Ma Chenglin brought Zhang Gu to a patient.

"This patient has just been placed with a gastric tube, and you show them how to fix the cotton thread. ”

Zhang Gu nodded, and explained to the nurses while demonstrating.

"The medical adhesive tape fixing method that we used before has four drawbacks. ”

"First, in order to facilitate the adhesive tape, the gastric tube is bent at the alar of the nose, resulting in discomfort caused by the lateral pressure of the nasal canal in the patient's nasal cavity. The second is that the patient sweats, or cleans the face so that the cheeks are moist, and the adhesive tape is easy to fall off, resulting in the loosening of the gastric tube. The third is the firmness of the adhesive tape, poor air permeability, the adhesive substances on the adhesive tape need to be wiped with turpentine, and some patients will have unbearable odor or allergies. Fourth, patients are worried that the gastric tube will fall off, which will reduce the amount of activity, which is not conducive to the patient's postoperative recovery. ”

The cotton thread fixing method can avoid the above drawbacks. ”

Seeing Zhang Gu talking eloquently, Ma Chenglin sighed slightly.

It seems that this Xiao Zhang has made an in-depth analysis of this gastric tube fixation method in order to make improvements.

It seems simple, but it actually makes sense.

No matter how small an innovation is, how can it be so easy?

It's rare!

Xing Wanhong, the head nurse, listened with relish, and Dr. Xiao Zhang's speech was very clear and thorough!

The little nurses also listened attentively, and some even took out small notebooks and took notes carefully.

"Here's how. ”

This time, because it was teaching, Zhang Gu explained in more detail than when he was in general surgery.

"The cotton thread is preferably around 45 cm, which is easier to adjust. First of all, it is better to put a figure-8 buckle in the middle of the cotton thread, pass through the end of the gastric tube, place it at the root of the nose, and gently tighten the ends of the cotton thread, so that the cotton thread is tightly tied to the gastric tube, and it is not easy to slip off. ”

Zhang Gu said while doing: "Tie a slipknot of cotton thread on each side, wrap a little cotton under the cotton thread hanging at the pinna, hang the cotton thread of the slipknot on the pinna respectively, and wrap the end of the gastric tube with sterile gauze and fold it backwards, and clamp it with a clip." ”

After Zhang Gu finished doing it, he glanced at the nurses, and casually pointed to a beautiful one: "You come and try to do it again." ”

The little nurse's face turned red, and she stood up a little nervously, and imitated the main points that Zhang Gu said just now.

Xing Wanhong, the head nurse, said with a smile: "Teacher Xiao Zhang said it well, we will remember it once." ”

Ma Chenglin also smiled beside him.

At this time, a young doctor came over and said in Ma Chenglin's ear with an embarrassed face: "Director Ma, the gastric tube in bed No. 7 has fallen off again, please re-intubate." ”

Ma Chenglin said angrily: "The swallowing disorder of bed 7 is the most serious in our department, and the gastric tube is also the most difficult to insert, don't you show me a good look!"

The young doctor was reluctant to speak.

Ma Chenglin turned his head to look at Zhang Gu who was teaching, and his anger disappeared a little: "But after today, we can use Xiao Zhang's cotton thread fixing method, and we will be able to make it easier." ”

Ma Chenglin came to bed No. 7 and tried to reinsert the gastric tube, but the patient just shouted pain, and after a while, Ma Chenglin also sweated slightly on his forehead.

In patients with this type of stroke and dysphagia, a gastric tube is the most difficult to place.

At this time, Zhang Gu walked over: "Director Ma, why don't I try." ”

The young doctor next to him said, "Doctor Zhang, the mucosa of the nose, pharynx, and esophagus in this case is already somewhat congested and edema, and the mucosa is damaged, coupled with swallowing dysfunction, it is difficult to intubate." ”

Zhang Gu smiled: "It's okay, there is a difficult way." ”

Ma Chenglin glanced at Zhang Gu: "You also have experience in intubation?"

Zhang Gu: "A little. ”

"For patients who can't actively cooperate, it's actually easier to use a tongue depressor. Do we have a sterile tongue depressor?"

