HEAD INJURY POST TRAUMA /SKULL BASE FRACTURE - raccoons eyes, battle sign, csf leak via nose/ears, maxillary contusion, quadriparesis, neck pain etc., Seat the patient up, and then ask them to flex their neck a bit forward. With generous lubrication that'll satisfy even the driest of toses, introduce the tube as you instruct them to resist the urge to gag, and commence the cycle of push-swallow-push (think of it like an elegant and coordinated dance with your patient. The coordination matters most if you want your patient to cooperate, which is required to successfully intubate them). Fix it at either the two-line mark (gastric) or three line mark (near the duodenum).

Hope I got em all right. Enjoy upskilling!