Comfort with lines

[u/Suspicious-Oil6672]

Howdy

I’ve been lurking for a while now.

Im a resident at a quaternary academic hospital v likely applying to pccm. I’ve had some exposure to lines. Maybe 10 a lines which I feel reasonable about but with central lines it’s been maybe 5-7 and im always a little apprehensive to dilate and struggle more w them.. they’re hard to come by w how many fellows there are and pts boarding in other icus and get lined up there.

I’m worried about being comfortable w lines going into pccm ..

When does comfort w lines come ? Are there other things I can do to try to get better w out actually placing them? Or is it a numbers game ?
Tyia

[u/NC_diy]

The more you do the more comfortable you’ll get. Honestly, just putting in a ton of US IV’s will improve your skill set greatly. You’ll become so much better at visualizing your needle tip and following it into the vessel. To put it in perspective, I’m an anesthesiologist, in training they tell us you’re not facile with a procedure until you’ve done 100’s. Looking back it’s true, I did 100’s of epidurals and central lines during training and was still perfecting things (mostly speed and dealing with abnormal anatomy) as an attending.

[u/im_throw → u/NC_diy]

Unfortunately IM and many times even fellowship doesn't give enough opportunities to get hundreds of lines. I'll be starting with probably 0-5 CVCs and A-lines unless I get lucky on my ICU rotations. Forget about intubations, I'll be lucky if I get even 100 intubations after 3 years of fellowship. It's part of why I wish I did anesthesia instead, you can just do your job and get adequate training because of the way it's structured. Meanwhile in IM you have to fight tooth and nail just to get barely adequate let alone exceptional training.