Therefore, when it is time to extract the fluid clinically, the doctor must listen to the patient and make sure that the location of the effusion is not mistaken. If there is a bedside B-ultrasound, it would be best to have another B-ultrasound for guidance at this time. However, under the medical conditions of that era in China, bedside B-ultrasound was nowhere to be found. Without B-ultrasound, we can only continue to rely on doctors to listen and percussion to solve the problem.
Returning to the patient in bed 6 again, it is too difficult for the doctor to detect obesity when he hears it.
Xin Yanjun looked serious as she put down the results of the imaging examination. The nurse next to her suggested again: "Don't wait for the cardiothoracic surgeon to come over."
Xin Yanjun¡¯s eyes fell on the students.
Xie Wanying¡¯s palms are percussing on the patient.
Knock knock, clear sound. Knock again. Alas, the sound is wrong and dull.
The patient, who was sitting on the chair with his hands on the back of the chair and his back to the doctor, seemed to hear something was wrong with the sound of being photographed. He turned his head and looked at the young female doctor: I had never seen him before.
Xin Yanjun approached the student and the patient, then raised her ears and listened carefully, and then looked at the student's hands.
At first glance, Mr. Xie¡¯s hands looked gentle and delicate, but I didn¡¯t expect them to be possessed of divine power, with sufficient strength and good control. When tapping, the strength was just right, and the force penetrated the thick fat layer. The boundary between unvoiced and voiced sounds is drawn.
¡°It can only be said that Xie¡¯s eyes seemed to see through the patient¡¯s fat layer first, and how deep the strength could be exerted to find the perfect depth.
This student was just as she had guessed. He could help her determine the boundary line and she could definitely draw fluid.
Xin Yanjun¡¯s confidence greatly increased and she said to the nurse: ¡°Pump!¡±
It seems that Teacher Xin is a very courageous doctor, gentle and kind on the outside, but very strong on the inside, which once again proves that every big doctor has a great character.
"What are you waiting for? I don't know how long it will take to wait." The patient had difficulty breathing today, and he was quickly taken out to relieve the patient's symptoms.
Wear a surgical cap, wear gloves, and be ready.
The syringe absorbs the local anesthetic lidocaine to perform local skin anesthesia and inject the skin.
The thorax puncture point is always suitable for a higher rather than a lower position. Especially in this patient, the effusion happened to be on the right side. Under the right lung is the liver. Having just come out of the Hepatobiliary Surgery Department, Xie Wanying knew very well that the liver was buried in the lower lungs and overlapped with the lungs. Therefore, doctors generally choose the puncture point at the ninth intercostal space at the lower angle of the scapula. Puncture below the tenth intercostal space must be done very carefully as it may easily penetrate other organs.
To determine which intercostal space this is, there is no B-ultrasound, and it can be determined by using the human anatomy. Feel the scapula. The scapula is on the posterolateral side of the human chest. This is why the patient should sit with his back to the doctor. Thoracentesis usually involves inserting a needle from the patient's back.
By convention, the lower end of the scapula corresponds to the seventh intercostal space. If you want to be more cautious, you can count from the patient's first rib down, and you will never go wrong. After all, some patients are weird. Individual differences may be due to birth or other reasons that cause the lower end of the scapula to not correspond to the seventh intercostal space.
This patient is obese and it is very difficult to move the ribs downward one by one. However, Xin Yanjun was confident today and asked classmate Xie around her to help.
Classmate Xie really did not disappoint her. He quickly touched the patient¡¯s first rib space and helped the teacher count down. (Remember the website address: www.hlnovel.com