The surgeon opens a cheat

Chapter 5 also improved the catheterization method by the way
Ma Chenglin brought Zhang Gu to a patient.

"This patient has just had a gastric tube, so you demonstrate and teach them the cotton thread fixation method."

Zhang Gu nodded and explained to the nurses while demonstrating.

"The medical tape fixation method that everyone used before has four disadvantages."

"One is to bend the gastric tube at the alar of the nose for the convenience of sticking the adhesive tape, causing the patient's nasal cavity to be uncomfortable due to the side pressure of the nasal tube. Second, the patient sweats or cleans the face so that the cheeks are wet, and the adhesive tape is easy to fall off, causing the gastric tube to loosen The third is the firmness and poor air permeability of the tape. The sticky substance on the tape needs to be wiped with turpentine, and some patients may experience unbearable odor or allergies. Fourth, patients are worried that the gastric tube will fall off, which will reduce their activity, which is not conducive to patients postoperative recovery."

"The cotton thread fixation method can avoid the above disadvantages."

Seeing Zhang Gu talking eloquently, Ma Chenglin felt a little emotional.

It seems that Xiao Zhang made an improvement after an in-depth analysis of the gastric tube fixation method.

It seems simple, but it actually contains truth.

No matter how small an innovation is, how can it be so easy?
Rare!
The head nurse, Xing Wanhong, listened with gusto, and what Dr. Zhang said was very clear and clear!
The little nurses also listened carefully, and some took out small notebooks and took notes seriously.

"Next is the specific operation method."

This time because it was teaching, Zhang Gu explained in more detail than when he was in the general surgery department.

"The cotton thread is preferably about 45 cm, which is more convenient to adjust. First, put a 8-shaped buckle in the middle of the cotton thread, pass through the end of the gastric tube, place it at the root of the nose, and lightly tighten the two ends of the cotton thread to make the cotton thread tightly tied to the stomach. Tube, not easy to slip off is better."

Zhang Gu said while doing: "Tie a slipknot on each side of the cotton thread, wrap a little cotton under the cotton thread hanging on the auricle, hang the slipknot cotton thread on the auricle respectively, and wrap the end of the gastric tube with sterile gauze. Fold it back and clip it with clips."

After Zhang Gu finished, he glanced at the nurses, and casually pointed to a beautiful one: "Come and try to do it again."

The little nurse blushed, stood up nervously, and imitated what Zhang Gu said just now, but it was almost the same.

Xing Wanhong, the head nurse, said with a smile: "Ms. Zhang said it well, we will remember it once."

Ma Chenglin also smiled beside him.

At this time, a young doctor came over and said in Ma Chenglin's ear with a embarrassed face: "Director Ma, the gastric tube on bed No. 7 fell off again, please re-intubate."

Ma Chenglin said unhappily: "The swallowing disorder on bed No. 7 is the most serious in our department, and the gastric tube is also the most difficult to insert. You don't want me to care about it!"

The young doctor was obedient and dared not speak.

Ma Chenglin turned his head to look at Zhang Gu who was teaching, and calmed down a bit: "But after today, we will use Xiao Zhang's cotton thread fixing method, so we can relax a bit."

Ma Chenglin came to bed No. 7 and tried to reinsert the gastric tube. The patient just complained of pain. After a while, Ma Chenglin also saw sweat on his forehead.

For patients with stroke and dysphagia, it is most difficult to place a gastric tube.

At this time, Zhang Gu came over: "Director Ma, why don't I try."

The young doctor next to him said, "Dr. Zhang, the nasal, pharynx, and esophageal mucosa of this patient are already congested, edematous, and mucous membrane damaged. Coupled with swallowing dysfunction, intubation is difficult."

Zhang Gu smiled: "It's okay, there is a difficult way."

Ma Chenglin glanced at Zhang Gu: "Do you also have experience in intubation?"

Zhang Gu: "A little bit."

"For patients who cannot actively cooperate, it is actually easier to use a spatula. Does our department have a sterile spatula?"

After hearing this, Ma Chenglin suddenly had some expectations, and winked at the young doctor next to him.

Soon, a sterile tongue depressor was delivered.

