It was still a little early to return to the hospital, but his three assistants were already in high spirits and waiting, ready to practice with Liu Muqiao.
I gained so much yesterday. It can be said that now I know what venipuncture is.
In particular, Liu Muqiao's handsome figure dazzled in front of his eyes whenever he closed his eyes, so they agreed to arrive at the hospital half an hour early.
"Good morning." The three little nurses smiled happily and greeted in unison.
"You guys were earlier." Liu Maqiao returned their smile.
"Head nurse Liu Ya had a quarrel with Zhao Yilin just now, and now she has gone to the office building."
"Because of what?"
All three shook their heads, "I don't know."
Liu Miqiao's heart skipped a beat, and he vaguely guessed that it must be related to him.
Sure enough, just as Liu Muqiao put on his white coat, Zhao Yilin rushed in like the wind.
"How's it going? What are you thinking about?" Zhao Yilin asked eagerly.
It’s the same problem as yesterday.
"Okay. However, you have to take care of my internship. I still have to participate in the internship rotation. If I only practice your neurology, my knowledge will not be complete."
"Then you still want to say it? I know, let's go!"
Zhao Yilin took him and left.
"Hey, don't worry! Why are you leaving? I haven't completed the formalities yet. Besides, head nurse Liu Ya, I promised to help her train nurses."
Zhao Yilin stopped, turned around and said, "I have already discussed it with Liu Ya. I will lend you a half-day loan first. We will discuss the rest in the afternoon."
After borrowing for a long time, Liu Miqiao understood that there must be a patient waiting for puncture.
When we arrived at the intensive care unit, we found a comatose patient with asymmetrical pupils, which was very dangerous.
Liu Muqiao picked up the CT film and looked at it for a while. It was another thalamic hemorrhage. The bleeding volume was about 20 ml.
"Are you sure?" Zhao Yilin asked quietly.
Liu Muqiao nodded.
"Then do it."
"Are you sure I won't be punished?"
Liu Miqiao is still a little worried. Hematoma puncture is the biggest surgery in neurology. In many hospitals, this kind of surgery has to be transferred to neurosurgery. Even in neurosurgery, it is not considered a minor surgery.
Zhao Yilin patted his chest and said, "With me, you don't have to worry about anything. You are the first assistant and I am the chief surgeon. What are you afraid of?"
Yes, it is actually difficult to distinguish between the chief surgeon and the first assistant. Whoever does it has great flexibility. Besides, with a superior doctor on hand to direct, he is the chief surgeon.
Dr. Zou remained silent. One hundred kilograms of radishes in his home were punctured and looked very ugly. However, facing such a hematoma, he did not dare to do anything.
The shadow area last time was too large.
"Then let's get started." Zhao Yilin waved his hand.
No one moved.
The puncture bag lay there quietly.
"Come on!" Zhao Yilin said.
"Me? Not him?" Dr. Zou asked doubtfully.
"Be prepared. He will puncture the same as last time." Zhao Yilin said.
Dr. Zou is in a mess.
I am a senior attending physician and I am about to become deputy chief physician. I will help you as an assistant as an intern?
Zhao Yilin had already seen what Dr. Zou was thinking, and he laughed twice and said: "I will be the surgeon, Liu Miqiao will be the first assistant, and you will be the second assistant. In this way, even though it is time-consuming and time-consuming to divide the stations, you can also get ten points."
p>
Zhao Yilin paused and added: "If you don't want to be your assistant, do you still want me to be Liu Muqiao's assistant?"
Dr. Zou's face turned red, and he finally invited Liu Miqiao. That's right. If I don't serve as an assistant, who will?
Originally, Zhao Yilin had no intention of letting Dr. Zou be his assistant, but he saw that Liu Miqiao showed no signs of making preparations by himself, and it was difficult to rush Liu Miqiao.
Dr. Zou has become a scapegoat.
There is a reason why Liu Miqiao didn't do it. Preparing for puncture is easy to say, but this is an aseptic operation, which is actually very procedural. If you make a mistake, you have to start over.
