In the ICU ward of the neurology department at 2:40, there are not many white coats left.

Except for the nurses who diligently shuttled around the bedside of different patients, the whole ward seemed a little empty.

Next to the bed of the 76-bed old lady, there are only four white coats.

The attending doctors, Director Song Changkong, Zhang Tianyang, and Lin Ke'an, who came to learn operation skills.

In fact, according to the normal process, the attending doctor will not come so early.

His time was far more precious than these junior doctors.

So there's no way he's going to wait here and wait for them to do their preparations, to get in their positions.

He'd go about his business in his office and wait until someone called him and said everything was ready.

But today the old lady's condition does not allow it.

All necessary items such as the laptop bag have been prepared and placed on the treatment cart for later use.

Zhang Tianyang pinched the drainage tube that extended from the old lady's skull at the head of the bed and signaled to the attending doctor.

"Let's start settling and get ready to clamp it off. ”

"Click!"

With a soft sound, the drain is clamped shut.

The four of them suddenly got busy.

The old lady's vital signs are stable in a stable position, lying flat with the head of the bed shaken up 30 degrees.

Whereas lumbar piercing requires lying on the side, bending the knees, bending the neck, and arching the back.

In order to prevent the drainage of cerebrospinal fluid from flowing back due to gravity and causing infection, the drainage tube must be clamped.

But the bloody case caused by the half-hour clipping of the drainage tube in the morning is still vivid.

Within half an hour, they had to wear out the cerebrospinal fluid.

Otherwise, you can only embark on the road of "gambling on your life".

Time is running out for them!

Shake the bed, lift the quilt, turn over, bend your knees......

The old lady, who was not actually heavy, was put in a good position, and two people were separated to stand in front of the old lady to help fix it.

When the old lady's entire back arched and exposed in front of him, Zhang Tianyang could see the remnants of the needle hole on it.

A rough count shows that there are more than a dozen.

It seems that before today, in order to extract the cerebrospinal fluid of the old lady, the doctors really made efforts again and again.

It's a pity that they all failed.

After wiping it with a hand sanitizer, Zhang Tianyang's palm pressed on the old lady's back, carefully looking for the puncture point.

Press your fingers on your spine, slide them up and down, and press down gently.

Feel the alternation of hardness and softness to find the best needle insertion point.

Zhang Tianyang has always been very fast, after all, the soldiers are fast, and a little later may affect the prognosis.

This time, however, it took a full minute just to determine the puncture point.

After pinching the cross, he turned his head to look at the attending doctor.

"Teacher, let me come?"

The attending doctor subconsciously wanted to refuse.

But looking at Zhang Tianyang's appraisal eyes, he swallowed back the words that came to his mouth in a daze.

His eyes fell on the puncture point where Zhang Tianyang's fingers were pressing.

The dozen or so needles there had not yet healed, and they were faintly blue-purple.

In the eyes of these needles, there is his share.

In fact, to be honest, his lumbar piercing technique is absolutely reliable.

According to past experience, the probability that he will not succeed the first time, the second time, or someone else will succeed is less than one percent.

So today, in fact, he came to the old lady with the attitude of doing his best to obey the fate of heaven.

To put it bluntly, it's one last effort and then start using anticoagulants.

Looking at Zhang Tianyang's attitude, think about the rumors he heard about this amazing intern in front of him.

The attending physician quickly made a decision.

"Yes, you try first. ”

But he still couldn't be completely reassured, so he hurriedly added.

"But I'm only going to give you ten minutes, three stitches. ”

"If you can't wear it, I'll come on, and I give myself a chance to get ten minutes and three stitches. ”

"We couldn't wear it, so we notified the family and put on anticoagulants. ”

In any case, before the drain clamps for half an hour, be sure to return the old lady to her normal position and reopen the drain.

"Good. ”

Zhang Tianyang nodded calmly at the attending doctor, then closed his eyes, took a deep breath, and adjusted his state.

In fact, the selection of the attending doctor is strictly not in accordance with the regulations.

A difficult operation, there is no reason to let the intern doctor work after the doctor at the attending level has failed once.

But in the white coat present, Song Changkong was unwilling to offend anyone.

In the eyes of the attending doctor and Lin Ke'an, Zhang Tianyang is no longer an ordinary intern.

Song Changkong and Lin Ke'an fixed the old lady with one shoulder and one leg on their shoulders.

The attending doctor just wanted to help Zhang Tianyang prepare items, but before his hand could reach for his waist to wear the bag, Zhang Tianyang suddenly opened his eyes.

