My medical skills add experience

Chapter 226 If something happens, something will happen, please ask the general surgery doctor to come to the rescue
The patient's condition was very dangerous, but the doctor in charge of the bed was limited and could not see it.

Zhou Can gritted his teeth and decided to talk about it.

After all, human life is at stake.

"Mr. Luo, there is something I want to report to you!"

Zhou Can has just arrived, and keeps his posture very low.

In the departments he worked in, not to mention the chief resident, even the attending physician, everyone was polite to him.Basically, they are trying to curry favor with Zhou Can.

"Doctor Zhou is being polite! Just tell me if you have anything to say!"

Seeing Zhou Can's serious face, Luo Shengsheng couldn't help but take it seriously.

"When I came, I happened to see a doctor in charge of the bed examining the patients in bed 51."

"Well, I know the patient in this bed. He was admitted to the hospital because of blood in the stool, abdominal pain, and severe malnutrition. We have done gastric and colonoscopy examinations on him, and even capsule endoscopy, but we still haven't been able to find out. Bleeding point. His kind of bleeding is intermittent, so it will be more difficult to check."

After listening, Dr. Luo took the initiative to explain the patient's situation to Zhou Can.

"Uh... When I passed by, the patient's condition looked quite dangerous. Judging from the complexion, lips and some superficial symptoms, it is likely that internal bleeding is occurring. And it is likely to be bleeding in the jejunum and ileum. It is very easy here If the thrombus is formed, if the treatment is not timely, it will be more passive to wait for the patient to go into shock before resuscitating."

When Zhou Can said this, there was a trace of solemnity in his tone.

This was to make Luo Shengsheng aware of the urgency of the situation.

He has been to the gastroenterology department twice, and to be honest, he didn't have a good impression.

The doctors in this department are a bit procrastinated, rigid, and too formulaic.Lack of flexibility.

For the gastrointestinal bleeding patient I met in the intensive care department last time, Zhou Can even went to find Xia Ping, the attending physician of the gastroenterology department, but when he heard that he was a regular trainee, he immediately hung up the phone.

The big boss style prevails.

"It's not that serious! The patient has been in the hospital for several days, and he has been bleeding intermittently. But if you are sure that he is bleeding, you can check again."

After hearing this, Luo Shengsheng's attitude was similar to that of a bed doctor.

This is a kind of inertial thinking.

The patient has been safe and sound, how could something happen suddenly?

Many doctors have this kind of paralyzed thinking.

"I suggest doing an angiography of the digestive tract immediately! After all, the colonoscopy has already been done, and the patient may not be able to bear it if it is done in a short time."

Colonoscopy can irritate the anus or large intestine mucosa to some extent, which is more likely to cause mucosal damage and a small amount of bleeding.There is even a certain probability of complications, intestinal damage, bleeding, or even perforation.

Therefore, under normal circumstances, it is not recommended to do colonoscopy continuously in a short period of time.

Zhou Can took the opportunity to cleverly propose an angiography of the digestive tract, and Luo Shengsheng's chances of accepting it would be much higher.

"Yeah, Dr. Zhou's suggestion is very good, but the doctor who treats this patient is Dr. Xia Ping. It's better to wait for him to decide what kind of examination to do. When he comes in a while, I will focus on it." Let me give you the suggestion of gastrointestinal angiography."

Luo Shengsheng's words were impeccable, and he was completely smooth like an old fritter.

"That's it!"

Zhou Can didn't say anything more.

He fulfilled his duty of reminder, but if the superior doctor didn't listen to him, there was nothing he could do.

As time passed, Zhou Can sat in the office quietly waiting for Dr. Chi to arrive.

When it was almost eight o'clock, a 47-year-old middle-aged doctor entered the office with steady steps.

"Doctor Xia is really a role model for our generation! He arrives at the hospital early every day for work and has never been late." Luo Shengsheng greeted him with a smile all over his face. Seeing his compliment, Zhou Can sighed.

Different people have different ways of living.

Luo Shengsheng flattered the superior doctor so much in order to survive better.

It is easier to get on top if you have a good relationship with the superior doctors in the department.

In all aspects can take advantage of some.

Improve your skills, grab opportunities for further study, participate in important projects, obtain opportunities for surgical training, and so on.These flattering people do have an advantage over honest people.

