My medical skills add experience

Chapter 31 Seemingly harsh, but caring

Opportunities are right in front of you, and you have to be bold and thick-skinned to get them.

"Doctor Xu, can I have an open abdomen?"

"no!"

Dr. Xu refused without thinking about it.

A smile appeared on the corner of Dr. Lu's mouth, and when he looked at Zhou Can, he somewhat mocked him for his ignorance.

"Zhou Can, don't worry, when the time is right, Dr. Xu will give you a chance to exercise." Ye Tingting winked at him, and expressed relief.

"Ok!"

Zhou Can smiled gratefully at her.

This is a second-level operation. Although laparotomy is not as dangerous as thoracotomy, the risk is not small.Being rejected by Dr. Xu was within his expectations.

Opportunities are always worth fighting for.

Success or failure is out of his control.

At least try your best and you won't regret it.

"You stand there and watch carefully!"

After Dr. Xu refused his request, he gave him another chance to watch and learn from the best angle.

Zhou Can was secretly happy, Dr. Xu clearly intended to train him.

"When choosing the position of the scalpel, it is necessary to avoid important blood vessels and nerves that may exist. There is not much difference in the position of the appendix between males and females, but the anatomical position of the appendix itself sometimes varies greatly, which needs to be combined with the patient's film. Determine the location of the knife. Under normal circumstances, the appendix is ​​located in the right lower abdomen, the middle and outer 1/3 point of the line connecting the umbilical cord and the superior iliac space, which is called McBurney's point."

While explaining, Dr. Xu demonstrated.

"Here, her Max's point is here. During the operation, the incision will be made along the Max's point."

This kind of practical experience is very important.

It was summed up by the predecessors after countless surgeries.

It can ensure that the operation will not go wrong to the greatest extent.

Zhou Can kept them in mind one by one, and he put away the idea of ​​rushing forward.Set your heart down and study hard.

After Dr. Xu finished explaining, he began to operate.

The scalpel seemed to be alive in his hands.

Drop the knife and pull back.

His eyes are sharp, and his movements are accurate, steady and fast.

The skin, subcutaneous fat, the anterior sheath of the rectus abdominis, the rectus abdominis, and the posterior sheath of the rectus abdominis, all layers of human tissue were cut open layer by layer as if by magic.

Zhou Can's eyes straightened.

This level is not inferior to Director Liu.

Never thought that the worst emergency department hides such a powerful expert.Moreover, Dr. Xu is only an attending doctor.

Not even the deputy director.

With such a high level of surgery, it is really a shame to be an attending doctor in the emergency department.

As these layers of tissue were cut open, blood began to flow out rapidly.

Dr. Lu's first assistant immediately held the electrocoagulation knife to help stop the bleeding.

It's just that Dr. Lu's level is really not flattering.

The speed is not bad, but accidental injury or incomplete hemostasis sometimes happens.

He is very sloppy in his work.

No wonder he was kicked out by the weight department.

If you can't correct the problem of sloppy work, you can only do first-level and second-level operations.I can't even preside over a second-level operation, I can only be an assistant.

As far as this level of hemostasis is concerned, Zhou Can is much better than him.

Contempt is contempt, Zhou Can is just a trainee, so naturally he is not qualified to criticize a senior resident doctor.

Dr. Xu frowned, but didn't say much.

It is estimated that there is no way.

The emergency department was already understaffed, so even if Dr. Lu's level skills and attitude were sloppy, he could only make do with it.

This is the real situation in the emergency department.

But now that Zhou Can and Jin Mingxi are two leaders, this situation will change soon.

"Remember, only two layers of peritoneal fat and peritoneum are left after cutting here. You must be careful during the operation, and you must not try to save trouble and make one size fits all. What is the most important thing in surgery? It is safe. Otherwise, no matter how good you are, a small mistake may destroy you forever."

When Dr. Xu said the last sentence, his tone was very special.

It seems to have deep emotions in it.

This made Zhou Can speculate about Dr. Xu's story.

I saw Dr. Xu holding the scalpel, as if carving a handicraft, with a dignified and focused expression, slashing and pulling unhurriedly.

The peritoneal fat layer was perfectly cut.

Next is the peritoneum.

As soon as it was cut open, pus overflowed.

Dr. Lu stood on the first assistant's seat, motionless like a dead man.

In this case, the pus overflow must be sucked out immediately.

