Chapter 2447 【2447】Good Job
If you look at the anatomical diagram, you will find that the bone plane of the posterior superior iliac spine is larger than that of the anterior superior iliac spine. The bone plane is large, and it is easier to implant when the needle tip falls down. It is not as small as the bone plane, and the needle tip falls down like the needle point is facing the wheat awn, which is easy to rub off and difficult to insert the needle vertically.
It is important to enter the needle vertically. The bone piercing itself is to penetrate into the bone, and the bone is hard, which means it takes a lot of effort. Inserting the needle vertically is like hammering a nail with a vertical force, and the force can be used to minimize the damage to the child's bones.
Some bones that are not easy to wear are common in clinical practice. When the clinical teacher pierces them, if the bone is drilled, the teacher's expression is hard. This kind of force is not only laborious but also afraid of excessive force. Zhang Desheng was not afraid of death for the first time, so he dared to start drilling hard all of a sudden. If the needle cannot be inserted vertically, the psychological setbacks of the novice will be far less than the instant collapse of the veteran.
Secondly, clinically, the bone marrow dilution rate of bone marrow extraction is quite high. What is bone marrow dilution, that is, no bone marrow is drawn or too little bone marrow is drawn, and most of the samples drawn are blood. If such a specimen is sent to the laboratory for bone marrow examination, it must be unqualified, and it must be re-taken, which is equivalent to a bone marrow failure.
If the problem is the posterior superior iliac spine, the child needs to sleep on his stomach, which can inhibit breathing to a certain extent. Perhaps based on such considerations, Zhang Desheng did not dare to choose the posterior superior iliac spine. The main reason is that the parents of this child are too difficult to deal with, and the doctors dare not take risks at all.
Instead of letting the child lie on the prone position, another method is to let the child lie on his side with his knees clasped tightly to expose the posterior superior iliac spine. This position is not very fixed. For this reason, Zhang Desheng respected Xie's opinion.
It may be a bit difficult to get a good posture, but when the time comes, the anterior superior iliac spine will not penetrate as classmate Xie said, and the needle will sway in the middle for a long time, and the consequences of the incident will be even greater.
There is no need to be too scared if a classmate comes to help.
Report to Teacher Tian to choose the posterior superior iliac spine, and Teacher Tian and Teacher Wang agree.
Several classmates began to help the children adjust their positions. Seeing this, the other two surgical students came up to help.
Carefully change the child to a side-lying position, and control the joint movement position when controlling the child, instead of pressing hard on the child.
The positioning is said to be the posterior superior iliac spine, but the actual puncture point is the protruding part between the posterior superior iliac spine and the fifth lumbar vertebra.
After changing the child's position, Zhang Desheng felt something different. With a gloved hand, you can touch the relatively flat bone surface, indicating that this position can expose the bony position to be operated on well. Unlike when he touched the anterior superior iliac spine at the beginning, he only felt the bumps and it was difficult to get the needle.
Contacted the child's current position was put by classmate Xie. Zhang Desheng praised in his heart: Xie is amazing.
Being able to feel the wide range of good acupuncture points, the doctor's confidence will naturally be much more abundant.
Zhang Desheng then worked hard, and the accuracy of the injection of the anesthetic on the periosteum was high, and it was easy to do. After pressing the part where the local anesthesia was completed, when the needle was given again, because of the confidence, the bone piercing needle went straight down, and when the syringe push rod was pulled, something came up quickly. The process was incredibly smooth.
If the doctor moves quickly, the pain and discomfort of the child will definitely be reduced a lot. Children, like adults, are most afraid of long-term pain.
Seeing the students pull out the bone marrow in twos and twos, the two supervising teachers nodded sharply: These students have done a good job, and they can do it by themselves without the guidance of the teacher.