98: Chapter 98 How did you manage to do that injection just now?
Inhale. Exhale. Inhale. End of exhalation. Now. Insert the needle.
The needle tip pierced the skin.
On the right side of the ultrasound screen, a bright spot appeared. The needle tip.
It was moving precisely along the path Lu Chen had preset.
The fifth intercostal space, avoiding the intercostal vessels and nerves along the lower edge of the ribs.
Passing through the intercostal muscle layer. Entering the pleural cavity.
At this moment, the lung tissue had just retracted upwards at the end of exhalation, and the window was completely open.
The needle tip did not touch the lung. Continuing to advance. Passing through the parietal pericardium. Entering the loculated cavity.
"It's there."
Lu Chen connected the syringe and aspirated. Pale yellow fluid surged into the syringe.
"Aspiration successful. The needle tip is in the loculated cavity, not touching the myocardial wall, and not touching any adhesion bands."
His voice was so steady that it didn't sound like someone performing a life-or-death procedure.
Director Li Sen turned his head to glance at the ultrasound image on the right screen. The position of the needle tip. Perfect. It stopped precisely in the center of the loculated cavity.
There was still a safe distance from the left ventricular wall. There was also enough space from the nearest adhesion band. One needle, one shot.
In that brief window at the end of exhalation, it took less than four seconds from the needle insertion to entering the loculated cavity.
"Start drainage."
Lu Chen quickly aspirated the fluid.
The first 50 ml tube. The second 50 ml tube. The third tube.
Fluid was continuously being withdrawn. The loculated cavity was visibly shrinking on the screen.
The compression on the lateral wall of the left ventricle was being rapidly relieved.
The data on the monitor began to change. The heart rate started to drop from 168. 155. 142. 130.
Blood pressure began to recover. 60/40. 68/45. 75/50.
Blood oxygen climbed from 87% to 90%. 91%. 93%.
"Blood pressure is coming back!" Shen Xiaoning's voice trembled slightly, but it was mostly with excitement.
Zhao Yaqin stared at the monitor data and let out a long breath. Director Li Sen's hands also relaxed a bit.
Lu Chen continued the drainage. Another 200 ml was withdrawn. The fluid in the loculated cavity was basically cleared.
Adding the 250 ml Director Li Sen had previously withdrawn from the main cavity, a total of nearly 500 ml had been drained.
The pressure within the pericardial cavity dropped significantly. The heart finally had enough space to relax normally.
The data on the monitor stabilized. Heart rate fell back to 105. Blood pressure recovered to 95/62. Blood oxygen returned to 96%.
The patient's consciousness also returned.
"Good, much better, I can breathe now..."
Lu Chen did not remove the needle. He maintained the position of the Puncture needle and observed for a full thirty seconds.
On the ultrasound screen, there were no signs of the loculated cavity refilling. The residual fluid in the main cavity was also slowly decreasing.
The heart's movement returned to a normal rhythm.
"Drainage complete. The loculated cavity is empty, with no signs of refilling. There is approximately 100 ml of residual fluid in the main cavity, no need to continue aspiration for now."
Only then did he slowly withdraw the needle. Removed the needle. Applied pressure dressing. The entire set of operations was smooth and fluid.
The Resuscitation Room was silent for about five seconds. Then Zhao Yaqin said, "Lu Chen, how did you manage that needle insertion just now?"
Her tone was not one of questioning. It was pure shock.
Wu Fan had entered at some point without anyone noticing, and he stood at the doorway, having seen the entire process.
"Holy shit." That was Wu Fan's assessment. Concise and clear.
Meng Yan was also there. The way she looked at Lu Chen had changed from initial appreciation to an expression bordering on awe.
Shen Xiaoning stood where she was, her hand still gripping the operation panel of the ultrasound device, her entire being stunned.
She knew Lu Chen was very capable. But she hadn't expected him to be capable to this extent.
