Countdown to IAC
I’m starting to feel that the IAC is almost within reach – and with this feeling comes the realisation that I’m soon going to be joining the on call rota.
I’m pleased that I’ve been able to do a few RSIs over the past week. Before I started CT1, this stood out on the IAC requirement list as one of the more challenging skills to master, especially compared to such tough tests as “demonstrate features of the anaesthetic machine” and “describe how the correct patient is identified for surgery”. It’s also one of the technical skills that you have very little exposure to before anaesthetics, and thereby start the job blindly assuming that you will not only learn to intubate, but be able to do this in a high-pressure situation with a potentially unwell patient, at risk of aspiration, necessarily relaxed (and not in a reversible manner if using sux).
Anyway – I have now done 4 or 5 RSIs and yesterday was a landmark in that I did one unsupervised. Help was available and at hand but fortunately not needed, although the capnography delay never felt quite so long. This was definitely a confidence boost ahead of soon going on the rota.
I am still very aware of my limitations – while I would be the last person to advocate increasing the number of assessments we are expected to complete, I haven’t had to do any arterial lines since starting CT1, and haven’t done a successful CVC line yet. So I will definitely be needing help at times – fortunately I’ve been reassured this is completely expected.
I also found another area of weakness today, when attempting to top up the vaporiser. It turns out that unless the adaptor is screwed onto the volatile bottle, inverting said bottle to fill up the vaporiser will unfortunately cause the volatile to tip out everywhere. Highly embarrassing and a timely reminder to stick to what I’m comfortable with.