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¡¾894¡¿You did a good job

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    Teacher Nie¡¯s tone is always like a lake, calm and calm, which fully reflects the outstanding calmness of a pediatric surgeon.

    Like Teacher Tan and Senior Brother Tao, they never encourage her to do something just because she is more timid. Teacher Nie does show another kind of boss style in this regard.  The anxiety in her heart seemed to be smoothed away by Teacher Nie's calm eyes. Xie Wanying calmed down and prepared to operate.

    There is only one word difference between the internal jugular vein and the external jugular vein, but they are very different.  One is a superficial vein and the other is a deep vein.  As a deep vein, the internal jugular vein runs deep in the muscles and is much more difficult to find than the superficial veins that can be clearly seen with the naked eye in the superficial fascial layer.  Being difficult to find means that the difficulty of piercing is doubled.

    Only doctors can perform deep vein puncture like this.

    If it is best to have ultrasound guidance, the success rate of invisible blood vessel puncture can be significantly improved.  On-site first aid does not have this condition, and doctors can only rely on their own experience and understanding of anatomy to operate.

    From the specific anatomical position, the internal jugular vein is next to the outside of the internal carotid artery, so the textbook says that the internal carotid artery must be found first.

    Recalling the steps in the book and instructional video, Xie Wanying carefully lifted the child's shoulders and back with clothes.

    Because it is best to perform internal cervical puncture in a high position rather than a low position, that is, the patient should be placed in a raised shoulder strap to perform the puncture.  This is because if a low puncture fails during puncture, hemopneumothorax is more likely to have more dire consequences and is less easy to detect.  The high position is relatively better, even if the puncture is mostly just local skin hematoma.

    Gently tilt the child¡¯s head back slightly to expose the child¡¯s neck.

    Wearing gloves, I gently touched the front and center of the child's neck with my fingers, and found the most obvious bony protrusion.  This is commonly known as the Adam's apple, and its anatomical counterpart is the thyroid cartilage.

    From the thyroid cartilage down, the first bony protrusion you feel is the cricoid cartilage.

    By crossing the horizontal line of the cricoid cartilage with your finger, you can quickly feel another artery pulse point, which is the internal carotid artery.

    After determining the location of the internal carotid artery, just insert the needle parallel to the outside.

    After her fingers determined the location of the internal jugular vein, Xie Wanying raised her head and asked the teacher with her eyes whether her positioning was correct.

    "That's right." Nie Jiamin nodded, a smile appeared in his silent black eyes again, and he continued to say to her in a gentle tone, "You are doing a good job, there is no need to worry."

    At this time, Teacher Nie felt a bit like a kindergarten teacher to her.  Xie Wanying couldn't help but feel relieved.  Once my nerves are relaxed, I can move more freely.

    Disinfect and spread the sheets.

    Nie Jiamin, who was on the opposite side, helped her turn the child's head to the left and fix it to prevent the child's head from moving during the puncture.

    Xie Wanying found and picked up the No. 22 trocar, connected the syringe, and stared at the child's skin.

    It is best to insert the needle at an angle of more than 30 degrees.  The following steps are similar to subclavian vein puncture, which is also a central venous puncture. After the puncture, the venous blood is withdrawn, a guidewire is inserted, the skin is broken, and then fixed.

    Recalling the subclavian vein puncture she had done before, Xie Wanying knew very well that as long as the first needle could be accurately inserted into the internal jugular vein, she would have nothing to worry about.

    ¡°are

    you

    "Okay?" Nie Jiamin looked at her focused face, with a slightly stern look in her eyes. It was unclear whether she was ready.

    "Yes." Xie Wanying replied, her eyes flashed, and she manually inserted the needle.

    Purple Pen Literature (remember the website address: www.hlnovel.com
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