super anesthesiologist

Chapter 145 Make up for the pot (please subscribe, please recommend tickets, thank you everyone!!!)

Lin Xiaobei thought for a while, and picked up Wang Xuguang first. He was a colleague, and he might have difficulties in work and urgently needed help.

"Hello, Mr. Lin, I'm Wang Xuguang. I used to study in the First Attached to S University and studied with you."

"I know, just tell me if you have something to say." Lin Xiaobei got straight to the point.

Wang Xuguang hesitated for a while on the phone, as if he had organized his words before he said: "It's like this, I'm very confused now. I have a patient with severed fingers and cuts on his palm, and I have done intermuscular groove and armpit for him Brachial plexus block, but the effect, the effect is not satisfactory. The surgeon suggested changing to general anesthesia."

Lin Xiaobei didn't take it seriously: "Then change it to Quanma!"

It is very common for a nerve block to fail. It happens even to anesthesiologists in a large general hospital of the attached first level, let alone a half-assed one like Wang Xuguang?
Anesthesiologists should not be obsessed with a certain method blindly, but learn to be flexible. The ultimate idea is to minimize the pain of the patient.

Wang Xuguang hesitated on the phone, "Ms. Lin, I am worried about this. This patient seems to have a difficult airway. I am in a private hospital, and I am the only anesthesiologist..."

Later, he hesitated to say it out, but Lin Xiaobei could tell that Wang Xuguang was just worried that one person would not be able to cope with the general anesthesia.Indeed, for an anesthetist of his level, it would be a lot of pressure to deal with difficult airway without help, and they couldn't afford the risk.

Lin Xiaobei asked directly: "Do you want me to help you?"

Wang Xuguang answered immediately: "Yes, yes, yes, Mr. Lin, I knew I was right to find you."

"I haven't promised you yet."

"teacher LIN!"

"Negative value from Wang Xuguang, +30".

Ha ha.

Lin Xiaobei said leisurely: "You have to give an address, right?"

Wang Xuguang was overjoyed immediately, "Sun Wen Trauma Hospital, No. 537, Xiling [-]st Road."

After hanging up Wang Xuguang's phone call, Lin Xiaobei felt a little strange, "Sun Wen Trauma Hospital"—why does the name seem familiar?
He dialed Tian Peng's mobile phone, not knowing why this guy was looking for him.

"What are you doing? I haven't answered the phone for a long time." Tian Peng complained on the phone.

"I was answering the phone just now."

"Are you dating now?"

Lin Xiaobei looked at Liu Xu, "No."

"Okay, call quickly, I will continue to help you." Tian Peng urged on the phone.

Lin Xiaobei just agreed to Wang Xuguang, so it's impossible to do it now.

"What's wrong with you?" he asked.

Tian Peng was a little impatient, "I have a patient here, the effect of the brachial plexus injection is very poor, and the anesthetist who changed to general anesthesia dare not do it, really Jill is upset."

Lin Xiaobei: "..."

"I'm dizzy. I just promised to help others. That guy has been with me before, and he is also in trouble."

"Are you stupid? You won't let other people in your department go for you? Stop the ink, hurry up and take a taxi, we can't wait. You can ask for a taxi to go directly to Xiling Road, 500 meters in front of Fengyuan Restaurant. Then I saw Sunwen Trauma Hospital.”

Lin Xiaobei: "..."

It turned out that the two guys were referring to the same place!
Lin Xiaobei cursed into the phone: "Ni Tuoma is an idiot!"

After hanging up the phone, Lin Xiaobei said to Liu Xu apologetically, "I'm really sorry, I'm going to help others fix the pot."

He originally wanted Liu Xu to go back alone, but Liu Xu looked at his watch, it was still early.

"I'll go with you!" Liu Xu begged, "I haven't had a nerve block for a long time."

……

When Lin Xiaobei brought Liu Xu to Sun Wen Trauma Hospital, Tian Peng rolled his eyes on him, then whispered in his ear: "Your sister, it's okay."

"Go away, she is my director's student."

Tian Peng hehe.

Sun Wen very politely invited them in.

In the operating room, Lin Xiaobei saw Wang Xuguang and the patient.When Wang Xuguang saw Lin Xiaobei, he was overjoyed as if seeing a savior.

"Mr. Lin, are you here?"

He also saw catkins following behind.

Wang Xuguang looked at Liu Xu and smiled meaningfully.

"She is here to study." Lin Xiaobei said.

