I'm really an intern

Chapter 13 The expression is getting crazy ヽ(｀⌒メ)ノ

Whether it is hemodialysis or plasma exchange, the purpose is to guide the patient's blood outside the body to be filtered and then reinfused.

And to draw out a large amount of blood, you need a sufficiently stable channel.

Patients with renal failure who need long-term regular dialysis often perform a small arteriovenous fistula operation on their hands, and use this as a long-term and stable channel for dialysis.

For patients without arteriovenous fistula, only temporary deep venous access can be selected, including internal jugular vein, subclavian vein, and femoral vein.

"Dongfang Hospital usually has an indwelling tube for the internal jugular vein, right?"

Zhang Tianyang asked, "Will Senior Sister know how to do it?"

"Can do."

Senior Sister Liang nodded, with a struggling look on her face, "But that family member..."

"It's fine for me as a family member." Zhang Tianyang dragged the consent form and walked to the intensive care unit, "Sister, let's prepare things!"

Obviously, the superior doctors usually give orders to the subordinate doctors, but upon hearing Zhang Tianyang's words, Senior Sister Liang didn't feel anything wrong at all.

As if it was supposed to be like this.

The little nurse Lin Lin quietly looked at this and that, and her impression of Zhang Tianyang inexplicably increased a lot.

"For the sake of milk tea, why don't you forgive him first?

After all, it is the patient who needs to be dealt with, not him...

It's not his fault, is it? "

Zhang Tianyang didn't know the inner drama of the little nurse, he just wanted to deal with the patient quickly.

Fortunately, the woman in red didn't do anything wrong this time, and the consent form was signed quickly, and the senior sister over there also pushed the treatment cart into the intensive care unit.

"Now the internal jugular vein catheter is going to be placed, can the family members avoid it?"

Zhang Tianyang directly drew the curtain around bed 41, isolating a space where only he and his senior sister in white coats were in.

"Uncle, can you turn your head to the left?"

Helping the patient in bed 41 to expose the right side of the neck, Zhang Tianyang stretched out his hand to feel the pulse of the carotid artery.

After feeling the obvious beating, move the fingertips slightly to the outside to find the clavicular head of the patient's right sternocleidomastoid muscle, the triangular area formed by the sternal head and the clavicle.

At the very top of the triangle is the puncture point.

Here, Zhang Tianyang made a light cross with his nails.

The whole process took less than half a minute, and he turned to look at Senior Sister Liang.

"Sister, are you ready to wear it?"

"Come on, let me see."

Senior Sister Liang took the position where Zhang Tianyang had just stood sideways, and began to locate the puncture point.

On the side, Zhang Tianyang had already pushed the treatment cart to a place where Senior Sister Liang could reach out, and began to quickly prepare items.

Unpack the central venipuncture kit and lay it out on the treatment cart.

Disassemble the sterile hole drapes and 5ml syringes, disassemble them in the air and let them slide down to the sterile area automatically.

Then prepare heparin, lidocaine, and anal iodine.

Senior Sister Liang spent more than a minute carefully confirming the puncture site, but when she was about to make a mark, she saw a faint cross.

Did the younger brother pick it out with his fingernails?

He just spent more than ten seconds touching it just now!

Very precise positioning.

Senior Sister Liang was a little surprised, she couldn't help but look at Zhang Tianyang behind her, and took advantage of the opportunity to see the neatly prepared equipment and supplies on the treatment vehicle.

She froze for a moment, "So fast?"

In the next second, the half-removed sterile gloves were handed over.

"Sister, shall we begin?"

"Ok."

Senior Sister Liang seemed to have sensed something in the dark, subconsciously pulled herself together.

But as soon as she stretched out her hand, Zhang Tianyang handed over the sterilized cotton swab soaked in Aneriodine.

"You! Uh..."

Senior sister Liang just wanted to reprimand Zhang Tianyang for polluting her gloves, but when she glanced at her, she found that Zhang Tianyang had already put on the sterile gloves at some point.

