My medical skills add experience

Chapter 268 A doctor's sense of responsibility is better than blue
The patient had lung cancer, which belonged to insufficient preoperative examination.

Although the situation was urgent at that time, and the patient's right lung was compressed by 80%, and he was accompanied by complicated diseases such as pneumothorax and severe pleural effusion, it was still a mistake in the work.

If it is known that the patient has a tumor in the lungs before the operation, he may be more cautious in the rescue and think of using double-lumen catheterization.

There are various objective factors in the occurrence of every accident.

Medical staff must be careful and careful to avoid accidents.

Now the patient's life is saved, and a medical accident was successfully resolved by Zhou Can.However, the patient's thoracotomy and exploratory surgery was not for nothing, but for the treatment of the disease.

If the lung tumor is not resolved, the patient will still die.

Just how to solve it is a problem.

With so many chief physicians and senior physicians here, how dare Zhou Can express his opinions indiscriminately!

To save someone just now, you can act urgently.

Now that the patient's vital signs have stabilized, he will never be this early bird again.

"What I mean is to listen to your chief physicians, and do whatever you say!"

Zhou Can's words made everyone amused.

The tense atmosphere in the operating room was once again diluted, and everyone could clearly feel that the discussion atmosphere became as relaxed as usual.

Zhou Can made great achievements without being arrogant, which made everyone feel good about him.

"Director Le, Director Liu, what's your opinion?"

Director Xueyan seeks other people's opinions.

"This operation is full of hardships, and it is not easy to save the patient's life. Everyone can express their opinions and work together to help this patient recover."

She gives full play to the softness and tolerance of women, and mobilizes everyone.

Join the discussion together.

"Then I'll throw bricks at you and express some immature opinions." Director Le's strength is not bad, especially in the cardiovascular field, the level is quite high.

"Personally, I think the operation plan for the patient was originally a thoracotomy for exploration. It was only a little accident during the anesthesia process of the thoracotomy, which disrupted the original operation plan. Now the chest has been opened and the cause of the disease has been found. Whether it’s time for Tailai or not, we might as well communicate with the family members immediately. Take this opportunity to remove the tumor and create favorable conditions for the patient’s follow-up recovery.”

This solution is the best solution, but many people still have concerns.

The main reason is that everyone still has lingering fears when they recall that the patient almost died during the general anesthesia.

Now that the patient has finally been rescued, many doctors are holding the principle that they would rather do nothing than fail.

According to their meaning, it is to keep the existing achievements and let the patients leave the operating room safely.

Don't overdo it.

"Removing the tumor is of course a very good plan, but everyone has seen the patient's condition, and the patient almost died. Under such circumstances, can the patient tolerate surgery to remove the tumor?"

A deputy chief physician raised objections.

"I also think it's better to be on the safe side. You can wait for the patient's physical condition to improve before performing this operation."

"Look at him like a candle in the wind, fluttering, I'm really worried that he won't be able to get off the operating table."

"Don't seek meritorious service, but seek no faults. It's better to be steady."

There are quite a few conservatives.

No one wants to be involved in a medical malpractice, let alone watch the patient die.

"Director Liu, you are an expert in the Department of Critical Care Medicine, and you are an anesthesiologist yourself. You have a certain authority in evaluating patients' surgical risks. Tell me!"

Xueyan looked at Director Liu.

When she asked this question, her opinion must be biased towards Director Le's proposal, and she wanted to have the operation done at once.

"Well... I don't dare to decide on this. Judging from the patient's tumor condition, I am afraid that the entire right lung needs to be removed, and the risk is quite high."

Director Liu's opinion is relatively neutral.

Being able to be the director of the intensive care medicine department is relatively smooth in dealing with various things.

He just came here to take part in rescuing this patient. Now that the mission is complete, he obviously doesn't want to cause any more trouble.He just wanted to get out as soon as possible and return to his intensive care medicine department.

"Doctor officer, what's your opinion?"

Director Xue didn't ask him the real anesthesiologist's opinion first, but asked him last after asking others.It can also be seen that the accident in this operation has greatly reduced the status of the official doctor.

The right to speak has subsequently declined, and it has become nothing more than a normal thing.

Doctor Guan was still in shock and obviously out of shape.

After hesitating for a moment, he said, "If it is decided to remove the tumor for the patient, I will apply for another anesthesiologist. Please invite Director Feng from our anesthesiology department."

At this time, I could feel that Dr. Guan not only spoke in a weak tone, but also began to be extremely unconfident in his professional ability.

Medical malpractice hits the doctors and nurses involved very hard.

Enough to make them seriously doubt their professional level.

Before that, Dr. Guan gave Zhou Can the impression of being calm, confident, and calm in situations.

I don't know how long it will take him to get out of the shadows after going through this incident?
"Please ask Director Feng to come and help immediately." After she finished speaking to the patrol nurse, she turned to look at Director Le. "Director Le, is it okay for you to come forward to communicate with the family members and ask them for their opinions?"

"no problem!"

Director Le readily agreed.

"Director Xue, Director Le, should you reconsider, the risk is too high!"

