My medical skills add experience

Chapter 186 Accidents happen frequently and difficulties abound.The director got a heart attack
The thymus itself is very close to the heart. After a tumor occurred in this patient's thymus, it has directly occupied part of the pericardium.

The injured artery is now blocked by direct ligation.

It is equivalent to cutting off the blood supply along the way.

The entire blood supply system of the human body is very delicate.Especially the blood vessels in the chest cavity.

Regardless of whether it is a vein or an artery, the heart is the core to form a system of blood circulation throughout the body.

The blood supplied from the thorax goes up to the brain and down to the soles of the feet, and all the limbs and organs of a person are supplied with blood.

Whether the patient's blood oxygen keeps dropping is related to the broken blood vessel is still unclear.

It’s just that if the thymoma is not completely separated, there is no way to anastomose this blood vessel now!

Director Hu Kan encountered unprecedented challenges.

"I'll try to increase the oxygen concentration first. But based on my feeling, the effect should not be great."

Dr. Feng tried to increase the concentration of oxygen inhaled by the patient.

Patients who need oxygen are often seen in the hospital.For example, pregnant women, pulmonary insufficiency or failure, chronic obstructive pulmonary disease, etc., may all need oxygen inhalation.

Oxygen inhalation of patients is generally low-concentration oxygen inhalation. Occasionally, in special circumstances, the oxygen concentration will be slightly increased.

But the oxygen supply concentration cannot be adjusted too high.

Otherwise, it will backfire.

Such as common, carbon dioxide retention, pulmonary function suppression, oxygen toxicity and so on.

Dr. Feng was very cautious when operating.

The patient's blood oxygen itself has a problem. If the oxygen supply concentration is too high, causing the patient's lung function to be inhibited, it will immediately make things worse.

Zhou Can watched silently from the side, his heart beating slightly faster.

Because he knows that he has been in cardiothoracic surgery for almost two months, and he has not been able to get too many hands-on training opportunities.Now, the opportunity has come.

Cardiothoracic surgery is indeed a master, and these directors and deputy chief physicians are all masters of the best.

Even the doctors in charge were unambiguous, and their surgical ability crushed doctors of the same level in other surgical departments.

But they have one biggest weakness.

That is slow.

Winning or losing does not matter.

Slow down, if it is placed in other operations, it will be fine.

Accidentally breaking an artery at this moment has already planted the root of disaster.Coupled with the slow speed of the operation, it basically means that the house leaks and it rains overnight.

Oxygen inhalation is not a panacea for hypoxemia.

In many cases, low blood oxygen cannot be resolved by oxygen inhalation.

Sure enough, as Zhou Can expected, even if the oxygen concentration was increased, the patient's blood oxygen saturation continued to drop.

It has fallen below 90.

"Oxygen inhalation doesn't work!"

Doctor Feng issued a warning.

Director Hu Kan, who was speeding up the operation, changed slightly, afraid of something.

This seems to be troublesome today.

"Director Le, how long does it take to anastomose the ruptured blood vessel?"

"It is estimated that the guard will take more than three hours."

Director Le can be regarded as a doctor with mature skills and quick hands and feet in the surgical team.

The time for anastomosis of larger arteries is usually half an hour to three to four hours.

For more difficult operations, eight hours are possible.

In the case of general arterial anastomosis and the placement of an inferior vena cava filter, the operation can usually be completed within half an hour.If it is a very difficult artery or blood vessel occlusion, corresponding drugs must be used for auxiliary treatment at this time, and the operation time will be greatly prolonged.

Moreover, even a top surgeon like Director Hu Kan would not dare to say that it can be stitched in one go.

If it fails, you have to re-sew.

There are also many risks in the operation, and the variables are very large.

"Doctor Feng, I don't think it's a two-handed preparation! Immediately prepare to establish extracorporeal circulation to prevent accidents."

"it is good!"

Doctor Feng agreed directly.

"I'll help you get it!"

Zhou Can got a lot of advice from Dr. Feng today, and his relationship with Dr. Feng is also quietly changing.

It's obviously gotten a lot closer.

The biggest difference between humans and animals should be that humans have complex emotions.

Although animals also have feelings, such as their partners, care and protection of their young, these are expressions of affection.

Human emotions are much more complicated.

