My medical skills add experience

Chapter 176 Slow, it will kill people.rescue

It may be difficult for patients and their families to tell whether a doctor has real skills.

But for doctors, everyone is an expert, and they can infer the other party's strength with just a little contact.

Zhou Can's slightly revealed strength has already made Dr. Long, the chief surgeon, look at him with admiration.

Never dare to treat him as an ordinary Pearson again.

"I dare not say 100%, at least [-]% sure. If you want to be [-]% sure, you can push the endoscope over and find out."

Zhou Can didn't dare to speak too harshly.

It's always good to have some leeway in anything.

Using an endoscope to detect unknown conditions in the chest cavity and cranial cavity is definitely much safer than directly opening a large surgical window.

The temporary addition of endoscopy items during the operation means that the cost will increase.

Endoscopy is divided into many types, electronic colonoscopy, enteroscopy, capsule endoscopy, fiberoptic bronchoscopy and so on.Among them, the most expensive examination is capsule endoscopy.

Also, the proposal proposed by Zhou Can is also breaking the rules.

In the case of thoracotomy, the use of endoscopy is still needed, which can easily arouse family members' doubts.

Doctor Long hesitated, thinking about the feasibility of Zhou Can's suggestion.

"If the bleeding point is really under this rib, I am afraid that this rib needs to be removed to complete the hemostasis operation. Endoscopic examination is both efficient and foolproof."

Zhou Can watched the patient's blood pressure drop rapidly, and was really worried for Dr. Long.

An indecisive character is actually not suitable for being a surgeon.

Because the situation is changing rapidly during the operation, any danger or emergency may happen.

Saving the patient's life may only be a golden hour or two.It has been delayed for a long time, and when you think of a perfect solution, I'm sorry, the patient can't wait to leave first.

I believe that when the patient reaches heaven, he will definitely complain in his heart. It is really bad luck for eight lifetimes. We just met such a slow-moving doctor.

"Check the endoscopy immediately!"

Under Zhou Can's persuasion, Dr. Long finally stopped being a mother-in-law and made the decision he should have.

The two assistants watched all this with extremely complicated emotions.

It's ridiculous that the main knife was directed by a Gui Peisheng to move forward.

Moreover, the two also felt that it was right for the chief surgeon to follow the advice of Gui Peisheng.

The endoscope is pushed over.

After turning on the machine, after a series of preparations, he quickly checked for bleeding in the chest cavity.

Dr. Long's technique of operating the endoscope is obviously immature.

Compared with Zhou Can, it is far behind.

Like a baby toddler, he manipulated the probe of the endoscope to explore carefully in the chest cavity.

Zhou Can looked depressed again.

Fortunately, this patient's life is hard, otherwise he would have stopped working early.

"The bleeding point should be in this section!"

In desperation, Zhou Can had no choice but to help Dr. Long narrow down the scope of investigation again.

Dr. Long must not lose face.

However, the patient's life was already hanging on the edge of the cliff, and Dr. Long's nerves were highly tense. At this time, Zhou Can pointed out the specific bleeding range for him, like a bright light, guiding him the way forward.

He carefully operated the endoscope to move slowly, approaching the target position.

There are many important organs in the chest cavity, such as the liver, heart, and lungs, and any injury to any organ may cause irreparable consequences.He has a reason to be so careful.

It's not entirely because of technical dishes.

"Shh!"

A red screen appeared on the screen.

It looks like blood is raining down on the endoscopic probe.

Dr. Long couldn't help being overjoyed, "I found it, I found it! The bleeding point is here!"

The other doctors and nurses breathed a sigh of relief, with relieved smiles on their faces.

Only Zhou Can was relatively indifferent to this result.

Because he had been diagnosed a long time ago, the current endoscopic examination is just to reassure the chief surgeon, Dr. Long.

"The broken blood vessel seems to be quite serious, and I'm afraid it needs to be re-stitched."

Zhou Can stared at the endoscope screen, and after seeing it, he made a treatment plan in his heart.

This blood vessel is so thick, the area it supports must not be small.

