My medical skills add experience

Chapter 187 Finally got it, one-on-one training
"The operation is so fast! Even if you go through the green channel of the chest pain center, it's not so fast, is it?"

A nurse was surprised.

Larger hospitals have chest pain centers, which are generally composed of emergency departments, cardiology, imaging, cardiac surgery, thoracic surgery, gastroenterology, respiratory medicine and other multidisciplinary cooperation to establish a regional coordinated treatment system to provide rapid treatment for patients with acute chest pain. And accurate diagnosis.

Patients with chest pain do not need to queue up for medical treatment and examination.

The original intention of building the chest pain center is because chest pain patients may be acute myocardial infarction, heart disease, aortic dissection and so on.

These diseases are critical illnesses.

For every minute of delay, the patient's risk of death increases significantly.

Therefore, it is necessary to receive a consultation as soon as possible, and then a quick diagnosis by an experienced doctor to determine the next treatment plan.

"I thought that I was on the site of cardiothoracic surgery, so there was no need to go to the emergency chest pain center. So I went directly to Director Xue for a diagnosis." Zhou Can explained.

"wise!"

"Director Hu is very kind to us, and he is the mentor of the entire cardiothoracic surgery department. Now that he is sick, I believe that every doctor in the cardiothoracic surgery department wants to do his best to save his life."

"Xiao Zhou, well done!"

Several leading doctors heard that Zhou Can directly asked Director Xue to jump in line to give Director Hu Kan a diagnosis and treatment, and they strongly agreed with Zhou Can's approach.

When encountering such a thing, we must do everything we can to save people first.

If you stick to the so-called rules pedantically and don't dare to overstep, then you are really stupid.

Zhou Can's approach is very suitable for them.

"Director Hu's safety is assured, everyone can operate with peace of mind! Making this operation beautiful is our best consolation to Director Hu."

Director Le said to everyone.

Needless to say, this method of boosting morale is quite effective.

Morale, which was originally low, quickly became high.

One by one is like being beaten with chicken blood.

It is also enough to see that Director Hu has a very high status in their minds.

"The patient's condition is very bad. According to this operation speed, it is not optimistic."

Doctor Feng poured cold water on this group of people.

This operation can be said to have twists and turns, and many things happened.

Now, for the doctors in Director Hu's department, the shortcoming of slow operation speed is infinitely magnified in this operation.

"Is the patient's vital signs still uncontrollable after the extracorporeal circulation is established?" Director Le asked in despair.

"According to the speed of your operation, it is basically equivalent to a death sentence for him." Dr. Feng did not turn corners when speaking.Director Le felt uncomfortable listening to these words.

"Director Le, can I try it? My separation speed is fast, which may shorten the operation time a lot." Zhou Can just stood up and asked for a try with the idea of ​​trying.

Director Le probably won't agree.

"I have seen Dr. Zhou's separation, not only fast, but also at a very high level. At least not lower than the attending level."

The nurse on tour actually helped Zhou Can speak at this time.

Zhou Can has some impressions of her. That time when Dr. Long performed the thoracotomy and hemostasis operation, this nurse sister also seemed to be a nurse on tour.

In that operation, Zhou Can performed extremely brilliantly.

Impressed all the doctors and nurses.

Dr. Long has been polite to Zhou Can ever since that operation.

"How do you know that his separation level is very high?" Director Le asked, staring at the nurse.

"One time Dr. Long performed a thoracotomy to stop bleeding. Dr. Zhou's surgical ability was so superb that even Dr. Long felt ashamed. Dr. Zhou's suturing, ligation, and various catheter placements are so good, I believe you I’ve seen it firsthand.”

The nurse girl replied neither humble nor overbearing.

She helped Zhou Can speak at this time, which made Zhou Can very grateful.

The two looked at each other, and she blinked at Zhou Can.

"Come here and try!"

After a battle between heaven and man, Director Le finally decided to use Zhou Can boldly before the battle.

Because Zhou Can's level of leather sewing is indeed very high.

They can be compared with him as the chief physician.

Director Le decided to look at Zhou Can's separation level first.

