Chapter 1186: [1186] Teacher Let Go
Returning to dical school to make up for shortcomings is only the first step. Anatomy in dical school is perford on cadavers, but in clinical practice, one faces living patients. Cases equally require accumulating extensive clinical experience.
This requires doctors to be both bold and ticulous. Female doctors tend to be less bold, which generally leads to them being outperford by their male counterparts in such operations. A bold female doctor who is daring and decisive is undoubtedly exceptional.
So, don’t be deceived by Teacher Xin’s constant gentle smile. Despite her warm deanor, her true identity is as one of Director Li’s key experts. At just over twenty years old, she dares to independently guide students in performing bronchoscopies. This shows that both her personality and skills are outstanding among doctors of her generation.
“Co, put on your cap and gown,” Xin Yanjun said confidently to the student.
The teacher and student put on disposable surgical gowns and caps, then donned sterile gloves.
The patient was already lying on the treatnt bed in a supine position.
Before the procedure, the nurse had given the patient a topical anesthetic to anesthetize the throat, similar to preparations for a gastroscopy.
This patient had hypertension, so to ensure safety, they connected the patient to an ECG monitor and adjusted the blood pressure monitoring frequency to once every three minutes to closely observe the patient’s condition.
As the assisting doctor, Xie Wanying needed to help her teacher apply sterile paraffin oil to lubricate the bronchoscope’s body. This would help reduce friction between the scope and the walls of the patient’s trachea during insertion.
Everything was ready.
Xin Yanjun leaned down and spoke to the patient to soothe her emotions: “Madam, during the upcoming examination, I need you to cooperate with . When I ask you to breathe in, just breathe in. Don’t be nervous. The tube going into your throat will feel uncomfortable, but please bear with it—it won’t take too long.”
The patient nodded. However, expecting her to remain calm like the doctor would be unrealistic.
The nurse handed a bottle of dripping dication to the doctor.
“Yingying, take this, and drip it into the larger nostril. It’s a lidocaine solution,” Xin Yanjun instructed the student.
The assisting nurse hesitated slightly, handing the dication to Xie Wanying sowhat reluctantly. She reminded her, “If there’s anything you don’t understand, always ask the teacher first.”
The nurse was worried that this intern might not know how to handle bronchoscopic procedures and could make mistakes through inexperience. Once Xin Yanjun began the operation, she would be entirely focused on the patient and couldn’t supervise the student.
The bronchoscope is an invasive procedure. Improper operation can harm the body, with a complication rate as high as 0.3%. The most common issue is bleeding, and a rare but severe bleeding occurrence could be fatal. Other complications like hypoxia or infection are undeniably troubleso when they arise.
Fully aware of the risks in dical procedures, Xie Wanying naturally didn’t take offense to the nurse’s nagging. She nodded in agreent.
Holding the bottle of dication, Xie Wanying followed her teacher’s instructions and began by observing the patient’s nasal cavity.
The bronchoscope can enter the airway through three routes: via the nasal cavity, via the oral cavity, or, if the patient has undergone a tracheotomy, through the tracheotomy tube. Clinically, most doctors prefer the nasal cavity route.
The reason is simple: the oral route is more susceptible to interference from the patient’s tongue and mouth. With the nasal route, even if the patient moves their nose, there’s nothing inside the nasal cavity capable of significantly disturbing the instrunt. For instance, today’s Case 21 patient is connected to a ventilator through oral endotracheal intubation, so the doctor would choose to insert the scope through the oral intubation tube into the airway.
In summary, the easiest route is the one to take.
Carefully comparing the sizes of the patient’s nostrils, they determined which nostril was larger and free of obstructions for inserting the scope.
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