The patient is a fat man with a visual weight of more than 200 catties and a thick and short neck.Such a patient is very difficult for Wang Xuguang and others to perform the brachial plexus blindly.

Lin Xiaobei asked Wang Xuguang carefully about the process of anesthesia, the dose and time of local anesthetic used.

According to calculations, the interest rate he has used has exceeded one hour.

Lin Xiaobei didn't want to perform general anesthesia here after learning about the general condition of the patient and the operation, otherwise he would have to stay here all night.

Lin Xiaobei adjusted the patient's position again, placed a drape on the shoulder of the affected side to fully expose the neck, and then carefully positioned the patient from under the collarbone.

After choosing the needle insertion point, he stepped aside and said to Liu Xu, "You have a try, just insert the needle from the point I set."

Liu Xu has been following Wen Xin, and the most anesthesia performed is neuraxial anesthesia. Except for the brachial plexus block, which has been performed on pigs and dogs in the laboratory, it is rarely done on patients.In pursuit of convenience, many teachers in the anesthesiology department use general anesthesia with endotracheal intubation for many operations that can be performed on nerve blocks, so as to facilitate management and avoid the embarrassment of poor anesthesia effect.

That's why she strongly requested to come here with Lin Xiaobei.

Liu Xu first touches the patient's intermuscular groove with the pulp of her left index finger, which is a habit taught to her by Lin Xiaobei.Many novices like to press with their fingertips when positioning, and often inadvertently think that their nails have pressed a concave mark, which is misleading.

The advantage of the finger pulp is that the pulp can clearly feel the patient's own anatomy.Of course, this is only for Lin Xiaobei, I don't know if Liu Xu can feel it.

Obviously Wang Xuguang didn't feel it, Lin Xiaobei saw the needle entry point of Wang Xuguang's intermuscular groove, which was several fingers away from the position he locked.

No wonder it didn't work out.

Liu Xu touched it for a while and frowned, "I don't know."

"It's so fat, and the neck is so short, it's normal that you can't figure it out. You can insert the needle from the point I set. Insert the needle slowly, and pay attention to whether the patient has a sudden emergency reflex." Lin Xiaobei instructed.

Without Lin Xiaobei by his side, the patient Liu Xu really didn't dare to do anything.In the attached operating room, almost all such patients are under general anesthesia with endotracheal intubation.

Liuxu opened the disinfection bag, put on gloves to disinfect, and after making full preparations, under Lin Xiaobei's watchful eye, began to infuse the patient's intermuscular groove.

Lin Xiaobei kept his eyes on during this process, he was still a little worried about Liu Xu's rough movements.

This is a common problem of many novices in anesthesia.They can't help being eager and excited all the time, and the movements in their hands are not very coordinated.

The catkins continued to insert the needle, and when it reached about 3 centimeters, Lin Xiaobei just wanted to remind her to slow down, when suddenly the patient let out an exclamation of “Ah——” and at the same time, the arm on the injured side jumped as if touched by high-voltage electricity Suddenly, Liu Catkin was startled, and her hands trembled and she pulled out the needle.

This is a typical reflex into the nerve sheath.

"Why did you pull out the needle?" Lin Xiaobei blamed.At this time, as an anesthesiologist, you should stabilize yourself and take the opportunity to inject local anesthetic.

And she wasted such a good opportunity.

"I, I didn't expect him to have such a big reaction." Liu Xu was aggrieved and surprised.This was the first time she encountered such an obvious "strange feeling" when she was undergoing a nerve block.

The main reason is that I was completely unprepared, so I was caught off guard.

The patient also had lingering fears, and said anxiously: "Doctor, do you still want to be beaten?"

"Yes, you will feel an electric shock when we hit a nerve, don't move, tell us in time." Lin Xiaobei urged.

"Well, I know. The electric shock just now was too severe, as if I was hit by electricity."

Liu Xu inserted the needle again from that position, this time slower and more carefully than before.At the same depth, the patient began to exclaim: "Ah, there is an electric shock!"

After the injection of the anesthetic, the patient felt hot and hot in the thenar area of ​​the stump of the palm, and the pain in the hand was relieved a lot immediately.

But this patient also had a broken little finger, and there was also an operation area on the ulnar side, so Lin Xiaobei instructed Liu Xu to give him an axillary nerve block, using only half the dose of the interscalene groove.

After the anesthesia was over, Tian Peng and Sun Wen started the operation. The patient no longer felt anything, even the cold feeling of the disinfectant on his hands disappeared.

Wang Xuguang saw it with envy and admiration, feeling ashamed.

(End of this chapter)