Chapter 1184: [1184] Contact with internal dicine procedures
The stethoscope is not unused, but it is generally not needed. If a patient’s cardiopulmonary function really has an issue, they’ll call for a consultation from cardiology or thoracic surgery to handle it. When it’s an ergency, the scalpel cos into play.
Internal dicine doctors always carry stethoscopes; there’s no choice, as clinical needs require it. Surgery emphasizes swift and decisive action. In internal dicine, there’s usually more ti to care for patients comprehensively in the ward compared to surgery. Frequently listening to the patient’s cardiopulmonary function is never a bad idea.
A similar distinction lies in the white coat. Surgical white coats tend to be dirtier than those of internal dicine doctors. On TV, white coats are often portrayed as fashionable trench coats for posturing, but their real purpose is like a chef’s apron—to prevent contamination from dirty materials spilling onto the doctor’s personal clothing.
During her surgical internship, Xie Wanying brought an extra white coat to the departnt almost every day as a backup, just in case of accidents. In internal dicine, such preparations are likely unnecessary.
Internal dicine involves fewer wounds, less drainage fluid, and less blood splatter or spray. Procedural work in departnts like pulmonology mostly involves prescribing dications and writing patient records. Occasionally, in the afternoon, sothing like a bronchoscopy might be perford. Large hospitals like Guoxie place significant attention on these procedures. If a patient’s condition is more severe, doctors will directly wear disposable surgical gowns, and it rarely gets ssy.
Why don’t surgeons wear them as well? Surgeons do wear them, but only when necessary. Routine operations frequently involve tasks prone to contamination, and constantly putting on and taking off gowns wastes ti and increases treatnt costs for patients. Expenses for disposable surgical gowns are counted directly in the patient’s bill.
In the afternoon, Xin Yanjun brought Student Xie to the departnt’s treatnt room.
Upon receiving the task notification, a nurse had started completing preoperative preparations there earlier in the day.
Soon, a newly admitted patient in Bed 3—a woman in her fifties—was brought to the treatnt room by the ward nurse.
During this morning’s rounds, the team discussed this patient, who had undergone outpatient examinations that indicated a potential lung issue. After admission, further evaluations were planned. X-rays showed shadows in the lung, and a CT scan raised suspicions of a lung abscess. After hospitalization, a bronchoscopy would also need to be perford.
So people might ask: Isn’t a CT scan enough? Why do we still need a bronchoscopy?
A CT scan is considered an indirect examination. It doesn’t compare to this type of endoscopy, which can directly collect diseased tissues for pathological analysis. Pathology remains the gold standard for diagnosis. In clinical cases, it’s not uncommon for CT scans to suggest benign results, only for endoscopy to reveal malignancies. If conditions allow, it’s undoubtedly better to perform a bronchoscopy for confirmation.
Moreover, certain early-stage diseases may not be visible on CT scans, while endoscopies like bronchoscopy can detect and locate them.
Even if the lesions found during bronchoscopy align with the CT results and confirm a non-malignant tumor, if the disease is caused by lung infections, specins obtained during bronchoscopy can be tested to identify the type of infection. This helps guide precise dication use in clinical treatnt and avoid antibiotic overuse. Bronchoscopy can even directly perform drug infusion and lavage treatnt for tumors and infected lungs.
The applications of bronchoscopy are extensive.
For instance, if a patient on a ventilator in Bed 21 develops mucus obstruction, the nurse’s suctioning tube—which is short and thick—can only suction secretions from the mouth, nose, and upper airway. Secretions in the lower airway can only be addressed using a bronchoscope.
As the discussion continues on bronchoscopy, so might ask: What exactly is a bronchoscope? A bronchoscope is a type of endoscope specifically for the bronchi and is considered the most advanced bronchial endoscope. Like biliary endoscopes, bronchoscopes co in flexible and rigid types. Flexible bronchoscopes are less damaging to the body and, without a doubt, the more advanced bronchoscope belongs to this category of flexible scopes, which are very expensive.
As a result, the nurse preparing the equipnt handles these costly dical instrunts with great care. Upon hearing Xin Yanjun’s intention to let the newly arrived student perform the procedure, she felt a bit concerned.
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