"The ventilator’s adjustnt paraters start with the four major settings: tidal volu, respiratory rate, inspiratory-expiratory ratio, and airway peak pressure (PIP). Further refinents include flow magic, inhalation oxygen concentration, alarm settings, ventilator sensitivity, and Positive End-Expiratory Pressure (PEEP). These paraters must be adjusted continuously based on the patient’s weight, respiratory symptoms and causes, variations in blood gas analysis, and other biochemical indicators. If the paraters aren’t properly adjusted, inappropriate chanical ventilation can most easily lead to ventilator-induced injuries, particularly barotrauma."
"When an alarm goes off, the first step is to identify its root cause: Is it high airway pressure or low airway pressure? Is it insufficient ventilation or overventilation? Could it even be that the patient has stopped breathing entirely, leading to imdiate asphyxia? Or maybe the ventilator itself is malfunctioning and issuing false alarms? So issues can be resolved by inspecting the ventilator’s operation and ensuring the tubes are unobstructed; others can be addressed by adjusting the ventilator paraters. In so cases, additional treatnts may be needed beyond relying solely on the ventilator, as ventilation alone might not resolve the problem."
A crowd had unknowingly gathered at the entrance to the ward. Among them were nurse aides, patients and their family mbers out for a walk, dical students who had just started their shifts, and passing doctors. Each was drawn to listen to the crisp voice coming from inside the room and stared at Xie Wanying’s face, all wondering the sa thing: Is this person a teacher? Is she giving a lecture to students?
Xin Yanjun glanced back and noticed the expressions of the onlookers at the door. She smiled. Truth be told, the new Student Xie was speaking exceptionally well—almost like she was giving a classroom lesson.
"Let’s go; it’s ti for the shift handover eting." Xin Yanjun pulled Xie Wanying’s arm, heading back toward the doctor’s office. "Afterward, if we have ti, I’ll let you personally adjust the ventilator paraters for a patient."
Teacher Xin was quick to let her take charge.
Such a prodigious student being placed in their departnt for an internship—there wasn’t much need to speculate. The hospital leadership clearly intended for them to give her ample opportunities to practice. If she were sent to a larger departnt, crowded with students, she’d likely miss out on hands-on experience; after all, she was a surgical student. Xin Yanjun and the doctors in Pulmonary dicine understood the hospital administration’s strategy all too well, and it so happened that their own plans aligned with it.
Having such a promising student—why keep her sidelined? Not utilizing her talents would be downright foolish.
The handover etings in Internal dicine were far more detailed than those in Surgery. Unlike Surgery, which was constrained by dayti surgical schedules, Internal dicine etings could afford to run longer.
Once the eting concluded, with no surgeries planned and an experienced professor providing guidance, ward rounds in Internal dicine might easily stretch to an hour or two. Patients were thoroughly interviewed, students were questioned right at the bedside, answers were discussed, and instructions were given back in the doctor’s office for prescribing dications. Patient dical records could be reviewed slowly and deliberately whenever ti allowed.
Compared to Surgery, Internal dicine was noticeably more relaxed. In the afternoons, aside from those on call, teachers with no departntal obligations could arrange their schedules however they pleased.
This slower-paced environnt left Xie Wanying feeling that even her typing speed on the departnt’s computer had slowed down. Her hand instinctively touched the stethoscope in the pocket of her white coat, checking that it was still there.
Internal dicine and Surgery differed significantly. Internal dicine doctors often carried stethoscopes on their person—it was practically standard equipnt. In Surgery, it depended on the specific departnt. For example, Teacher Tan, as a general surgeon specializing in gastrointestinal cases, rarely used a stethoscope; when he did, he often couldn’t rember where he had placed it and would borrow one from soone nearby in a hurry. Senior Tao, in Hepatobiliary Surgery, would stuff his stethoscope haphazardly into the pocket of his white coat, but it was rarely seen in use. Senior Cao from Neurosurgery seed to favor flashlights over stethoscopes.
The reason surgeons from specialized departnts didn’t commonly use stethoscopes is that their work frequently required direct physical examination. For many specialized conditions in Surgery, palpation was often more effective than auscultation.
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