I really don't want to be a doctor

Chapter 426 Pneumothorax!

"Don't you even auscultate the patient?"

Jing Xiaoran put down the stethoscope in his hand, and said calmly.

The basic clinical operations are visual, tactile, percussion, and listening.

Auscultation is the use of the ear or a stethoscope to listen to the internal sounds of the body.

In clinical practice, it is mostly used to listen to heart sounds and breath sounds.By auscultation.

According to the characteristics and changes of the sound, such as the frequency, intensity, interval time, noise, etc. of the sound, the medical staff can diagnose whether there is disease in the relevant organs.

Auscultation is the most basic operational skill for all medical staff.

However, with the development of scientific examination technology, these most basic skills of many doctors have begun to degenerate, relying too much on examination equipment, thus ignoring the simplest technical means.

But often, these most basic physical examinations can help doctors make a diagnosis as much as possible and narrow down the scope of the disease!

Even sometimes, the signs displayed by the patient are more accurate than the machine's examination results!
"I, I... I just had a physical examination." Dr. Zhang stammered, "I just didn't auscultate."

In fact, it is not that he is unaware of his problem, but that he himself is in the department of endocrinology. Most endocrinologists are diabetic patients and rarely need to use a stethoscope.

Therefore, he was extremely unconfident in his auscultation skills, so he simply stopped listening.

When Jing Xiaoran saw this, he knew that Dr. Zhang was probably a typical specialist doctor, who might only treat his own professional diseases.

Even simple diseases encountered in other specialties may not be diagnosed in the first place.

The disease that this old man suffers from is a very common sudden disease.

"I'll stop talking nonsense." Jing Xiaoran said to the young woman, "The disease your grandfather suffers from is pneumothorax."

A pneumothorax is when air enters the pleural space, causing a pneumothorax.

The lung tissue and visceral pleura are usually ruptured due to lung disease or external force, or the tiny emphysema bubbles near the lung surface are ruptured, and the air in the lungs and bronchi escapes into the pleural cavity.

As soon as the voice fell, the young woman hadn't responded yet. Doctor Zhang's expression froze, and he immediately grabbed the stethoscope in his hand and placed it in the old man's lung auscultation area.

"Pneumothorax? What kind of disease is this?"

The young woman was a little puzzled at this time.

She thought that the lung disease diagnosed by Jing Xiaoran was the same as traditional Chinese medicine Xue, but this looks different!

The young woman's brows frowned into the word Chuan.

At this moment, Dr. Zhang put down his stethoscope, his right hand trembled slightly, and he swallowed, "Yes, it's a pneumothorax."

At this time, Xue Zhongzhong stayed aside, expressionless, and did not make any remarks.

"Doctor Zhang, you also said it was pneumothorax?" the young woman asked.

"Yeah." Doctor Zhang nodded shyly, "I didn't auscultate at first, but just after auscultation, I found that the breathing sounds of the old man's lungs disappeared."

If it is not easy to hear other things, but the breath sound disappears, Dr. Zhang can still hear it easily!
When the pneumothorax reaches more than 30%, orthopnea may appear, the thorax on the affected side is full, the intercostal space is distended, the respiratory movement is weakened, the percussion is drumming, the heart or liver dullness disappears, and the chatter and breath sounds are weakened or disappeared.

At this moment, the old man's condition worsened again!
He was panting heavily, and the frequency of his breathing accelerated!

The cyanosis of the lips deepened!

It seems that he will pass out at any time due to difficulty in breathing!
"Not good! It looks like tension pneumothorax!" Jing Xiaoran frowned, "If it's not dealt with in time,"

Pneumothorax can be divided into closed pneumothorax, open pneumothorax and tension pneumothorax.

Tension pneumothorax refers to the rupture of larger alveoli or larger and deeper lung laceration or bronchial rupture, the breach communicates with the pleural cavity and forms a one-way valve, also known as hypertensive pneumothorax.

When inhaling, air enters the pleural cavity from the opening, and when exhaling, the valve closes, and the air in the cavity cannot be discharged, causing the pressure in the pleural cavity to continuously increase, oppressing the lung and causing it to gradually collapse.

Patients with tension pneumothorax often show high mental tension, fear, irritability, shortness of breath, suffocation, cyanosis, sweating, weak and fast pulse, drop in blood pressure, clammy skin and other shock states, and even unconsciousness, coma!
If not rescued in time, it often leads to death!

"What to do!" The young woman asked anxiously.

Jing Xiaoran rolled his eyes inwardly, does this beautiful woman only shout from the side?

"Find a syringe!" Jing Xiaoran said to Doctor Zhang.

This time, Dr. Zhang understood immediately and took out a 50ml syringe from the first aid kit.

"Is this ok?"

"Enough." Jing Xiaoran nodded, took the syringe, and pulled off the pillow of the syringe, "Do you know how to do it?"

"I know." Doctor Zhang nodded, then shook his head again, "But I haven't done it."

"Then I'll puncture it!" Jing Xiaoran said in a deep voice, "Go find a pair of rubber gloves, and cut a hard part of a fingertip 1cm open."

"Ah?" Dr. Zhang was taken aback for a moment, his heart was frantically questioning.

It is true that he himself has not treated this kind of tension pneumothorax, but the young and over-the-top student in front of him, has he ever had a puncture?
I knew the identity of the old man in front of me was unusual!
If there is even the slightest mistake, then the rest of their lives will be over.

"What are you still doing in a daze!" Jing Xiaoran interrupted Dr. Zhang's thoughts, "Look at the state of this old man, if you don't puncture the air in the lungs in time, if the lungs rupture or the bronchus is crushed, everything will be over!"

The principle of first aid treatment for tension pneumothorax is to deflate immediately and reduce the pressure in the pleural cavity.

In an emergency, a thick needle can be used to pierce the pleural cavity at the midline of the second intercostal clavicle on the injured side, and a jet of gas will be discharged, which can achieve the effect of exhaust and decompression.

At this time, Dr. Zhang was also awakened!
He glanced at the old man on the bed, he was already in a state of extreme difficulty breathing.

What Jing Xiaoran said was right, if he didn't deal with it, the old man's lungs would become more and more swollen.

Finally, with a "bang", it broke!

Ignoring Dr. Zhang, Jing Xiaoran is now concentrating and squatting beside the bed.

"Hold the patient, don't let him move around!" Jing Xiaoran told the two young and beautiful stewardesses beside him.

Although the stewardess has a delicate figure, delicate face, and even a faint body fragrance, Jing Xiaoran doesn't have time to appreciate it now.

"Yes, is it dangerous?" The man in the peaked cap swallowed.

Jing Xiaoran didn't raise his head, "If you don't bother me, there is no danger at all."

The man in the peaked cap opened his mouth, but under the stern gaze of the young woman beside him, he finally closed his mouth.

Holding a pillow with a 50ml syringe in his hand, Jing Xiaoran closed his eyes, took a deep breath, and then let it out slowly.

Opening his eyes, there was a trace of determination in his eyes.

"I'm going to impale!"

(End of this chapter)