Chapter 1189: [1189] Further Challenge
[1189] Further Challenges
From the initially difficult passage through the throat, to the rugged tracheal cartilage rings that form a ridge needing careful navigation, and on to the maze-like bronchial pathways that are intricately interconnected—each segnt demands the doctor to overco obstacles.
The bronchoscope must continually be maintained in a central position to ensure the teacher’s work proceeds smoothly.
Her hand gently supported the side of the patient’s head, making subtle adjustnts according to the teacher’s maneuvers. Xie Wanying’s movents were delicate and ticulous, ensuring Teacher Xin operated comfortably while keeping the patient at ease. The female patient hardly noticed her head being restrained, indicating that even while being held, she found the position acceptable and rather comfortable.
It was quite remarkable. The nurse glanced at Xie Wanying again, and her gaze no longer bore the sense of disdain reserved for a rookie.
The tactile feel was smooth, the operation fluid. The tube quickly reached the lesion area, where the doctor used a clamp to extract a sample, preparing it for pathology.
The examination was completed, and the tube was successfully withdrawn from the patient’s airway.
Post-procedure, the patient’s anesthetized throat rendered her nearly speechless, but she nodded at the doctor to indicate: everything was fine, with no discomfort.
A satisfied patient brings the greatest joy to the dical staff.
After instructing the nurse to return Bed 3’s patient to the ward, Xin Yanjun placed both hands into the pockets of her white coat, pondering sothing before speaking to the nurse: “Prepare everything for ; I’m going to perform a fluid extraction for Bed 6.”
She was referring to a chest puncture to extract pleural effusion.
The nurse, upon hearing this instruction, exclaid in surprise, “Doctor Xin, haven’t we already arranged for the thoracic surgeons to handle this?”
Chest puncture is traditionally fundantal to thoracic surgery. Although respiratory physicians are also capable of performing it, their proficiency does not typically match that of surgeons.
When the procedure is comparatively straightforward, respiratory physicians often do it themselves. For more challenging cases, or when uncertain, they request assistance from thoracic surgery.
However, waiting for a specialist from another departnt to co over is not easy and often depends on their availability.
Xin Yanjun recalled that the last ti a thoracic surgeon ca for consultation, they were so occupied that they could only visit the respiratory departnt late in the evening. It seed likely that they would remain too busy to assist in the next few days. She had no idea how long she and the patient would need to wait. Calling to rush the other departnt felt inappropriate.
Fortunately, a treasure of a surgical intern had arrived today. Their stellar performance proved the rumors true. Xin Yanjun contemplated her options: with this student’s help, she could confidently proceed with the chest puncture for Bed 6’s patient.
“Let’s go to Bed 6.”
Teacher Xin beckoned, and Xie Wanying followed, ntally reviewing the patient’s dical record and the discussions from this morning’s ward rounds.
Bed 6’s patient was a middle-aged man, in his forties, but quite obese.
Obesity ant thick layers of fat, making it difficult for the doctor to locate anatomical landmarks like bony protrusions, complicating the identification of the puncture site. This was exactly why the internal dicine departnt had referred the case to surgery.
Surgeons, who frequently operate with tools on the human body, have a far clearer ntal visualization of internal structures compared to internal dicine physicians. They could reliably perform the procedure based on experience even when physical landmarks were elusive.
The nurse prepared the surgical tools afresh and wheeled the treatnt cart to Bed 6’s room.
Xin Yanjun donned her stethoscope and rechecked the patient’s lungs, instructing the student to listen alongside her.
Lung auscultation, like heart auscultation, follows a sequence.
The standard procedure progresses from the front of the chest and sides to the back.
The heart is examined for heart sounds, while the lungs are assessed for breath sounds. Breath sounds, as the na implies, are vibrations created by airflow in the respiratory tract and alveoli during breathing.
User Comments
0 comments from readers