Doctor's Life Simulator

Chapter 277 Arrangements Clearly

What happened next, apart from Wu Youtu and Qin Lang, the rest of the trainee doctors, Cai Qing, were completely ignored, neither able nor qualified to participate.

Especially Wu Youtu's trainee doctor, who was dismissed after being assigned some chores.

Instead, Cai Qing was greeted by Qin Lang, and went with him to perform the operation, gaining a lot of insight.

The trainee doctor, a little red-faced, watched Qin Lang lead a group of people away in a hurry. After they had gone far, he took out his mobile phone and googled the traumatic diaphragmatic hernia that Qin Lang just mentioned. :
".Traumatic diaphragmatic hernia is a kind of hernia formed by chest and abdominal trauma leading to rupture of the diaphragm, and the internal organs of the abdominal cavity protrude into the chest cavity through the diaphragm gap. It is often accompanied by severe compound injuries. The clinical manifestations are intricate and easy to be misdiagnosed. Delay in treatment can lead to incarceration, necrosis and perforation of the herniated abdominal organs, and in severe cases, the death of the patient!"

Looking at the introduction of this disease, the trainee doctor felt hairy all over his body. If he was in charge of this patient and only performed a simple chest cavity sealing and drainage, it would only further delay the patient's condition and possibly lead to the patient's death.

Thinking of this, the trainee doctor was afraid for a while. If it weren't for Dr. Qin's meticulous diagnosis today, the consequences would be disastrous.

"It seems that this doctor Qin is really good."

The trainee doctor's thoughts were flying. It seemed that in the future training, he really needed to change his attitude.

In the operating room, under the entry-level traumatic diaphragmatic hernia repair, although Qin Lang's operation is average, he is still able to handle the entire operation process and preoperative preparations with ease.

Before Director Zu Liang arrived, Qin Lang had already made arrangements in an orderly manner.

Due to the patient's difficulty in breathing, support has been given. At the same time, the patient is combined with burns, and active fluid rehydration, blood transfusion, anti-infection, and anti-shock treatment are performed simultaneously.

"Doctor Wu, assist me in placing a gastrointestinal decompression tube for the patient"

Under Qin Lang's leisurely arrangement, Wu Youtu was also determined, and proceeded step by step according to Qin Lang's arrangement.

Cai Qing, who was on the side, was also shocked when he saw Qin Lang controlling the rhythm of the entire operation and directing the senior attending physician.

No wonder, Director Tian and the two doctors Yang recommended and favored Dr. Qin so much, it is really amazing.

"Cai Qing, get ready, the final abdominal closure is up to you."

Qin Lang had already thought about the whole process, so he naturally arranged a little sweetness for his little assistant.

As a resident doctor, Cai Qing's basic skills are still good, but she did not expect that she would get the chance to get started so quickly, and it was still a surgery performed by the chief surgeon of the general surgery department.

My own teacher is really amazing, even the chief director of the general surgery department made arrangements clearly.

Cai Qing followed obediently and got ready.

After a while, Director Zu also entered the operating room. He was naturally very nervous and a little surprised when he heard about the patient's condition.

In fact, this symptom is very rare, especially when it is combined with burn symptoms, it is easy for doctors in the general surgery department to ignore it, let alone the doctors in the burn department.

Zu Liang, as the director of the general surgery department, is very clear that many physicians lack understanding of traumatic diaphragmatic hernia. In the case of a burn patient, it is difficult to ask for a detailed medical history, detailed physical examination, and it is easy to read the films. ignore.

The most important thing is that the condition of this disease is complex and its clinical manifestations are atypical, which can easily be covered up by other symptoms and signs.

Therefore, he was very shocked to hear that Qin Lang managed to find out the disease just by doing a simple ward round.

"This Qin Lang, when did you learn the diagnosis of diaphragmatic hernia?"

Zu Liang rushed over anxiously, preparing to make arrangements for the patient as soon as possible and prepare for the operation, but when he actually entered the operating room, he was completely stunned.

Because, Qin Lang has arranged everything that needs to be prepared in advance in an orderly manner.

Seeing Director Zu coming in, Qin Lang had arranged for Chen Wenhao to complete general anesthesia with endotracheal intubation, and even adjusted the patient's position to the best position.

Because different body positions correspond to different incision options, for example, the supine position is adopted for abdominal approach, the lateral position is adopted for transthoracic approach, and the oblique position is adopted for transthoracic combined approach.

"Director Zu, we've finished the preparations, and I'll leave it to you."

Qin Lang neatly handed over the position of the chief surgeon to Director Zu, turned around and arranged for Wu Youtu, and began to cooperate together.

Zu Liang nodded slightly. When was he in the general surgery department, he had such a satisfactory operation.