When Ma Chenglin heard this, he suddenly had some expectations, and gave the young doctor next to him a look.

Soon, a sterile tongue depressor was delivered.

The nurses who were practicing the cotton thread fixing method next to them also looked at this side curiously at this moment.

Zhang Gu said: "For this kind of patient who cannot actively cooperate with intubation, it is best to adopt a semi-sitting and lying position of 15 to 30 degrees, which is easier to place the catheter. ”

"Director Ma, I'm not good alone, please use a tongue depressor and an opener to cooperate with me. ”

Ma Chenglin smiled: "Okay, as long as you can successfully insert a gastric tube, I will be your deputy." ”

He vaguely felt that this little Doctor Zhang might have to come up with a new improvement method again!

Ma Chenglin's heart suddenly became hot.

The cotton thread fixing method is convenient for the nurses. But this modified catheterization method will be convenient for these doctors in the future!

The two wore sterile gloves. Under Zhang Gu's instructions, Ma Chenglin wrapped the patient's tongue with gauze and gently pulled it out with one hand.

Zhang Gu took advantage of the situation to insert the opener from the corner of the mouth on one side, and after fixing it, lubricate the front end of the gastric tube and slowly insert it from the nasal cavity on one side.

After inserting about 15 cm, Zhang Gu said: "Director Ma, press the base of the tongue with a tongue depressor." ”

Ma Chenglin's eyes have become brighter and brighter, and his brain is also alive, and he has a hunch that Zhang Gu's method is likely to really work!

Taking advantage of Ma Chenglin's suppression of the root of his tongue, Zhang Gu quickly sent the gastric tube into the predetermined length.

The young doctor next to him was wearing a stethoscope and tried to inject 10 milliliters of air, and at this moment he was overjoyed: "It's sent into the stomach!

Zhang Gu said: "Director Ma, let go." ”

Ma Chenglin's eyes lit up, and he let go of it a little excitedly and took out the tongue depressor.

After Zhang Gu skillfully fixed the gastric tube again, he got up and said with a smile: "Okay." ”

Ma Chenglin looked at the time just now, and was amazed in his heart, this time the re-catheterization was fast and easy, and it was the easiest time since he re-catheterized.

Xing Wanhong and other nurses also had ripples in their hearts, they knew best how much trouble these patients with dysphagia had brought to Corey's catheterization and fixation work!

These troubles are in the hands of Dr. Zhang, but they can be easily resolved.

Ma Chenglin looked at Zhang Gu seriously, and said sincerely: "Doctor Zhang, you have to teach me this hand, and if there are any other things, you can take them all out!"

Zhang Gu smiled: "How can there be anything else, that's all." The key to this catheterization method is that the tongue depressor allows patients who are unconscious, or who have difficulty swallowing, and cannot cooperate with the pharyngeal esophageal gastric transmission to open the pharyngeal cavity and make it easier to intubate. ”

"In fact, the reason is very simple, patients with normal swallowing function, the vestibular contraction closes when swallowing, the entrance of the organ is temporarily closed, and the entrance of the esophagus is partially open, so that it is convenient for the entry of the gastric tube. The role of the 30-degree semi-recumbent seat, opener and tongue depressor is to replace this part of the function, so that patients with disabilities can also fully expose the pharyngeal passage during the intubation process. ”

Ma Chenglin couldn't help nodding when he heard this, and said with a smile: "You are still meticulous in your observation, and you also know how to use tools such as openers and tongue depressors." ”

Xing Wanhong also sighed: "It's not difficult to say this method, but before I saw it with my own eyes, I just couldn't think of it!"

After Ma Chenglin digested it for a while, he felt that he had almost mastered it.

He stared at Zhang Gu with burning eyes: "Doctor Zhang, don't you think that your improved catheterization and fixation method is very valuable for publication and promotion? This can be published in an article!"

The number of stroke patients with dysphagia in our department is also large enough to do a comparative test, and the data is enough to support an article. ”

Zhang Gu's heart moved when he heard it, his first main quest was a play.