I'm really an intern

Chapter 222 You Are Not Bad

Zhang Tianyang felt innocent.

I don't know why, just now his sixth sense made him vaguely feel a wave of resentment that had just arisen.

What else did he do to be missed?

I think should not be?

He still saved someone just now, the seventh-level pagoda.

The attending doctor calmed down a bit, and was about to let the more reliable Director Song make an ending.

Unexpectedly, before he could speak, a female voice suddenly came from behind a circle of white coats.

"The cerebrospinal fluid is produced by the choroid plexus. It first fills the ventricles, then flows into the subarachnoid space along the pores connecting the ventricles to the outside, and finally is absorbed by the villi-like particles of the arachnoid and re-enters the blood. This is the circulation of cerebrospinal fluid."

A very confident and process answer, a very standard answer.

The attending doctor couldn't help but nodded in agreement, while the surrounding white coats subconsciously turned their heads and made way for a passage.

Lin Ke'an was not stage-frightened either, and walked two steps forward along the vacant space.

She was answering the questions asked by the attending doctor, but her eyes were fixed on Zhang Tianyang.

It's not that she wants to pretend, but that she thinks the attending doctor is too boring.

Although she felt that she guessed the whole thing, Zhang Tianyang was the one who experienced it personally and made the correct operation.

She desperately wanted his answer.

It's like after an exam, even if you know that you have a perfect score in nine out of ten, you still hope to be a pair with the standard answer.

So Lin Ke'an took the initiative to take it without waiting for the doctor in charge with a happy face to say anything.

"On this old lady, she suffered from subarachnoid hemorrhage, and the drained cerebrospinal fluid is not normally colorless and transparent, but dark red."

"This shows that her subarachnoid hemorrhage is more serious and the amount is larger."

She spoke fast, and stared at Zhang Tianyang's face.

Not only is it blocking the mouth of the attending doctor, but it is also comparing with the "standard answer".

"At this time, the blood clot may block the passage between the ventricle and the outside, and the old blood may also block the absorption structure of the cerebrospinal fluid, which is the arachnoid granule."

"The cerebrospinal fluid is continuously produced at a normal rate, but it cannot be absorbed, which will cause a sharp increase in the pressure in the ventricle.

The ventricles expand, hydrocephalus occurs, and other brain tissues are compressed, thus endangering the patient's life.

That's why this old lady needs to drain the cerebrospinal fluid. "

After finishing speaking like a cannonball, Lin Ke'an completely ignored the exclamation in a lowered voice and the faces that suddenly realized and were waiting for the next step.

She even ignored the attending doctor who was smiling and trying to praise her.

He just stared at Zhang Tianyang closely, waiting for the "correct answer".

Zhang Tianyang raised his eyebrows.

No wonder this girl is known as Xueba, she still has something.

He nodded slightly, and continued.

"This old lady has just had a CT scan and needs four transfers between the hospital bed and the flat car, and between the flat car and the CT instrument."

"Under normal circumstances, in order to maintain intracranial pressure, prevent excessive drainage of cerebrospinal fluid, and prevent too little drainage, the bottle connected to the drainage tube should be at the same level as the patient's head."

"When passing the bed, the balance is difficult to control. In order to avoid the reflux of the cerebrospinal fluid that has been drained, the drainage tube will be clamped."

Speaking of this, some white coats who reacted fairly quickly suddenly widened their eyes.

That's it!

It turned out to be because of this!

Lin Ke'an's frowning brows gradually relaxed.

Eighty-nine is close to ten.

Zhang Tianyang continued to explain.

"There are bumps on the way to send the patient for examination. Similarly, clamp the drainage tube."

"For at least half an hour, the drainage tube has been clamped, and the cerebrospinal fluid that should have been drained is trapped inside and cannot be absorbed or drained, which will lead to hydrocephalus."

"The swollen ventricles pressed the patient's respiratory center, causing what we saw, a sharp drop in blood oxygen saturation."

"Unclamping, the cerebrospinal fluid accumulated in the ventricle has a channel to flow out, the pressure of the ventricle drops, the volume decreases, the oppression is relieved, and the patient will recover naturally."

After explaining in one breath, Zhang Tianyang shrugged.

Sure enough, he saw "shocked", "suddenly realized", and "so it is" expressions on the faces of a circle of white coats.

"It turned out to be so!"

"Why didn't I think of that?"

"My God, if you don't explain this to me in detail, how the hell would I think about it!"

"Fortunately not my patient"

Regarding this, Zhang Tianyang was noncommittal.

Clinical practice is a process of bold guessing and careful verification.

In the process of daily diagnosis, it is actually the same. Various similar diseases are ruled out through various evidences, and finally the correct diagnosis is made.

When he guessed the reason just now, he couldn't believe it.

Isn't it just half an hour?Why does cerebrospinal fluid accumulate to the point of oppressing the respiratory center?

But it turns out, that's it.

The attending doctor struck while the iron was hot, and quickly used Zhang Tianyang's words to beat these little bastards.

"Everyone should learn from Xiao Zhang in the future, observe more, think more, and practice more."

"I'm not joking with you."

"This is the ICU ward of the Department of Neurology, and the lives of patients here are in danger at any time."

"When a patient has an accident, the doctor in charge of the bed may not always be there. After all, people always have to eat, drink and sleep."

"But I hope that if something happens, no matter which one of you is next to the patient, you will take what happened today as a wake-up call."

"Quickly call the superior doctor and use your own brain at the same time."

"Just like Xiao Zhang and this classmate Xiao Lin, try to have a rescue idea or measure before the superior doctor arrives."

If you do well, you will be rewarded, and if you do not well, you will be punished.

The attending doctor glanced at the little white cats and gave instructions.

"In order to strengthen your abilities, starting today, I will assign daily tasks. Everyone will read the books for me after they go back, and check them every other day!"

"No!"

"No!"

"Oh my God!"

Suddenly there was a low wailing sound from below.

Facing the vague resentment rushing towards his face, Zhang Tianyang blinked, expressing his innocence.

"Howling, what's going on, continue to make ward rounds!"

The attending doctor waved his hand and led a group of tearful little white cats to complete the remaining ward rounds.

Zhang Tianyang paused slightly, and looked at Lin Ke'an who was also standing still and staring at him.

"you're good."

This seems to be the second time that Xueba'an has expressed his approval for him.

Zhang Tianyang thought about her well-organized thoughts today, and replied seriously.

"You're not bad either."

This is a sincere compliment.

After all, he has been in the clinic for two months, and it seems that others have always praised him for being great, and he has never praised others.

But this was just a small episode, his eyes fixed on the old lady who had regained his stability for a while, and his brows were frowned.

The top priority now is the old lady's condition.

After thinking for a moment, his eyes became serious, and he resolutely chased in the direction of the attending doctor's rounds.

(End of this chapter)