My medical skills are a billion points

Xiao Chu didn't speak, Gao Yingjun said first: "We will make preoperative preparations immediately, and interventional surgery can be performed soon. But the old lady will need to live in the intensive care unit in the future."

"No problem, I agree!"

Zhang Jun readily agreed this time.

Since the old lady's son agreed to undergo interventional surgery, Xiao Chu and Gao Yingjun returned to the office to make relevant surgical preparations.

The implantation of the inferior vena cava filter needs to be transferred to the interventional department for surgery, because angiography is required.

Gao Yingjun then said: "Xiao Chu, let's transfer the patient to the interventional department after Zhang Jun signs the consent form for the operation."

Xiao Chu waved his hand.

"No! After we transfer the old lady to the ICU, we can put a filter on her in the ICU."

"What? Put a filter on her in the ICU?"

Gao Yingjun was a little surprised.

Generally speaking, patients with lower extremity venous thrombosis who need a filter must be transferred to the interventional department, and the filter can only be placed under contrast imaging.

If you don't go to the intervention department, it's not impossible, but you must operate under the guidance of color Doppler ultrasound.

The requirements for the operator are very high.

It is possible to put a filter in the ICU, but currently in the emergency department, no one can do this, not even the director Chen Bin.

"Who will do it for her?" Gao Yingjun asked, and immediately realized.

"Xiao Chu, you can't do it for her, right?"

Xiao Chu nodded: "It's me."

Just a week ago, Xiao Chu rescued a patient who suffered from cardiac arrest, and he was rewarded by the system for rescuing him.

It happened to be the inferior vena cava filter implantation, and it was advanced.

Coupled with his ability, Xiao Chu can completely implant the filter without using a color ultrasound.

Of course, it is still necessary to use color Doppler ultrasound to make an appearance.

Chapter 287 It's reasonable to know how many surgeries

"Isn't it? Brother!"

Gao Yingjun was surprised and bewildered.

"You can even put the inferior vena cava filter? Oh my god, what other surgeries does Xiao Chu have that you don't know? Did you also take all the interventional surgeries?"

Xiao Chu can do brain surgery, thoracic surgery, abdominal surgery and vascular surgery.

Now he even covers all interventional surgery.

How could this not shock Gao Yingjun!

As far as Xiao Chu's current ability is concerned, from Gao Yingjun's point of view, he is simply an all-round miracle doctor.

The key is that every operation performed by Xiao Chu is flawless.

And the patient is recovering very well.

And Xiao Chu is just an undergraduate student, how can this make him a doctoral student?

Seeing that Gao Yingjun was in a daze, with an expression of admiration, Xiao Chu said calmly:

"Calm down, as a doctor in the emergency department, it's reasonable for me to know a few extra surgeries, right?"

"Otherwise, how can you be worthy of the title of emergency doctor?

In the future, as long as we can perform surgery in the emergency department, we will never trouble other brother departments.

Doctors in other departments are already busy enough, let's not make trouble for them, shall we? "

Seeing Xiao Chu's serious joke, Gao Yingjun wanted to beat him up.

But after thinking about it, it seems that Xiao Chu's force value is much stronger than him.

I can only sigh secretly.

This guy Xiao Chu is a monster, not something ordinary people like them can compare to.

While speaking, Gao Yingjun had already drawn the patient's blood and tested the six most important blood coagulation tests, as well as liver and kidney function.

Two or 10 minutes later, the blood coagulation function came out, and the results showed that they were all normal.

Explain that there is no surgical contraindication, the preoperative preparations are ready, and the old lady can be operated on.

Gao Yingjun first asked Wang Panpan and his family to push the old lady into the ICU.

Then Xiao Chu, Gao Yingjun and Wang Panpan came to the ICU, ready to place the inferior vena cava filter for the old lady.

Of course!

All is ready except for the opportunity!

There are enough manpower, but there is still a lack of equipment.

Their emergency department is not equipped with this inferior vena cava filter.

I can only go to the equipment department and get a set back.

Such infrequently used medical consumables are basically not equipped in every department.

Under normal circumstances, they are kept in the equipment department.

Or when necessary, it is also fine to have the device manufacturer deliver it directly.

In fact, this filter is not too big, it is just a small box more than one meter long.

First put the patient in a good position, Xiao Chu puts on the disposable surgical gown and sterile gloves by himself, and after completely disinfecting the patient, he prepares to place the inferior vena cava filter.

When the vena cava filter is placed in the interventional department, angiography is usually required to see the position of the inferior vena cava clearly before it can be inserted accurately.

This is because other departments need color Doppler ultrasound to assist in positioning and imaging, but to Xiao Chu, these are trivial matters.

He only needs to activate the ability to accurately place it.