Direct and rough ligation to stop bleeding, even if there is no ischemic necrosis in the area it feeds, it will be severely malnourished.

It is equivalent to cutting off one of the important main roots of a tree, which will definitely affect the growth of the tree.

In fact, the human body is more complex and much more fragile than a tree.

In terms of the tenacity of life, plants are more than ten times stronger than humans.

"Damn it, if I knew the bleeding point was here and I needed to remove this rib, I shouldn't have cut it here." Dr. Long scolded his mother while standardizing the bleeding point.

Then the incision was rapidly enlarged, and the ribs were sawed off.

It's not as easy as you think to take this rib. It's a delicate job to separate the rib from the surrounding tissue.

Dr. Long's separation technique barely touches the threshold of attending treatment, and in fact has not yet reached the level of attending treatment.

Seeing him slowly and carefully separating the surrounding tissues, Zhou Can became anxious again.

Even if autologous blood is reinfused, it will take time.

It is even more impossible to input back infinitely.

If the bleeding is not stopped in time, the patient will become more and more dangerous.The risk of postoperative complications also increases significantly.

The human blood system is very wonderful.For example, in patients with high blood pressure, many people who do not understand medicine will naively think that high blood pressure means that there is too much blood in the blood vessels?
If you cut a wound on the patient and bleed some of the blood, wouldn't it return to normal?
If you encounter a doctor who advocates this treatment method during treatment, don't hesitate to call the police immediately.Nine times out of ten, he is a charlatan, a fake genius doctor.

The blood of the human body accounts for about 8% of the body weight.

A 100-jin adult has about 4000 milliliters of blood.If it is a fat man weighing 200 pounds, it is not surprising that there are 8000 milliliters of blood in his body.

The normal blood volume of most adults is around five or six thousand milliliters.

Take an adult with 4000 ml of blood as an example, the blood that really participates in the circulation in his body is actually only about 70%, and at most it will not exceed 80%.

The remaining 30% of blood will be stored in various tissue cells in the body.

When our body is injured, it loses 500ml of blood.Do you think the blood in the blood vessels will decrease because of this?

will not.

When the body's blood system detects that the blood in the blood vessels has decreased, it will quickly mobilize body fluids to replenish it.

Most of our human body is water.

The water content of newborns may even be as high as 80%, and that of adults is lower, around 60%.

Therefore, in theory, even if the body loses 4000 ml of blood, if this process is not in a very short period of time.Our body can replenish the lost blood and maintain it at 4000 ml.

Of course, after all, it is supplemented by body fluids, the total amount of blood has not changed, but the concentration of blood has been diluted.

There will definitely be problems with the body.

Red blood cells, white blood cells and platelets, albumin, globulin, coagulation factors, electrolytes, these trace elements are lost, and body fluids cannot quickly replenish them.

This disrupts the entire circulatory system of the body.

The consequences are dire.

Theoretically speaking, donating about 200ml of blood each time is not harmful to the body, but beneficial.Donating more than 400ml of blood at a time may cause certain harm to the body.

Frequent blood donation in a short period of time is also harmful.

According to scientific judgment, it is harmless for adults to donate blood every six months or so.

The patient on the operating table had been bleeding profusely, and he had already bleed a lot. The situation was actually quite dangerous.

Dr. Long must have realized this too. When he was separating the tissue around the ribs, his forehead was constantly sweating.

As time passed, even if Zhou Can had the ability to do better and faster than Dr. Long.

But the identity of Gui Pei and the newcomer determines that he can only stand still and wait for the opportunity quietly.

Show off in front of a superior doctor unless approved by that superior doctor.Otherwise, you will find trouble yourself.

"The patient is dying! How long will it take to stop the bleeding?"

Doctor Guan has remained silent.

Seeing the patient's vital signs getting weaker and weaker, like an oil lamp about to go out, Doctor Guan was really anxious.

"It's too difficult to separate this cut rib from the surrounding tissue, and I'm afraid it will damage important blood vessels and nerves. Doctor Guan will find a way to hold it for a while."

