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Chapter 244 Acting Bravely in the Righteous Way (Part [-])
By the time the pre-hospital emergency doctor on the ambulance jumped out of the car and rushed to the conference room, Li Fengmin's operation had basically come to an end.

Dr. Chen first clamped the distal end of Li Fengmin's external iliac vein with his left index finger and middle finger, and with the assistance of a tourniquet at the root of his thigh, he completed a vein blocking hemostasis without a hemostat.Then he carefully pasted the hemostatic patch that Hu Jia had cut on the vertically torn part of the external iliac vein.It’s like putting a rubber patch on a punctured bicycle tire, except you don’t have to apply any weird adhesive to the interface between the patch and the blood vessel, and you don’t have to pre-sand the outside of the blood vessel that needs to be repaired.

According to the operation requirements of Takeda TachoSil patch, Dr. Chen put his hands in Li Fengmin's stomach and has not let go. According to the instructions, after the patch comes into contact with blood, it takes about 1 minutes from the activation of the coagulation substance to the coagulation substance enough to stick the patch. [-] minute of time.At the scene, there were not enough conditions for Dr. Chen to judge with the naked eye when the surgical field was sufficient, so just to be on the safe side, Dr. Chen simply stuffed both hands into Li Fengmin's stomach.The left hand pressed the patch on the damaged blood vessel and continued to apply pressure, while the right hand continued to maintain the posture of "blocking" the external iliac vein, only occasionally loosening the finger and then pinching it back immediately - this is to prevent the blockage. The clipping effect was so good that the patch didn't get enough blood to stick to the blood vessel.

Li Fengmin's situation is actually very dangerous. Bleeding exceeding 1500ml is undoubtedly the primary danger.If it is in a well-equipped operating room, about one-third of the hemoperitoneum that was collected by Dr. Chen with a curved plate can still be infused back into Li Fengmin's body after being recovered and purified by the corresponding equipment. Combined with plasma and crystalloid support, these risks can be overcome.

Not long after Dr. Chen announced that the patch was effective and the external iliac vein bleeding had been effectively stopped, the pre-hospital emergency doctor rushed into the conference room.Then he was frightened by the scene in front of him and ran out again, grabbing the first aid kit in his hand.

"Come back!" Doctor Chen waved his hand towards the door, dumbfounded, "Have you brought high-concentration sodium chloride injection or 706?"

706-generation plasma, that is, hydroxyethyl starch injection with a concentration of 6%, is a blood volume expansion solution commonly used in clinical practice.Usually, it is mainly used to reduce the need for blood transfusion during surgery, and emergency fluid replacement for burns and other situations.You know, there is definitely no blood transfusion device on the ambulance, and blood will not be prepared at the same time.As for Li Fengmin, who has already experienced symptoms of hemorrhagic shock, it is of course more conducive to his recovery later if he can expand his blood volume now - without plasma, some crystalloids and colloids are not bad.A certain amount of hyperosmotic crystalloid can mobilize the blood stored in the organs into the circulatory system, and the plasma substitute 706 can further increase the blood volume, which helps to ensure that there is enough fluid in Li Fengmin's circulatory system.This has positive implications for maintaining brain perfusion.

"Not in 706, but the sodium chloride injection has a concentration of 7.5%." The pre-hospital first aid was still in a two-way battle and almost wanted to go first, but when he heard the other party's tone, he felt that the cannibals on the stage were not feasting. But a group of colleagues are saving lives.

"It's okay, bring it first." Dr. Chen slowly pulled out his hands, and after waiting for a while, he turned the sigmoid colon, which was a little bit in the way, and relaxed a little after confirming that there was no other bleeding. "Don't worry about shutting down all of the abdominal cavity, but shutting down part of it. You may have to deal with it after you get to the hospital."

After the surgery is over, it's not as simple as sewing the belly on.Generally speaking, how to cut it has to be sewn back.After cutting the skin, fascia, and muscles, the muscles, fascia, and skin have to be stitched back one by one.And you can't just use one style technique to sew from beginning to end.Muscles need stronger sutures to prevent cracking during movement, and fascia needs stronger continuous seam stitches.According to different needs, different techniques and sutures of different thicknesses are used for suturing, which is an essential ability of a qualified surgeon.

And Dr. Chen, who dared to perform laparotomy and exploratory surgery in this environment, has naturally far exceeded the limit that the word "qualified" can express.With more than 35 years of surgical experience and years of experience in dealing with difficult and severe patients, he can subconsciously allocate all resources during the operation.And this kind of ability told him that under the current situation, it was impossible to complete a "qualified" "abdominal closure".

The sutures that Hu Jia found were prepackaged synthetic sutures with leather needles, but the models were only 4-0 and 0. The length of the 4-0 thread was only 45 cm, and the 0 thread was longer, but It is only 60CM.Not only is it not long enough to close the abdomen, but the thread is either too thick or too thin to be used at all.

And most importantly, this is not the operating room of the First Affiliated Hospital of Tongde Medical College in Yunhe City, and there is no surgical team that Chen Tianyang is used to.This is the meeting room of a five-star hotel in Sanya. Under the illumination of spotlights, Chen Tianyang can even see some hairy pollutants floating in the air.

Even if he closed his abdomen with the existing resources, after Li Fengmin was sent to the hospital in Sanya, the doctors here would still have to open his abdomen again for peritoneal lavage and disinfection.It's better to save a little effort, and connect the skin around the stomach with the No. 0 wire first, so as to save Comrade Li's intestines from accidentally dangling out when carrying it.

Sun Li'en diagnosed Li Fengmin's cause, while Chen Tianyang was the chief surgeon of the operation, and Hu Jia was the person in charge who provided the instruments during the operation.The three of them had to go to the hospital with the ambulance, while the other veteran experts who participated in the operation, led by the person in charge of the hotel, went to the bathroom to wash off the blood on their bodies.

"You guys are really brave." In the slightly crowded ambulance, the pre-hospital emergency doctor finally calmed down and said to the three people in front of him, "Without anesthesia and circulation support, you dare to perform laparotomy? "

"If you don't do this operation, he will die." Chen Tianyang was the chief surgeon, and he glared at the emergency doctor in front of the hospital very dissatisfied, "If you wait for your car to arrive at the place, Lao Li will have to fight even if he has blood transfusion support."

"But you are not afraid of postoperative infection if you perform surgery under that condition?" The pre-hospital doctor also knew that the patient's situation was urgent, but he always felt that the behavior of the three of them was a bit too much. "That place is not a hospital, so it must not be in line with the place where your medical license is registered, right? Even if you are all doctors, you might be held accountable for practicing medicine illegally."

"Infection after surgery? You have to die to be infected." Chen Tianyang spread his hands disdainfully, "As for the operation, anyway, I am the chief surgeon, even if the certificate is suspended, I will hang myself alone - and, who said that we are Practicing medicine?"

The emergency doctor in front of the hospital choked on the last rhetorical question.

"We are just a group of brave people with corresponding professional abilities." Chen Tianyang smiled cunningly, "Do you understand the courage to do justice?"

(End of this chapter)