When a doctor opened a plug-in

"Let me tell you, Chen Cang's words are very good. I've heard people talk about thoracic puncture before, but it's far worse than Chen Cang!"

"The most important thing is to look handsome!"

"Is it really that exaggerated?"

"It's even more exaggerated. We asked a dozen or twenty people yesterday, but we didn't ask them, and everything is good! I think Chen Cang is a must when it comes to thoracic puncture!"

"I'm obedient, Chen Cang has no match yet!"

"They are in the establishment of the Second Academy of the Province. Now they are sent out to study for postgraduates. They are handsome, with good work and good people. Come on!"

...

A few well-trained little girls talked happily. Actually, none of them came to the training today. They just came over and listened to it again. This is the same as the class in college. Which teacher speaks well, looks handsome, and sucks fans. There are so many people here!

In fact, many of those who came to participate in the training program were already graduate students, but at that time they did not obtain the training program certificate after graduation.

But now as a doctor, you are required to have a training certificate, which is as important as the qualifications of a practicing doctor. Without a training certificate, you cannot be promoted to an intermediate professional title.

To put it bluntly, if you don't have a training certificate, you won't be rated as the attending doctor.

So many people come to participate in the training.

But at this time, we can see that the male to female ratio of medical students is coming.

Among the ten people, there are seven girls and three men.

Therefore, boys are relatively easy to find in medical schools.

...

After the group pushed the door and entered the chest piercing room, they suddenly saw a man standing inside.

This man...the oily head wants to cover up the reality of baldness, and the new white clothes wants to stop the raised belly, which looks very greasy...

Suddenly, the person who was about to sign in hesitated!

This person should...not Chen Cang, right?

"This is Chen Cang? So... abstract?"

Even the few people who came yesterday were dumbfounded: "No! I don't know Chen Cang, my classmate yet, where is Chen Cang?"

Several people signed the letter reluctantly and looked at Shi Qi with curiosity.

It's all here, can't you go?

Shi Qi looked at everyone coming soon, opened the ppt with a smile, and smiled like Wu Yanzu: "Well, welcome everyone to the Second Provincial Hospital. I am Shi Qi. Today I will tell you about the operation of thoracic puncture. And precautions."

"Maybe everyone doesn’t know me well, but after a long time, I’m familiar with it. I used to be the director of the thoracic surgery department of our hospital. I have been reforming since then. I went to breast surgery. So speaking of the explanation of thoracentesis, I think the second hospital of the province I should be the most suitable, right?"

Having said that, Shi Qi smiled humorously.

"Thoracentesis is used a lot in clinical practice, and it is very important to medical workers. Everyone is a future doctor, so it is really necessary to master such a technique."

"I'm usually very busy, but after receiving the invitation from the Guidance Training Center, I still feel that this matter is more important, so I am here, and now I will start..."

Shi Qi's materials were left by Li Shijian at the time. Li Shijian, who was outside his chest, often trained with Chen Cang at the time, so the materials were all prepared.

Shi Qi is now going to be the director of the Guidance Center. Because the old director of the breast department does not retire, he can't go there at all, and...clinical, he doesn't want to do it now.

Three years as the director of thoracic surgery, three years in Xianyu, where did such a hard life?

Being a director of the Guidance Training Center and supervising hundreds of students, I feel comfortable.

What Shi Qi said... is quite satisfactory, just like the scoring standard, very standardized and very official.

Everyone sounds okay.

However, those who heard Chen Cang's explanation yesterday suddenly felt that it was a bit unsatisfactory.

Without comparison, there is no gap. Sometimes, the level of clinical doctors can be seen from the explanation. Some people have something to say, and some people are dry.

But thinking that they are the original director outside the chest, everyone still thinks that they should be quite competent, perhaps just not good at explaining.

So patiently listened, and after finishing speaking, Shi Qi looked at everyone, "Are there any questions?"

At this time, a person asked: "Teacher Shi, the 2010 British Thoracic Society's Pleural Disease Guidelines pointed out: For malignant pleural fluid, the amount of fluid drawn for therapeutic pleural puncture should be determined by the patient’s symptoms at the time. The liquid volume should not be 1500ml, and what you just said is that it should not exceed 700ml for the first time and 1000ml in the future. Concord Respiratory Medicine believes that it should not exceed 600ml for the first time and 1000ml in the future. The domestic volume is more conservative for the first time. This is why ?"

This question is out!

Most of the people present were blinded!

This question is awesome!

Just listen to it!

Because the five-six-seven-eight version of internal medicine says that it will not exceed 700 for the first time and will not exceed 1000 in the future, but it seems that no one really asks why this question is!

Shi Qi was taken aback. This question was well asked. He pointed to a girl in front and asked, "What do you think of this question?"

The girl hesitated: "I used... the eighth edition of "Internal Medicine" to read..."

As soon as he said this, everyone around him was dumbfounded, and he burst into laughter.

Shi Qi also smiled, and said: "Recruitment pulmonary edema will occur because of too much fluid withdrawal, so we are relatively more conservative than foreign countries."

The girl froze for a moment: "Then you won't be afraid of the first 1500 in foreign countries? Is the difference between our domestic and foreign countries because of our conservative ideas?"

Shi Qi was stunned for a moment: "Each guide is a theory derived from evidence-based medical research with a large number of cases and experience. I think we should respect the guide."

At this time, a girl suddenly raised her hand and said, "Mr. Shi, in fact, this value has a source, and it is not a dead value."

"Physiology tells us that the average total lung capacity of an adult male is 5000ml, of which the vital capacity is 3500ml + the residual air volume is 1500ml. Based on this, we speculate that the volume of the thoracic cavity should also be about 5000ml, so the unilateral chest cavity is about 2500ml.

For a patient with a large amount of pleural effusion, we took out 1000ml at one time, 25, which is quite a lot. If 1500ml is taken out at one time (unilateral), it will be 35 of the volume of the chest cavity on one side, which is basically insurmountable. There is a gap."

"Evidence-based medicine statistics show that it is an indisputable fact that Europe and the United States are taller. Correspondingly, their chest volume is also larger than ours, so it is understandable that their single pumping volume is larger than ours."

"And the real meaning of the guidelines is not to emphasize this value, but this is only a critical value. In fact, in our clinical practice, in fact, this "700ml, 1000ml" cannot be static, because each patient's age, body type, and condition It’s not the same. We can’t use these two numbers dead. It’s more important to observe the patient’s condition at any time. This is also the case abroad. The guide is a relatively wide range. As every doctor, you should always observe the patient and adjust the dosage."

The girl's voice was not loud, but she silenced the audience.

These words, all at once, clearly explained the meaning of the value of the chest piercing fluid, and instantly let the audience understand it, and suddenly there was a feeling of sudden realization.

That's it!

Even Shi Qi suddenly felt a sense of enlightenment. It was really good, it turned out to be like this.

Shi Qi couldn't help asking: "This classmate, what I said is really good! I have a good understanding."

The girl actually didn't want to say anything, but one of them couldn't help but said it. Naturally, she didn't expect such a big response. Looking at the people around, they looked at her wowly, and suddenly blushed.

"Actually... this is not what I said, this is what Teacher Chen said." The girl said with a look of embarrassment, and then pointed to the classmates next to her, "You ask them, they know too!"

Several classmates nodded one after another: "Yes, Teacher Chen has said it all."

Everyone was dumbfounded!

Who is Teacher Chen?

That Teacher Chen?

Even Shi Qi looked blank, who is Teacher Chen?It looks familiar.