I Can See Health

   Chapter 217 A long way to go

   Jinghua Second Hospital.

  The total number of inpatients in the Cardiology Department is rotated once a year.

   General responsibilities of hospitalization, mainly responsible for emergency consultation of all cardiology departments.

  When the night shift ward is short of manpower, it will be temporarily on duty or assist in rescue.

   Li Qinghua, the rotating inpatient chief this year, is a senior attending doctor.

  Although he has not been promoted to deputy chief physician, he has rich experience and is not inferior to those deputy chief physicians.

   The main reason is that there are not enough papers, so I have not been able to get promoted.

   Now that the pericardial puncture is in trouble, Yin Xinhua had to call Li Qinghua for help.

  …

   This is the second time that Li Qinghua has come to the eighth district in his heart tonight.

   "Junior Sister Yin, your night shift is quite fulfilling!"

  Yin Xinhua shrugged and said helplessly to Li Qinghua: "Senior brother, you are making fun of me too, I really can't do anything about it. The night shift was fine some time ago. I don't know what happened to this night shift."

   After finishing speaking, Yin Xinhua glanced at Fan Zhiping without any trace.

   "Does the family agree to the puncture?"

  Li Qinghua came to the doctor's office to check the patient's auxiliary examination results.

  Before general invasive operations, it is necessary to check the patient's blood routine, coagulation pattern, etc.

   "The family has agreed and has signed." Yin Xinhua said.

   "Okay." Li Qinghua checked the patient's tests and found no contraindications, "Then let's start."

   "Brother, the patient's pericardial effusion has many compartments." Yin Xinhua said, "It may be difficult."

   "Tuberculosis?" Li Qinghua raised his eyebrows.

   "It's not very clear for the time being, but there is a high probability."

   "Okay, let's go see the patient."

  …

   came to the ward.

  Li Qinghua saw Lu Chen standing beside the bed.

   He suddenly remembered that it seemed that Lu Chen had a blind puncture of his pericardium when the elevator broke down.

   After that, Li Qinghua met Lu Chen several times on the night shift.

  Some time ago, Lu Chen, as a member of the school team, successfully won the first place in the National Medical Skills Competition for Jinghua Medical University!

   This is amazing!

   "Lu Chen, I remember you can do pericardiocentesis independently, right?" Li Qinghua asked Lu Chen.

   He can puncture blindly, and this kind of puncture under ultrasound guidance is even less of a problem.

  Lu Chen said modestly: "Mr. Li, I haven't done this kind of puncture of encapsulated pericardial effusion."

   Speaking without intention, the listener intentionally.

  Lu Chen is telling the truth.

  Although he has trained many times in the system space, even including encapsulated pericardial effusion, he has only done one case of puncture of pericardial effusion in reality.

   Compared to Li Qinghua's rich piercing experience, Lu Chen is no different from a rookie.

Fan Zhiping, who was beside him, stared blankly at Lu Chen.

   How many operational skills does Lu Chenhui have!

   Can still perform pericardiocentesis independently...

   Many attending doctors in their county hospitals do not have this ability.

  Although Lu Chen is the first in the national medical skills competition, the competition is just a competition after all.

  The objects of the competition are all tool simulators.

   Simulation and real people, the gap is still big.

   "Then wait by my side for a while and fight for me." Li Qinghua said.

   "Okay, Teacher Li." Lu Chen nodded.

  …

   For general pericardial effusion, pericardiocentesis can be performed after localization under ultrasound.

   For this kind of encapsulated effusion, the ultrasound probe needs to be operated continuously, and ultrasound images are given in time for operation.

   The ultrasound doctor had already left, and Li Qinghua pushed up the CCU ultrasound machine.

   "This is..." Lu Chen wondered, "Didn't the ultrasound doctor already leave? Who will do the cardiac ultrasound?"

   "You don't need a sonographer. Brother Li will do a heart ultrasound himself." Yin Xinhua said.