After swallowing the second half of the sentence, Senior Sister Liang had no choice but to sterilize.

Just after the disinfection, Zhang Tianyang turned his head and handed over the 5ml syringe filled with lidocaine.

Senior Sister Liang paused for half a second, then resignedly took the syringe and started anesthesia.

Immediately afterwards, the special syringe with the puncture needle installed and the heparin pumped was also handed over.

Turning his head again, the guide wire was ready, and the small blue tube used to expand the channel was quickly delivered to his hand.

The three-lumen tube was filled with heparin early without warning and was stuck. As soon as I stretched out my hand, the needle for the surgical suture was handed up.

This is the first internal jugular vein catheterization that Zhang Tianyang has experienced in the real world, but it is not the first internal jugular vein catheterization in his life.

The time spent in the system space and the sweat shed have become Zhang Tianyang's experience and confidence at this moment.

The "Medical Great Feeding Technique" was used, which immediately made Senior Sister Liang short of breath.

Obviously she is the trainee doctor with rich clinical experience, and she should be the leader of the internal jugular vein catheterization this time.

But why do you always feel that you are being urged to leave by your junior?

Mingming's younger brother is his subordinate doctor.

But why did this internal jugular vein catheterization make me feel trembling when I was instructed by a superior doctor while complaining about it when I first started it?

I'm afraid that if I do a wrong step, I won't be able to keep up with the opponent's rhythm...

After tying the last surgical knot and reconfirming that the number of the tube has been fixed, Senior Sister Liang stepped aside.

Zhang Tianyang quickly picked up the sterile gauze that had been prepared, wiped the blood on the patient's neck, and put on a transparent dressing.

Until now, watching Zhang Tianyang start to tidy up the equipment and pollutants, Senior Sister Liang finally secretly breathed a sigh of relief.

Looking at the time, apart from the time for preparing items in the treatment room and signing the consent form with the patient, it only took 7 minutes for Zheng'er Bajing to perform the internal jugular vein catheterization.

Senior Sister Liang couldn't help feeling a little dizzy.

In addition to practice and regular training, she has been in the clinic for seven or eight years, and has performed [-] or [-] cases of internal jugular vein catheterization.

It takes ten minutes at best.

Why did it only take 7 minutes today under the "help" and "urging" of my junior...

She couldn't help but began to ramble in a low voice.

"I'm an experienced doctor. I haven't seen any scenes. I'm not surprised at all. I'm not shocked at all. I really don't think my junior is very powerful. I...

hiss--

But he is really amazing!

I can't betray my heart! "

Senior Sister Liang has always had a straight-forward temper. If she is angry, she will hate you, if she doesn't like it, she will ignore you, and if she is happy, she will talk to you more.

She has been transparent for so many years, but now because of Zhang Tianyang, she is gradually going crazy.

ヽ(｀⌒メ)ノ

……

Ten minutes later, the CRRT nurse at the bedside pushed the machine and arrived on time.

Zhang Tianyang didn't feel relieved until the thick blood plasma slowly flowed out along the tube of the machine, was filtered, and returned to the patient again.

After saying "hard work" to the CRRT nurse beside the bed, Zhang Tianyang returned to the doctor's office.

At the current time, at 25:41 in the evening, he was going to write the [-]-bed admission, the first course of disease, the internal jugular vein catheterization record and the human albumin use record while it was hot.

Sister Liang, who had just sat down at a computer and adjusted her state, came over.

"Junior Brother, you still have to write the medical records, so you didn't go back so early?"

"Well, at least five or ten minutes."

"Then, let's have dinner together?"

Senior Sister Liang raised her phone.

"My treat."

　Thank you Fushengyueguang, Laofang, and May Fourth, these three big guys for their rewards, it’s costly~

　　Today's double update, silently asking for a vote and investment is not too much, right?

　　

　

(End of this chapter)