Let the second senior sister rest well, Xie Wanying and Liu Jingyun only chatted with the patient for a while and then went back to school.
Fast forward to Monday afternoon.
The old lady in bed 8 is going to have surgery tomorrow. Considering the critical rescue that this patient may need during and after the operation, central venous catheterization was planned. The advantage of central venous catheterization is that during infusion, the drug from the central vein reaches the heart faster than the peripheral vein, which is very important for patients in urgent need of rescue.
In general, physicians will prefer the subclavian vein for puncture over the various options for central venous access. Because the subclavian vein catheter is compared with the internal jugular vein, external jugular vein and femoral vein, it is easier to fix and perform post-care.
Later, if the patient needs chemotherapy, PICC catheterization will be performed. This is a central venous catheter inserted into a peripheral vein. Clinically, the basilic vein is mainly selected in the forearm.
Subclavian vein puncture is a relatively difficult technique. Once the puncture is unsuccessful, it is possible to enter the artery and cause an arterial fistula, and even if it is mistakenly inserted into the apex of the lung, it will cause terrible complications such as pneumothorax.
The anatomical location 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 whole body, than the right one, and the surrounding tissues are more complicated. Therefore, the doctor chose the right subclavian vein puncture as much as possible.
Regarding medical knowledge, medical students either take out their notebooks temporarily to review, or try to find the key points in their memory.
Every time there is such a high-tech operation in clinical practice, medical students need to seize the opportunity to observe and learn. Because the opportunity is rare.
The general ward is not an ICU, and not all patients need to be rescued all the time, and there are few opportunities for central venous puncture.
It has been almost two weeks since I came here, and it is the first time that Xie Wanying and her classmates have the opportunity to observe such an operation, and the students are very excited.
Compared with the students, Dr. Sun Yubo, the little Sun teacher who was going to perform puncture on the patient, felt a little uneasy.
Brother Liu is not here, and went to the operating room for surgery. This time it was impossible for Tan Kelin himself to accompany him to the ward and watch him operate. Tan Kelin was busy. For this kind of thing, the attending doctor can watch the hospital do it.
Guoxie University Hospital, surgery department, full of talents. There is always a need for the deputy high-level executive to go out in person. The attending ability is all high level.
Therefore, it is Dr. Shi Xu, another attending physician in the group, who is in charge of watching the resident physician operate. Compared with Dr. Liu, Dr. Shi is thinner and more refined. He wears 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, Dr. Shi Xu and not Dr. Liu Chengran will be the first assistant for the old lady's surgery tomorrow.
On weekdays, she didn't get along much with Dr. Shi Xu, who just came back. Xie Wanying noticed the uneasiness on Teacher Xiao Sun's face, and wondered what was going on.
Luo Yanfen stuck to her ear to gossip: "Teacher Shi is more boring than Teacher Tan. But once you get anxious, it's scary."
In this way, there is a reason why Sun Yubo likes being with Senior Brother Liu the most.
In fact, resident doctors are only a little better than medical students. They have not graduated for a long time, and their clinical experience is not very sufficient. Most of them have relatively few practical operations, and they are low-qualified doctors. When encountering this kind of complicated and seldom-done practice, the senior seniors let the juniors practice their hands, and the mentality of the junior seniors is not much different from that of medical students.