As soon as he stretched out his hand, Qin Lang had already handed over the scalpel to his hand, and Zu Liang directly began to make a midline incision on the left upper abdomen through the abdomen.

With Qin Lang's timely assistance, Zu Liang was like a fish in water, and successfully completed the detection of separation and adhesion. Fortunately, Qin Lang found it in time, and there was no necrosis or perforation of the abdominal organs, and only minor repairs were carried out.

Soon, Director Zu returned the abdominal viscera, and began to reveal the rupture of the diaphragm. Seeing the extremely small rupture, Director Zu was also slightly surprised. How did Qin Lang discover this? It is possible to miss the diagnosis, and there is a high probability that it will be discovered after thoracotomy in the later stage.

It's just that when the patient has emergency symptoms, the situation is different when it is discovered.

Many ruptures of the diaphragm, due to misdiagnosis, missed diagnosis, and delayed discovery, the edge of the tear shrinks, only widely dissociated, closed without tension, and even encounters difficulties in defect repair, and artificial materials or autologous tissue reconstruction is required, which will undoubtedly increase the cost of surgery. Difficulty, and the pain of the patient after the operation.

"so close."

Zu Liang's evaluation of Qin Lang was a little higher in his heart.

Next, Director Zu completed the short mattress suture of the rupture, and after he completed the first step, Qin Lang had already prepared the chest drainage tube in advance.

All movements are coordinated smoothly, and the next step is to receive the water and seal the bottle.

"The final closing is up to you."

Qin Lang gave Cai Qing an order, and of course Zu Liang and Wu Youtu had no objection to this.

After a close belly, Cai Qing still did it in a well-regulated manner, and in his heart, he admired his teacher Qin very much.

Young, good at technology, and willing to give yourself a chance to get started, this is perfect.

Thinking that before, those trainee doctors who were with him still felt sorry for him, Cai Qing raised his mouth slightly, his little teacher is amazing!
And when the operation was coming to an end, Wei Guoqiang also heard the sound and came to the operating room.

On the bed of the burn department, a patient was found to have a traumatic diaphragmatic hernia. Of course, he was very nervous, for fear of accidents.

However, when he entered the operating room, the entire operation had been perfectly completed.

Seeing Zu Liang, Qin Lang, Wu Youtu, and Cai Qing, before Wei Guoqiang asked, Zu Liang said something envious:
"Director Wei, you are really lucky to have discovered a young hero like Dr. Qin. This operation, traumatic diaphragmatic hernia repair, is a smooth and easy operation that I have done."

Wu Youtu was also on the side, and immediately reported the cause and effect of the entire operation to Wei Guoqiang.

Hearing that Qin Lang found out so keenly, even Zu Liang thought it was easy to miss the diagnosis of traumatic diaphragmatic hernia, Wei Guoqiang felt a little complicated.

There are too many people in the Qin Gallery.

"Qin Lang, you did a good job. Of course, I also want to thank Director Zu for his help."

Wei Guoqiang praised a few words, and walked out of the operating room with a few people.

After a few people pushed the patient into the ward again, several other trainee doctors who were still in the ward, You Daren, also came over.

"The operation was very successful. The patient was indeed a traumatic diaphragmatic hernia as judged by Dr. Qin."

Wu Youtu proudly shared the results with colleagues immediately.

"Really, Doctor Qin, how did you come up with this conclusion?"

They want to know how Qin Lang discovered the real cause of the patient, and listen to his analysis process.

Director Zu and Director Wei also pricked up their ears. They also wanted to know how Qin Lang deduced it.

After all, before, when the time was urgent, Qin Lang just said a few words, which made them not understand the seriousness. Until now, they are still in the fog.

As for sharing diagnosis experience, Qin Lang is still very happy. The entire treatment center can only go further if everyone becomes better. The medical field has always required the strength of a team. No matter how good a person is, he cannot go far. .

Seeing that Qin Lang was about to start an analysis, Cai Qing took out a small notebook and recorded it. Looking at Qin Lang surrounded by a group of senior doctors, he is really handsome.

". The characteristics of X-ray diagnosis of traumatic diaphragmatic hernia are: one side of the diaphragm is raised, the diaphragm surface is not clearly displayed, and dense shadows or air bubbles appear above it, and the mediastinum moves to the healthy side. The characteristics of CT diagnosis of traumatic diaphragmatic hernia are: diaphragm Disappeared, part or all of the diaphragm surface was unclear, and the false diaphragm surface was elevated, air-liquid level or gastric bubbles could be seen in the chest cavity, and the mediastinum shifted to the healthy side”

Listening to Qin Lang talking eloquently and gracefully, everyone was in admiration.

Even Wei Guoqiang and Zu Liang gained something from Qin Lang's knowledge.

(End of this chapter)