   "Do it yourself?" Lu Chen was taken aback.

   The clinical work of a cardiologist is already very tedious, yet there is still time to learn ultrasound?

   "Yeah." Yin Xinhua said, "Brother Li's heart ultrasound skills are similar to those of the teachers in the ultrasound room."

   "This, this is too powerful." Lu Chen sighed.

   Now the medical specialization is very serious, let alone an imaging technology, many doctors will not learn the professional content of other departments.

  I saw Li Qinghua skillfully turn on the cardiac ultrasound machine, pick up the ultrasound probe, apply couplant, and then place the probe under the patient's xiphoid process.

   "There is a lot of pericardial effusion, and there is separation." Li Qinghua said solemnly, "Although there is no obvious sign of pericardial tamponade, it must be punctured as soon as possible!"

   Although Lu Chen can't read ultrasound images, the images produced by Li Qinghua are very clear.

   On the display screen of the ultrasound machine, a peristaltic mass of heart is visualized.

   Around the heart is a dark liquid area.

   This liquid dark area is pericardial effusion!

   After Li Qinghua finished the operation, he said to Lu Chen, "Let's start."

  Lu Chen nodded, opened the cardiac puncture bag, and placed it on the table above.

  Li Qinghua first disinfected the location where the puncture was located, then put on gloves, began to spread towels and anesthetize.

  Lu Chen's job is very simple, that is, to help Li Qinghua deliver the utensils in the puncture bag.

  …

  Li Qinghua is indeed one of the most experienced attending physicians in the Cardiology Department of the Second Hospital of Jinghua.

   This seemingly difficult encapsulated pericardial effusion was successfully punctured and drained in Li Qinghua's hands.

  Lu Chen was shocked!

   He believed that he had already trained the pericardiocentesis skillfully in the system space.

   However, if this patient were to be given to him, he would not be able to do better than Li Qinghua.

   One of the biggest factors is the presence of echocardiography.

   Ultrasound is performed by the operating doctor himself.

   This is like having a right-hand man who knows what's going on in the heart.

  When puncturing, you will not look forward and backward, afraid of hurting the heart muscle.

  Compared to Li Qinghua, Lu Chen was completely at a disadvantage in cardiac ultrasound.

   At most, he can only understand a little bit of heart ultrasound images, but he can't operate at all.

   "The drainage tube is in place, don't put too much pericardial effusion for the first time." Li Qinghua said.

  Regardless of the puncture and drainage of any effusion, the fluid that can be drained for the first time is limited.

   "Okay." Yin Xinhua said with a smile, "Thank you, Brother Li."

   "Hands up." Li Qinghua said, "Then I'll go back first. I remember that you also have portable echocardiography in the eight areas of your heart. Sister Yin, you are on the interface under the xiphoid process, pay attention to the situation of pericardial effusion."

   "Received, brother."

  After the puncture, Yin Xinhua removed part of the patient's pericardial effusion, and the patient's symptoms of chest tightness improved a lot immediately.

  Li Qinghua explained some precautions, and then pushed the cardiac ultrasound machine downstairs.

   "Senior sister, we also have ultrasound machines in the eight areas of our hearts?" Lu Chen wondered, "How come I've never seen it before?"

"Yes, but it's portable, it's only the size of a palm, and no one in the department usually does ultrasound, so it's basically used." Yin Xinhua said, "I'll go to the treatment room to get it later, this one under the xiphoid process. Location, I will still be a little bit.”

After   , Yin Xinhua went to the treatment room to get a portable echocardiograph.

  …

   After Li Qinghua's pericardiocentesis, Lu Chen even understood his own inadequacy.

   Even though he has the system by his side, he has trained many pericardiocentesis in the virtual space of the system.

   But when encountering such a difficult operation, it is still a little powerless.

   On the road to becoming a top doctor, Lu Chen has a long way to go.

   (end of this chapter)