To let the second senior sister have a good rest, Xie Wanying and Liu Jingyun only chatted with the patient for a while and then went back to school.
In the blink of an eye it was Monday afternoon.
The old lady in bed No. 8 will have surgery tomorrow. Considering the critical care that this patient may need during and after the operation, we are going to insert a central venous catheter. The advantage of central venous catheterization is that when infusing, the drug can reach the heart faster from the central vein than from the peripheral vein, which is very important for patients who need emergency treatment.
Generally speaking, doctors will choose the subclavian vein as the first choice for central venous puncture among various options, because the subclavian vein catheter is easier to fix and perform follow-up care than the internal jugular vein, external jugular vein and femoral vein.
If the patient needs chemotherapy later, PICC catheterization will be performed. This is a peripherally inserted central catheterization, and the main clinical choice is the basilic vein, which is located in the forearm.
Subclavian vein puncture is a difficult technical job. If the puncture fails, it may enter the artery and cause arterial fistula, or even cause terrible complications such as pneumothorax if the puncture is mistakenly performed into the apex of the lung.
The anatomical location of this area is complex, with various important blood vessels and tissues mixed together. The left subclavian vein has an additional thoracic duct, the longest lymphatic duct in the body, compared to the right one. The surrounding tissues are more complex, and chylothorax would be worse if punctured by mistake. Therefore, doctors choose to puncture the right subclavian vein whenever possible.
When it comes to medical knowledge, medical students either take out their notebooks to review it or try hard to find the key points of knowledge in their 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.
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Ordinary wards are not ICUs, and not all patients need emergency treatment all the time, so there are fewer opportunities for central venous puncture.
It has been almost two weeks since Xie Wanying came here. This is the first time that she and her classmates have the opportunity to observe such operations. The classmates are all very excited.
Compared to the students, Dr. Sun Yubo, the teacher who was about to perform puncture on the patient, felt a little uneasy.
Senior Brother Liu was not here, he was in the operating room. It was impossible for Tan Kelin to accompany him to the ward and watch him operate. Tan Kelin was busy. For this kind of thing, the attending physician could just watch and do it in the hospital.
The National Association Hospital, the Department of Surgery, is full of talented people. There is no need for a deputy senior doctor to come in person. The attending physicians are all at a high level.
Therefore, the person in charge of watching the resident doctor's operation was another attending physician in the group, Dr. Shi Xu. Compared with Dr. Liu, Dr. Shi was thinner and more gentle, wearing a pair of small black-framed glasses and with long fingers. It was said that he was a little older than Dr. Liu and had better skills. Therefore, Dr. Shi Xu would be the assistant to the old lady's surgery tomorrow instead of Dr. Liu Chengran.
Xie Wanying didn't spend much time with Dr. Shi Xu, who had just returned. She noticed the uneasiness on Teacher Sun's face and wondered what was going on.
Luo Yanfen whispered gossip into her ear: "Teacher Shi is more boring than Teacher Tan. But once she gets anxious, she's very scary."
In this way, there is a reason why Sun Yubo likes to be with Senior Brother Liu the most.
Resident doctors are actually only slightly better than medical students. They have just graduated and have not been there for long. They do not have much clinical experience and have little practical experience. They are junior doctors. When encountering such complex and seldom-performed practical operations, senior doctors let junior doctors practice. Junior doctors have the same mentality as medical students. It is because they have done less and have no confidence.
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