At the moment when everyone thought something terrible was about to happen, he stepped up. One needle. Four seconds. He pulled a person back from the brink of death.
After securing the drainage needle in the main cavity, Director Li Sen straightened his body. He looked at Lu Chen. He was silent for two or three seconds.
"You said you've observed ultrasound-guided Puncture a few times?"
"Yes."
"You can perform a procedure at this level after just a few observations?"
"Maybe I just have a knack for it."
The corners of Director Li Sen's mouth twitched. Talent. He had been practicing medicine for over twenty years and had seen countless gifted young doctors. But none could reach the level of Lu Chen.
That Puncture just now. From window identification to needle insertion to completing the drainage. The ultrasound image interpretation ability, spatial judgment, needle feel, and timing control displayed throughout the entire process. Each item was not at the level a Resident Physician should possess. Not even at the level an Attending Physician should have. That was an operational capability above the associate senior level.
"You kid." Director Li Sen finally said only these three words. But the approval in his tone was heavier than any words of praise.
Lu Chen did not reply. He was cleaning up the instruments after the Puncture. He threw the used needle into the sharps container, removed the sterile drape, and wiped the ultrasound probe clean before returning it to its place.
Zhao Yaqin was nearby, issuing follow-up medical orders for the patient. Monitor ECG, monitor blood pressure, repeat ultrasound, and check the pericardial effusion for routine, biochemical, and cytological analysis. They needed to figure out exactly what caused the pericardial effusion.
"Contact the Cardiology Department for a consultation. After the patient's condition is stable, transfer them to the Cardiology Department for further treatment." Director Li Sen gave the instruction.
"Okay." Zhao Yaqin nodded.
"Lu Chen, come out with me." Lu Chen followed Director Li Sen out of the Resuscitation Room.
In the hallway, the family members were still waiting. Seeing Director Li Sen come out, Zhou Desheng's wife was the first to rush up.
"Director Li! How is my husband!"
"He is out of danger. The fluid in the pericardium has been drained, and his heart function is recovering."
"Really? That's great! That's great!" The woman burst into tears immediately. The group behind her also let out a sigh of relief, speaking words of gratitude in a cacophony of voices.
"Thank you, Director Li!" "Director Li is truly a miracle doctor!" "Director, thank you so much for this time!"
Director Li Sen waved his hand. "Don't thank me; the most critical step just now wasn't done by me." He stepped aside, revealing Lu Chen behind him. "It was completed by this Dr. Lu Chen."
Everyone's gaze turned to Lu Chen simultaneously. Zhou Desheng's wife was stunned. She looked Lu Chen up and down. A twenty-four-year-old face. The ID badge hanging on his white coat read Resident Physician. So young?
"When your husband had a sudden emergency, this Dr. Lu independently completed an extremely high-difficulty ultrasound-guided Pericardiocentesis and drainage procedure, pulling your husband directly back from the edge of cardiac arrest."
The woman froze for a second. Then she rushed directly in front of Lu Chen.
"Dr. Lu! Thank you! Thank you so, so much!" She could no longer hold back her emotions, wiping away tears as she spoke. "You saved my husband's life!"
Lu Chen took half a step back. "Ma'am, this is our duty, please don't be so formal."
"No, no, I must thank you! Your name is Lu Chen, right? I'll remember it!"
The group behind also surged forward. "Dr. Lu, thank you for your hard work!" "So young and already so capable!" "This is the strength of our Jiangcheng Central Hospital!"
Among them, that Dr. Fang who had followed earlier was now standing behind the crowd, his expression somewhat complex. He had just seen everything that happened in the Resuscitation Room through the window outside.
He had been a cardiologist for fifteen years. He had done Pericardiocentesis. But that kind of procedure, precisely inserting the needle from the apex of the heart during the window period of the respiratory cycle in loculated effusion, he couldn't do.
Never mind that he couldn't do it, most of the cardiology experts he knew couldn't do it either. This young Resident Physician, who looked only about twenty years old. What on earth is his background?