The second senior sister was told to have a good rest. Xie Wanying and Liu Jingyun only chatted with the patient for a while and then went back to school.
It's Monday afternoon in the blink of an eye.
The old lady in bed No. 8 will undergo surgery tomorrow. Considering that this patient may need critical and critical care during and after the operation, we are going to do central venous puncture and catheterization. The advantage of central venous puncture and catheterization is that during infusion, the medicine is transferred from the center
Intravenous input reaches the heart faster than peripheral veins, which is important for patients in urgent need of rescue.
Generally speaking, doctors will first choose the subclavian vein for puncture among various central venous puncture options. Because the subclavian vein cannulation is easier to fix and provide post-care than the internal jugular vein, external jugular vein and femoral vein.
If the patient needs chemotherapy later, a catheter will be inserted. This is a peripheral vein insertion of a central venous catheter. Clinically, the basilic vein is mainly selected, which is located in the forearm.
Subclavian vein puncture is a relatively difficult technique. Once the puncture is unsuccessful and mistakes are made, it may enter the artery and cause an arterial fistula, or even accidentally puncture the lung apex, which may cause terrible complications such as pneumothorax.
The anatomy of this place is complex, with various important blood vessels and tissues mixed together. The left subclavian vein has more thoracic duct, the longest lymphatic duct in the body, than the right side, and the surrounding tissues are more complex, which can lead to chylothorax by mistake.
It's even worse. So the doctor chooses to puncture the right subclavian vein whenever possible.
For relevant medical knowledge, medical students either take out their notebooks to review them temporarily, or they try to find the key points of knowledge in their own memory.
Every time there is such a high-tech operation in the clinic, medical students need to seize the opportunity to observe and learn. Because the opportunity is rare.
A general ward is not an ICU, so not all patients need rescue at all times, and there are few opportunities for central venous puncture.
It has been almost two weeks since I came here. Xie Wanying had the opportunity to observe such an operation with her classmates for the first time. The classmates were very excited.
Compared with the students, Dr. Sun Yubo, the junior teacher who had to perform puncture on the patient, felt a little uneasy.
Senior Brother Liu was away and went to the operating room to perform the operation. This time, it was impossible for Tan Kelin to accompany him to the ward and watch him operate. Tan Kelin was busy. This kind of thing can only be done by the attending doctor who is watching from the side.
The Department of Surgery at the National Association Hospital is full of talented people. The deputy chief is always needed to take action in person. The ability to treat patients is of a high level.
Therefore, the person responsible for watching the resident doctors operate is Dr. Shi Xu, another attending physician in the team. Compared with Dr. Liu, Dr. Shi is thinner and more elegant, wearing a pair of small black-rimmed glasses and has long fingers. It is said that
He is a little older than Dr. Liu and has better skills. Therefore, the old lady’s first assistant in surgery tomorrow will be Dr. Shi Xu instead of Dr. Liu Chengran.
She didn't get along much with Dr. Shi Xu, who had just returned recently. Xie Wanying noticed the uneasiness on Teacher Xiao Sun's face and wondered what was going on.
Luo Yanfen put her ear to her ear and gossiped to her: "Teacher Shi is more boring than Teacher Tan. But once you get anxious, it's scary."
Therefore, there is a reason why Sun Yubo likes to be with Senior Brother Liu the most.
Resident doctors are actually only a little better than medical students. They have just graduated recently and do not have sufficient clinical experience. Most of them have less practical operations and are junior doctors. When it comes to such complicated practical operations that are rarely done, seniors
Seniors are allowed to practice their skills. There is not much difference between junior psychology students and medical students. Whoever is allowed to do less has no confidence.