"Haha, I don't dare to be a role model, but it does take a certain amount of willpower to persevere for decades. How are the patients in my group not surprised?"

If there was only one Dr. Xia in the Department of Gastroenterology, this elegant-looking middle-aged man should be Dr. Xia Ping whom Zhou Can had a conversation with on the phone once.

Dr. Xia obviously didn't know Zhou Can, so he just glanced at him slightly and didn't speak.

Instead, he walked to a seat at the desk, put down his handbag, and habitually turned on the computer to check the various records and nursing conditions of the patients in this group.

"Just now, Dr. Zhou Can said that the patient in bed 51 may be experiencing internal bleeding. He suggested that we give the patient an angiographic examination of the digestive tract."

Luo Shengsheng took advantage of the opportunity to tell the story.

"Zhou Can?"

Dr. Xia's eyes fell on Zhou Can's face again, and he looked at him carefully.

"This name is a bit familiar, looking at the tight face, are you?"

"I'm Zhou Can, a new student from Guipei. I'll ask Dr. Xia to teach me more in the future."

Zhou Can greeted with a smile.

As for flattering him like Luo Shengsheng, he couldn't do it.

Even when treating the chief physician, Zhou Can never grovels, at most he treats him with normal respect.

There is no right or wrong in this kind of thing, nor does it mean that he is more noble because he is unwilling to bow his knees.

It's just that the way of life is different.

He wants to live with more dignity.

I would rather gain bonus points for strength through diligent study and hard work, rather than gain bonus points by groveling to please superiors.

Occasionally he would flatter, but it was much more advanced than Luo Shengsheng.

Most of what he shoots is that kind of high-end flattery.

"Oh... I remembered. Last time, there was a patient with lower gastrointestinal bleeding in the intensive care department. You called me. Later, I heard that I was diagnosed by you. The young man is quite capable."

Doctor Xia Ping has a deep memory of this incident.

The patient was treated by him for a long time without any effect, and was finally sent to the intensive care medicine department. Seeing that his life was hanging by a thread, he might prepare for the funeral at any time.

Unexpectedly, a small-scale trainee named Zhou Can found out the real cause of the disease, which turned out to be infection with a parasite that had never been seen before.

That patient was cured, which was equivalent to slapping Dr. Xia Ping in the face.

Therefore, Xia Ping has a deep memory of this matter.

He was afraid that he would be slapped in the face again today.

"How did Dr. Zhou know that the patient in bed 51 was bleeding from the gastrointestinal tract?"

Xia Ping suffered a loss once, and learned a lesson this time, he did not dare to take it lightly.

"I came to report in the morning, and when I happened to pass by, I saw a bed doctor measuring the basic signs of patients in bed 51..."

Zhou Can recounted what happened.

"Therefore, I suggest that an angiography of the digestive tract be performed on the patient immediately, and that the patient be treated in time to avoid tragedy."

"You need to make an appointment with the interventional department for gastrointestinal radiography. You can confirm that it is jejunum or ileal bleeding just by looking at it?" Dr. Xia Ping has already paid attention to this matter.

It's just that he is still skeptical about Zhou Can's diagnosis.

Not to mention Zhou Can, even he, an attending physician with more than 20 years of working experience, could not judge the bleeding site of a patient with just a few glances.

Especially gastrointestinal bleeding, very difficult to judge.

At this time, a nurse ran into the office in a panic.

"Dr. Xia, Dr. Xia, please go and have a look. The patient in bed 51 suddenly got worse and deteriorated, and he is close to a state of shock! Doctor Zhang, who is in charge of the bed, is doing his best to treat him, so let me come over and report quickly."

Tragedy still happened.

Zhou Can secretly sighed.

This group of doctors in the Department of Gastroenterology should be sent to the Department of Critical Care Medicine for a few months of training.

Let them feel what it means for a patient to die in the next second.

Gastrointestinal diseases are generally chronic diseases, and patients with sudden death rarely appear.Generally, the disease develops slowly, leaving sufficient time for the doctor to treat.

Diagnosing and treating this type of patients for a long time has also developed a work style of gastroenterologists who are unresponsive.

"I'll go right now!"

Xia Ping didn't even have time to think about it, and hurriedly ran to the ward.

If something goes wrong, he needs to take the main responsibility.

What's more, it happened under Zhou Can's repeated reminders, so the responsibility is even greater.

"Fuck, something really happened!"

