Chapter 3493: 【3493】this scene

   Chapter 3493 [3493] This scene

  I said earlier that the internal jugular vein cannot be selected. If it is in vvecmo mode, the left and right femoral veins may have to be selected. In vaecmo mode, the femoral artery and femoral vein on one side can be selected for puncture.

  Arteriovenous puncture is risky.

  In order to ensure the success rate of puncture, a contrast machine is used to assist in the interventional operating room.

  How to do bedside puncture like this without contrast machine.

   Xie Wanying suggested to the teacher: "use ultrasound equipment to help, it can detect the diameter of the patient's blood vessels, so that the doctor can better choose which side of the blood vessel to puncture and locate."

  The teachers listened to her suggestion and thought about it first.

   It is a bit troublesome to push the ultrasound machine to the bedside, and people need to think about whether it is necessary. It stands to reason that there are many doctors in their country who are familiar with this type of puncture, so it is not necessarily necessary to use machines to assist their doctors in blood vessel positioning.

In this regard, Xie Wanying raised another technical question: "If the femoral artery cannulation is performed, the blood supply to the distal lower extremity needs to be ensured. Once there is a situation, with the regular inspection of ultrasound equipment, the problem can be found in time and the distal lower extremity artery closed and perfused to avoid the problem. Complications occur."

  After hearing what she said, Zhang Huayao, who offered to change the model, had to look up at her, his eyes were about to explode. It can be seen that he really didn't consider this issue just now.

   Don’t blame him, even if he is a boss, he has never used a machine, and he is not very familiar with all possible clinical complications.

Since Teacher Zhang wants to switch to the vaecmo mode, Xie Wanying has to make some suggestions: "The membrane lungs and pumps used in the vaecmo mode and vvecmo mode can be carefully considered if the need to move the patient for emergency treatment is excluded. The vaecmo mode involves cardiac assistance. , it is best to use a centrifugal pump and a hollow fiber membrane lung. Simple breathing assistance can use a roller pump and a silicone membrane lung.”

   This time, it was Director Wang's turn to listen to her words, and hurriedly turned around to check whether the machine was installed incorrectly. He didn't seem to have seen these in the manual. Director Wang touched his body and took out a notebook to record.

  The surrounding doctors have been silent for a long time, only to see the two leaders being instructed by the one-sided teacher Xie again and again. This scene makes people completely speechless.

   "It's all up to you." Zhang Huayao gave instructions with a quick wave of his hand.

   It can be seen that the boss really doesn't mind being pointed out by Mr. Xie.

  Shen Youhuan hurriedly called the ultrasound department to send the machine, because he or Du Yeqing should be the one to do the puncture later.

  Actually, having an ultrasound machine has various other advantages. For example, the punctured femoral vein canal reaches the junction of the right atrium and the inferior vena cava, with a length of 40 to 55 centimeters. If there is an ultrasound machine using a probe to probe, it may be more accurate to know whether it is inserted in place.

  The machines are put in place one by one.

  The sonographer pushed over the ultrasound machine. The nephrologist brought in a hemofiltration machine.

  After Dr. Liu from the Nephrology Department arrived at the scene, he confessed to Mr. Zhang: "I haven't done it, and I don't know how to do it. I didn't even know that our hospital had an ecmo machine before."

  Boss Zhang pointed to Teacher Xie who was opposite him: "You can ask her."

   "Where is her teacher?" Dr. Liu asked the same question as Director Wang, who is the identity of this young boss in front of him.

  If it wasn't for being stared at by Mr. Zhang and not saying anything, Xie Wanying would have wanted to say that she was not a teacher a long time ago.

   "Listen to what she has to say first," Big Brother Zhang said.

  It doesn’t matter what your identity is, what matters is that you can save people by asking technical information to help you.

   Thank you for your support! ! good night dears~

  

  

  (end of this chapter)