The surgeon and the anesthesiologist are like comrades fighting side by side.

One person is responsible for cover and one person is responsible for charge.

"Ask the blood center again, can you still get two bags of plasma?"

Doctor Guan said to the patrolling nurse.

"I'll ask right away!"

The nurse called to urge the plasma to go.

Sometimes when encountering some rare blood types, there is really not much plasma in stock.

This is still a top-tier provincial hospital like Tuya. If it were a small hospital, they would have already called around to find someone to borrow it.

After about a minute or so, Dr. Long's expression became extremely solemn, and his movements almost completely stopped.

Seeing this, Dr. Long almost stomped his feet in a hurry.

The doctors and nurses next to him saw that their hearts were also tense.

The chief doctor, Dr. Long, seems to have encountered a problem.

If it is normal, it doesn't matter if the operation is done slowly.

Because slow work leads to careful work.

But right now, the patient has a massive chest hemorrhage, time is life, and I'm afraid the patient can't afford it.

The doctors and nurses didn't even dare to vent their breath, hoping that Dr. Long could quickly overcome the difficulties in the operation.

"Damn it, the more you are afraid of something, the more you will come. The blood vessels and nerves are dense here, and the separation is too difficult. I can definitely do it successfully when I separate slowly. Now the pressure is huge, my heart is nervous, and I can't perform at my level. I'm afraid it's just I can ask Director Hu for help now."

Dr. Long scolded his mother while asking himself to go down the stairs.

A plausible explanation was given.

Director Hu Kan is the Ding Haishen needle in the hearts of all doctors in the Department of Cardiothoracic Surgery.

When encountering uncertainties during the operation, the first thing to do is to ask Director Hu Kan for help.

Known as "the most stable scalpel", it has never disappointed the doctors of cardiothoracic surgery.

"Director Hu was invited by the Department of Obstetrics and Gynecology to preside over a joint operation. I'm afraid there is no way to rush over now." The surgical nurse said.

This news made Dr. Long feel as if he had fallen into an ice cellar.

A heart also sank straight down.

The better surgeons in cardiothoracic surgery have all inherited Director Hu Kan's "steady knife" feature.

While pursuing stability, it is unavoidable that the surgical process will slow down.

There are no perfect people and things in the world.

Where there are advantages, there must be disadvantages.

"I remember that Dr. Zhou seemed to do a good job of separating."

At this critical juncture, Doctor Guan spoke again.

Everyone looked at Zhou Can again. What is the origin of this punished Gui Peisheng?
The anesthesiologist seemed to be very optimistic about him.

Dissection is recognized as one of the most difficult surgical techniques to achieve.

Incision and suture are just general surgical techniques, but separation is classified as advanced medical technique.

Not many doctors can practice it well.

"It would be a good chance for him to get a chance to sew the skin once for Gui Peisheng. He did a good job of separating important tissues, blood vessels, and nerves?"

Doctor Long was full of disbelief.

It's just that if this Gui Peisheng can successfully and safely separate the most difficult part of the rib, I will twist his head off and use it as a chamber pot.

"I saw with my own eyes that he successfully completed the difficult separation of nerves and blood vessels in third- and fourth-level operations. Even near the brainstem, he was competent. Do you think he has the strength?"

Doctor Guan never pushed Zhou Can out, it was to take care of Dr. Long's face.

Now that the operation has encountered a major setback, if Zhou Can is not allowed to take action, the patient will have a huge risk of death.

So he didn't dare to procrastinate any longer.

"Doctor officer, you can't trick me!"

Dr. Long was a little dubious.

"It's as if something happened to the patient, so it has nothing to do with me! Let him go now, or it will be too late."

Doctor Guan rolled his eyes.

In his capacity, does he need to lie?

Besides, life is at stake in this matter, who dares to play tricks?
"Young man, don't be dazed, come here quickly. You first separate the tissue that is attached to the ribs and show me." Dr. Long gritted his teeth and decided to let Zhou Can try it.

This decision is ridiculous.