Zhou Can didn't ask for instructions this time.

It was too late to ask for instructions.

Immediately pick up the suction device and suck up the pus.

"I didn't expect the suppuration to be so severe. Her illness must have been dragging on for a long time."

Dr. Xu gave Zhou Can an appreciative look.

If Zhou Can hadn't reacted quickly just now, it would have easily caused wound contamination.

"Doctor Lu, stand over there and pull the hook with Jin Mingxi. Xiao Zhou stands here and is in charge of assisting."

Dr. Xu saw that Zhou Can's auxiliary ability and adaptability seemed to be better than Dr. Lu's, and he didn't show any favor to Dr. Lu, so he directly changed Zhou Can to the first assistant seat.

Appendectomy retractor is not particularly hard, and the operation time is relatively short.

But this arrangement is equivalent to promoting Zhou Can to the first assistant, while Dr. Lu, who is older and more senior, is demoted to the second assistant.

Even though he was wearing a mask, he could feel that Dr. Lu's complexion was a bit ugly.

Anyway, Zhou Can is how the superior arranges and how to do it.

After standing on the first assistant seat, he used the electric coagulation knife in one hand and the suction device in the other.

Looking forward to it.

The peritoneum was cut bit by bit until it was as big as the surgical wound.

At this point, you can already see what's inside.

Bursts of stench came to my face.

The abscess was more serious than imagined.

Necrotic tissue sticks together, like minced meat.

"Make the wound a little wider."

Zhou Can quickly electrocoagulated the bleeding point to stop the bleeding, and then carefully sucked out the pus in the abscess.

It must be sucked clean, otherwise it is easy to cause abdominal contamination.

That would be troublesome.

There is no harm without comparison.

Compared with Dr. Lu's clumsy assistance, Zhou Can is not only ten times more serious, but also has enough hemostasis to beat Dr. Lu by two blocks.

"Xiao Zhou, come and look for the cecum."

"it is good!"

Zhou Can understood that Dr. Xu was focusing on training himself.

It is almost a hand-in-hand teaching.

He followed the colon belt, pushed aside the fat pendants on both sides, and searched carefully.Soon the cecum was found, which was slightly whiter than the small intestine.But it is not pure white, but gray and white.

When the cecum is found, the appendix is ​​also found.

Because they are connected.

Zhou Can used gauze pads on his fingertips to lift up the cecum, and then successfully found the appendix along the colon.

"The adhesion seems to be particularly serious."

Zhou Can looked at Dr. Xu.

"It's not that hard to separate them as long as you're careful."

Dr. Xu looked very calm.

I saw him carefully separating the adhesions.The whole process is meticulous, precise, and unhurried, revealing the style of a master.

When they were separated, he kept teaching Zhou Can some skills and explaining the main points.

It took almost half an hour to completely separate the adhesion tissue.

"Next, the necrotic cecum can be removed. Remember, whether it is removing the cecum or the appendix, it should be done outside the abdominal cavity as much as possible to prevent contamination of the abdominal cavity. If conditions do not allow it, it can only be removed in the abdominal cavity, and gauze must be placed around it. Properly protect all layers of the abdominal cavity."

The lesions have been separated, and it is enough to propose laparotomy.

The stump of the colon was sutured by Dr. Xu himself.

He told Zhou Can and Jin Mingxi the key points, precautions, and various sewing methods without reservation.As for Dr. Lu, he should have taught him a long time ago.

"Retract the intestines, and then clean up the accumulated blood and fluid. After the inspection is correct, you must check the number of surgical instruments and consumables."

There are often irresponsible doctors who forget surgical instruments or gauze in the patient's body.

Eventually cause medical malpractice.

These good habits need to be developed from the beginning.

"Xiao Zhou, shut up your stomach!"

Dr. Xu was right in not agreeing to open his laparotomy and remove his cecum.

Because Zhou Can lacked both experience and surgical skills.

After learning this time, at least the next time Zhou Can is asked to cut the cecum or appendix, the confidence will be much greater.

The growth of every doctor is accumulated over time and gradually grows up.

The experience point system can accelerate his growth, but it cannot help him achieve it overnight.

Dr. Xu also delegated authority to him a little bit and cultivated him slowly.

It seems harsh, but it is actually a kind of love.

If a child is just learning to walk, let him run, which is tantamount to doing him harm.Because that kid can't run very far and falls badly.