Zhou Can used to help Dr. Feng with work, and he never said thank you, and his attitude was always indifferent and cold.

Until today, he suddenly taught Zhou Can anesthesiology knowledge, experience and skills.

It can be regarded as a qualitative breakthrough in the relationship between the two.

Just like falling in love, at the beginning, at most, we will watch a movie together, go shopping, send text messages, and make phone calls.Until the relationship heated up, one day, they suddenly held hands.

And the woman did not refuse.

This is a substantial breakthrough.

Zhou Can has established extracorporeal circulation for patients many times, and he is very familiar with it, and the speed is far faster than others.

[Insert experience value +1, +1...]

When he performed femoral artery cannulation again, he obviously felt that the operation was easier than before.

Checking the attributes quietly, the implantation technique has quietly risen to the middle level of indications.The current experience value is 6001/10000.

Others rely on hard work to get rich, but he relies on hard work to quickly earn experience points to upgrade his medical skills.

Although it is somewhat similar to immortal cultivators taking pills, there are some flaws.

However, this kind of upgrade speed that catches up with others for ten years, or even more than ten years, still makes Zhou Can feel extremely happy.

Experience can be accumulated slowly.

Only by upgrading your skills can you get more opportunities to exercise.

General surgeons who have practiced suture to the level of deputy director may not be able to succeed in 20 years.It took Zhou Can only one year to actually upgrade from the internship level to the deputy director level.

Not one, but two medical skills of suture and ligation, both of which have been upgraded to level five.

This kind of corner overtaking and asymmetrical competition is naturally very cool.

Some defects caused by the rapid improvement of medical skills are nothing.

Extracorporeal circulation was quickly established.

However, extracorporeal circulation can only be used temporarily for emergencies, and the duration is generally about six hours.

If the time is exceeded, ECMO will often be transferred.

With extracorporeal circulation, the surgery continued.

Zhou Can felt a little regretful, thinking that the opportunity had come.

Unexpectedly, Tuya's top weight department has many methods and complete equipment.An extracorporeal circulation temporarily solved the problem.

"Sweat!"

Director Hu Kan said to the nurse.

Only then did Zhou Can realize that Director Hu Kan's forehead was covered with fine sweat.

The patient's dangerous situation just now must have brought great pressure to Director Hu.It's just that as the chief swordsman, he must stabilize the morale of the army and force himself to be calm.

After the nurse wiped his sweat, it didn't take long before his forehead was sweating again.

There seemed to be something wrong with his face, and he looked a little pale.

It's a pity that the mask covers most of the face, so it's hard to see clearly.

"Director Hu's body seems to be in trouble!"

Zhou Can keenly noticed that Director Hu Kan was sweating coldly on his forehead, his face was pale, and his hand movements became extremely slow.

"Sweat!"

After less than 5 minutes, he yelled at the nurse again.

At this time, other doctors also noticed Director Hu's strangeness.

"Director Hu, why don't you sit by the side and rest for a while, and let me take over the rest of the operation!"

Director Le immediately took the initiative to share the heavy responsibility.

"Alright! The patient's fibrous connective tissue adhesion is serious, so you must be careful during the operation."

Director Hu Kan staggered when he backed away.

After all, Zhou Can is a practicing family boy, with sharp eyesight and quick hands, he rushed forward and helped him up.

"Director Hu, be careful!"

These directors are the pillars of Tuya Hospital. If they fall off the operating table, the consequences will be serious.

After all, they are not young.

"Xiao Zhou, help me sit over there and have a rest!"

Director Hu Kan still likes Zhou Can very much.

Zhou Can supported the surgeon, only to find that Director Hu Kan's body was much thinner than expected.And his body was shaking.

This is by no means normal.

"Do you need to go outside the operating room to drink some water and eat something to replenish your strength?"

Zhou Can thought Director Hu was out of strength.

"It's okay! I'll just sit over there and rest for a while. This operation is extremely difficult. Although Director Le has studied with me for many years, he still lacks some skills in many aspects. I am a little worried."

Zhou Can already knew that Director Le was the apprentice of Director Hu Kan.

To be precise, many people in the Department of Cardiothoracic Surgery are apprentices of Director Hu Kan.

He is never stingy with giving advice to other doctors.