"Isolate this little vessel."

He pointed to a very thin vein on the gland to separate Zhou Can.

Even if the vein is broken, it is easy to stop bleeding.

With such a small vein, the risk is completely controllable.

When Director Le asked Zhou Can to try his hands, he was extremely cautious.

Zhou Can put on sterile gloves, stood at the main knife position, and without any nonsense, brushed and brushed, three times, five divisions, and two, and easily separated the vein.

"The speed is fast enough!"

Director Le carefully checked the vein and the tissue on the thymus.

In fact, the thymus gland of an adult has the most fat on it.

After the inspection, Director Le's eyes lit up, and he couldn't help being amazed.

"This level of separation is really good. You must be careful and careful in the process of separating the thymus. If you encounter a part that is not sure, stop immediately, understand?"

After seeing it, Director Le decided to take some risks and let Zhou Can complete the rest of the separation operation.

As the patient's condition deteriorated, the operation had to be expedited.

Right now, I am afraid that only Zhou Can is capable of this task.

Another way is to ask for help from other departments.

But this kind of thing, unless it is absolutely necessary, I really can't get rid of that face.

And even if people are invited, the speed may not be so fast.

In the entire Tuya Hospital, the person with the fastest operation speed is Dr. Xu.

Zhou Can is the successor of Dr. Xu, and he has acquired a trace of the essence of quick knife technique, and he should be the second fastest person in surgery.

"understand!"

Zhou Can was about to use the knife after gaining Director Le's initial trust.

Nisuke and the other doctors are still full of concerns.

"Director Le, would it be too risky for him to complete such a dangerous operation with a regular trainee?"

Director Le was not responsible for the accident.

They also have to follow the bad luck.

"There is no doubt about employing people. As far as I know, he has already participated in many high-risk surgeries outside the bone and outside the nerves. Including multiple grade [-] major surgeries. I believe he will not take the lives of patients." joke."

Director Le resisted all opinions and insisted that Zhou Can complete the most difficult separation task.

From his words, it can be heard that he has a certain understanding of Zhou Can's past.

This is quite normal.

The circle is so big. Many of the chief doctors of Tuya Hospital have established friendships across departments.

What's more, neurosurgery, bone surgery, and cardiothoracic surgery are all major surgeries.

It's like a big family.

It's too common for the bosses in various departments to have private contacts and chat occasionally.

This is why Zhou Can never dared to lie.

If people ask casually, they will immediately get rid of it.

Lying is basically tantamount to self-sabotage.

"Xiao Zhou, let's start!"

"it is good!"

Zhou Can began to quickly separate the thymus tumor.

The reason why the separation is difficult is mainly because of the adhesion of connective tissue, and there is a lot of fat around it, and it is close to the heart.

It is really a great trust for Director Le to let him do the surgery.

Brush brush!
The quick knife technique and the separation technique are integrated, and his separation speed, efficiency, and accuracy are all amazing.

Time passed by minute by minute.

Every minute and every second was thrilling for the doctors present.

Zhou Can's operation speed has completely refreshed their cognition.

Never thought that someone could separate so quickly.

Director Le and the second assistant were not too surprised, because they had seen Dr. Xu's knife skills.

Compared with Dr. Xu, there is a big gap between Zhou Can and Dr. Xu.

Dr. Xu's fast-knife surgery on patients in his peak period, I believe everyone who has seen it will leave an indelible impression for a lifetime.It can only be described as amazing.

"All right!"

Zhou Can looked up at the time, and it took 23 minutes.

This is the longest time he has spent separating an organization, and it usually takes at most ten minutes to complete.It even has a history of getting it done in a few seconds.

The difficulty of separating this thymoma is too high.

"This, is this the end?"

The second assistant was a bit awkward in speaking.

He had thought about what to do if Zhou Can broke a large blood vessel with a knife, and thought about how Zhou Can would separate a small part and leave the stage halfway. The tumor was completely separated.

"Director Le, can you let me do the removal of the entire thymus and the tumor together?"

Zhou Can made an inch of it.

Desperately grab the chance of surgery.

