Chapter 17 Closed Thoracic Drainage

  Before long, the nurse pushed a small cart over with the surgical supplies needed for the closed thoracic drainage procedure, including the chest closure package, thoracic drainage bottle and tube, treatment tray and gloves. Although closed thoracic drainage surgery is an invasive procedure, it is essentially still a minor surgery, but even minor surgeries are surgeries that carry some degree of risk, just smaller ones.

  "I'll do it, you be my assistant." Director Zhu said while putting on his gloves and looking at Tang Xiaofeng, who quickly put on his gloves as well.

  Director Zhu carefully examined Liu Yuanyuan again, roughly confirming the location of the effusion. He chose a spot between the fifth rib under her shoulder and began disinfecting and anesthetizing the area...

  Closed thoracic drainage is a widely used technique in thoracic surgery, and it is an effective method for treating empyema, traumatic hemothorax, pneumothorax, and spontaneous pneumothorax. Based on the principle of gravity drainage, it is an important measure to rebuild and maintain negative pressure in the thoracic cavity after thoracotomy, drain gas and liquid from the thoracic cavity, and promote lung expansion. Its purpose is to better improve negative pressure in the thoracic cavity, allowing air, blood, and fluid to be discharged from the pleural cavity and preventing their reflux, promoting lung re-expansion and closure of the pleural cavity; balancing pressure, preventing mediastinal shift and lung compression. For patients with empyema, drainage should be performed as soon as possible to eliminate pus, eradicate the abscess, and allow the lung to expand early, restoring lung function.

  Tang Xiaofeng assisted Director Zhu, with 1% procaine 20ml, to prepare the skin, subcutaneous tissue and muscle layer for infiltration anesthesia. After everything was ready, Director Zhu made an incision at the site of skin infiltration anesthesia, using hemostatic forceps to separate the subcutaneous tissue and muscle layer until reaching the pleural cavity, and enlarged the opening on the pleura. He clamped the curved end of the drainage tube with hemostatic forceps and inserted it into the pleural cavity through the incision. As they watched the blood-red fluid flow from Liu Yuanyuan's thoracic cavity into the drainage bottle, Director Zhu and Tang Xiaofeng exchanged a smile and let out a sigh of relief at the same time. After putting away all the instruments on the cart, Director Zhu instructed the nurse to observe Liu Yuanyuan closely and notify Tang Xiaofeng immediately if anything happened. "Director Zhu, I'll put away the instruments, you can go back to your office now, there are still people waiting for you." Tang Xiaofeng reminded him, and Director Zhu suddenly remembered that his friend was still waiting for him in the office. He arranged for Tang Xiaofeng to come to the office after putting away the instruments to discuss something with him, and then hurriedly walked towards the office.

  Tang Xiaofeng came out of the instrument room and hurried back to the office to write Liu Yuanyuan's medical record. After finishing Liu Yuanyuan's medical record, Doctor Tang was still alone in the office. The whole emergency department was busy, and Tang didn't dare to stay in the office any longer. As soon as he opened the door and walked out, he saw a man and a woman walking towards the office, with the woman holding a microphone and the man carrying a camera on his shoulder, taking pictures randomly in the emergency department.

  The journalist, seeing the scene, Tang Xiao Feng immediately recognized the other's profession and was sure they were there to interview the car accident patients. He didn't mind, as journalists coming to the hospital also served a good promotional purpose for the hospital. Generally, no one paid much attention to them, anyway, it wasn't the first or second time that journalists had come to the hospital for an interview recently. On the day he arrived at the hospital for his internship, the journalist had already surrounded the emergency department, and over time, he got used to it. He walked quickly towards the emergency hall, where there were more injured people, and at this moment, they might still need help from others, after all, it was a collision accident involving a unit's shuttle bus.

  But unexpectedly, the female reporter holding the microphone saw Tang Xiaofeng and stopped him. She pointed the camera at Tang Xiaofeng and said into the microphone: "Hello, I am from Tengyang Daily..."

  "I'm not clear about this traffic accident at all, you've interviewed the wrong person. If you want to ask something, go ask those people over there, they're the ones who are most clear about the situation." Tang Xiao Feng pointed to some lightly injured people in the corridor and then let the female reporter pass, lifting his foot and walking away.

