My medical skills add experience

Chapter 216 Become a teacher, the fourth and fifth-level medical skills

"Thank you! Thank you for letting me feel the warmth of the new department!" Dr. Wu Ziyu thanked Zhou Can repeatedly, with sincere words and sincere eyes. "I would like to thank Dr. Zhou for letting me understand how far I am from an excellent doctor. I will guard against arrogance and impetuosity in the future, and follow Dr. Zhou's example to steadily improve my surgical skills and medical level."

Today, Zhou Can taught her a good lesson.

Her misunderstanding of Zhou Can was eliminated, and at the same time, her eyes were greatly opened.

The matter was satisfactorily resolved.

"Not to mention Dr. Wu, even I was extremely shocked when I saw Dr. Zhou's surgical prowess. I never thought that a doctor who has been trained for less than two years can have such a strong surgical prowess. In this operation Some separations and resections require at least deputy director-level surgical capabilities to complete. It's really amazing!"

Director Mo was also full of praise for Zhou Can's surgical skills.

"Maybe I am more courageous, and the teachers also take good care of me. They all teach me everything, so I am improving faster! In fact, my surgical skills are far from the level of deputy director. If I die, I will be at the level of attendings." .”

What Zhou Can said was the truth.

Before practicing the quick knife technique, his surgical skills were solid.

Later, the fast knife method was promoted to the entry level. Using the fast knife method to control separation, incision, and debridement medical skills is equivalent to using internal strength to activate martial arts.Shengsheng raised the level of separation and incision medical skills to a great level.

Obviously only at the attending level, but can display the strength of the deputy director level.

This is exactly what makes the quick knife method so fascinating.

Zhou Can doesn't know whether "stable knife" and "precise knife technique" also have this ability.

Anyway, he has fallen in love with the magic of the quick knife technique.

Every time I have an operation, I feel a hearty sense of pleasure.

"The strength is outstanding, but he can be humble and humble at all times. The future of the young man is limitless!" Director Mo was very emotional.I am also very optimistic about Zhou Can's future. "This operation was successfully completed, so I am relieved. To be honest, let alone me, other chief physicians have not confirmed Dr. Zhou's surgical ability. We are somewhat worried about entrusting those patients to you for surgery. .”

Zhou Can smiled wryly after hearing this.

The chief physicians are all mature and steady, with good medical ethics.

Zhou Can, a junior trainee, took over the surgical patients they were treating. Although it was out of good intentions, the chief physicians were more worried that Zhou Can's surgical skills were not enough.

In order to be responsible to their patients, although they did not expressly object, they appointed Director Mo to the operating room to inspect Zhou Can's surgical ability.

Now it is confirmed that Zhou Can's surgical ability is stronger than imagined, and Director Mo can also explain to others well.

"Director Mo, I'm going to accompany Zhou Can to operate together in the next two days. Please pay more attention to the outpatients of the thyroid clinic. If you encounter difficult and miscellaneous diseases, you can consult with the doctors of the entire department."

Old Liu exhorted.

"Don't worry, nail and breast surgery is your department, and it's also our department. Everyone will work hard to do a solid job. We will never do things that will ruin our jobs."

Director Mo waved at Old Liu, and took Wu Ziyu to leave.

"Director Mo, Director Liu, can I stay in the operation to help with the operation? My surgical ability is far inferior to that of Dr. Zhou, but I can do things like pulling hooks, suturing skin, and stopping bleeding."

Seeing that Zhou Can's surgical skills are so strong, Wu Ziyu was somewhat stimulated, and she was not willing to lag behind too much.

Zhou Can's surgeries are fully booked for the past two days, both big and small.

If she followed suit, she would definitely learn a lot of surgical skills and experience.

This will be of great benefit to her improvement of surgical skills.

"I have no objection, it depends on whether Director Liu agrees!"

Director Mo took care of the doctors under him to the best of his ability.

"What kind of work has the department arranged for you these two days?" Elder Liu didn't rush to agree.

The department has just been built, and there are many things to do.

Manpower is also very tight.

Even if it is just a resident doctor, the workload assigned is very heavy.

If she is left in the operating room, there will inevitably be some work that belongs to her that needs to be distributed to others.

"The task assigned to me is to manage the ward, as well as write medical records and prescribe medical orders. Don't worry, I will not delay my work. I will adjust shifts with other colleagues and work overtime at night."

she said hastily.

"That's fine, you don't stay in the operating room for more than eight hours. Young people, it's good to work hard and study hard, but you should also pay attention to rest. You need to ensure at least six hours of sleep every day."

Old Liu couldn't bear to reject her eager eyes.

Finally chose to agree.

She will be Zhou Can's assistant.

