Morning all, (again apologies for grammar/ spelling, blame minute iPhone keypad)

I seem to say it every week, but that was another busy one! Lots of learning this week. One of the consultants spent quite a bit of time going through epistaxis management. Not just nose packing , but using ENT techniques to evacuate anterior chamber, isolate bleed, cauterise and repack if necessary.

I have also relocated a couple more anterior shoulder dislocations under N2O, propofol or midazolam ( depending on condition and consultant) which is extremely satisfying. One young fit lad came in with a painful shoulder, I assessed it, x rayed it, identified an anterior dislocation, went into resus and relocated it under guidance and discharged patient with a follow up clinic appointment. I later saw the same lad down the pub, carrying his shopping in his injured arm, nursing a pint with the other. He cheerfully thanked me and informed me not to worry, his sling was in the bag!

Friday was entertaining as I attended the ED plastering and minor treatments study day. We spent the day learning how to apply volar, below knee, scaphoid and full leg backslabs, as well as brushing up our skills in thumb spica application, future splints, ankle strapping and other techniques. Really useful skills for the road and expeditions as well as ED! A good day, lots more learnt.

Combined with the weekly consultant led junior doctors teaching sessions, daily lunch time 'teaching bites' and optional middle grade training sessions the formal learning opportunities are endless and are definitely things we could do more of in the ambulance service! It really does create a learning culture that I feel we sometimes lack. This culture really motivates people to search out new techniques and develop best practice hence making the job much more rewarding for the clinician to say nothing of the benefits for the patients. OK, soap box moment over.

In short, many skills learnt this week.

Thoughts of the day;

1. Ongoing work based teaching/education is a very good idea for many reasons
2. Continuously self critiquing own practice makes for a better, more confident and contented clinician
3. Simple practical skills can keep people out of hospital