  Tang Xiaofeng had no good feelings towards reporters, and could even be said to have a kind of disgust. Reporters were always a double-edged sword for hospitals, but for doctors or patients, they were simply a nightmare. Medical accidents, doctor-patient conflicts, disregard for patients' emotions... the relentless pursuit of interviews was suffocating. As Tang Xiaofeng thought about this, his feelings of disgust grew stronger, and he quickened his pace, rushing to the emergency room, pushing open the door and stepping inside.

  Rescue room with three beds were all filled, doctors and their students were busy with rescue work, each patient who needed rescue was equipped with sufficient medical personnel, Tang Xiao Feng wanted to help but couldn't get involved, could only stand by and watch.

  The rescue room was filled with a tense and oppressive atmosphere, full of the scent of death. After a critically injured patient was declared dead after failed resuscitation efforts, Tang Xiao Feng didn't want to stay in the rescue room any longer.

  As Tang Xiao Feng arrived at the emergency department's triage desk, he was about to ask Director Sun if there were any more patients that needed attention. "Ring, ring, ring..." The nurse who was organizing the registration answered the phone skillfully: "Hello? Tengyang City People's Hospital Emergency Department." "This is the rescue center, a patient with a headache has been sent over." "We're already full here." "He should be arriving soon." "Okay, got it." "Director Sun, another patient is about to arrive," the nurse said as she hung up the phone and hurriedly informed Director Sun.

  Just after finishing speaking, the emergency room door was pushed open and a man was pushed in, with a painful expression on his face. Next to him was a girl of about 20 years old. "Doctor, come quickly and take a look at my dad, what's wrong with him?"

  Tang Xiaofeng and Sun Feng rushed over upon hearing the noise, and pushed the patient towards the emergency room. "Doctor, you must save my father!" The girl cried while pulling on Director Sun's arm.

  "Don't worry! We'll try our best! Just wait for a moment. Don't be too anxious!"

  "ECG monitoring, bedside lamp, CT." Director Sun said while putting on his gloves and mask. He quickly put on the stethoscope to listen to the patient's heartbeat. The patient was coughing non-stop and shouting: "Doctor, my head hurts." The voice was so hoarse that Director Sun felt a bad premonition.

  "Get a blood test, check the blood, and do a full set of blood tests." Director Sun continued to instruct.

  "Bring a tray over." Tang Xiaofeng took some of the patient's fresh sputum, "Go and have this tested." After a while, Wang Hui came over with the test results.

  "Director Sun, this is the test report." Tang Xiaofeng hastily moved closer to Director Sun to look at the test report.

  "Director Sun, I suspect he has primary bronchogenic carcinoma?" Tang Xiaofeng said after reviewing the lab results.

  "Your judgment is correct. Moreover, I estimate that the optimal treatment period has already passed. 40ml of physiological saline plus 8mg of mitomycin, administered intravenously."

  Director Sun continued to observe the patient and said: "Neuron-specific enolase shows 16μg/L, he has undergone chemotherapy, but it seems that the effect is not obvious. Continue with physiological saline 40ml plus vincristine 3mg, intravenous injection."

  "Physiological saline 40ml plus Long Spring Earth Xin 3mg, intravenous injection."

  They were watching the patient's vital signs while injecting various drugs.

  "Wang Hui, notify of critical illness, and go with family members."

  "Alright! I'll go now." Walking out of the emergency room, Wang Hui held up a notice and shouted: "Which one of you is Wang Xuemin's family member?" "Doctor, I'm his daughter. How's my father doing now?" A girl asked anxiously.

  "Has your father ever had such a situation before?"

  "Yes. Isn't my dad very dangerous?"

  "This is a critical notice, your father's condition is extremely dangerous, you need to be mentally prepared."

  "Doctor, no matter how much money it costs, I just want my dad to live one more day in this world."

  "I only have this one relative left." The girl suddenly couldn't control herself and burst into tears.

  "Don't be too anxious, we'll try our best to rescue them. Liu Li, come over and take care of the family members."