He is a master in puncture technique, but he has only seen the aseptic operation and brain puncture preparation process once. To be precise, he is still a rookie.
Dr. Zou was ready, turned around and asked, "Is it your turn now?"
He has drilled a hole into his skull.
Liu Muqiao nodded, said "Yeah", took a step forward, stood at position C, picked up the puncture needle, checked it, and then made an aiming motion.
The needle was inserted.
The "pop" sound is so light that only the operator can feel it. Anyone who does the puncture will be excited to pierce this membrane.
The same goes for Liu Muqiao, he feels very happy.
This is the dura mater.
It is also the first risk point for puncture. If the dura mater is not punctured cleanly in an instant, the dura mater may be avulsed, causing epidural bleeding.
This is the first time Liu Muqiao has experienced this pleasure.
Last time, the dura mater was stabbed by Dr. Zou, and he felt somewhat regretful.
Next, I inserted the needle in one step without any hesitation or trembling. I pulled out the needle core and blood flowed out.
I put on the needle and drew out 15 milliliters of blood, inserted a few millimeters into it, and drew out a few more milliliters, which was not much different from the blood volume reported by CT scan.
It’s done.
Such patients do not need catheter drainage and there is no active bleeding.
"I'll do it."
Seeing Liu Miqiao packing up the equipment, Dr. Zou took the initiative to step forward. Just now, he had to accept Liu Miqiao's smooth movements.
It's not a coincidence, it's real effort.
"How did you do it?" Dr. Zou asked.
"Understand the anatomical relationship and imagine a three-dimensional diagram. As long as you do this, it's not difficult." Liu Miqiao said while taking off his gloves.
Zhao Yilin shook his head, "Not difficult? Haha, maybe it's not difficult for you. Your hands are more stable and accurate than the robot. Last time we watched a teaching video, the error of the robot was about 3 mm. You
, I estimate that the error is only 3 millimeters at most."
"Plus or minus 1 millimeter." Liu Maqiao said lightly.
"1 millimeter?" Zhao Yilin found it hard to believe, "Where did you learn it?"
Liu Muqiao did not answer.
"You said you would lend me a whole morning, just this one patient?" Liu Miqiao asked.
"Who knew it was so fast? Look, it only took ten minutes, and these ten minutes were mainly used for disinfection preparations. When you puncture and draw blood, one minute is too fast." Zhao Yilin said.
p>
Dr. Zou put away the equipment and said: "Director, why not ask Dr. Liu to perform the drainage surgery on bed 36?"
Generally, interns are called by their classmates, or directly by their first name, or "doctor", which is an exception.
"Okay. Liu Muqiao, there is another patient with a bleeding volume of more than 100, and his family is still hesitating whether to save him or not. He should have been placed in the intensive care unit, but his family thought it was too expensive and did not agree. I will do the work and see if he agrees.
Puncture and drainage." Zhao Yilin walked out first.
When Liu Miqiao and Dr. Zou walked out of the intensive care unit, their family members gathered around them, asking, "How is it?"
They mainly surrounded Dr. Zou.
"It was very successful. A total of 21 milliliters of congestion was extracted. As long as there is no more bleeding, it will feel better day by day. In general, there should be no problem in taking care of yourself."
"Thank you, thank you."
Several pairs of big hands held Dr. Zou's hand tightly.
When he arrived at the doctor's office, three or four people surrounded Zhao Yilin.
"Are there any sequelae?"
"How much will it cost?"
"Can you take care of yourself?"
……
A series of questions.
Zhao Yilin waited for them to finish asking and said: "More than 100 milliliters is a massive hemorrhage, and it is in the basal ganglia and ventricles. The sequelae are certain. There is not much chance of living on one's own. As for money, it's hard to say. Use more and use less."
It has something to do with your decision. However, I can tell you clearly that without surgery, the hope of survival is very slim. With surgery, there is only a one-third chance. You decide."
The family members finally understood, and after a few people discussed it, they decided to fix the problem!
"Discharge!"
Liu Muqiao sighed, and a living life ended like this.
What can be done?
Medicine also has limitations, and the value of treatment for such patients is indeed not great.
This chapter has been completed!