The title of this post refers to an adage in medicine referring to how you learn to perform certain medical tasks. Another one is “when you hear hoofbeats, think horses not zebras,” meaning that you should think of common diagnoses first rather than rarities as common things are quite frankly much more likely.
Although it is sort of fun to wonder if the patient actually has a pheochromocytoma….maybe one day I’ll see one….
Anyways, what follows is a brief retelling of some of “first times.” Don’t worry, no one has been hurt or injured or harmed! Or, at least people told me my needle sticks didn’t hurt….
FIRST BLOOD DRAW: My first blood draw was on a fellow med student (and his first blood draw on me…it you wanna poke, you best be prepared to get poked, it’s only fair). Young people tend to have good veins so I got the flash (flash back of blood, indicating you are in the vein) pretty easy. Now, the first time I tried on an older individual or a heavier individual…that was a different story.
FIRST BLOOD DRAW ON SOMEONE THAT WAS NOT MY FRIEND: I did get the vein on the first try (lucky for me, it was a skinny person), but the patient did faint on me. Literally on me. Wasn’t prepared for that.
FIRST IV: This was done on the same friend as my first blood draw (and ditto, he did his first IV on me). It was a 22 gauge IV (ie this is smaller than a “large bore” IV you would use in a truama situation; the smaller the needle, the less it should hurt!). I didn’t press down on his vein after removing the tourniquet so, when I removed the needle from the angiocather, it got a little messy (blood) but nothing too crazy…glad I had a chuck under his arm though! Its a good thing we were young and hardy med students…
FIRST INTUBATION: I did a 2 week anesthesia elective where I was lucky enough to get to intubate people. My first intubation was done with an attending basically “hand over hand” to make sure I could see the cords well and insert the tube correctly. Success!
FIRST BABY DELIVERY: My first delivery was done on the last day of my OB rotation…and was probably one of the most exciting days of med school (many people would agree on this even if they weren’t interested in going into OB/GYN). I remember wanting to make certain I put the boots on (big shoe covers basically). The attending also had her hands over my hands for this one, which was definitely reassuring to me as it can all happen kind of fast and it is a bit overwhelming when you are delivering a real live baby rather than just going through the 7 cardinal movements of labor on a model. I am pretty sure I told everyone from the bodega dude to my doorman that I delivered a baby that day.
FIRST 24 HOUR CALL: On our surgery and OB rotations we took 24 hour call. On surgery, our 24 hour shift was on the trauma service. Luckily, I did get to sleep for about 4 hours. Med school trains you to be able to sleep anywhere at anytime. Just ask my friends…
FIRST ABG: An ABG is an arterial blood gas, meaning we’re wanting to get arterial blood rather than the venous blood you normal get with a blood draw. An ABG tells you of the acid/base status of the patient and the procedure is a bit more involved than a simple venipuncture. I’ve been lucky enough to try an ABG once or twice. I have yet to have success.
FIRST CPR: Yep, still haven’t done this. Only done it on a mannequin. But, I have that 30:2 ratio down pat.
I’m sure there will be many more firsts to come….and seconds, thirds, fourths, and fifths!
As my PSA of the day, if you are a lady blogger, consider applying for one of Nuun’s Hood to Coast teams! Many of my good friends have done it and have had wonderful times. I’d be submitting my application in a heart beat if I didn’t have the whole residency bit. 🙂
TELL ME: CURIOUS – ARE YOU SCARED OF NEEDLES AND HATE BLOOD DRAWS? DOCTORS APPOINTMENTS THAT YOU DREAM EVERY YEAR? WHICH IS WORSE TO YOU – DOCTOR OR DENTIST?
I am the world’s biggest weirdo and LOVE the dentist…so much so that I wondered at one point if I should become a dentist.
Until next time…