It would be unimaginable if it was changed in normal times.

Zhou Can stepped forward, not talking nonsense, and asked the nurse to help put on the sterile gloves, took the scalpel, and began to separate directly.

Swipe!

After two cuts, Dr. Long's eyes were straightened.

Damn, this is not at the level of Gui Peisheng, it is not far behind the director's strength.

The expressions of other doctors and nurses were even more exaggerated.

I thought it was a rookie, but I didn't expect it to be a bronze.When they thought Zhou Can was at the bronze level, Zhou Can showed his king-level strength at a critical moment.

The shock it brought them was astonishing.

After seeing Zhou Can's stronger surgical ability, the surgical nurse couldn't help thinking of the last operation, the patient with a torn chest wall.

Zhou Can made it clear at the time that the patient was prone to large areas of ischemic necrosis.

Neither Dr. Duan nor Dr. Zhao listened to him.

Doctor Zhao was so angry that he punished Zhou Can to stay here and clean the operating room.

She couldn't help feeling worried for the patient.Now it seems that the level of doctors Duan and Zhao is probably not as good as that of Zhou Can, so they failed to find the problem.

At that time, if something happened to the patient, doctors Duan and Zhao would regret it.

Because that's medical malpractice.

The doctors involved should be held accountable.

"Go on, go on! It's been a long time, so powerful, how could it be just a regular training?"

Dr. Long didn't care about face or face at all.

After seeing Zhou Can's separation ability, all that's left is worship and respect.

Many people think that respecting strength is only applicable to the environment of the law of the jungle. In fact, in society, those with strength are often more likely to be respected and worshiped by colleagues.

Zhou Can is also not polite, because the patient's condition is critical.

With a few knives in his hand, the tissue part that Dr. Long regarded as a "major difficulty" was easily separated by Zhou Can.

After the ribs were removed, Zhou Can glanced at the bleeding blood vessels.

A thick artery.

Blood was still gurgling out.

"Needle holder, 7-gauge wire. Pointed forceps."

Zhou Can said to the nurse.

When the surgical nurse looked at him now, many little stars appeared in her eyes.

Without saying a word, he followed Zhou Can's instructions and handed over the required equipment.

Doctor Long didn't intend to stop it either.

After seeing Zhou Can's amazing knife skills and superb separation skills, Dr. Long knew that there was a huge gap between the two.

He wants to see what Zhou Can will do next?
Such a thick thread is definitely not anastomotic.

The sutures used in the operation are generally 1, 4, and 7 sizes.

The larger the number, the bolder it is.

Zhou Can directly ligated the proximal end of the ruptured artery after taking the thread.The whole movement is smooth and flowing, as simple as drinking water and eating.

It seems to be a "frivolous" operation, but the effect of ligation is very good.

Not loose or tight, just to strangle the blood vessels and prevent blood from flowing out.

Moreover, the pulling on the surrounding tissues during knotting is almost negligible.

Zhou Can's separation skills are so good, they may not be able to see the depth because their own separation skills are too poor.All I know is that Zhou Can's separation technique is more powerful than Dr. Long's.

Suturing and knotting is a basic skill that every surgeon must learn.

Knotting and sewing are usually practiced the most.

Surgery, it’s all about making up for it.

The lesion was excised, and the wound was sutured.

So once you have practiced suturing, you can use it anytime.In addition, knotting and suturing can be practiced with a variety of props. Compared with other medical skills, they generally have a higher level.

They think that the level of knotting is already very good.

In the end, when they compared with Zhou Can, they realized how big the gap was.

The highest state of any surgical technique is not how gorgeous the operation is, let alone how neat the incision is, nor is it that the stitches are arranged exactly like a computer printout.

But just right, just right is the highest state.

If it is too much, it is not as good as it is, and if it is worse, it is worse.

Just right is the highest state.

Whether it is the part of the ligation, the tightness of the knot, or the strength of the pulling, Zhou Can is just right.This kind of operation effect is the ideal state pursued by doctors, and the damage to the patient is minimal after the operation.

(End of this chapter)