Zhou Can also stayed in Neurosurgery for several months. Wu Baihe is more famous than Director Hu Kan, but his appeal and support in the department are far less than that of Director Hu Kan.

When imparting surgical experience and skills, Wu Baihe's patience is much less.

When instructing, it is often not very detailed.

The lower-level doctors need to guess, perfect and comprehend by themselves.

Director Hu Kan is a very good teacher and he is very patient when explaining problems.When encountering a subordinate doctor for advice, he will take the trouble to explain the main points until the subordinate doctor understands it.

Zhou Can was originally an apprentice of Dr. Xu, and he was considered a potential competitor of Director Hu Kan's department.

But he has been selflessly cultivating Zhou Can.

For example, without his approval for this operation, how could Director Le dare to call Zhou Can to study?

Zhou Can respects such a respectable and lovely chief physician from the bottom of his heart.

After helping Director Hu Kan to sit down on the round stool by the wall, Zhou Can let him go.

"I'm fine, you don't need to guard me. You stand in front of the operating table to see and learn more, such an extremely difficult operation opportunity is extremely rare." Director Hu Kan waved to Zhou Can.

"Row!"

Zhou Can walked towards the operating table, but he chose to stand on the other side.

Watching Director Le perform surgery from this angle, the angle of view is a bit worse.But it is convenient for Zhou Can to check Director Hu Kan's situation at any time.

Intuitively, Director Hu Kan is not as simple as being exhausted.

At this age, people are often in high-stress work conditions, and cardiovascular diseases and high blood pressure are easy to find.

The patient was in danger just now, and Director Hu must have been greatly stimulated. Increased blood pressure or tachycardia are all possible.

Director Le's surgical ability is obviously much worse than that of Director Hu Kan.

However, separation of thymoma should be completely sufficient.

Time flies, and the patient's condition is not good.

Surgery is also facing great difficulties.

Hu Kan, the chief surgeon, was forced to leave the stage due to physical discomfort.

The combination of multiple crises made this operation even more dangerous.In the operating room, the atmosphere became more and more oppressive.

"Speed ​​up the operation as much as possible, and the patient's blood pressure is dropping. Breathing is also weakening."

Doctor Feng urged Director Le and the others.

If it wasn't for the poor condition of the patient, he couldn't have urged the chief surgeon.

Because this will bring a lot of psychological pressure to Director Le.

The most feared thing about surgery is nervousness.

"It's too close to the great blood vessels of the heart, and the adhesion is very serious. I'm a little worried about breaking it."

Doctors usually subconsciously avoid the words "accident" and "accident" when they talk during surgery.

Breaking the great blood vessels of the heart will immediately cause massive bleeding.

A blood vessel has been ruptured.

Breaking another one, this surgery will become the worst one ever done.

"Director Hu, Director Hu!"

Zhou Can glanced at Director Hu Kan who was sitting against the wall from time to time.

It was found that Director Hu's body was tilted to one side.

While calling, he rushed over and helped the person.

"I...have a bit of chest pain and tightness!"

Director Hu was short of breath, his forehead was covered with sweat, and his body was shaking very violently.

"Does Director Hu have heart disease?"

Zhou Can asked Director Le and others.

Some of them have been operating with Director Hu Kan for many years, so they should know something about it.

"Director Hu never discloses his physical condition. We don't know." Director Le has stopped the operation at this time, and all other doctors and nurses are looking at Director Hu.

"His symptoms are a bit like a myocardial infarction. The emotional stimulation just now may have aggravated the myocardial infarction. I will take Director Hu for an examination first. Director Le, do you think it's okay?"

Hu Kan fell down, the highest status in the operating room was Director Le.

"go quickly!"

Director Le urged him.

"Director Hu, don't worry, we will finish this operation properly."

After urging Zhou Can, he comforted Hu Kan again.

All the doctors present were cardiothoracic surgeons, and Director Le was good at the cardiovascular field.After being reminded by Zhou Can, he also found out that Director Hu Kan's situation is very serious.

Zhou Can directly carried the person out of the operating room.

Without changing his clothes, he rushed to the cardiothoracic surgery clinic wearing the protective clothing in the operating room.

Along the way, many family members and doctors and nurses watched.

They don't know what's wrong?
Director Hu performed surgery on the patient, but he made himself need to be rescued instead.