Instantly, everyone felt that something was different.

The next moment, Zhang Tianyang began to move.

Reach directly over the cart and glance at the items on it.

Quickly stuffing everything except the waist bag into the attending doctor's hand, he tore the waist bag with a mistake with both hands.

The action is swift and bounces off.

As soon as he stretched out his hand, he had already smoothed out the iodine in the attending doctor's hand, opened the lid, and then dumped it in the air to the fixed position in the waist bag.

casually put the half bottle of Iodine, which was no longer used, on the small table next to the bed.

As soon as he stretched out his hand, he pulled out several syringes, large and small, in the hands of the attending doctor.

Quickly open the bag and pour it into the piercing bag.

As soon as he stretched out his hand, he took sterile gauze in the hand of the attending doctor......

Reaching out again, he took the sterile glove again......

However, in a dozen seconds, the attending doctor had just come back to his senses, and there was only a small bottle of lidocaine left in his hand.

This anesthetic, which needs to be checked by both parties, is the only thing that can only be extracted with the assistance of a second person.

As for the rest, Zhang Tianyang is covered by himself.

Seeing Zhang Tianyang quickly put on gloves, loaded syringes, checked his waist through the needle, and placed glass tubes, he seemed to see the afterimage of his fingers in a trance.

"Teacher, lidocaine?"

It wasn't until Zhang Tianyang frowned and reminded him that the attending doctor woke up like a dream, hurriedly checked the label of lidocaine, and then broke the cap, tilted the bottle, and let Zhang Tianyang suck with a syringe.

Soon, the items were fully prepared.

Zhang Tianyang's movements slowed down again.

Sterilized three times, positioned again, local anesthesia, and then the puncture needle was picked up.

In fact, his speed is still a lot faster than normal, but it is significantly slower than the speed he showed before.

Showing his seriousness and prudence.

The tip of the needle enters the skin along the channel through which the anesthetic is administered, and then slowly protrudes vertically into it.

On the opposite side, the two white coats seriously fixed the old lady's body, and Song Changkong even used his knees.

The patients in the ICU ward are all bedridden for a long time, so in order to greatly avoid the occurrence of pressure sores, the mattresses here are inflatable mattresses.

Of course, there are many benefits in ordinary times, but for the operation of lumbar puncture, it is not a good thing.

Because the air mattress is too soft and not easy to fix.

But Zhang Tianyang's heart is as heavy as water, his hands are as steady as a mountain, and the tip of the needle is moving forward according to the established route.

Soon, the tip of the right finger that feeds the needle has a feeling of obstruction.

The tip of the needle poked into the bone.

Zhang Tianyang's hand paused, his expression was as usual, and he slowly pulled out the needle and withdrew the tip of the needle.

This is a very common situation.

Although it is soft to press with your fingers, many times it may be just an illusion.

This is because the depression is not necessarily a "gap" where the needle can be inserted, but more likely a bone that is deeply hidden.

He was normal.

But after all, the first shot has already failed.

Then, there is the second shot.

The position and angle of the needle were slightly adjusted, and soon, the obstacle was felt again on the tip of the right finger.

But not bones.

The fingertips were forced, and the tips of the needles continued to be sent in, and soon, Zhang Tianyang felt a sense of frustration that he had not seen for a long time.

The left hand of the skin is fixed to the body of the needle, and the right hand gently pulls out the inner core of the puncture needle.

Did it work?

The other three white coats gathered in front of the hospital bed subconsciously held their breath.

One second.

Two seconds.

Three seconds.

No fluid is coming out of the end of the needle.

The color of disappointment appeared on three faces.

It is indeed helpless to appear then.

They subconsciously had hope for Zhang Tianyang, but they must know that this patient had gone through many attempts before him, and even the attending doctor did not extract the cerebrospinal fluid in person.

The current situation seems to be expected.

"Is it really going to be an anticoagulant?"

The helpless choice came to the minds of the three of them.

After all, Zhang Tianyang has already failed two shots, and if he fails again, he can almost announce the beginning of this old lady's gamble.

The needle core was sent back again, Zhang Tianyang held the needle in his right hand, and pressed the skin again with his left hand.

"You're going to pull out the needle and try it a third time, right?"

The three white coats subconsciously thought so.

But Zhang Tianyang had a calm face, and his right hand was slightly strained.

I didn't pull the needle out, but I went in a little bit more.

A subtle touch bloomed at his fingertips, and he paused again.

Remove the needle core.

Keep your eyes on the end of the needle.

Waiting for that drop of miracle.