Whether it is hemodialysis or plasmapheresis, the purpose of the blood is to direct the blood from the patient's body to the outside of the body and filter it back into the body.

And to draw a large amount of blood out, a sufficiently stable channel is required.

Patients with kidney failure who need regular dialysis for a long time often have a minor arteriovenous fistula surgery on their hands, and use this as a long-term and stable channel for dialysis.

Patients without arteriovenous fistulas have temporary deep venous access, including the internal jugular vein, subclavian vein, and femoral vein.

"The East Hospital usually has a tube for the internal jugular vein, right?"

Zhang Tianyang asked, "Senior sister will do it?"

"Will do. ”

Senior Sister Liang nodded, a struggling look appeared on her face, "But that family member ......"

"I'll just talk about the family. Zhang Tianyang pulled the consent form and walked to the intensive care unit, "Senior sister, let's prepare things!"

Obviously, it was usually the senior doctor who gave orders to the junior doctor, but when she heard Zhang Tianyang's words, Senior Sister Liang didn't feel anything wrong at all.

It seems like it's supposed to be like this.

The little nurse Lin Lin quietly looked at this and that on the side, and her impression of Zhang Tianyang in her heart rose a lot inexplicably.

"For the sake of milk tea, why don't you forgive him for once?

After all, it is the patient who has to deal with the sick, not him......

You don't blame him, do you?"

Zhang Tianyang didn't know the inner drama of the little nurse, he just wanted to deal with the patient quickly.

Fortunately, the woman in red didn't do anything this time, and the consent form was signed quickly, and the senior sister over there also pushed the treatment cart into the intensive care unit.

"Now that we are going to have an internal jugular vein catheterization, is it okay for the family to avoid it?"

Zhang Tianyang directly closed the curtains around bed 41, isolating a space where only he and his senior sister were in two white coats.

"Uncle, can you tilt your head to the left a little bit?"

Helping the patient in bed 41 to expose the right side of his neck, Zhang Tianyang reached out and touched the pulse of the carotid artery.

After feeling a noticeable beat, the fingertips are gently moved outward to find the clavicle head, sternal head, and clavicle of the patient's right sternocleidomastoid muscle.

At the very top of the triangle is the puncture point.

Zhang Tianyang gently pinched a cross with his fingernails here.

The whole process took less than half a minute, and he turned his head to look at Senior Sister Liang.

"Senior sister, are you going to wear it?"

"Come, I'll see. ”

Senior Sister Liang turned sideways to replace the position where Zhang Tianyang had just stood and began to locate the puncture point.

On the side, Zhang Tianyang had already pushed the treatment cart to the place where Senior Sister Liang could reach out and began to quickly prepare items.

Unpack the central venous puncture kit and spread it out on the cart.

Disassemble the sterile drape, 5ml syringe, volley it apart and let them slide automatically into the sterile area.

Then prepare heparin, lidocaine, and iodine.

Senior Sister Liang spent more than a minute carefully confirming the puncture site, and when she was about to make a mark, she saw a faint cross.

Did the junior brother pluck it out with his fingernails?

He just spent more than ten seconds touching it!

Good and accurate positioning.

Senior Sister Liang was a little surprised, and couldn't help but look at Zhang Tianyang behind her, and saw the neatly prepared instruments and materials on the treatment car.

She was stunned for a moment, "So fast?"

In the next second, the half-dismantled sterile gloves were handed over.

"Senior sister, shall we start?"

"Okay. ”

Senior Sister Liang seemed to feel something in her dark, and subconsciously cheered up.

But as soon as she stretched out her hand, Zhang Tianyang had already handed over the disinfectant cotton swab that had been stained with Aner iodine.

"You!......"

Senior Sister Liang just wanted to scold Zhang Tianyang for contaminating her gloves, but when she glanced at it, she found that Zhang Tianyang didn't know when she had also worn sterile gloves.

The second half of the sentence was swallowed into her stomach, and Senior Sister Liang had no choice but to bury her head in disinfection.

As soon as he finished detoxifying, Zhang Tianyang turned his head, and handed over the 5ml syringe with lidocaine suction.

Senior Sister Liang paused for half a second, resigned herself to take the syringe and began anesthesia.

Immediately afterwards, the special syringe with the puncture needle and heparin drawn was also handed over.

Turning his head again, the guidewire was ready, and the small blue tube used to expand the channel was quickly delivered to the hand.

The three-lumen tube was filled with heparin early without reminder and stuck, and as soon as I reached out, the needle that had been threaded with surgical sutures was handed over.

This is the first internal jugular vein catheterization Zhang Tianyang has experienced in the real world, but it is not the first internal jugular vein catheter in his life.

The time spent and the sweat in the system space have all become Zhang Tianyang's experience and confidence at this moment.

The "medical big feeding technique" was used, which suddenly made Senior Sister Liang breathless.

Obviously, she is a trained doctor with rich clinical experience, and she should be the leader of this internal jugular vein catheterization.

But why do you always feel like you're being urged to go?

Obviously, the junior brother is his own junior doctor.

But why did this internal jugular vein catheterization be done, and I made the feeling of trembling when I was guided and complained by a senior doctor when I first started?

I'm afraid that I will not be able to keep up with the other party's rhythm if I do something wrong......

After tying the last surgical knot, it was confirmed that the tube had been fixed again, and Senior Sister Liang moved out of the way.

Zhang Tianyang quickly picked up the sterile gauze that had been prepared, wiped the blood on the patient's neck, and applied a transparent dressing.

It wasn't until now, watching Zhang Tianyang start to clean up the equipment and pollutants, that Senior Sister Liang finally secretly breathed a sigh of relief.

After looking at the time, except for the time to prepare items in the treatment room and sign the consent form with the patient, the time for internal jugular vein catheterization was only seven minutes.

Senior Sister Liang couldn't help but feel a little dizzy in front of her.

Coupled with internship and training, she has been in the clinic for seven or eight years, and has done 80 cases of internal jugular vein catheterization.

At its smoothest, it takes 10 minutes.

Why did it only take seven minutes today with the "help" and "urging" of my junior and younger brothers......

She couldn't help but start babbling under her breath.

"I'm an experienced doctor, I haven't seen any scenes, I'm not surprised at all, I'm not shocked at all, I really don't think my junior brother is very powerful, I ......

Hiss –

But he's really amazing!

I can't betray my heart!"

Senior Sister Liang has always been a straight pipe to the end, she scolds you when she is angry, ignores you if she doesn't like it, and is willing to talk to you more when she is happy.

She has been transparent for so many years, but now because of Zhang Tianyang, she is gradually going crazy.

ヽ(｀⌒´メ)ノ

......

Ten minutes later, the nurse at the CRRT at the bedside pushed the machine into place on time.

It was not until the thick plasma slowly flowed out of the tubes of the machine, filtered, and returned to the patient's body that Zhang Tianyang was relieved.

After saying "hard work" to the nurse buddies at CRRT next to the bed, Zhang Tianyang returned to the doctor's office.

At 6:25 p.m., he was ready to write the admission of the 41st bed, the first course of illness, as well as the internal jugular vein catheterization record and the human blood albumin use record while it was hot.

I just found a computer and sat down, and Senior Sister Liang, who had adjusted her state, came over.

"Senior brother, you still have to write medical records, why didn't you go back so early?"

"Well, at least fifty minutes. ”

"So, let's eat together?"

Senior Sister Liang raised her mobile phone.

"I'm in for a treat. ”