Although the system has fixed the BUG and can only use the ability three times a day for free, it is enough for Xiao Chu.

As long as Xiao Chu doesn't use his abilities intentionally, he doesn't need to spend points to exchange times at all.

Therefore, Xiao Chu didn't need the cooperation of radiography or color Doppler ultrasound at all.

Of course, in order to deceive others, it is necessary to use a color ultrasound to assist.

He first asked Gao Yingjun to put a color ultrasound probe on the sterile film, and check the inferior vena cava in the lower abdomen of the patient.

Inferior vena cava filters are divided into permanent and temporary.

What Xiao Chu chose for the patient was a temporary inferior vena cava filter.

It is made of six Phynox alloy strips arranged symmetrically.

It is olive-shaped after release, and hexagram-shaped when viewed from above and above.

The outer diameter of the outer sheath is 9F, and the outer diameter of the push rod is 7F.

Can be inserted via the antecubital, internal jugular, and femoral veins.

The inferior vena cava filter is usually removed within two weeks after insertion.

Relatively speaking, temporary filters can be removed within two weeks.

And compared to permanent filters, the price is much cheaper.

If a permanent filter is used, Zhang Jun may not be able to accept it.

Inferior vena cava filter implantation can generally be implanted by puncture from the internal jugular vein and femoral vein.

And Xiao Chu chose to insert it into the femoral vein, which is the most commonly used implantation site.

As for Gao Yingjun and Wang Panpan, they just stared at Xiao Chu's movements by the bedside without blinking.

Because the two of them can't help at all.

This kind of filter job can be done by one person as long as he is skilled.

Xiao Chu performed local infiltration anesthesia on the patient's right thigh root.

Even if the patient is in a coma, anesthesia is still required.

After all, the patient's consciousness has recovered to some extent. If the anesthesia is not administered, the pain will cause her limbs to move around when the guide wire is punctured, thus affecting the effect of the puncture.

After finishing the game, Xiao Chu activated his ability.

And he just made Gao Yingjun wear sterile gloves, and hold the color ultrasound probe against the lower abdomen.

And Xiao Chu glanced at the color Doppler ultrasound screen, in fact, in his mind, the condition of the patient's inferior vena cava had already fully emerged.

He flushes the entire filter release system first in preparation for implantation.

The femoral vein is then punctured at the midpoint of the groin.

For Xiao Chu, this femoral vein puncture is too simple!

Then implant the guide wire, and use the short expansion tube in the package along the guide wire to expand step by step.

Then insert the outer sheath tube and the matching long expansion tube through the guide wire as a whole, and the front end of the expansion tube exceeds the level of the renal vein.

Fix the sheath, pull out the expansion tube slowly, and turn the valve at the end of the sheath to close.

Flush the sheath with heparin saline to prevent thrombosis.

Then insert the filter delivery device.

From this step, Xiao Chu stopped pretending to stare at the color ultrasound screen, but stared at the patient's lower abdomen.

Because of this, the patient's inferior vena cava in his mind is displayed more clearly.

The filter is inserted, identifying the tip of the filter, below the level of the renal vein ostium.

Withdraw the sheath and tighten it with the screw interface of the handle.

Confirm the position of the top of the filter again, then slowly release the filter and slowly withdraw the sheath 3 cm.

At this point, if it is done in the interventional department, another radiography is required.

Look at the position of the filter, whether it is correct, whether the shape is intact, and whether the blood flow of the inferior vena cava is normal.

But for Xiao Chu, all the blood vessels of the patient are in his mind.

Just like in front of your eyes, there is no need for radiography at all.

After the filter was put in place, Xiao Chu took the ultrasound probe and probed the patient's lower abdomen a few times.

At this time, the position of the filter has been displayed on the color ultrasound screen, and the display is very correct.

Less than 10 minutes had passed since Xiao Chu started the puncture until the filter was put in correctly.

As a doctor in the emergency department, Gao Yingjun can of course understand color Doppler ultrasound.

Although he does not know how to place an inferior vena cava filter, he can still see the position of the filter displayed on the color Doppler ultrasound.

Gao Yingjun tilted his head, looked at the color ultrasound screen, and then at Xiao Chu, with an expression of disbelief.

"It's over so soon?!"

"And it's so accurate?!"

Chapter 288

Xiao Chu pulled out the sheath, and then pressed the puncture site with his left hand to stop the bleeding.

Looking up at the surprised Gao Yingjun, Xiao Chu said lightly: "It's just a filter, how long will it take? Of course it's fast and accurate, the shorter the time, the better."

Gao Yingjun shook his head.

"Xiao Chu, I found that now I am immune to your Versailles."

The inferior vena cava filter implantation, although only an interventional procedure.

But it is not that simple, not to mention it is done under the guidance of color ultrasound.

This will be more difficult.