My medical skills are a billion points

So he had to hire someone to do it.

However, calling someone from the anesthesiology department, or calling someone from the intensive care unit, takes about 5 minutes at the fastest.

In 5 minutes, no medicine has been given to the patient. It can be said that the risk of these 5 minutes is very high.

But Zhou Ziqiang didn't know how to do this operation, and he didn't dare to do it rashly, so he had to take the risk of asking someone from the anesthesiology department to come over.

Xiao Chu was at the side but could see clearly.

In 5 minutes, I am afraid that the patient in front of me would have been rescued long ago, so why wait so long without taking medicine.

So Xiao Chu had no choice but to stand up and say: "Brother Zhou, let me do the deep vein catheterization!"

In fact, deep vein catheterization is not a technically difficult operation.

However, there are not many clinicians who really know how to operate it.

It is mainly this way of infusion, which is mainly used for critically ill patients.

The general wards are full of ordinary patients, and there is no need for deep vein catheterization for infusion.

Deep vein catheterization is, after all, an invasive operation.

A thicker catheter is inserted into a deep vein.

Ordinary patients only need an intravenous needle or an indwelling needle.

It is obviously unreasonable for ordinary patients to use this kind of deep vein catheterization, and it is impossible for patients to agree.

That's why most of the doctors in the hospital don't know how to do this.

Only the intensive care unit or anesthesiologist will do this kind of operation.

Of course, as a surgeon, Zhou Ziqiang, if he wants to learn, this kind of operation is easy.

But after all, he has never studied or operated, so he can only stare blankly at present.

Hearing that Xiao Chu could do deep vein catheterization, Zhou Ziqiang was a little surprised again.

Chapter 72

"Xiao Chu, you can also do this operation, you are really knowledgeable."

The main reason why Zhou Ziqiang did not perform deep vein catheterization was his disdain.

Look down on this kind of operation without technical content.

If you let him practice for a while, he will definitely do this kind of operation.

However, the matter is urgent right now, and it is not feasible to ask him to perform deep vein catheterization.

While preparing the equipment, Xiao Chu smiled and said, "I have operated this during my internship, so it should be fine."

Xiao Chu quickly prepared the necessary equipment, and then began to perform deep vein catheterization on the patient.

The first step is to position the patient.

Use a head-plantar-foot-high position of 15°C, place a small pillow behind the shoulders (dorsiflexion), and turn the head to the opposite side.

The lower border of the clavicle is taken as the puncture point 1-2cm medial to the midpoint of the clavicle (or between the midpoint of the clavicle and the inner 1/3).

Generally choose the right side.

Routinely disinfect the skin three times and spread a disinfectant towel.

Local anesthesia was infiltrated with 2% lidocaine, and the needle was inserted at the selected puncture point.

The needle tip points to the head, and is about 45° to the longitudinal axis of the sternum, and 10°-30° to the skin.

When inserting the needle, the tip of the needle touches the clavicle first, then retracts, and then raises the tail of the needle, and inserts the needle close to the lower edge of the clavicle with negative pressure, the depth is generally 4-5cm.

If the dark red venous blood is drawn out smoothly, remove the syringe and introduce the guide wire.

Insert the expansion tube along the guide wire to expand the skin and subcutaneous tissue.

Withdraw the dilation tube, and send the indwelling catheter into the vein along the guide wire, and the insertion length is about 12cm.

Withdraw the guide wire and connect the infusion catheter.

Place a small gauze pad at the needle entry point, cover it with sterile gauze, and fix it with adhesive tape.

Xiao Chu's movements were very quick, from the beginning to the end, it took no more than 5 minutes.

Moreover, he inserted the needle once into the subclavian vein, and directly drew out the dark red venous blood.

Unlike some doctors who puncture several needles, they still cannot draw back blood.

Zhou Ziqiang was amazed by Xiao Chu's quick operation.

"Xiao Chu, you must have learned this technique during your internship? Your speed is too fast!

And it's so accurate, even if you call someone from the intensive care unit or the anesthesiology department, it's not as fast as you! "

Zhou Ziqiang said in surprise, and gave Xiao Chu a thumbs up.

"Sure enough, it's you who is better!"

Now that the subclavian vein catheter has been placed, the nurse hastily infused the patient with the medicine that Zhou Ziqiang had prescribed earlier.

Since the patient is in septic shock, the infusion rate is very fast.

The main treatment is a large amount of rehydration, replenishing blood volume, anti-infection and raising blood pressure.