When Luo Shengsheng looked at Zhou Can, his eyes were completely different.

Not to mention him, when the other two interns in the office looked at Zhou Can, they also worshiped like a god.

This Gui Peisheng is simply the Prophet Emperor.

"Boss Luo!"

Zhou Can stood up and looked at Luo Shengsheng.

"Ah... yes, yes! Doctor Zhou can tell you anything." Luo Shengsheng took the initiative to lower his posture to the extreme.

The word command is used.

"I went to the ward to follow up. The patient's condition has progressed to the stage of shock. I'm afraid there is not much time left for the doctor to call for help. When Dr. Huichi comes, please explain to me."

Zhou Can has super skills in rescue, intervention and endoscopic surgery.

Follow the past to have a look, maybe it can help.

It is an obligation for medical staff to rescue patients in an emergency, and it is also a minimum professional ethics.

Zhou Can followed to the ward, only to see that the patient was unconscious, and his family members were beside him in great grief.The doctor in charge of the bed was in a hurry to do the necessary rescue measures.

"Immediately send the patient to the interventional department for an emergency angiographic examination of the digestive tract."

Doctor Xia Ping's face sank like water.

Looking at the patient's condition, based on his decades of medical experience, his heart sank to the bottom.

Knowing that something is wrong.

If you don't do it right, you will have a big fall today, and your career and future will be seriously affected.

At this moment, Dr. Xia Ping felt a trace of regret in his heart.

If he had followed Zhou Can's advice immediately instead of asking questions and being indecisive, maybe this kind of thing would not have happened.

"Everyone has an accident now, so you just let me do this imaging examination. Earlier, this doctor Zhou proposed to do an imaging examination, but you refused to agree. If something happens to my father, I will sue even if I go bankrupt." In the end, let you, a quack doctor who does nothing, be punished as he deserves!"

At this moment, the patient's son completely broke out.

Any family member would be extremely angry.

As early as 20 minutes ago, Zhou Can suggested that Dr. Zhang, who was in charge of the bed, send the patient for gastrointestinal contrast examination as soon as possible.

As a result, Doctor Zhang, who was in charge of the bed, scolded Zhou Can instead.

Now that the patient seems to be dying, the superior doctor of the hospital agreed to do this contrast examination.

From the patient's point of view, isn't this just intentionally delaying the treatment until the person is about to die?

"Now is not the time to make noise. The most important thing is to try to save the patient's life as soon as possible. Once a person falls into shock, it will be very dangerous and may die at any time."

While appeasing the excitement of the patient's family, Dr. Xia Ping arranged to send the patient for an emergency examination.

Zhou Can pushed the flat bed over, but the family members still agreed with him, and cooperated to get out of the way.

"Hurry up and lift the patient up!"

Zhou Can took a look at Dr. Zhang who was called a dog by his family members, but dared not reply.

This doctor in charge of the bed lacks the beatings of his family members, so if he suffers a second time, he can learn a lesson.

In order not to use the official's assignment to treat the patient next time.

Without further ado, Dr. Zhang helped lift the patient onto the trolley, and rushed the patient to the interventional operating room for examination.

Soon, the patient was sent to the intervention room.

To do this examination, a catheter needs to be inserted into the superior mesenteric artery. The doctor who performed the operation is a novice, and he can make people die suddenly when he sees it.

"Let me do it!"

Zhou Can couldn't argue, and stepped forward to take over the job.

I saw that he was skillful and successfully inserted the catheter into the superior mesenteric artery very easily.

The contrast agent was poured in, and after almost two or three seconds, the abnormality was discovered.

The patient had abnormal staining and contrast extravasation in the upper left abdomen.

Contrast medium overflows at this part, which means that it is a bleeding point.

"It turned out that the bleeding point was in this area. No wonder the colonoscopy failed to detect it. During the examination, the patient just stopped bleeding, so it was impossible to think that the bleeding point would be here."

Dr. Xia Ping admired Zhou Can so much at the moment.

It's hard to put into words.

This Gui Peisheng is too awesome.Just looking at the patient with the naked eye, the bleeding site can be located in the ileum or jejunum area according to the patient's symptoms.

Now the bleeding point has been identified, which means that the blood vessel branches in the upper part of the jejunum are bleeding.

"Doctor Peng, where's your master? The patient's condition is so serious that it needs to be dealt with urgently. You don't usually operate much, so I'm afraid you won't be able to do it. Hurry up and call your master!"

