I'm not sure your and Rowley's views are exclusive. There are plenty of
procedures that I only get to do once or twice per year but I'm still
perfectly competent at them when I do them. Some of these relate to the
rarity of particular presentations, some to the dilution that you talk about
as trainees need to practise. Either way, I don't buy this argument that you
get "deskilled" at something because you're not doing it every week. I
haven't rode a bicycle for twenty years, but I'm dammed sure if I got on one
tomorrow...
You get my drift.
AF
----- Original Message -----
From: "McCormick Simon Dr, Consultant, A&E" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, June 02, 2005 8:28 PM
Subject: Re: Bone injection guns
Fair enough, but it doesn't answer the question. I can't remember the last
time I needed to put in an 'emergency' neck line or do a cut down.
Sometimes there just isn't enough of a need for a procedure to gain or even
maintain the skill in doing it. This is an increasing problem in many
departments I suspect. As staff numbers are increased to deal with the
'minor & major' workload there are less resus cases to go round and so
exposure to critical care interventions is diluted for both trainer and
trainee. I don't know what the solution is but I'm aware of my slow but
inexorable deskilling in such procedures.
Simon McCormick
-----Original Message-----
From: Rowley Cottingham [mailto:[log in to unmask]]
Sent: 02 June 2005 20:18
To: [log in to unmask]
Subject: Re: Bone injection guns
I regard rapid vascular access as a core skill. IJ, subclavian, femoral
(closed and open) and cut down should all be part of the armamentarium.
Best wishes
Rowley.
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Andy Webster
Sent: 02 June 2005 12:23
To: [log in to unmask]
Subject: Re: Bone injection guns
If you can't get an A and E consultant
in fast enough (and some are neither resident nor living close to their
hospitals
That's assuming that the Consultant has had the opportunity to maintain
skills in central venous cannulation. How many/how often do you need to do
them to maintain competence?
Andy Webster
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