An older senior deputy chief physician persuaded him full of worries.

"It's not that we don't want to seek stability, but that the patient has only two options. Either take this opportunity to remove the tumor. Or close the chest immediately and treat conservatively. If you choose conservative treatment, it will take at least half a year before the second thoracotomy. At that time, The tumor has already spread. And it is hard to say whether the patient can survive for half a year."

Director Le patiently analyzed the patient's condition for the old comrade.

In fact, even if I believe him, even if he doesn't say anything, this old comrade knows the consequences of conservative treatment.

At this time, it is a test of a doctor's sense of responsibility.

Taking the risk of cutting a patient's tumor is of great benefit to the patient.For doctors, there are huge risks.

Although the surgical consent form will be signed before the operation, there is still a lot of trouble for the patient to die on the operating table.It can negatively affect the doctor's reputation.

Other interests will also suffer.

After Director Le finished his analysis in public, he didn't speak any more.

Soon, Dr. Feng rushed to the operating room.

Zhou Can can be regarded as half of his apprentice, and when he saw him, he hurriedly greeted him honestly.

Doctor Feng was cold and taciturn as usual.

He just nodded slightly and hummed.

Looking at Dr. Guan, "It's normal for something to happen. There is no anesthesiologist who hasn't died before." Unexpectedly, when we met, Dr. Feng didn't blame Dr. Guan, but cared for him warmly. with relief.

"That's what I said, but when I really saw the patient almost died due to anesthesia, the psychological shadow is still difficult to dispel in a short time. I... I really don't have confidence in this operation, and I dare not take any more risks."

Dr. Guan lowered his head in shame, like a child who has done something wrong, repenting in front of his parents.

"You have been an anesthesiologist for so many years, and it's not like you haven't seen a patient die. As a doctor, from the moment we study medicine, we should understand that the road is full of thorns, and there are countless difficulties and obstacles ahead, and cliffs are waiting for us. Go for it. It’s not terrible to have an accident, the terrible thing is not to learn from the lesson and fall twice in the same pit.”

Dr. Feng's words deeply touched every doctor and nurse present.

Yes, when I first studied medicine, where did my initial aspiration and drive go?
Which medical student really studies medicine just to have a good job, just to make money?Being able to have a decent job and a good social status is just part of studying medicine.

Everyone thinks more about saving lives and healing the wounded, and being an angel in this world.

Saving the lives of patients and relieving their pain is what every medical student really wants to pursue.It is also the most simple feelings of doctors, nurses and pharmacists.

It is a passion for the medical industry.

"I... will reflect deeply, adjust my mentality, and strive to return to normal work as soon as possible. Please let me go home and rest for two days, and give me a time to adjust myself."

After Dr. Guan heard this, he didn't back down.

At least I didn't think about quitting the anesthesiologist industry.

"I won't approve this fake. Get up from wherever you fall. I can help you with the anesthesia work for this operation, but I still hope that you will preside over the anesthesia work, even including the management of the entire perioperative period." Dr. Feng Although he was a bit colder and more serious, the way he taught his apprentices was very clever.

Whether it is teaching Zhou Can or an official doctor, they can teach students in accordance with their aptitude.Especially when the official doctor encounters a major setback, he is not like other senior doctors who don't care about the three sevens and twenty ones, and just swear at him.Instead, find ways to help them come out of the shadows.

"All right!"

Doctor Guan reluctantly agreed, but finally agreed.

Doctor Feng has supported him like this, if he continues to back down blindly, he will really become an idiot who cannot be supported.

"Director Xue, you can communicate well with your family members, and you can just operate directly. You don't have to worry about the anesthesia work for this operation, our anesthesiology department will fully undertake it."

After Dr. Feng persuaded Dr. Guan, he expressed his opinion to Director Xue.

Do things clearly.

"Okay, thank you. Thank you to the doctors in the anesthesiology department for escorting our high-risk operation. Director Le is communicating with the family members outside. If the family members agree to take this risky operation, we will carry it out immediately."

Director Xueyan thanked him.

She has always been gentle with others, making people feel very comfortable like a spring breeze.

Doctor Feng looked at Doctor Guan again.

"Tell me, what mistakes did you make in this operation? What have you learned?"

"There were many mistakes. Before the general anesthesia operation, according to the usual practice, I injected scopolamine to the patient, ignoring the possible risks. This is one of them. After the accident, I participated in the rescue work with Director Hu. At that time, we only focused on helping the patient recover spontaneous breathing and heartbeat as quickly as possible, but ignored the risk of blood clots in the patient's pleural effusion, which eventually caused blood clots to block the drainage tube, resulting in the failure of the first rescue. This is the second .”

Doctor Guan checked and corrected himself, and reflected on two mistakes.

"If I encounter a patient with spontaneous hemopneumothorax in the future and undergo anesthesia after closed thoracic drainage, I will choose double-lumen endobronchial intubation instead of blindly pursuing speed. I can't save trouble."

Dr. Guan made a profound review and reflection.

After listening, Dr. Feng was a little dissatisfied.

"do you have anything else?"

"Others?" Doctor Guan thought for a while and shook his head slightly.