The nurses who were practicing the cotton thread fixation method looked at this side curiously at this moment.

Zhang Gudao: "For this kind of patients who cannot actively cooperate with intubation, it is best to adopt a semi-sitting position of 15 degrees to 30 degrees, which makes it easier to intubate."

"Director Ma, I'm not good enough on my own, please use a tongue depressor and gag to cooperate with me."

Ma Chenglin smiled: "Okay, as long as you can successfully insert the gastric tube, I will be your assistant once."

He vaguely felt that this little doctor Zhang might come up with a new improvement method again!

Ma Chenglin's heart suddenly became hot.

The cotton thread fixation method is convenient for nurses.But this improved catheterization method will be convenient for doctors like him in the future!

Both of them put on sterile gloves.Under Zhang Gu's instructions, Ma Chenglin wrapped the patient's tongue with gauze, and gently pulled it out with one hand.

Taking advantage of the situation, Zhang Gu inserted the gag from one side of the mouth. After fixing it, he lubricated the front end of the stomach tube and slowly inserted it from one side of the nasal cavity.

After inserting it about 15 centimeters in, Zhang Gu said, "Director Ma, use the tongue depressor to hold down the base of the tongue."

Ma Chenglin's eyes became brighter and brighter, and his brain became active. He had a hunch that Zhang Gu's method might really work!
Taking advantage of Ma Chenglin pressing the base of his tongue, Zhang Gu quickly inserted the gastric tube to the predetermined length.

The young doctor next to him wore a stethoscope and tried to inject 10 milliliters of air. At this moment, he was overjoyed: "It has been sent into the stomach! I heard the sound of water in the stomach echoing!"

Zhang Gu said: "Director Ma let go."

Ma Chenglin's eyes glowed, and he released his tongue depressor with a little excitement.

After Zhang Gu skillfully fixed the gastric tube again, he got up and said with a smile, "That's it."

Ma Chenglin looked at the time spent just now, and was amazed in his heart. This time, re-inserting the tube was quick and easy, and it was the easiest time since he re-installed the tube.

Xing Wanhong and other nurses also had ripples in their hearts. They knew how much trouble these patients with dysphagia brought to the department's tube placement and regular work!

These troubles are in the hands of Dr. Zhang, but they can be easily resolved.

Ma Chenglin took a serious look at Zhang Gu, and said sincerely: "Doctor Zhang, you have to teach me how to do this. If you have anything else, you can bring it all out!"

Zhang Gu said with a smile: "There are no other things, that's all. The key to this tube placement method is that the tongue depressor can make patients unconscious, or have difficulty swallowing, and cannot cooperate with the patients who are unable to transfer to the pharynx, esophagus and stomach. Open the pharynx for easier intubation.”

"In fact, the reason is very simple. For patients with normal swallowing function, the vestibular contraction is closed during swallowing, the entrance of the organ is temporarily closed, and the entrance of the esophagus is partially opened, which facilitates the entry of the gastric tube. The [-]-degree semi-recumbent seat, gag and tongue depressor The role of the plate is to replace this part of the function, so that patients with disabilities can fully expose the pharyngeal cavity during intubation."

Ma Chenglin couldn't stop nodding, and said with a smile, "It's because you observe meticulously and know how to use tools such as gags and tongue depressors."

Xing Wanhong also sighed: "This method is not difficult to say, but before seeing it with my own eyes, I just couldn't think of it!"

After Ma Chenglin digested it for a while, he felt that he had almost mastered it all.

He stared at Zhang Gu with scorching eyes: "Doctor Zhang, don't you think your improved tube placement and fixation method is worth publishing and promoting? This can definitely be published as an article!"

"Exactly! There are enough patients with stroke and dysphagia in our department to conduct a comparative experiment. The data is enough to support an article."

Zhang Gu's heart was moved when he heard this, his first main mission was about to start.

　PS: Improving the gastric tube and cotton thread fixation method is not difficult at first glance. In fact, it has gradually become popular in the past five or six years. Until now, some hospitals across the country still use the adhesive tape fixation method. Every step of innovation and improvement to promote change is not easy.

　　
　
(End of this chapter)