An 83-year-old man was "swollen" by gas all over his body, and ultrasound guidance opened a "life channel" for him

Obesity, long-term infusion, severe edema, repeated chemotherapy...these factors make the veins of some patients fragile and difficult to find.

Recently, a peripherally inserted central catheter (PICC) was successfully inserted in the third ward of the Respiratory Department (Respiratory ICU) of Hunan Provincial People's Hospital for a patient with extensive subcutaneous emphysema.

Grandpa Zou, 83, who lives in Anhua County, was in a critical condition because of massive left-sided pneumothorax and extensive subcutaneous emphysema from head to toe. He needed immediate intravenous access for fluid infusion and anti-infection treatment. However, conventional venous puncture was not possible. His body was like a blown-up balloon, and it was difficult to find any blood vessels.

Since ultrasound cannot penetrate gas, ultrasound-guided puncture of blood vessels encountered unprecedented challenges. After discussion, Cao Jun, the deputy chief physician in charge of the bed, and his team decided to perform venous puncture while exhausting gas and searching for a cannulated blood vessel under ultrasound.

After Wang Fen, deputy chief nurse from the intravenous treatment committee, performed an ultrasound assessment of the patient's vascular condition, it was discovered that his entire body was filled with subcutaneous gas and no blood vessels could be found.

However, with superb skills and rich clinical experience, after repeatedly expelling the subcutaneous gas and exploring the location of the blood vessels under ultrasound, he finally successfully implemented PICC for Grandpa Zou.

"Patients with systemic subcutaneous emphysema like this are still very rare, and it is not easy to successfully insert a PICC." Deputy Chief Nurse Wang Fen said that ultrasound-guided intravenous catheterization not only improves the success rate of puncture, but also shortens the puncture time, reduces pain and anxiety for patients, improves operational safety, and reduces the risk of complications.

The application of difficult peripheral venous puncture and catheterization under ultrasound guidance in critical care is becoming more and more widespread, which solves the nursing difficulties of difficult peripheral venous puncture in existing work and opens up a life channel for the venous access of special patients.

Hunan Medical Chat Special Author: Xie Yanzhi and Zeng Juanli, Department of Respiratory Medicine, Hunan Provincial People's Hospital

Follow @湖南医聊 to get more health science information!

(Edited by YT)