Temperature is set. The second step is to ensure that the bed the newborn is lying on, just like an adult patient’s bed, can adjust the height of the head and foot of the bed. For a child with ARDS like this, the head of the bed needs to be raised slightly to assist with the airflow from the high-frequency ventilator reaching the lung base to help open the alveoli.
To diagnose whether the child has ARDS, taking an x-ray to assist the doctor in making a clear diagnosis is ideal. Carrying the child back and forth to the x-ray room is impractical. After all, even adults now have the option of mobile x-ray machines at the bedside. The newborn resuscitation station can certainly be equipped with such equipnt, allowing the child to undergo x-ray directly without leaving the station, quickly and efficiently.
Now, let’s start with the x-ray.
After the x-ray, Nie Jiamin puts the earpieces of the stethoscope on and places the chest piece on the child’s small chest wall for auscultation. No matter how skilled the boss is, they must examine the patient physically rather than solely relying on auxiliary examination reports for diagnosis. That is certainly not the spirit of cautious and true dical practice.
The large stethoscope head is considerably oversized for the small child, requiring the doctor to focus intently on listening. Nie Jiamin listens with great concentration and at a swift pace, quickly issuing a directive contrary to his usual slow deanor: "Put on the ventilator."
No real boss is genuinely slow-tempered. The urgency and severity of the patient’s condition dictate how much ti the doctor can allocate to arranging dical interventions. When it’s not urgent, the doctor can ticulously consider the treatnt plan and search for solutions. If the patient’s situation does not permit, urgent life-saving asures must be prioritized.
Regarding the child’s lungs, upon listening, the alveolar breath sounds have almost diminished to the point of disappearing, so there is no ti to wait.
The high-frequency ventilator is incredibly important for a child with ARDS, more crucial than dication; it should be used imdiately.
The pre-prepared ventilator is pushed over, and since the child temporarily has spontaneous respiration, intubation is not required, as previously ntioned; instead, nasal cannula is used to connect to the ventilator. How to adjust the paraters of the ventilator. Xie Wanying recalls Xin Yanjun’s guideline during respiratory dicine, that the best paraters for the ventilator are always adjusted at the patient’s bedside. The doctor carefully and patiently adapts the settings based on the patient’s condition changes; all other guidelines and dogmas are rely references.
All patients have individual differences, and no machine is sophisticated enough to match the experiential calculation of the human brain; the machine’s basic mode cannot handle the variability among patients, hence relying only on doctors.
Now, Nie Jiamin stands by the ventilator, assisting the child step by step in adjusting the parater values.
The speed of finding suitable paraters depends on the doctor’s technical proficiency.
The boss is indeed a boss; just a few button presses, and others quickly notice the rhythm of the child’s small chest rising and falling has beco regular.
Xie Wanying observes the teacher’s parater adjustnts while also learning dication administration from Senior Luo.
Previously, Student Xie reported the numbers, and Luo Jingming glances at the child’s weight again to calculate the dication dosage. The scales under the newborn resuscitation station directly asure the child’s weight as 2205g, which is almost identical to Xie Wanying’s estimation.
"Should we administer Gursu?" Luo Jingming asks the supervisor’s opinion to finalize the dication plan.
Children certainly cannot have drugs injected into their veins casually.
Gursu is the trade na for an imported dication, whose components are exactly the pulmonary surfactant (PS) that many premature infants lack post-birth.
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