My Medical Skills Give Me Experience Points Chapter 1211 - 478: Closed Thoracic Drainage, Pedantic Teacher_3

~3 minute read · 670 words
Previously on My Medical Skills Give Me Experience Points...
Zhou Can successfully managed the pneumothorax patient's condition through closed thoracic drainage and guided deep breathing exercises before returning the patient to the ward with instructions for monitoring and supportive therapy. Eager for his assistance in a high-difficulty surgery, Director Xue Yan urged him to the operating room, recognizing his expertise in handling surgical emergencies. The next day, Zhou Can checked on the patient, noting improved symptoms and a low-grade fever, while emphasizing caution with the drainage tube amid ongoing bleeding managed effectively by the attending physician, Dr. Pu, who deferred to his guidance.

He hadn't received any guidance from others; it was solely based on his individual survival tactics in the professional environment.

"You handled it excellently. For a patient experiencing hemopneumothorax, this approach is spot on. In treating these cases, performing proper drainage lets the lung inflate again and seal off the bleed, allowing natural recovery in most situations. If the bleeding keeps going, you need to think about a swift thoracotomy to stop it. During your shift change, make sure to brief the next doctor thoroughly and keep monitoring the patient diligently."

Zhou Can wasn't acting superior at all.

Even attending physicians usually addressed him in this collaborative manner.

He once attempted overly courteous speech with them. But that ended up making the recipients uneasy, turning discussions awkward and strained.

With his busy schedule, Zhou Can lacked the luxury for excessive politeness and chatter.

He's direct by nature and avoids phony courtesy. Eventually, he chose to communicate naturally.

"Alright, I'll ensure the handover is detailed."

Dr. Pu jotted it down meticulously in his notepad.

"Dr. Zhou, could you explain the reasons for bleeding in these patients? The real-world handling differs a lot from textbook descriptions, and I'm eager to gain more hands-on knowledge."

He shared this with a friendly grin.

"The primary reasons for hemothorax involve breaks in the adhesions linking the visceral and parietal pleura. Bleeding typically arises from damaged or cut small arteries at the edges of chest wall adhesions. Thus, once the lung expands and squeezes the bleed, it achieves hemostasis. The majority of hemopneumothorax cases heal without operation. Your quick blood transfusion and IV hemostatic meds were spot-on."

As Zhou Can shared valuable clinical insights, he freely commended Dr. Pu's efforts.

"In practice, hemopneumothorax appears more frequently in young men, hitting the left side harder than the right. This condition sneaks up subtly, hard to spot, often delaying diagnosis. That's the reason my orders emphasized vigilant tracking of the patient's blood loss."

Yesterday, after the closed thoracic drainage procedure on the patient, Zhou Can issued verbal instructions.

He simply omitted detailing the response to emerging hemopneumothorax.

He trusted that the bedside physician and nursing staff would promptly alert a higher-up doctor.

Had he not hurried off to the OR for two urgent major operations then, Zhou Can could have spotted the hemopneumothorax with a little more observation time.

From the drainage output overnight, the hemorrhage remained substantial.

With luck, no thoracotomy for hemostasis will prove necessary.

Yet illness rarely bends to a doctor's hopes. It shows no mercy, even toward suffering families.

Diseases strike without pity, delivering harsh blows to sufferers.

Hence, close monitoring of this patient remains crucial to avoid mishaps.

"If I may inquire, how much time after starting closed thoracic drainage do we assess the need for surgery in these cases?"

Dr. Pu diligently recorded Zhou Can's key points in his notebook.

A sharp memory pales against a dependable written record.

With so much for doctors to absorb, note-taking proves invaluable.

"Generally, if air leaks persist beyond twenty-four hours of drainage, additional steps are warranted. For many patients, the ongoing bubbles in the water seal bottle gradually fade over three to four days until they stop completely. Just a few will leak gas for up to a week, signaling a major tear that's tough to fix with drainage alone. In those, thoracotomy for repair becomes required."

Whether to novices or seasoned staff, Zhou Can shares knowledge openly, explaining with patience.

This praiseworthy instructional approach came from mentors like Director Hu Kan, Dr. Xu, Director Shen, and more.

The senior instructors Zhou Can met, despite their reserved or distant styles, always patiently guided him when he posed thoughtful questions showing true interest.

Up to now, Zhou Can has yet to face a veteran physician unwilling to instruct him.

That includes the reserved Director Feng from Anesthesiology, who even proactively invited Zhou Can to shadow and study under him.