Originally, Mr. Liu was responsible for the more difficult work of pulling the hook and stopping the bleeding.There is no way, the manpower is insufficient, and the deputy director has to play the role of an assistant.

While serving as the first assistant, Mr. Liu is nominally the chief surgeon, directing Zhou Can's surgery.

When encountering the part of the operation that Zhou Can is not yet competent for, he needs to do it himself.

Now that there is an assistant at the resident level, Mr. Liu can relax a lot.

After all, like the thyroid tumor removal operation just now, the two regular trainees and the three interns are absolutely incapable of being qualified for the assistant job.

"Has Dr. Wu participated in tertiary surgery?"

"I have participated in it many times, usually as the third assistant. The most completed operations are hemostasis and skin closure." She is honest enough.

It takes at least the third year for the vast majority of residents to gradually gain some opportunities for some slightly higher-risk surgical operations.

Just like when Zhou Can was in the emergency department back then, at the beginning, even draining a patient with an abscess was exciting for a long time.

Surgeons grow up little by little and get over it slowly.

"Well, the next operation is the removal of thrombosed hemorrhoids. You can try to help Dr. Zhou!"

Liu Lao decided to try her depth first.

Later, she will be given opportunities for surgery and exercise.

The patient was brought in quickly.

It is a female patient in her 30s. She walks like a young girl who has just broken her melon, limping and showing pained expressions on her face from time to time.

Hemorrhoids are soft venous masses formed by stasis, dilation and buckling of the hemorrhoidal venous plexus under the rectal mucosa and under the skin of the anal canal.

Thrombosed hemorrhoids, if not treated in time, will cause great pain to patients.Difficulty sitting or lying down, difficult and painful bowel movements.

The female patient's walk has become like this, indicating that the condition has progressed to a very serious level.

"Please lie down on the operating table!"

Wu Ziyu took the initiative to arrange for the female patient to lie on her side.

After all, most of the operating rooms are male doctors, and female patients will feel embarrassed.

Wu Ziyu is also a woman, so it is easier to gain the trust of patients and relieve the embarrassment of patients.

The actual surgeon of this operation is still Zhou Can.

A minor surgery that does not require a specialized anesthesiologist.

Local anesthesia can be administered directly to the patient by the surgeon.

"Old Liu, wouldn't it be better to use caudal anesthesia in her situation?"

Zhou Can's first- and second-level general surgery experience is quite rich.

In addition, he has learned a lot of anesthesia knowledge and skills from Dr. Feng, so he can easily handle local anesthesia for this second-level minor operation.

With a little understanding of the patient's condition, the most suitable anesthesia plan can be given accurately.

Hemorrhoid surgery can generally use local anesthesia, caudal anesthesia, and if necessary, lumbar anesthesia can also be used.

"Sacral anesthesia is very suitable, let's start!"

Old Liu gave him a look of approval.

Being able to flexibly use the most appropriate anesthesia method shows that Zhou Can's level of anesthesia has made considerable progress.

Zhou Can took the anesthetic prepared by the equipment nurse and began to perform caudal anesthesia on the female patient.

This form of anesthesia is more difficult than local anesthesia injected into the muscle.

It involves injecting a local anesthetic into the sacral cavity through the sacral hiatus to block the sacral nerves.It is a type of epidural anesthesia, and it is mostly suitable for operations on the rectum, anus, and perineum.

"Doctor Zhou's injection technique is so strong!"

Wu Ziyu watched Zhou Can operate from the side, and couldn't help but marvel at it.

If it were her, let alone a single success, even if she was given ten chances, one success would be considered good.

She has only seen this kind of anesthesia two or three times.

Because she used to follow Director Mo, and the operations she performed were basically thyroid operations.

Zhou Can performed sacral anesthesia on the patient just now, and it seemed that he did it easily and easily.This also shows Zhou Can's strength even more.

She secretly made a comparison. Even if Director Mo operated it himself, it would be difficult for him to be as relaxed as Zhou Can.

"It's nothing, you will practice more in the future, and you can do it easily."

Zhou Can smiled indifferently.

"Can you teach me a little bit? I have seen other doctors operate two or three times, but they are not as good as you. I have always wanted to learn, but I have not learned."

Seeing that he was easy-going, Wu Ziyu took the opportunity to ask him for advice.

Normally, she would not dare to ask the deputy director and chief physician directly during the operation.

"The most difficult step in the implementation of caudal anesthesia is the puncture of the caudal canal. The patient can be placed in a lateral or prone position. Depending on the patient's condition, different lying positions can be adopted to minimize pain for the patient. The lateral position When lying on the back, the patient’s back is bent backwards, and the knees are moved closer to the abdomen, like a curled shrimp. In the prone position, the patient’s hips are placed on a small pillow, the legs are slightly separated, the toes are turned inward, and the heel is turned outward to relax the buttock muscles .”