After Zhou Can sewed the patient's abdominal cavity, he earned another [-] experience points.

A total of ten stitches were performed on the patient.

His sewing skills are also becoming more and more proficient.

Suturing on patients is completely different from suturing on pigskin and white mice.

First, the feel is different.

Human skin is more delicate and appears more delicate when sutured.

In addition, when practicing with pigskin, there is no psychological pressure.When suturing patients, they will naturally feel nervous and have a lot of psychological pressure.Mental power is also highly concentrated throughout the process.

To be precise, this is the fourth time he has stitched on a patient.

Compared with the first time, all aspects have improved significantly.

Although I still can't be as calm and unhurried as Dr. Xu, at least I won't be as tense as the first time.When he closed the abdominal cavity for the patient just now, his heart was relatively calm.

This kind of improvement in mood is by no means what the experience point system can give.

It can only be improved through surgical experience.

"The sewing is not bad. In the future, I can entrust you with the work of suturing the epidermis and closing the abdominal cavity. It is estimated that Dr. Lu and Dr. Jin have already looked down on this kind of work, right?"

Even a fool can see that Dr. Xu is deliberately cultivating Zhou Can.

"It's good to let Zhou Canduo exercise." Jin Mingxi expressed his opinion.

"I really don't like skin stitching and closing the mouth. When will Dr. Xu let me preside over a second-level surgery!" Dr. Lu said with a smile.

"When will you get rid of your sloppy behavior, and come to me again to make this request!" Dr. Xu said to him mercilessly.

Doctor Lu smiled awkwardly and stopped talking.

The old lady's operation was very successful. After waking up from anesthesia, she was pushed out of the operating room by the nurse.

……

In the emergency operating room, a steady stream of patients are sent in, and the volume is large.

For Zhou Can, it is simply a paradise for upgrading his medical skills.

It's a pity that there are many operations that cannot be done.

Either it will be presided over by Dr. Xu, or the patient can only be persuaded to transfer to a specialist for surgery.

He was busy until twelve o'clock in the evening, when the doctor who took over shift came, Zhou Can got off work.

When he walked out of the hospital, Zhou Can felt that his body was almost falling apart.

Being a doctor is really tiring.

But today's harvest is too big to imagine.

He not only achieved his goal of staying in the hospital as a regular Pearson, but also quickly integrated into the big family of the emergency department.It has been preliminarily approved by Director Lou and Dr. Xu.

Next, as long as you don't kill yourself, the future of development is absolutely bright.

Doctor Xu has obviously started to focus on training him now.

Even Jin Mingxi didn't have this treatment.

In addition, he has earned a lot of experience in the four medical skills of suturing, hemostasis, ligation, and injection.Cutting experience points is the least earned, earning only 2 points.

For the slightly risky dissection, Dr. Xu was worried about accidents, so he basically performed the surgery himself, and dared not let Zhou Can do it.

At most, when cutting, Zhou Can will explain the key points and precautions of each step in detail.

After all, it takes a long time to train a medical talent.

It can't be done in a day or two.

Zhou Can also made study adjustments according to the current situation.

When I return to the dormitory after get off work, I can buy more white mice and rabbits to practice dissection at home.Although practicing dissection on small animals, the increased experience value is 5 times less than practicing on the human body.

But there is no risk.

And if you want to practice, you can practice at home every day.Even if he only increases his incision experience by twenty or thirty points a day, after two or three months of practice, his incision skills can be raised to the level of attending.

He didn't have time to look at his phone all day, so he took out his phone to check it.

There are quite a lot of unread messages.

The group of students in class 512 has exploded.

Almost all the students and teachers sent messages in the group congratulating him and Yang Chan on successfully obtaining the qualification for regular training.

Yang Chan has already replied in the group.

It is nothing more than thanking the teacher for cultivation, thanking the students for their blessings and so on.

Zhou Can did not reply in the group for a long time, and some students quit.

Start to gather together.

Why would he pay attention to his teachers and classmates now that he is so prosperous now?
What's more, some people say that he is now the champion of Tuya Hospital's regular training exam, and even the teacher doesn't pay attention to him, I'm afraid he has forgotten his teacher's kindness long ago.

Zhou Can roughly flipped through the messages in the class group, and was speechless for a while.

　Thank you book friend 170301201120213 for your support!
　　
　
(End of this chapter)