Chapter 297 This Is What Teacher Chen Said!

"Let me tell you, Chen Cang's speech is very good. I've heard others talk about thoracentesis before, but it's far worse than Chen Cang!"

"The most important thing is to look good!"

"Is it really that exaggerated?"

"It's more exaggerated than this. Yesterday, more than a dozen or 20 people asked questions, but we didn't ask anyone else. We can do anything! I think Chen Cang is a genius when it comes to thoracentesis!"

"I'm obedient, Chen Cang doesn't have a match yet!"

"They are the establishment of the Second Provincial Academy. Now they are sent to graduate school. They are handsome, the unit is good, and the people are not bad. Come on!"

...

A few little girls from regular training had a great time chatting. In fact, they are not here for the training today. They just came over and continued to listen to it again. There are so many people coming to the class!

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

Now, being a doctor requires a regulated training certificate, which is as important as the qualification of a practicing doctor. Without a regulated training certificate, there is no way to advance to the intermediate professional title.

To put it bluntly, if you don't have a regulatory training certificate, you can't be evaluated as an attending doctor.

So many people came to participate in the training.

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

Among the ten people, there were seven girls and three boys.

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

...

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

This man... the oil head wants to cover up the reality of baldness, the new white clothes wants to stop the bulging belly, looks very greasy...

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

This person should be... 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. Where is Chen Cang?"

Several people reluctantly signed the signature, and looked at Shi Qi curiously.

Come here, can't you go?

Seeing that everyone was coming, Shi Qi opened the ppt with a smile, and put on a smile like Wu Yanzu: "Well, welcome everyone to the Second Provincial Hospital, I'm Shi Qi, and today I'm here to tell you about the operation of thoracentesis. and precautions."

"Perhaps you don't know me very well, but after a long time, you will become familiar with me. I used to be the director of the thoracic surgery department of our hospital, and it has been reformed since then. I went to the breast surgery department, so when it comes to the explanation of thoracentesis, I feel that the Second Provincial Hospital I should be the most suitable, right?"

Having said this, Shi Qi smiled humorously to himself.

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

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

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

Shi Qi is now going to become the director of the training center, because the breast department, the old director does not retire, he can't go there at all, and... clinical, he doesn't really want to do it now.

Three years as the director of the Department of Thoracic Surgery, and three years as a salted fish, where did you have to live such a hard life?

Being a director of the training center, taking care of hundreds of students, is quite comfortable.

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

Everyone can hear it.

However, those who listened to Chen Cang's explanation yesterday suddenly felt a little unsatisfactory.

There is no difference without comparison. Sometimes, the level of clinical doctors can be seen from the explanation of things.

However, thinking that he was the original director outside the chest, everyone still felt that he should be quite competent, maybe he was just not good at explaining it.

So he listened patiently, and after speaking, Shi Qi looked at everyone: "Is there any problem?"

At this time, a person asked: "Mr. Shi, the 2010 British Thoracic Association's pleural disease guidelines pointed out that for malignant pleural fluid, the amount of fluid for therapeutic thoracentesis should be determined according to the symptoms of the patient at the time. The volume of liquid should not exceed 1500ml, and what you just said is not more than 700ml for the first time, and no more than 1000ml in the future, while the Concord Respiratory Medicine believes that it should not exceed 600ml for the first time, and should not exceed 1000ml in the future. The domestic volume for the first time is more conservative. why?"

Out of this question!

Most of the people present were blinded!

This question is so stupid!

Sounds like a master!

Because the 5, 6, 7 and 8 editions of Internal Medicine wrote that the number should not exceed 700 for the first time, and it will not exceed 1000 in the future, but it seems that no one really asked this question why!

Shi Qi was stunned for a moment. This question was a good question. He pointed to a girl in front of him and asked, "What do you think about this question?"

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

As soon as these words came out, everyone around was dumbfounded, and then they burst into laughter.

And Shi Qi also smiled and said, "Because too much fluid is drawn too quickly, recruitable pulmonary edema will occur, so we are relatively more conservative than abroad."

The girl was stunned: "Then you won't be afraid of 1500 for the first time abroad? Is the difference between our domestic and foreign countries because of our conservative ideas?"

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

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 volume of an adult male is 5000ml, of which the vital capacity is 3500ml + the residual capacity is 1500ml. Based on this, we speculate that the volume of the thoracic cavity should also be about 5000ml, then the unilateral chest cavity is about 2500ml.

For a patient with a large amount of pleural effusion, we can withdraw 1000ml unilaterally at one time, 2/5 of the volume, which is quite a lot. If 1500ml (unilateral) is withdrawn at one time, it is 3/5 of the unilateral chest cavity capacity, which is basically It is an insurmountable gulf. "

"Evidence-based medical statistics show that it is an indisputable fact that Europeans and Americans are taller, and their thoracic volume is also larger than ours, so it is understandable that their single pumping volume is larger than ours."

"The true meaning of the guidelines is not to emphasize this value, but a critical value. In fact, in clinical practice, this "700ml, 1000ml" cannot be static, because each patient's age, body shape, and condition are different. It’s not the same, we can’t use these two numbers, it’s more important to observe the patient’s condition at any time, and the same is true in foreign countries. The guideline is a relatively wide range, as every doctor, you should observe the patient at any time and adjust the dosage.”

The girl's voice was not loud, but it made everyone in the audience quiet.

These remarks were thorough and clear, and the meaning of the chest piercing fluid extraction value was explained at once, and the audience instantly understood, and suddenly there was a sense of sudden realization.

I see!

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

Shi Qi couldn't help but ask: "This classmate, you said it well! You understand it very well."

The girl didn't actually want to say anything, but she couldn't help but say it, and naturally she didn't expect such a big response. Seeing the people around her, they all looked at her with a blank expression, and she blushed suddenly.

"Actually... this is not what I said, this is what Teacher Chen said." The girl said embarrassedly, and then pointed to the classmates beside her, "You ask them, they also know!"

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

Everyone was dumbfounded!

Who is Teacher Chen?

That teacher Chen?

Even Shi Qi was at a loss, who is Teacher Chen? So familiar.