Must-know procedures

[Apoplexy__]

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Surprised no one even mentioned taking out drains, catheters or lines. I'd think it'd be embarrassing if you didn't know how to do those.

Yikes. Sounds like I need to play catchup in MS4 then.

 

[evilbooyaa]

Surprised no one even mentioned taking out drains, catheters or lines. I'd think it'd be embarrassing if you didn't know how to do those.

Can't say I really remember how to do this. I'll ask for supervision before I pull one though since removing one of the above is almost never an emergency (while placing one likely is)

 

[VisionaryTics]

Also, just because you did something once or twice in medical school does not mean you can do the post-op care for other specialties.

As in the case when the PM&R resident at the rehab hospital called to tell us he removed half the sutures on an orbital reconstruction with all kinds of flaps and grafts.

Why did he remove half the sutures? Because he decided halfway through that he couldn't figure out why the sutures were placed and called to ask.

 

[operaman]

Also, just because you did something once or twice in medical school does not mean you can do the post-op care for other specialties.

As in the case when the PM&R resident at the rehab hospital called to tell us he removed half the sutures on an orbital reconstruction with all kinds of flaps and grafts.

Why did he remove half the sutures? Because he decided halfway through that he couldn't figure out why the sutures were placed and called to ask.

Wow. No other words.

 

[VisionaryTics]

I think one of the most important skills to learn in med school is wound assessment and care.

Being able to take a dressing off, look at a wound, decide whether it's infected/healing well/healing poorly/etc, and then appropriately re-dress the wound.

It's something I really try to show the med students, because all sorts of specialties end up seeing patients with wounds. So many people are afraid to look because they don't want to bother the patient or repack the wound or "mess with" another services wound (despite the fact the nurses are changing it most of the time) etc.

 

[KnuxNole]

True, wound care is helpful. of course, it needs to be emphasized in residency or else you'll forget it, since skills you learn in med school go away like wildfire compared to being a resident.

 

[Kaustikos]

Disagree. Other crucial must know procedures include:

1. Proper list printing (I.e. In Gravity rounding order, perfectly aligned so as to minimize steps from room to room on rounds)

2. Coffee fetching

To number 1: I made a map of the route our team took for rounding. Only because the residents/fellows didn't understand why the general surgery rounding route was so confusing. I made it google map mode. I think it was my biggest accomplishment... lol

Worst is when someone doesn't know how but is too embarrassed to ask. That leads to people trying to yank pigtails without cutting the string, reaccumulation pneumothoraces from an improperly pulled chest tube, or pulling a line while a patient is sitting up in a chair (actually happened on a medicine service a couple years ago, patient died).

Yeah, agreed. When people asked and I didn't know I said "Never done it, but I want to know how it's done". I defer on doing some things alone or if no one is nearby.

Can't say I really remember how to do this. I'll ask for supervision before I pull one though since removing one of the above is almost never an emergency (while placing one likely is)

In addition to wanting to know how to do it, I wanted to learn to make the intern/residents life easier. When we're rounding on 15 abdominal cases and need to pull jp's while the intern deals with consults... I find it's almost obvious you should speak up or try to help.

I think one of the most important skills to learn in med school is wound assessment and care.

Being able to take a dressing off, look at a wound, decide whether it's infected/healing well/healing poorly/etc, and then appropriately re-dress the wound.

It's something I really try to show the med students, because all sorts of specialties end up seeing patients with wounds. So many people are afraid to look because they don't want to bother the patient or repack the wound or "mess with" another services wound (despite the fact the nurses are changing it most of the time) etc.

Yeah,
Agreed on wound care/assessment. Pretty sure residents/fellows took note on your attitude towards post-op care in regards to how they treat you in OR. If you just showed up for procedures and didn't do any post-op care like wound care/dressing changes/etc... you didn't do **** in the OR.

We try to hammer this into our student's heads on the 3rd year clerkship.

Doesn't work and we have to deal with occasional complaints about having to do wound care being "scut"

It's not the scut work that bothers me. Just a) don't act like it's life-threatening omg you're so amazingly special if you do it and/or b) Be condescending when asking. Oh well

 

[Mass Effect]

Surprised no one even mentioned taking out drains, catheters or lines. I'd think it'd be embarrassing if you didn't know how to do those.

There's nothing embarrassing about not knowing how to do these things. In fact, most people will never have to do it.

 

[KnuxNole]

There's nothing embarrassing about not knowing how to do these things. In fact, most people will never have to do it.

True, I don't think most residencies teach this either, so there is noone to educate peeps. I know I've never done it in my life, I think the surgeons would PREFER if I never touched it, since it's their work that I'm messing with.

 

[Psai]

Worst is when someone doesn't know how but is too embarrassed to ask. That leads to people trying to yank pigtails without cutting the string, reaccumulation pneumothoraces from an improperly pulled chest tube, or pulling a line while a patient is sitting up in a chair (actually happened on a medicine service a couple years ago, patient died).

can you explain these in more detail, i'm not familiar