"Where is Director Xue's clinic?"

Zhou Can asked the guiding nurse.

"over there!"

The guiding nurse naturally recognized the person Zhou Can was carrying, and hurriedly led the way.

Zhou Can carried him into the outpatient room. At this moment, Director Hu's condition became even worse.

Already delirious, his face was extremely scary.

"Doctor Zhou!"

Director Xueyan was inquiring about a patient, and she was startled when she saw Zhou Can suddenly barge in with someone behind her back.

"During the operation, Director Hu suddenly had a problem with his body. It's a bit like a heart attack. Please take a look!"

Zhou Can finished speaking hastily, and then apologized to the patients and their families who were seeking treatment, "I'm sorry, our doctor's situation is extremely critical, so cut in."

"It's okay, we're chronically ill anyway, so don't worry."

The family members are very understanding.

Sell ​​it well to the doctor, and you can get some care for the follow-up diagnosis and treatment.

At least that's what family members and patients think.

"It really looks like a heart attack. Hurry up and register for Director Hu. I will give him a physical examination first, and then issue an application form for the examination. Judging from the situation, I am afraid that emergency rescue is needed."

Without registration, there is no way to enter the system.

The doctor will not be able to issue a check request form.

Acute myocardial infarction involves sudden acute occlusion or high-grade stenosis of at least one blood vessel, resulting in acute ischemia of the blood-supplying myocardium, followed by myocardial injury and subsequent necrosis.

Worsening of MI is measured in minutes.

Emergency rescue can greatly reduce the risk of death for patients.

One of the meanings of rescue is to save the myocardium as much as possible and preserve heart function.Otherwise, even if the patient is saved, the quality of life in the second half of his life will be seriously affected.

"I don't have Director Hu's ID card!"

Zhou Can said.

"Just write your name. Hurry up, I'll add a number."

Director Xue is already an expert, so her account must have long since disappeared.

Adding an account temporarily is the benefit of having network resources.

Zhou Can ran to find the girl at the manual registration window. She heard that Director Hu Kan had an accident during the operation, and she was very sympathetic.Without saying a word, he helped Zhou Can to settle the matter.

Zhou Can took the number and returned to Director Xue's outpatient room.

At this point the physical examination is complete.

She is already opening the inspection application form.

"Go to the heartache center first and do an urgent electrocardiogram, and then do a chest X-ray."

"Row!"

When Zhou Can was doing a chest X-ray behind Director Hu Kan's back, he used his 'privilege' again to jump in line for the examination.

Human life is at stake, and there is nothing that other patients and family members can do if they are dissatisfied.

In fact, the patients who see specialist outpatient clinics here are basically chronic diseases.

If it's really an emergency, why would you wait in line here?I had already called the emergency department and went through the emergency procedure.

Zhou Can didn't take director Hu Kan to the emergency department, mainly out of consideration of saving time.

Moreover, patients with myocardial infarction like this have to be transferred back to cardiothoracic surgery for surgery.Or call a cardiothoracic surgeon to the emergency department for surgery.

Instead of tossing back and forth, it is better to directly use the familiar relationship and go through a special process to save Director Hu Kan's life.

After examination, Director Hu Kan really had an acute myocardial infarction.

After seeing the results of the examination, Director Xue immediately arranged for inpatient beds, consulted with other chief physicians in the department, and formulated a surgical plan.

While notifying Director Hu Kan's family members, Zhou Can hurried forward and back, playing the role of temporary family members.

After discussion, it was finally decided to perform interventional surgery for Director Hu Kan.

This is also a common surgical option for acute myocardial infarction.

Opening the occluded blood vessels in the shortest time is the key to the treatment of myocardial infarction.

After Director Hu's family members arrived, Zhou Can quietly left and returned to the operating room.

At the moment, thymoma surgery is still going on intensely.

"Xiao Zhou, is Director Hu okay?"

Seeing Zhou Can come back, they asked about Director Hu's situation.

"The result of the diagnosis is acute myocardial infarction. A surgical plan for interventional treatment has been formulated, and an emergency operation will be performed for Director Hu soon."

This kind of interventional surgery is not a difficult operation for the experts in cardiothoracic surgery.

I believe that as long as Director Hu is not lucky, he will be able to turn the crisis into safety soon.

(End of this chapter)