Dr. Xia Ping's status in gastroenterology should not be low.

At least it can be seen from the attitude of the doctors in the operating room towards him.

"Okay, I'll call right away!"

Without saying a word, the young interventional doctor hurriedly asked Master for help.

I was on duty at night, and it seemed that it was almost time to switch over, but I didn't expect this kind of thing to happen.

This patient has fallen into a state of shock. It is probably the first time he has encountered interventional surgery on the digestive tract for so long.His face turned pale with fright.

"Before his master comes, let me try it! The patient may not be able to wait until then!"

Zhou Can said this to Dr. Xia Ping.

"Okay, Dr. Zhou is here!"

At this moment, Xia Ping felt that Zhou Can was a savior sent from heaven.

Just now, seeing Zhou Can easily insert the angiography catheter into the artery, he knew that Zhou Can must have a strong ability in interventional surgery.

With the approval of the superior doctor, Zhou Can no longer hesitated.

Operate the microcatheter to the bleeding artery.

It reaches the first branch of the superior mesenteric artery, the branch of the vessel in the upper part of the jejunum.

The seemingly simple operation, without a certain level of intervention skills, cannot be operated at all.At least Xia Ping and Dr. Zhang don't have this ability.

In order to confirm the accuracy of the test results, Zhou Can injected contrast medium again for examination.

It was determined that the blood vessel responsible for the bleeding was this one.

Just as Zhou Can was about to discuss the next treatment plan with Xia Ping, the patient's condition deteriorated sharply again.

The patient suddenly turned his eyelids up, his whole body twitched, and his blood pressure dropped wildly.

It dropped directly to 45/28mmHg.
This frightened Dr. Xia Ping.Not only him, but the doctors and nurses beside him were all nervous and their faces were solemn.They rushed into the rescue.

Even the doctors and nurses who were doing another operation in the nearby operating room, as long as they could spare their hands, rushed over to help rescue the patients together.

Dr. Xia Ping directly adjusted the patient's infusion speed to the maximum.

"Adrenaline, two shots first!"

He kept urging.

"Two are too few, at least four at a time!"

Zhou Can's rescue skills are by no means inferior to Dr. Xia Ping's.

Following the anesthesiologist Dr. Guan and Dr. Feng, I learned so much first aid knowledge and life support skills.He has also been trained in the intensive care medicine department for three months, which is enough to make Zhou Can's rescue level much better than that of ordinary attending doctors.

After all, there are specializations in the surgery industry, and many attending physicians are only good at knowledge in their own field.

"Push four!"

Doctor Xia Ping hesitated for a moment, and finally chose to listen to Zhou Can.

Although this made him feel a bit dull, but thinking of Zhou Can's many excellent performances, Xia Ping could only do so willingly.

In fact, when rescuing patients, one or two doctors with the highest level are definitely the backbone of the operating room.

All doctors and nurses follow their orders.

Zhou Can is so young, but the rescue decision he made can make an attending physician do what he says, which inevitably makes other doctors and nurses take time to look at him.

"Has the red blood cell suspension in the blood bank been adjusted?"

Zhou Can was not polite at all, and asked directly.

"I adjusted it, and it will be delivered right away."

A nurse rushed to answer.

"Give me the deep vein catheter package!"

Zhou Can's ability to place tubes is afraid that few people can be better than him.After receiving it, put a deep vein catheter directly on the patient.

At this time, the blood bank finally delivered the blood.

After a series of rehydration, catheterization, pressurization, blood transfusion, and embolization of bleeding vessels, the patient was finally pulled back from the death line.

All the doctors and nurses breathed a sigh of relief.

But this is only an emergency rescue measure.Didn't really solve the lesion problem.

"Call the general surgery department and ask them to send the surgeon over to perform an emergency laparotomy on the patient."

Physicians do surgery, not their specialty.

For the patient's condition, only by asking a doctor from the general surgery department to help, can the patient's lesions be completely cured.

Zhou Can's mouth moved, and finally swallowed back what he wanted to say.

He is not high enough to preside over this operation.

We can only wait for the general surgery doctor to come over.

I just came out of general surgery yesterday, and today I can see the doctor of general surgery again in gastroenterology, which is really interesting.

I just don't know which doctor will be sent by the general surgery department to help?

(End of this chapter)