I Can See Health: Chapter 89 Pericardiocentesis!
Chapter 89 Pericardiocentesis!
He Sirong was stunned for a moment, then moved away unconsciously.
She frowned, quietly operating Lu Chen.
Lu Chen stepped forward and stood in front of the patient's bed.
"Lu Chen, you, do you know that?" Ke Yue asked suspiciously.
Lu Chen didn't speak, just nodded!
Now the situation is urgent, and he has no time to explain.
Pericardiocentesis, he can train hundreds of times in virtual space.
From anesthesia to puncture, he kept every step in his mind.
Taking a deep breath, he started anesthesia.
…
Outside the elevator with only one door.
"He can have a pericardiocentesis?" Li Yao raised this doubt in her heart.
Not only her, but everyone else looked at Lu Chen's actions in the video in astonishment.
There are many doctors and nurses in the eight districts of the heart.
Many of them knew Lu Chen, a graduate student who had just come to the department, and was only a first-year graduate student this year.
Pericardiocentesis is different from conventional operations such as thoracocentesis, abdominal puncture, and lumbar puncture.
This is an operation skill that many residents and even attending physicians do not know, let alone let them operate alone in this situation!
Everyone didn't dare to come out, and stared at Lu Chen closely.
Director Lin Cui glanced at Lu Chen, frowning slightly.
This boy has an impression on him.
is Li Yao's student this year!
Once she explained the electrocardiogram to everyone, this student also made a lot of limelight!
Lin Cui glanced at the video again. He Sirong, who was standing beside Lu Chen, flashed a hint of disappointment in his eyes.
You have done pericardiocentesis independently, but why do you get nervous when it comes to this time?
…
Inside the elevator.
Lu Chen started anesthesia before puncture.
The puncture site selection for blind piercing is generally under the xiphoid process.
The point of anesthesia is where the puncture takes place.
Lu Chen chose the point of anesthesia——
The puncture point is made below the junction of the xiphoid process of the sternum and the left seventh costal cartilage, and the puncture direction is 45° to the abdominal wall.
Needling is directed upward, backward, and slightly to the left into the posterior lower part of the pericardial cavity.
Lu Chen performed local anesthesia from the skin to the pericardial parietal layer at the puncture site.
"His hands are steady!"
Jiang Qingyan watched Lu Chen's operation, which was in stark contrast to He Sirong's trembling hands, and the nervousness in her heart calmed down a lot.
As for Li Yao outside the elevator, seeing Lu Chen's skillful operation, in addition to being delighted, it was also a little strange.
Any operation skill is just practice makes perfect.
However, there are very few patients who need pericardiocentesis, and there are not many opportunities for a student to get started.
How could Lu Chen be so skilled?
And looking at his movements, this anesthesia technique is very smooth, without the slightest stagnation.
This kind of technique is completely different from what he can have at his age.
…
Lu Chen has inserted the anesthesia needle into the pericardium.
While injecting anesthesia, **** back the needle.
Suddenly, Lu Chen felt that the needle was missing for a while.
A sense of failure, which indicates that the barrier has been broken and the needle has entered the pericardium.
And Lu Chen didn't feel it, the obvious vibration of the needle tip hitting his heart!
This means that it is safe to puncture at this point!
Withdrawing the needle tube, yellow liquid immediately appeared in the needle tube!
Ke Yue and Jiang Qingyan looked at Lu Chen with joy.
The anesthesia is successful, and the effusion is successfully extracted, then half the success!
On the side, He Sirong looked stunned and stared blankly at Lu Chen, but he didn't know what he was thinking.
"Have it! Have it!"
The people outside the elevator could see Lu Chen's operation clearly through the video.
"This needle went down and it was successfully pierced into the pericardium. It's not easy!"
"I haven't even checked the situation, and there is drainage fluid in his needle."
"I think... Could it be that he is lucky?"
…
After anesthesia, the next step is puncture!
Clamp the rubber tube connected to the puncture needle, and the puncture needle is inserted into the selected and local anesthesia site.
Lu Chen held his breath and began to inject the needle slowly under negative pressure!
The location and angle of the needle insertion are extremely particular.
If it is under the guidance of ultrasound, the needle can be seen in the ultrasound, and the risk of puncture is greatly reduced.
When the needle is close to the heart muscle, stop the needle.
Now, Lu Chen can only carefully insert the needle.
In order to prevent the needle from being too deep and directly poking the myocardial tissue!
…
The people around also held their breaths, their mood up and down following Lu Chen's operation.
Feeling the feeling of breaking through the obstacle again, Lu Chen stopped the needle injection.
I saw light yellow liquid flowing out of the needle tube, which indicates that the puncture needle has entered the pericardial cavity!
After the puncture needle entered the pericardial cavity, Lu Chen immediately said to Jiang Qingyan, "Help me connect the syringe to the rubber tube."
Jiang Qingyan nodded, handed the phone to Ke Yue, quickly put on her gloves, and assisted Lu Chen.
Routine pericardiocentesis, if it is a therapeutic puncture, may require an indwelling drainage bag.
But now the situation is critical, Lu Chen did not continue the operation, but directly released the clamp and began to extract the pericardial effusion.
He wants to quickly extract part of the pericardial effusion to quickly relieve the pressure on the pericardium by the effusion!
The syringe is 50ML, which means that a tube of fluid that Lu Chen draws is 50ML.
The first extraction of pericardial effusion should be around 100-200ML.
If a large amount of pericardial effusion is drawn in a short period of time, it may lead to the occurrence of pulmonary edema.
…
"Draw out!"
Outside the elevator, when everyone saw that Lu Chen's puncture was successful and the liquid was successfully extracted, a heart that was lifted fell one after another.
Li Yao was also relieved.
Being able to perform pericardiocentesis safely means that the patient's life safety has been guaranteed for so long!
Everyone was amazed when they saw Lu Chen's operation.
"The speed of this classmate's puncture is really fast! From anesthesia to puncture, it took only one and a half minutes!"
"Is this really a blind puncture? I suspect that he performed the puncture under ultrasound guidance!"
"I'm sure this classmate has performed no less than 10 pericardiocentesis cases independently! Otherwise, he wouldn't be so proficient!"
…
Lu Chen extracted a total of two and a half tubes, about 150ML of pericardial effusion.
As the pericardial effusion is withdrawn, the breathing rate of the patient on the bed slowly slows down.
on an ECG monitor.
The patient's blood pressure and blood oxygen saturation finally did not continue to decline, but rose slowly.
at the same time.
Lu Chen noticed that the health value on the patient's head did not continue to drop, but returned to the previous fifty!
"Lu Chen, don't you continue smoking?" Ke Yue said, "Although the patient's symptoms are better, the symptoms of pericardial compression have not been completely relieved."
Lu Chen shook his head, "This is the first time I smoked today, so I can only put so much for the time being. If there is no obvious discomfort in the future, I can continue to pump again, and I can put more fluid in the second time!"
Ke Yue nodded.
It seems that a crisis has been lifted.
But at this moment, Lu Chen discovered that **** effusion flowed out from the rubber tube connected to the puncture needle!
Lu Chen frowned.
What started out was a yellow liquid, how did it turn **** in a blink of an eye?
(end of this chapter)