Wednesday, November 11, 2009

Local Anaesthesia

Strangely, I"m still kind of excited by this so I"m going to have to blog about it.

Yesterday we had a Local Anaesthesia Workshop in which we got introduced to lignocaine, the different mixes it comes in (such as various percentages and with adrenaline) and injection techniques.
The techniques were described to us and drawn out on the whiteboard by the tutor (lets call him "Harry O") and we were then expected to proceed to perform that technique on a foam mock up of skin or toe.
The skin one was pretty simple, poke it in, inject along three lines to cover part of the area of the lesion without pulling the needle out completely, pull out the needle and reinsert in an area that has been anaesthetised and continue until the entire area is completed. Note that a maximum dose is of 3mg/kg of lignocaine or 7mg/kg of lignocaine+adrenaline, which usually still works out to be in the 10s of mL, so you should be fine...

Anyway, when we reached the toe/finger part in which we learned to perform a ring block, which in itself was pretty straight forward I guess. Inject vertically as close to the bone as possible, withdraw the needle but not all the way so you can reorient it and inject horizontally, then withdraw and inject on the other side of the bone by way of the previously anaesthetised area.
The hard part was that Harry O decided to stand in front of my and watch my injection.
I decided that a good start would be to not stick myself with a needle. Done.
Perhaps I should probably not hit the bone either. Success.
Alright, now lets see if I can do "withdraw but not all the way" thing. Success.
Ok, going surprisingly well, now to do the final injection on the other side, again, avoid the bone. Success.

I was done!

Harry O then leaned in towards me, at which point I was expecting a tip, perhaps a hint on methodology or technique (I had changed grip on my syringe a few times), but his words were "That was done as perfect as anyone could have done it. Very well done."

I don"t believe I have ever recieved such a compliment in Med school. Ever.

Even more surprisingly was that following the class, he asked for my name, just for future reference.

I think I"m ready to take on these exams.


PTR said...

nice. I honestly thought this was going to be a story about how you injected yourself by accident. Glad it wasn't!

KT said...

VERY proud of you mate. I'd let you jab me any day!