Subclavian vein catheterization is just a simple episode.

The follow-up treatment is all about medicine, which is beyond Xiao Chu's control.

However, some test results of the patient have also come out.

His white blood cell count was particularly high, and he also had wound infection problems.

Basically, it can be determined that it is septic shock.

It belongs to the kind of severe sepsis, mainly anti-inflammatory treatment, and blood pressure control.

For this kind of disease, as long as the inflammation is controlled and the patient no longer has a fever, he can usually recover within a week or so.

In the afternoon, Xiao Chu received several patients with head injuries and hand injuries that needed to be stitched.

There was no major surgery involved.

After work, when he returned to his residence, Xiao Chu simply packed up his things for home.

Xiao Chu took a total of three days off.

So early the next morning, Xiao Chu went to Jinchuan City Bus Station and bought a ticket back to his hometown, Shicheng County.

Shicheng County is about [-] kilometers away from Jinchuan City.

Under normal circumstances, Xiao Chu can reach home in more than two hours.

When the departure time came, the long-distance bus drove out of the bus terminal unsteadily.

Xiao Chu took the first bus, but it was already 7 o'clock, and there were already a lot of people going to work on the road.

The bus drove out of the congested road with difficulty, and finally drove onto the viaduct.

After the bus got on the viaduct, the speed increased significantly.

There are still 5 kilometers ahead, and you can turn to the highway.

Once the bus is on the highway, it will run at full speed.

In two hours, Xiao Chu will be home.

However, the bus was on the elevated road and had just driven about 2 kilometers away.

Unexpectedly, the speed slowed down slowly, and finally stopped with a "creak".

At the beginning, no one cared about what happened to the passengers in the car? .

After all, it is normal for vehicles to stop and go on the road.

But the bus stopped for a full 5 minutes and still didn't start, which caused many passengers to start talking.

"Master, why don't you go?"

"There was a car accident ahead and there was a traffic jam. I won't be able to leave for a while!"

The driver said, and opened the door of the bus to get some air.

Passengers who have something good to do, just come down to watch the excitement.

Xiao Chu was so bored in the car now that he also got out of the car.

I found that there were many cars blocked about 30 meters away.

A car in the front collided with a minibus.

The front of the minibus has sunk in and stopped in the middle of the road.

Cars are horrible.

The front of the car was shattered, and all the airbags in the car had exploded.

A faint cry for help could be heard in the car.

Due to the scene of the car accident, the entire viaduct was completely blocked.

If all vehicles want to pass, they have to wait for the traffic police to come and clear the scene of the accident.

It seemed that the car accident had just happened not long ago, and neither the traffic police nor the ambulance had arrived yet.

Many people who were relatively close to the scene got out of the car and went to watch.

Hearing the cries for help from inside the car, they also rushed forward to help.

If there is a car accident, someone is bound to be injured.

As a doctor, Xiao Chu's mission dictated that he also hurried to the scene.

Arriving in front of the scene in person, Xiao Chu saw the situation clearly.

A man in his 30s was trapped in the cab in the car.

Perhaps because of the violent impact, his mind was a little blurred.

Fortunately, he was wearing a seat belt, otherwise he would have been thrown out.

The person calling for help was behind the car, a woman in her 30s.

Due to the violent collision, the vehicle was deformed, and the cab and rear doors could not be opened.

The woman could only desperately call for help.

The few men who came forward to help also tried their best to pull on the car door.

However, the manpower is limited, and the door cannot be opened anyway.

Fortunately, the glass on the rear door has been broken.

Because the woman was wearing a seat belt, she was only slightly injured. With the help of everyone, she was slowly picked up from the window.

After the woman came out, she didn't care about her own injuries, and begged everyone at the scene: "Big brothers, please save my husband quickly!"

A middle-aged man said helplessly: "Your husband is stuck, and the car door can't be opened. We don't have tools to save him. Besides, I think he was seriously injured. It's not clear now, and we don't have any tools." If you dare to touch him, wait for the fire truck and the doctor to come!"

The woman also knew that the middle-aged man was telling the truth.

Even though she was extremely anxious, she immediately wanted to rescue her husband.

But because her husband's right leg was stuck too tightly, there was nothing anyone could do. .

She could only hold her wound on the sidelines, crying and waiting.

Xiao Chu stepped forward and looked at the condition of the injured man.

His situation is not optimistic.

Chapter 73

The man suffered severe trauma to his right thigh.

The femoral artery has been severed, and the blood loss is relatively fast.