Chapter 44 (2/2)
“Yes!” the nurses replied.
The position was easy, the objective clear. It was not a difficult task.
Gloves went on his hand, a needle at the ready. Once the insertion point was located, Zheng Ren began the procedure.
He did not follow the textbook protocol of subclavian vein catheterization—puncturing one to two centimeters below the midshaft of the clavicle, with the needle angled horizontally and pointed in the direction of the sternoclavicular joint.
Instead, he chose the infraclavicular block as the insertion point, which was below the clavicle and lateral to the midclavicular line.
The nurses had seen subclavian vein insertions before, but the situations had not been as dire and the patients did not have such low blood pressure readings.
Had Zheng Ren lost his senses? Why did he pick the wrong insertion point?
In the midst of the chaos, they did not manage to warn him. Zheng Ren’s hands were steady and quick, and the nurses could only watch as he pressed his left hand on the patient’s chest.
He pressed down onto the skin with his left thumb until it was level with the costoclavicular ligament and marked the point, then removed his thumb and proceeded to puncture the skin there.
All this was curated from thousands of books’ worth of literature regarding subclavian venipuncture and hands-on practice from the System’s intensive training.
During training, all the simulation mannequins had been positioned in the correct way. At first, Zheng Ren completed the procedure in three minutes, which was a bit slow. Toward the end, he could finish with one simulation mannequin in under a minute.
He used 234.6 minutes in the System training to complete 452 venipunctures.
This number might have been lower than some doctors from the emergency departments and intensive care units of larger hospitals, but Zheng Ren had completed them in one go. All the simulations were high-difficulty patients with low blood pressure and low blood volume.
Challenges came with great rewards. Zheng Ren’s phlebotomy skills could be considered among the best in the country.
No one would get the chance to perform hundreds over high-difficulty venipunctures. Only the System could provide such opportunities.
Blood flowed on the first attempt!
It was not standard procedure but the results were evident. The seasoned nurses around Zheng Ren were stunned.
This kind of high-difficulty venipuncture usually took at least five minutes. It involved multiple punctures and maneuvers to find the vein, seemingly dependent on luck. Five minutes to get into the vein was for experts.
Yet, how long did Chief Zheng take? Excluding the time it took to position the patient, it had been only two minutes. No, not even two minutes, one minute…or less. In the blink of an eye, venous blood was seen to flow out.
“Fix an IV line and administer the methylene blue.” Zheng Ren held the catheter and raised his voice when he saw no one following up with the next step.
He could not shout as his throat was totally wrecked. The previous panic-induced a release of epinephrine and dopamine in his body, keeping him in an excitatory state.
“Oh! Oh! Oh!” The nurses around Zheng Ren woke from their stupor, took the venous catheter and connected it to the infusion tube.
“Maximum flow rate. Once the infusion is done, continue with the glucose solution. Then, perform a gastric lavage,” Zheng Ren instructed.
“Yes!” replied the seasoned nurses in unison. They were from other departments but had been rea.s.signed to face the emergency.
He allowed the nurses to administer the treatment and went to position the other patients.
Zheng Ren took the needle and thread from the catheterization kit and started to secure the subclavian vein catheter.
He moved without delay as if under an army general’s command.
Once the st.i.tches were done, he watched the glucose and methylene blue solution drip in the drip chamber. Only then was he rea.s.sured.
The next patient was already positioned for the procedure. Zheng Ren took off his gloves and rubbed his hands with an alcohol-based sanitizer. He opened the catheterization kit, put on a new pair of sterile gloves, and got to work.
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