Sleepless Doctor

"Does Director Peng know about the latest technology of stellate ganglion block anesthesia?" Wu Mian asked mildly.

"..." Peng Peng was startled.

The latest technology? what is that? Peng Peng shook his head subconsciously.

"It can't be said to be the latest, but it's just a little trick, I think it's quite practical." Wu Mian said.

"Teacher Wu, please tell me." Peng Peng suppressed his curiosity and said.

"Let’s talk about the problem first, technology can’t be learned in a day." Wu Mian continued, "Just looking at your expression, I feel that the process of blocking anesthesia...it didn’t go well at the beginning, did it?"

"Yeah." Peng Peng did not shyly tweak, and directly nodded and admitted, "This patient has no problem with the preoperative physical examination. I think the block anesthesia will be completed quickly. But I tried 3 during the stellate ganglion anesthesia. There was bleeding in the first two times, and there was no blood until the third time."

"A small amount of blood was drawn back during the first two injections. After giving up the drug injection, the needle was inserted deeper in the third injection than in the previous two.

When the needle tip touched the bone, I heard that you did not withdraw the needle. It is estimated that the left hand was unstable and the needle tip continued to slide in a little bit, which caused the needle to be inserted too deeply. Although there is no blood and cerebrospinal fluid withdrawn, the needle tip is too tight. There may be no blood, and the possibility of entering the blood vessel by mistake cannot be ruled out."

Wu Mian went back to Director Peng’s previous operations. Director Peng became more surprised as he listened to him. How could he see it with his own eyes... No, I would never see that the needle tip touched the bone during the operation and did not withdraw the needle.

It's like traveling to Teacher Wu and telling yourself the wrong process before. And it was the operation process that I realized in a dim, but not sure.

For an instant, Peng Peng felt that he was split and exploded directly.

He stared at Wu Mian in a daze. How did Teacher Wu know the most private thing in the operation?

"Haha, don't be weird." Wu Mian smiled, "I just made an inference based on normal guesses. Generally speaking, the situation just happens when the anesthetic is injected into the vertebral artery. This is a high probability."

"There is a saying that happy lives are the same, but unfortunate lives have their own misfortunes. In our operation, the situation is similar.

It's just that because of the different anatomy of each person's body, every success may be a little different, but most of the failure cases are the same. "

Wu Mian looked at Peng Peng with a smile on his face, as if he was teaching a student, but he was not too harsh.

"Teacher Wu, you are really amazing." Peng Peng drily praised. He is actually not sure what Wu Mian is saying, but it is always right to say two good things.

"In the horizontal section of the seventh cervical vertebra, the vertebral artery has not yet entered the transverse foramen, and its position is close to the stellate ganglion. This may be an anatomical factor that caused the puncture to enter the vertebral artery. I believe you have paid attention to it, but the problem It will still happen."

"To avoid...it is impossible to completely avoid it. After tracheal intubation, there must be at least one spare set." Wu Mian said, "The other is to do stellate ganglion anesthesia under ultrasound guidance."

"Ultrasound? Not very useful, right."

"That was in the past, neither the technology nor the machine was enough." Wu Mian said with a smile, "The first two generations of B-ultrasound machines have been able to see the spread of local anesthetics during injection."

"..."

Peng Peng and Zhang Zimo were all startled.

The carotid and vertebral arteries have relatively thick blood vessels. If the blood flow can be seen on the bedside ultrasound, it would be better to say something. Can B ultrasound see the penetration of local anesthetics?

Teacher Wu is sure you are not joking?

"The block under ultrasound guidance is safer and more reliable than the traditional block method by palpation of the transverse process positioning. It can not only avoid blood vessel damage and stray blood vessels, but also reduce the amount of local anesthetics."

"The traditional method requires 8-10 mL of 1% lidocaine, and 2-3 mL under ultrasound guidance. The onset is faster than the traditional blocking method. The dosage is small and safer."

After Wu Mian finished speaking, she looked at Director Peng with a smile.

"Teacher Wu... is the technique you said is difficult?" Director Peng stammered.

After listening to Wu Mian, Peng Peng felt a bit dry in his voice, and his words began to be uncomfortable.

"Do you want to learn? I teach you." Wu Mian smiled.

"real?!"

Peng Peng realized the benefits of this matter, even earlier than Zhang Zimo and Director Qian. After all, he is an old driver of Wanchang.

Ms. Wu Mian Wu said that this technique is not only safer and more reliable. If you can use B-ultrasound to locate and supervise, you can get out of it and bring a few apprentices.

Before and during the operation, various operations are handled by someone, so you only need to hold the B-ultrasound probe to guide you. Now I am busy every day until 7 or 8 o'clock in the evening, and the amount one person can do is still limited.

And the most critical point is that Peng Peng does not want to let go.

The old director was emptied from time to time, so Peng Peng would rather work late every day than being a church apprentice or starving master.

But with new technology, things are completely different! In Peng Peng's mind ~www.wuxiaspot.com~, a new map of the future has been outlined.

If there is B-ultrasound positioning during the operation, the most difficult blind puncture step is omitted, and the young doctor is responsible for guiding the puncture, and the young doctor is responsible for the manual puncture.

It can also increase the number of patients treated efficiently and safely, and master the upstream core technology!

As he gets older and accumulates more and more patients, Peng Peng also feels a little powerless recently.

People have to persuade the old, this kind of powerlessness is diffused around life from home to work.

But once the role changes... Peng Peng suddenly felt that his eyes suddenly opened up, and a blue ocean was waiting for him!

Wu Mian was just smiling, looking at Director Peng's unpredictable expression, smiling without saying a word.

Thinking of this, Peng Peng's heart was enthusiastic.

"Ms. Wu, the technique you mentioned..."

"The technique is very simple, mainly to distinguish blood vessels and nerves. As for the infiltration of anesthetic drugs, let me be honest, you need at least 10,000 clinical operations to accumulate before you can initially master it." Wu Mian said.

"That's okay!" Peng Peng said, "Mr. Wu, when will you have time?"

Zhang Zimo glared at Peng Peng, saying that was too rude.

Peng Peng was completely unaware of his rudeness and looked at Wu Mian with excitement.

"Don't worry, you should familiarize yourself with the B-ultrasound first." Wu Mian said with a smile, "First, you need to understand the linear array probe, how the frequency 9~13MHz is defined, and then the direction of the probe is 30° to the sagittal plane of the neck~ How to put 45°. If you have done these basic skills, let's contact at any time."

Hearing what Wu Mian said, Peng Peng's head was big.

He knows what kind of high-frequency linear array probe the B-ultrasound probe seems to be, but although Mr. Wu said briefly, would it have a deeper meaning?

Is it possible to dismantle the B-ultrasound machine and learn from the most basic?