Procedure complications

[JustPlainBill]

So, as I've mentioned before, the residency I went to not only couldn't teach Boy Scouts what to do in a candy store but they had very little procedural training at the time I was there. It was only during my 3rd year towards the end that the attending who did in office procedures returned back to the residency side from the faculty clinic side and began running a procedures clinic. I got a few knee injections but that's about it. Shave/punches were limited to Derm and they guarded them like a hawk. Even when I asked to get into the Derm procedures clinic the case was always "too complicated/risky" for a FM resident to attempt.

Anyway, so I'm getting my feet under me and am wanting to start doing some more procedures. Shaves/punches/cryo/injections don't look all that difficult but what usually stops me in my tracks is that I don't know the most common complications or how to deal with them when they occur. Where would one get that? From Pfenninger & Fowler? I'm looking into an NPI course but that's expensive.....

Thoughts?

---

Members don't see this ad.

 

[VA Hopeful Dr]

The AAFP article about skin biopsies mentions complications very briefly at the end: http://www.aafp.org/afp/2011/1101/p995.html

Same for cryo: http://www.aafp.org/afp/2012/1215/p1118.html

And injections: http://www.aafp.org/afp/2002/0715/p283.html

 

[VA Hopeful Dr]

That said, I do love Pfenninger & Fowler. I've started branching out as well into things I never did in residency and its gone very well using just that book.

 

[cabinbuilder]

So, as I've mentioned before, the residency I went to not only couldn't teach Boy Scouts what to do in a candy store but they had very little procedural training at the time I was there. It was only during my 3rd year towards the end that the attending who did in office procedures returned back to the residency side from the faculty clinic side and began running a procedures clinic. I got a few knee injections but that's about it. Shave/punches were limited to Derm and they guarded them like a hawk. Even when I asked to get into the Derm procedures clinic the case was always "too complicated/risky" for a FM resident to attempt.

Anyway, so I'm getting my feet under me and am wanting to start doing some more procedures. Shaves/punches/cryo/injections don't look all that difficult but what usually stops me in my tracks is that I don't know the most common complications or how to deal with them when they occur. Where would one get that? From Pfenninger & Fowler? I'm looking into an NPI course but that's expensive.....

Thoughts?

Seriously. Watch everything on youtube. There is a video on how-to do just about anything. Last one I watched was doing a paracentesis in the ER when the ER doc tells me it's been >10 years since he did one. Heck, it had been 4 yrs for me. ER doc says "tag you're it". Nice. So I watched the video, did the procedure, done.

Watch on once to get a piece of metal out of an eye with an 18 gauge when out working on an Island with no help but and ER nurse. Saved my butt on that one too. Sometimes you just have to get over your hesitation, find you confidence, and "Do it".

 

[VA Hopeful Dr]

Seriously. Watch everything on youtube. There is a video on how-to do just about anything. Last one I watched was doing a paracentesis in the ER when the ER doc tells me it's been >10 years since he did one. Heck, it had been 4 yrs for me. ER doc says "tag you're it". Nice. So I watched the video, did the procedure, done.

Watch on once to get a piece of metal out of an eye with an 18 gauge when out working on an Island with no help but and ER nurse. Saved my butt on that one too. Sometimes you just have to get over your hesitation, find you confidence, and "Do it".

I think NEJM has a video library that does this too.

http://www.nejm.org/multimedia/medical-videos