I can see health

Chapter 89 Pericardial puncture!

He Sirong was taken aback for a moment, and then unconsciously stepped aside.

She frowned and quietly followed Lu Chen's operation.

Lu Chen stepped forward and stood in front of the patient's bed.

"Lu Chen, you, will you?" Ke Yue asked doubtfully.

Lu Chen didn't speak, but just nodded!
Now that the situation is urgent, he has no time to explain.

He has practiced pericardiocentesis hundreds of times in the virtual space.

From anesthesia to puncture, every step is kept in mind by him.

Taking a deep breath, he began to anesthetize himself.

……

There is only one door outside the elevator.

"He knows pericardial puncture?" Li Yao had this doubt in his heart.

Not only her, but everyone else looked at Lu Chen's actions in the video in amazement.

There are many doctors and nurses in the eighth district of the heart.

Many of them knew Lu Chen, a graduate student who just came to the department, and only graduated this year.

Pericardiocentesis is different from routine operations such as thoracentesis, paracentesis, and lumbar puncture.

This is an operation skill that many residents and even attending doctors do not know, let alone let them operate alone in this situation!

Everyone didn't dare to show their anger, they stared at Lu Chen closely.

On the other hand, Director Lin Cui glanced at Lu Chen, frowning slightly.

He has an impression of this boy.

It's Li Yao's student this year!

When she explained the electrocardiogram to everyone, this student also made a lot of limelight!
Lin Cui glanced at He Sirong who was standing next to Lu Chen in the video again, a look of disappointment flashed in his eyes.

He had obviously completed a pericardial puncture independently, but why did he start to get nervous at such a time?

……

Inside the elevator.

Lu Chen started anesthesia before the puncture.

The choice of puncture site for blind puncture is generally under the xiphoid process.

The anesthesia site is where the puncture will take place.

Lu Chen chose the anesthesia spot——

The puncture point is made below the junction of the sternal xiphoid process and the left seventh costal cartilage, and the puncture direction is 7° to the abdominal wall.

Acupuncture goes up, back, and slightly to the left into the posterior lower part of the pericardial cavity.

Lu Chen applied local anesthesia at the puncture point from the skin to the pericardial wall.

"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 stabilized a lot.

As for Li Yao outside the elevator, seeing Lu Chen's skillful operation, besides joy, she was also a little strange.

Any operational 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 do it himself.

Then how could Lu Chen be so skillful?
And looking at his movements, the anesthesia technique was very smooth without any stagnation.

This method is completely unlike what he can have at his age.

……

Lu Chen had already inserted the anesthesia needle into the pericardium.

While injecting anesthetic, withdraw the needle tube at the same time.

Suddenly, Lu Chen felt that the needle was missing.

A feeling of falling, which means that the barrier has been broken and the needle has entered the pericardium.

And Lu Chen didn't feel the obvious vibration of the needle tip hitting his heart!
This indicates that it is safe to puncture at this point!
Withdraw the needle tube, and a yellow liquid immediately appeared in the needle tube!

Ke Yue and Jiang Qingyan looked at Lu Chen with joy.

If the anesthesia is successful and the effusion is successfully extracted, that is half the battle!
On the other hand, He Sirong was stunned, staring blankly at Lu Chen, but he didn't know what he was thinking.

"Have it! Have it!"

The people outside the elevator also saw clearly Lu Chen's operation through the video.

"After this needle went down, it directly penetrated into the pericardium. It's really not easy!"

"Before I even looked at the situation, there was drainage fluid in his needle."

"I think... Could it be his luck?"

……

After the anesthesia is over, the puncture is next!
The rubber tube connected to the puncture needle is clamped, and the puncture needle is inserted into the selected and local anesthetized site.

Lu Chen held his breath and began to insert the needle slowly under negative pressure!

The position and angle of the needle insertion are very 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 myocardium, it is enough to stop inserting the needle.

Now, Lu Chen can only insert the needle cautiously.

In order not to insert the needle too deep, it directly pokes the myocardial tissue!

……

The people around were also holding their breath, and their moods fluctuated with Lu Chen's operations.

Feeling the feeling of breaking through the barrier again, Lu Chen stopped inserting the needle.

I saw light yellow liquid flowing out from the needle tube, which indicated that the puncture needle had entered the pericardial cavity!
After the puncture needle entered the pericardial cavity, Lu Chen immediately said to Jiang Qingyan, "Help connect the syringe to the rubber tube."

Jiang Qingyan nodded, handed the phone to Ke Yue, quickly put on her gloves, and helped Lu Chen.

Routine pericardiocentesis, if it is a therapeutic puncture, may require a drainage bag.

But now that the situation is critical, Lu Chen did not continue to operate, but directly let go of the clamp and began to extract pericardial effusion.

He wants to quickly extract part of the pericardial effusion to quickly relieve the pressure of the effusion on the pericardium!
The syringe is 50ML, which means that one tube of fluid collected by Lu Chen is 50ML.

The first extraction of pericardial effusion should be around 100-200ML.

If a large amount of pericardial effusion is withdrawn in a short period of time, pulmonary edema may occur.

……

"Pull it out!"

Outside the elevator, when everyone saw that Lu Chen had successfully punctured and extracted the liquid, their hearts dropped one after another.

Li Yao also breathed a sigh of relief.

Being able to perform pericardiocentesis safely means that the life safety of the patient is guaranteed for so long!
Everyone was amazed when they saw Lu Chen's operation.

"This classmate's puncture is really fast! From anesthesia to puncture, it only took one and a half minutes!"

"Is this really a blind puncture? I suspect that he performed the puncture under ultrasound guidance!"

"I'm sure that this classmate has independently performed no less than 10 pericardial punctures! Otherwise, he couldn't be so proficient!"

……

Lu Chen took out two and a half tubes in total, about 150ML of pericardial effusion.

As the pericardial effusion is pumped out, the breathing rate of the patient on the bed slowly slows down.

on the heart rate monitor.

The patient's blood pressure and blood oxygen saturation finally did not continue to drop, but rose slowly.

at the same time.

Lu Chen noticed that the HP on the patient's head did not continue to drop, but instead returned to the previous level of more than 50!
"Lu Chen, stop 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, "It's the first time I pump today, so I can only put in so much for the time being. If you don't have obvious uncomfortable symptoms, you can continue to pump, and you can put more fluid in the second time!"

Ke Yue nodded.

It seems that a crisis has been resolved.

But at this moment, Lu Chen discovered that bloody fluid flowed out from the rubber tube connected to the puncture needle!

Lu Chen frowned.

What started out was yellow liquid, how did it become bloody in a blink of an eye?

(End of this chapter)