He couldn't think of any other mistakes.

"Zhou Can, tell me!"

Doctor Feng suddenly looked at Zhou Can.

At this moment, Zhou Can is studying the patient's lung tumor, and is drawing up a resection plan in his mind.

Suddenly hearing Doctor Feng's question, he turned his head and looked over.

"Uh... I can only provide some precautions. For example, after tracheal intubation, when the mask inhales oxygen and nitrogen, the ventilation volume should not be too large. When I rushed here to participate in the rescue just now, the ventilation volume was quite large. And After intubation, you need to ventilate the side lung, and try to use low tidal volume and low pressure for ventilation. Finally, when the patient is breathing spontaneously, if the respiratory resistance increases and the water column of the drainage tube does not fluctuate, the ventilation should be stopped immediately.”

Zhou Can spoke modestly, pointing out the problems he saw after arriving.

These are all errors in the operation of the official doctor.

Maybe the official doctor was completely out of control at that time, which caused many mistakes.

If the patient had a condition during the first rescue and the ventilation could be stopped immediately, the situation might be better.

Doctor Guan did not stop the ventilation at that time, indicating that his professional knowledge was flawed.

"Dr. Zhou's words awakened the dreamer. After listening to it, I realized that there are still so many mistakes. Thank you for your guidance." Doctor Guan thanked him sincerely. "It was found that the patient's breathing resistance increased, and the water column of the drainage tube did not fluctuate. Besides stopping the ventilation immediately, is there any other measure?"

He really didn't understand, so he took the opportunity to humbly ask Zhou Can for advice.

"You can try to squeeze the drainage tube. If it doesn't work, you can quickly change the patient's position, or enter the chest for treatment."

Zhou Can was not stingy, and shared everything he had learned.

Doctor Feng nodded again and again, his eyes showing approval.

"It turns out there are so many methods. My knowledge is too short on how to deal with this. In the future, I will learn more from Dr. Zhou." For the first time, Dr. Guan discovered that the gap between him and Zhou Can had widened. so big.

You know, many times in the past, he was the one who taught Zhou Can anesthesia.

Today, Zhou Can is already better than blue, and has clearly surpassed him in some areas of knowledge.

Feeling Zhou Can's progress firsthand, Dr. Guan was extremely shocked.

It also aroused his desire to learn and wanted to catch up.

Otherwise, it would be a shame to be overtaken by a junior.

Although Director Xueyan and the others in the operating room did not speak, their perception of Zhou Can's strength in their hearts was quietly raised to a higher level than the original one.

They are all medical students. It is easy to tell who has a higher level and who has a lower level.

Zhou Can didn't know that just because of a small 'discussion' with the official doctor, the doctors and nurses present had invisibly raised their opinion of him by a level.

At this moment, Director Le had finished communicating with the family members and came in.

"The family members were shocked when they learned that the patient had lung cancer. They even suspected that our doctor was lying. After much effort, they finally convinced them. The family members agreed to have the tumor removed."

Director Le reported the hard-won progress to everyone.

Sometimes it's really hard to be a doctor.

Not only do we have to find ways to find the cause of the disease and treat the patient's disease, but we also have to do our best to communicate with the family members.

Taking this patient as an example, the doctors could do more than do less, close the chest cavity, and tell the family members that surgical resection of the tumor is too risky.After the patient recovers, he will come back to the hospital in half a year to see if there is a chance for surgery.

There was nothing the family could do.

Can only follow the doctor's arrangement.

Now, doctors take huge risks to consider the vital interests of patients, but they still have to be questioned by family members.This makes the doctor feel very hurt and tired.

"Let's prepare for the operation! Can Director Le be the chief surgeon?" Director Xueyan's surgical ability is relatively weak, but her academic ability is very strong.

She has the ability to perform tumor resection for this patient, but she feels that she will be more confident if she lets Director Le perform the surgery.

"I can perform the surgery, but this operation is quite special. The patient's current condition is not very good. The shorter the operation time, the better. Dr. Zhou's operation is very good, and the speed is far better than ours. Moreover, he performs the operation, and the patient's The amount of bleeding is the least among all the doctors I have seen. It is more beneficial for the patient to have him perform the operation."

Director Le recommended Zhou Can as the surgeon.

At the beginning, when Zhou Can was trained in cardiothoracic surgery, Director Le was deeply impressed by his strong surgical skills.

Half a year has passed now, and the surgical prowess that Zhou Can showed during the chest opening just now is even more terrifying than before.That's why he wanted Zhou Can to perform this operation.

"Doctor Zhou, can you? You can rest assured that the risk will be borne by me."

Director Xueyan looked at Zhou Can.

In fact, deep down in her heart, she also preferred to let Zhou Can preside over the operation.

Slow down, it will really kill people.

The patient is already like this, and the sooner the operation is completed, the better.

"I'm OK."

Zhou Can did not refuse.

He has a deep connection with cardiothoracic surgery, and it is his duty to contribute now.

As for personal gains and losses, he didn't think too much about it.

He has studied carefully just now, and he is fully capable of removing the patient's lung tumor.

(End of this chapter)