If you look at the anatomy diagram, you will find that the bone plane of the posterior superior iliac spine is larger than that of the anterior superior iliac spine. With a larger bone plane, it is easier for the needle tip to implant when it falls. Unlike the small bone plane, when the needle tip falls like a needle tip against a wheat awn, it is easier for it to implant.
It is difficult to insert the needle vertically by wiping it.
It is very important to insert the needle vertically. The bone puncture itself has to penetrate into the bone, and the bone is hard, which means it requires effort. Vertical needle insertion is like a hammer hammering a nail, and the vertical force is easy to insert, and the force can be used to minimize the impact on the child's bones.
minimal damage.
Some bones that are difficult to penetrate are common in the clinic. When the clinical teacher is pricking, the expression on the face of the teacher would be like using force. This kind of force is not only laborious, but also afraid of excessive force. Zhang Desheng is not afraid of death for the first time, how can he dare to do it all at once?
Start drilling hard. If you cannot insert the needle vertically or penetrate it, the psychological frustration of the novice will be far less than that of the veteran who will collapse instantly.
Secondly, clinically, the bone marrow dilution rate caused by bone marrow extraction is quite high. What is bone marrow dilution, that is, no bone marrow can be extracted or too little bone marrow is extracted, and the specimens extracted are mostly blood. Such specimens are sent to the laboratory
If you want to do a bone marrow examination, you will definitely fail it and need to draw it again, which is equivalent to a failure of bone puncture.
If the problem is to choose the posterior superior iliac spine, the child will need to sleep on his stomach, which will inhibit breathing to a certain extent. Perhaps based on this consideration, Zhang Desheng did not dare to choose the posterior superior iliac spine. The main reason is that this child is too difficult for parents to deal with.
Doctors simply don't dare to take risks.
Instead of letting the child lie in the prone position, another method is to have the child lie on his side and hug his knees tightly to expose the posterior superior iliac spine. This position is not easy to fix. For this reason, Zhang Desheng respects Xie's opinion.
It may be a little difficult to get into a good posture, but when the time comes, the anterior superior iliac spine cannot be inserted as Xie said, and the needle hangs around in the middle for a long time, which will cause even greater consequences.
There is no need to be too afraid when classmates are here to help.
Reported to Teacher Tian to choose the posterior superior iliac spine, Teacher Tian and Teacher Wang agreed.
Several classmates began to help the child adjust his position. Two other surgical students saw this and came up to help.
Carefully change the child to a side-lying position. When controlling the child, control the joint movement position instead of pressing hard on the child.
The location is said to be the posterior superior iliac spine, but in fact the puncture point is the protrusion between the posterior superior iliac spine and the fifth lumbar vertebra.
After changing the child's position, classmate Zhang Desheng felt something different. When he touched it with his gloved hand, he could feel a relatively flat bone surface, indicating that this position better exposed the bony location to be operated on. Unlike the
When he first touched the anterior superior iliac spine, he felt only a raised point that was difficult to acupuncture.
The child's current position was put in by classmate Xie. Classmate Zhang Desheng praised in his heart: Classmate Xie is awesome.
Being able to feel the wide range of acupuncture points will naturally make the doctor more confident.
Zhang Desheng then worked hard, and the anesthetic was injected onto the periosteum with high accuracy, and he was able to do it easily. He pressed the area where the local anesthesia had been completed, and because he had the confidence to inject the needle again, he inserted the bone puncture needle straight down and pulled the syringe plunger.
I soon felt something coming up. The process was incredibly smooth.
If the doctor acts quickly, the child's pain and discomfort will definitely be relieved a lot. Children, like adults, are most afraid of long-term pain.
Seeing the students extracting the bone marrow in twos and threes, the two supervising teachers nodded sharply: These students did a good job and they can do it on their own without the teacher's guidance.
