I'm really an intern

Chapter 492 Who is the anesthesiologist?

Even if one thousand or ten thousand Pan An anesthesiologists were unwilling, and even stubbornly deleted that paragraph, Zhang Tianyang's assignment to him was still a matter of raw rice and cooked rice.

so what?

Seeing that Zhang Tianyang didn't regard himself as an outsider at all, he went to the computer on his own, and started to mess around on his own, Pan Narcotics could only helplessly keep silent.

After being dazed for a while, he suddenly picked up the 20ml syringe that he had just pumped out the glucose.

After staring at it for a while, he bent down and took out a larger 50ml syringe from under the anesthesia table.

After hesitating for a few seconds, he took out the second syringe, and then silently asked the nurse to give him another bottle of glucose.

It wasn't until seeing two large, one small, and three syringes lined up on the table next to the monitor that Pan Anesthesia felt that enough was enough.

"Teacher Pan, can you teach me how to use this anesthesia system?"

Turning his head, Zhang Tianyang was looking at himself humbly and expectantly in front of the computer.

Pan Narcotic wanted to put on a straight face, but after a pause, he sighed resignedly.

"Let me tell you about our anesthesia account first..."

Although the entire hospital uses the same system, the templates of general departments and several special departments such as anesthesiology and imaging departments are also different.

Accounts of general departments can issue diagnoses, prescribe medical orders, write medical records, etc., with various interfaces and complex functions.

Although the accounts of the anesthesiology department can also see various medical records of patients, but in terms of operations, they can only create anesthesia records.

The anesthesia record is actually a large chart with interlaced lines of different colors and thicknesses, and various circular and triangular pattern villages are distributed.

At first glance, it seems to be disorganized, but in fact it contains information including the start and end time of the operation, the vital signs data of the patient throughout the operation, the time and dosage of medication during the operation, and the measures taken during the operation.

Pan Narcotic explained carefully, and Zhang Tianyang listened carefully, and when he looked at the criss-cross chart again, he felt that it was really organized.

"Well, let me tell you about the anesthetics we commonly use."

The first operation had already started before Zhang Tianyang came. At this time, there was no need to replenish anesthetics, so Pan Anesthesia simply continued to tell Zhang Tianyang.

In fact, these things should not be mentioned so early. Normal interns should first follow the anesthesia teacher to learn the process, learn the operation, and listen to the teacher's instructions.

After following for a few days, getting familiar with the process, and knowing when to use which medicines, I began to explain the functions and usage methods of various medicines.

But who made Zhang Tianyang in front of him?

What does he need to be familiar with?
Pan Narcotic complained frantically in his heart, but his face was calm.

"You should know that our anesthetic drugs are divided into general anesthetic drugs and local anesthetic drugs, right?

In fact, general anesthetic drugs can be divided into three types: sedatives, analgesics, and muscle relaxants. "

"I know."

Of course Zhang Tianyang knew this kind of theoretical knowledge.

In short, sedatives are for calming down and sleeping, analgesics are for pain relief, and muscle relaxants are for relaxing muscles and preventing them from exerting themselves.

"Sedative drugs mainly include propofol, etomidate, dexmedetomidine, etc.

Analgesic drugs mainly include fentanyl, sufentanil, alfentanil and remifentanil, as well as commonly used morphine and pethidine.

Muscle relaxant drugs are mainly divided into vecuronium bromide, rocuronium bromide, cisatracurium, atracurium and so on. "

While talking, Pan Narcotics picked up various medicine bottles at hand to signal.

The sedative drug used in Dongfang Hospital is propofol, which is a large tube of milky white liquid, which is often called "milk".

Remifentanil is commonly used as an analgesic drug, and atracurium is used as a muscle relaxant. These are powdered powders that need to be prepared with normal saline.

"The three types of drugs have different mechanisms of action, and the order of administration is also different. This is very important!"

Pan Narcotic's face suddenly became serious, and even Zhang Tianyang subconsciously sat upright.

"Like the patient we're operating on now, intubation anesthesia requires three types of drugs, and the order is sedation, analgesia, and muscle relaxation. Don't confuse them! Do you know why?"

Even though Pan Narcotics has full confidence in Zhang Tianyang, he still has to ask this kind of question.

Because it's very important!
Senior anesthetists have stepped on mine before!

At this time, Zhang Tianyang didn't hesitate much, and spoke directly.

"Because muscle relaxants must be given last!
After the muscle relaxant is given, the patient's muscles relax, so he has no way to resist, but if he is not given sedation and analgesia, he is conscious at this time! "

Zhang Tianyang's face also became serious.

In the case of muscle relaxants but no sedation and analgesia, any operation is a kind of torture for patients lying on the operating table.

Think about it, you're in excruciating pain, but you can't speak, scream, or even move!
This is not performing surgery, this is Ling Chi!

"very good."

Seeing that Zhang Tianyang answered correctly as expected, Pan Narcotics seemed a little relieved.

But when he continued to talk about the use of anesthetics, it was still in detail.

"During the entire operation, our anesthesiologists need to adjust the medication according to the actual situation.

For example, it is necessary to adjust the patient's blood pressure and heart rate.

For another example, when the first surgery is about to be performed, more analgesia needs to be given, and if an electric knife is used during the operation, an additional dose is required before the surgery is performed.

Otherwise the patient may have a stress response...

What's more, sometimes patients do not need general anesthesia, and when subdural anesthesia is needed, additional drugs are used. "

"Local anesthetics are mainly divided into amide local anesthetics and ester local anesthetics..."

"In addition to intravenous administration, we also have inhalational anesthesia here, look here..."

"..."

After a whole set of introductions, Pan Anesthetic said his mouth was dry, but he was also somewhat proud.

Because Zhang Tianyang listened carefully.

But with the passage of time, after the two operations, Pan Anesthesia gradually discovered something was wrong.

Although the two operations went smoothly, except that in the first half of the first operation, he chose the medicine for the patient himself, and Zhang Tianyang always took the first step before he said what medicine he wanted to give to the patient. The medicine was picked out and handed to himself.

But what he handed over was really the medicine he was going to give!

This guy made it seem like Zhang Tianyang is making decisions, and he is just a handyman who injects drugs?

Who is the anesthesiologist and who is the intern?

Pan Anesthesia was still in a mess, but Zhang Tianyang had already clicked on the information of the next patient to be operated on.

"Teacher Pan, it looks like a little boy will come later."

　Thank you, the lord of the ronin boss~ Boss is generous~
　　
　
(End of this chapter)