He just separated the entire thymus, including the thymoma, and he earned a lot of separation experience points.

Not to mention anything else, the extra 100 separation experience points for the first time separating extremely difficult organs and tissues were enough to make him extremely happy.

In the past five months, he has not experienced such a hearty operation for a long time.

In the intensive care unit, needless to say, there are very few opportunities for surgery.

When it came to cardiothoracic surgery, the only decent operation I had done with Dr. Long was the open chest operation to stop bleeding.

"Row!"

Director Le has more confidence in him.

Even the most difficult separation of the thymus and tumor was successfully completed by Zhou Can, which was ten times easier than this, so there is nothing to say.

Decisively let Zhou Can operate.

Zhou Can first freed the thymus vein, and then performed ligation at the deputy director level.

After ligating and cutting off the vein, he carefully removed the thymus and the entire tumor.

The operation is not finished here.

It's just that the most core part of the operation has been completed.

After cleaning the surrounding tissues, there were no hidden dangers, Zhou Can looked at the ruptured artery.

"Director Le..."

"If you are sure, do it. The separation and resection of the thymus and the tumor with the highest risk are all done by you. Is the repair of this blood vessel still missing?" Director Le saw that the operation was going smoothly, and made great strides forward. The main force of the army' was wiped out.

He was really happy in his heart.

It's like the emperor used a young general, but this young general named Huo Qubing turned out to be a military god. He killed the Huns with three strikes, five divisions and two, and they were defeated for thousands of miles, fleeing to the area outside Monan.From then on, there was no royal court in Monan, and the Huns' rebellion was completely subsided.

Director Le boldly used Zhou Can, just as successfully as Emperor Wu used Huo Qubing.

Zhou Can first separated the broken ends of the ruptured blood vessels, then trimmed them, and then anastomosed them.

The suture and ligation at the deputy director level is really cool.

Even though he only had an anastomosis at a lower level, it allowed him to perform an anastomosis that was not inferior to the deputy director's level.

[Congratulations on your first successful anastomosis of a large artery in the heart. You will be rewarded with 100 experience points for suturing, 100 experience points for ligation, and 100 experience points for anastomosis.]

Zhou Can was awarded a total of 300 experience points once, and he was so happy that he couldn't close his mouth.

After the suture and ligation skills have been upgraded to level five, one hundred thousand experience points are required to upgrade further.

If you want to accumulate so many experience points and earn only 1 point at a time, it may take more than ten years to reach level six.It can only be said that it is too difficult to be promoted to the director level.

No wonder some surgeons have been deputy chief physicians until they retire.

If Zhou Can thinks of a way, like now, he will specifically challenge some difficult surgical tasks.You can get 100 experience point rewards once, and you can be promoted to the director level, which may be done in two or three years.

After completing the arterial anastomosis, Zhou Can debrides the wound in the chest cavity and stops the bleeding.

Then there is no problem, test whether the blood supply is smooth.

"Good cow, the artery and blood vessel were anastomosed successfully in only one time."

Someone couldn't help but marvel.

What made them even more envious was Zhou Can's astonishingly fast operation speed.

In the past, in their cognition, only slowness can be stable, and slow work produces meticulous work.

Now watching Zhou Can perform the operation, their cognition has been subverted.It turns out that surgery can be done quickly and well.

"Shut up!"

Director Le is very satisfied with the operation results.

Zhou Can has never completed chest closure independently.Especially this big thoracotomy.

I've seen it many times.

Since Director Le didn't say to change people, he wasn't polite.

The stainless steel wire was taken from the nurse and the sternum was sutured.

A drain is then placed behind the sternum.

"Director Le, please check it out. If there is nothing wrong, I will suture the incision layer by layer."

Zhou Can watched so many surgeries and took so many notes, so he knew every step by heart.

It finally came in handy today.

At least everything is done well, above the standard.

For him personally, it was also a very important growth experience.

"Excellent! Keep going!"

Director Le and the doctors present had thoroughly seen Zhou Can's surgical prowess today.

The nurse girl who spoke for Zhou Can showed a smug smile.

