Going back to medical school to make up for your shortcomings is only the first step. Medical school dissects dead people, and clinical work involves living people. You also need to do more cases to accumulate clinical experience.
This requires doctors to be bold and careful. Female doctors have always been less courageous, which leads to them being generally inferior to male doctors in such operations. Female doctors who have the courage to act are definitely outstanding.
So even though Teacher Xin is smiling all the time, his smile is so gentle. His true identity is a general under Director Li. In his twenties, he dares to take students to play bronchoscopy alone, which shows that his character and skills should be both good and bad.
Stand out among doctors of the same age.
"Come on, put on your hat and get dressed." Xin Yanjun said to the students grandly.
The teacher and student put on disposable surgical gowns and sterile gloves.
The patient is lying on the treatment bed, supine.
Before the operation, the nurse gave the patient a topical anesthetic to numb the throat, like a gastroscopy.
This patient has high blood pressure. For safety reasons, the patient is connected to an ECG monitor and the blood pressure monitoring frequency is adjusted to once every three minutes in order to observe the patient's condition.
As an assisting doctor, Xie Wanying needs to help the teacher lubricate the fiberoptic bronchoscope body with sterile paraffin oil, so that the friction between the lens body and the patient's tracheal wall can be reduced when entering the patient's airway.
everything's ready.
Xin Yanjun lowered her head, talked to the patient, and calmed the patient's emotions: "Sister, I will do this examination later. Please cooperate with me. Just inhale when I tell you to inhale. Don't be nervous. It's just a little bit when the tube goes into your throat.
I'm not feeling well, please bear with it, it won't be too long."
The patient nodded, looking as calm as the doctor but it was impossible.
The nurse then handed a bottle of dripping medicine into the doctor's hand.
"Yingying, take it and put it into her big nostril. It's chlorine anesthetic liquid." Xin Yanjun said to the student.
The cooperative nurse hesitated for a moment, then reluctantly gave the medicine to Xie Wanying, and told her: "If you don't understand anything, remember to ask the teacher first."
I am afraid that this intern has never been exposed to fiberoptic bronchoscope operation and does not know how to do it. Once Xin Yanjun starts the operation, she will never take care of the students and must focus entirely on the patient.
Fiberoptic bronchoscopy is an operation that invades the human body. Improper operation can harm the human body, and the complication rate is as high as 0.3%. The most common bleeding, occasional massive bleeding, can be fatal. Other complications such as hypoxia and infection are very serious.
trouble.
Well aware of the pros and cons of medical operations, Xie Wanying would not object to the nagging of the nurse sister and nodded.
Holding the drop bottle in hand, Xie Wanying followed the teacher's instructions and first observed the patient's nasal cavity.
There are three ways for the fiberoptic bronchoscope to enter the airway, through the nasal cavity and through the oral cavity. If the patient has a tracheotomy, it can be inserted through the incisional cannula. In clinical practice, the preferred route by most doctors is through the nasal cavity.
The reason is very simple. If the tube is passed through the oral cavity, it will easily be interfered by the patient's mouth and tongue. If it is passed through the nasal cavity, no matter how much the nose is moved, there is nothing in the nose that can make big movements. It is bound to be difficult to disturb the tube. For example, 21 patients today are intubated through the mouth.
The tube is connected to the ventilator, and the doctor will first place the scope into the airway through the intubation tube in the mouth.
In a nutshell, whichever road is easier to enter is the one to enter.
Carefully compare the size of the patient's two nostrils to see which nostril is larger and does not obstruct which nostril the tube enters through.
