February 13, 2022 A story about PIC memories I think the last one about when to install PIC or infusion ports should have been written very clearly, no longer explained to see no

February 13, 2022 A story about PIC memories

I think the last one about when to install PICC or infusion ports should have been written very clearly, and the advice not to explain the incomprehensible should be read twice.

Speaking of PICC, it reminds me of what used to happen before, to write down the right record.

Sometimes, doctors will meet patients who do not cooperate for various reasons, and doctors need to find ways to solve them.

This is estimated to be 10 years ago, there was a breast cancer patient, about 50 years old, who needed postoperative chemotherapy, the use of epirubicin, vascular conditions are not good, which should obviously be catheterized, such as PICC.

The problem is that the patient adamantly refuses to catheterize and asks for direct intravenous infusion of chemotherapy drugs.

I can only advise: big mother, the standard chemotherapy you use contains epihrubicin, which is harmful to blood vessels and tissues, your blood vessels are difficult to find, the risk of direct infusion is too large, and it is really necessary to do PICC. In fact, it is not painful at all, although there is a risk of blood clots and infections, but it is very small, our technology is also very good, don't worry.

The patient disagrees: this is too troublesome, affects my activities, affects the bath, is inconvenient, I do not dry.

I continued to advise: Big lady, what to do in case of exudation, if the exudate is too much, the skin of the hand may appear obviously broken.

The patient does not agree: then you give me a way.

I advise again: then you should consider changing a chemotherapy plan and choosing other chemotherapy drugs, but the efficacy is a little worse.

Patients disagree even more: where can this work, I want this best plan, I can hold it, it's okay, you will give me a needle.

Repeated persuasion is ineffective. That's when the doctor makes a big move, which used to be very effective. Call the patient's husband and daughter to the side, know it with affection, move it with reason, and let them persuade the patient. Who knows that they have a bitter smile: saying that it is impossible, it will certainly not be persuaded, and it will be scolded, and the patient's family status is the highest, saying one thing is not the same. That road doesn't work either.

There is no way, can only ask the patient and family to sign, indicating that they have been told that PICC should be done, but the patient himself does not agree, requires intravenous infusion, and bears the responsibility. The patient signed it and asked for an infusion.

On the day of the infusion, the nurse and I were nervous, afraid that something would go wrong. The nurse carefully operated, repeatedly instructing the patient's family to keep a close eye on the back of the infusion hand, and once there was exudation, it must be reported as soon as possible. Fortunately, the patient completed the treatment.

(Tip, even if the blister, epihrubicin instructions are also written to recommend the central vein, that is, PICC or infusion port and other infusions, is not mandatory, that is, even this drug, the doctor does not have the right to force the patient to do PICC and then infusion)

The story ends.

I had never thought of it before that there was another threat: if you didn't do PIC, I wouldn't treat you. The doctor's duty is to find a way to save the patient's life, and if the patient is not willing to cooperate with the unwanted operation, he threatens not to give standard treatment, which is actually harming the patient in disguise, which is obviously wrong. I didn't dare to threaten this patient, I was bound to be complained about, and I still had to continue treatment, because it was my responsibility.

Of course, forced PICC installation is not a big deal, and there are too many things worse than this nature in oncology medical treatment.