Zhou Can is very competent in teaching her the anesthesia knowledge and skills he has mastered.

"Before the puncture, first touch the tip of the coccyx, which is the position." He pointed to the tip of the patient's coccyx. "About 3 to 4 centimeters from the midline to the head, you can feel a V-shaped or U-shaped depression. There is a bean-sized bony protruding sacral horn on each side of it. This depression is the sacral hiatus. Find this hiatus and perform Piercing, that's basically it."

In Zhou Can's eyes, it was a very simple anesthesia operation. When explaining it, he realized that being a teacher is so hard.

He actually told her a lot.

Recalling those senior doctors who taught him, and took the trouble to explain to him the operation skills, precautions and specific steps, he couldn't help feeling deeply grateful.

If you are not a teacher, you will not know the hard work of the teacher.

If you are not a parent, it is difficult to understand the difficulty of being a parent.

"I have basically learned how to find the sacral hiatus. Can you talk about the specific puncture? I'm a bit stupid, so don't bother me." She said a little embarrassed.

Seeing her thirsty eyes, it was very similar to when Zhou Can asked the superior doctor for advice.

"You are very smart. All doctors are similar to you when they learn the actual operation. I learned this anesthesia operation, and I learned it from the teacher for a long time."

Zhou Can told her a white lie.

At the beginning, when Dr. Xu taught him this operation, he only learned it once.

"First make a skin mound in the center of the sacral hiatus, and the needle passes vertically through the skin and the sacrococcygeal ligament covering the sacral hiatus. When penetrating the ligament, there will be a sense of loss as the resistance suddenly disappears. At this time, place the needle stem at a 30-degree angle to the skin Insert the needle to enter the sacral cavity."

Zhou Can gestured again.

However, the patient was not punctured again.

Otherwise, the patient should curse.

"Thank you for teaching me so patiently."

She carefully took notes, and she must be going back to study carefully.

After successful anesthesia, the operation officially begins.

The female patient is not lethargic or anything like that, the person is awake.

She originally felt that such a young doctor was somewhat worried about performing an operation on herself.But after listening to Zhou Can teach Wu Ziyu, she changed her opinion.

Being able to lead an apprentice, the medical skills will definitely not be bad.

It is also a master.

She waited at ease for Zhou Can to operate on her.

"Has Dr. Wu done this kind of operation?"

"No! This is just the first time I've seen it!"

She shook her head shyly.

"Look carefully at every step of my operation. First make a radial incision at the thrombus."

Zhou Can explained while operating on the patient.

"After cutting the skin, you can see purple blood clots. Here, that's it."

Zhou Can pointed it out to her.

"Use your thumb and index finger from the bottom of the thrombus to the direction of the incision, and forcefully squeeze out all the blood clots. Be careful not to force too hard or be too gentle, otherwise the blood clots will not be squeezed out or the blood clots will not be squeezed out completely. Therapeutic effect. Vaseline gauze or small cotton balls dipped in styptic powder and benzocaine powder can be used to fill the wound.”

Zhou Can performed the operation very quickly.

As soon as the words were finished, the operation was basically completed.

"Remember, don't suture the wound, just let it heal gradually."

There are many wounds that cannot be sutured.

Hemorrhoid wound is one of them.

Some novice surgeons have made jokes once.There are also those half-learned doctors who open clinics, because they lack the guidance and checks of superior doctors, and even have a certain degree of medical malpractice.

This operation is relatively easy, and it will be considered complete if it is done here.

Old Liu stood beside him without saying a word.

Just watching Zhou Can teach Wu Ziyu to perform the operation, Liu Lao showed a gratified smile in his eyes.

After a doctor's skills have improved to a certain level, especially when he is a little older, he will especially hope to pass on his medical skills and teach more people.

Watching Zhou Can teach Wu Ziyu, this is the performance passed down from generation to generation.

So Liu Laohui felt very pleased.

After this female patient was pushed out, new patients soon came in.

Zhou Can continues to act as the absolute main force, performing operations on patients quickly and efficiently.Wu Ziyu helped him in some minor operations.When encountering high-risk and difficult secondary surgery, you can only be a secondary assistant.

Liu Laohui will personally help Zhou Can.

When Zhou Can performed the fourth operation today, his hemostasis was finally promoted to level five as he wished.

[Hemostasis, level five, current experience value 1/100000, junior level of deputy director. 】

This is his fourth five-level operation.

At this rate, after the three-year period of regular training, it may be possible to upgrade most of the medical skills to the level of deputy director.

Then the cow B.

Basically all tertiary surgeries can be performed independently, and even start to challenge the core surgical part of the fourth-level surgeries.

(End of this chapter)