It was because of her recommendation that this surgery took a major turn.

Half an hour later, Zhou Can finished suturing, and the patient's vital signs began to rise steadily after he finished closing the chest cavity.

At this moment, the operation is over and the patient is completely safe.

"Doctor Feng, the patient can be awakened from anesthesia. Because of his special situation, he will be transferred to the intensive care unit for observation for a day. After the patient's vital signs are completely stable, he will be transferred to the general ward for care."

Director Le made safe postoperative arrangements.

"Xiao Zhou, you performed very well today. After surgery, I can give you some chances to practice."

"thanks, thanks!"

Zhou Can finally found the right opportunity and opened up the situation.

In the Department of Cardiothoracic Surgery, which is full of experts, it is really difficult for a regular trainee like him to gain important opportunities for surgical training.

The main reason is that cardiothoracic surgery is basically a third-level or fourth-level major operation. Let alone him, even those senior residents basically help pull the hook, suture the skin, intubate and so on. .

The high-risk practice they have done is probably chest piercing.

After the operation, Zhou Can found that it was already 47:[-] in the evening.

Today's situation is considered good.

If Director Le insisted not to let him do it, it would be normal for them to perform surgery at midnight.

Surgeons have a high income, but they often have to commute to and from get off work, earning hard-earned money.

Back at the doctor's office, Zhou Can thought Director Xue must have left work long ago.

I didn't expect that she was still in the office.

"Doctor Zhou, did your operation go well?"

She seemed to be waiting for Zhou Can to get off work.

Zhou Can is not sure either.

After all, his status is very high, and there is no certainty when Zhou Can will have the operation.

"The operation went well. How is Director Hu?"

Zhou Can still remembers this matter in his heart.

Director Hu Kan's broad mind and selfless teaching to junior doctors make people respect and like him from the bottom of their hearts.

Now that something happened, everyone is very concerned about his safety.

"Interventional surgery has been done, a vascular stent has been placed, and I am still living in the ICU for the time being. But the overall situation is quite optimistic." Director Xue introduced the general situation.

After Zhou Can heard this, a happy smile appeared on his face.

"It's good to be safe!"

He was really happy for Director Hu.

The fatality rate of acute myocardial infarction is quite high.As long as the treatment is not timely, even if it is rescued, the person is basically useless.

Many people only know that nerve cells cannot regenerate, but they do not know that cardiomyocytes are also non-renewable.

Therefore, cardiomyocytes are very precious, and every one that dies is one less.

Therefore, for patients with acute myocardial infarction, early opening of blood vessels is very important. The earlier the blood vessels are opened, the more cardiomyocytes can be saved, and the heart will not undergo significant remodeling.

For patients with myocardial infarction, time is the heart muscle.

Zhou Can discovered Director Hu Kan's abnormal situation in time, and carried out inspections behind his back to win precious rescue time, which is a great contribution.

I believe Director Hu will be very grateful to him when he wakes up.

"Didn't Dr. Zhou want to ask me about the comprehensive medical examination? If there is no other important thing now, let's talk!"

Director Xue really made a special trip to wait for him.

Zhou Can didn't say anything, but he was deeply moved in his heart.

Hurry up and sit down, and humbly ask Director Xue for advice.

"I have selected [-] exam questions here, you just need to answer them. If you don't know how to answer them, you can leave them blank."

Director Xue moved the chair and let Zhou Can sit in front of her work computer to answer the questions.

This kind of treatment made the doctors on duty in the office envious.

To be able to receive such meticulous one-on-one training from Director Xue, as long as the foundation is not too bad, I believe that I will definitely pass the comprehensive medical examination.

Zhou Can found that these exam questions were very targeted.

The knowledge involved is extremely wide.

It turned out that she had been operating the computer just now and was selecting test questions for him.

The woman's heart is as delicate as a hair, which is fully reflected in her body.

Zhou Can answered every question seriously, and she just watched from the side.

It should be to use this method to figure out Zhou Can's shortcoming in knowledge in the shortest possible time.Then he helped Zhou Can make a short-term study plan in a targeted manner.

(End of this chapter)