My medical skills add experience

Chapter 34 The third advanced medical skill

The emergency department of Tuya Hospital is always so busy, before eight o'clock, the corridor is already full of patients seeking treatment.

Many patients who obviously should register for a specialist clinic number, in order to see a doctor earlier, or they have run out of appointments for that day's specialist clinic number.They crowded into the emergency department.

This also exacerbated the shortage of emergency department staff.

"Doctor Zhou, hurry up and help in the operating room. There is a car accident patient who needs emergency surgery."

Seeing Zhou Can, Ye Tingting immediately called him to support the operating room.

Based on my feeling, her title should not be too low.

Certainly not junior nurse level, at least junior nurse.

She seems to have a special affection for Zhou Can, and she took care of Zhou Can in the operating room yesterday.

Jin Mingxi, who entered the emergency department with Zhou Can, did not have this treatment.

"Okay, I'll go right away!"

As soon as Zhou Can heard that there was an operation possible, he immediately became excited.

After changing into the surgical gown, I went into the operating room to have a look.

I saw Dr. Xu, an unfamiliar resident doctor, an anesthesiologist, and equipment nurse Tang Ling. A total of four people were preparing the patient for surgery.

"Good morning, Doctor Xu! Good morning, you all!"

Zhou Can took the initiative to greet the four of them.

The patient's thighs were bloody and bloody.The bloody trousers have been cut off.

Perhaps due to lack of manpower, the equipment nurse has multiple roles and is disinfecting the patient's upcoming surgery.

Although in the eyes of doctors, there is no distinction between men and women.

But when she watched her disinfect the patient's perineal area, she was obviously embarrassed.

"Let me do it!"

Zhou Can took the initiative to snatch the pliers from her hand, and sterilized the patient with sterile cotton.

"Thank you!"

Tang Ling showed him a grateful smile.

"polite!"

When Zhou Can was an intern, he did this kind of thing a lot.It is very proficient in operation now.

It was done in no time.

"Introduce the catheter to the patient."

Doctor Xu ordered.

This is usually the job of nurses.Tang Ling held the catheter and looked at Zhou Can for help.

"In the future, when I am present, just leave this kind of work to me."

Zhou Can took the initiative to take the catheter without her asking, and skillfully inserted the catheter into the patient.

Catheterization serves multiple purposes in a critically injured patient like this.

For example, obtaining urine samples for laboratory tests, real-time monitoring of whether the patient is urinating normally after surgery, etc.

[Congratulations on getting the implantation technique, the current experience value is 1/1000 of the third level.Special equipment or drugs such as vascular stents, bone nails, and springs can be placed in the corresponding tissue parts of the patient. 】

Zhou Can was stunned for a moment, then ecstatically.

Implantation is an advanced medical technique.

Its practice is extremely difficult.

But it is widely used in various high-difficulty precision operations.Such as heart stent placement, vascular balloon placement, etc.

It is directly at the third level, which is equivalent to the inferior level of a resident doctor, which makes Zhou Can very satisfied.

If this medical skill is practiced well, when it returns to surgery one day, it will definitely shock everyone.

He was pleasantly surprised by inserting a urinary catheter and actually getting implantation.

It seems that these humble chores can also be rushed to do in the future.

Inserting a urinary catheter can get 1 insertion experience point, which is simply not too cool.

It's as enjoyable as picking up hundred-dollar bills on the street.

At present, he already has three advanced medical skills, if he can raise them all to the attending level.At that time, I will be able to take on some difficult surgical work.

"The patient's legs have been severely fractured internally. Our emergency department can only deal with the injury initially to ensure the safety of the patient's life. We will do our best to keep his two legs and then transfer them to the surgeon."

Dr. Xu set the tone for this operation.

The emergency department simply does not have the conditions to perform all operations on such patients.

Its job is to rescue critical patients and do its best to save lives.

"Dr. Lin's suturing and ligation level is much higher than that of Xiao Zhou, so Dr. Lin will be my assistant, and Xiao Zhou will be in charge of assisting and part-time as a nurse on tour."

After Dr. Xu arranged the division of labor, several people took their positions.

"Ouyang, are the patient's vital signs okay?"

"Operation possible."

Before the operation, the opinion of the anesthesiologist must be obtained first.

The patient's blood pressure was significantly low and his heart rate was too fast.Indicates excessive blood loss.

There is a femoral artery in the thigh that is fast enough to bleed to death.

Judging from the current situation, the femoral artery is likely to have been ruptured.

Many people may not know how high the risk factor of femoral artery rupture is.I believe everyone knows that if the neck is cut, a person can easily die.

In fact, if the trachea in the neck is cut, the person will not die immediately.

But when the carotid artery is cut, blood will spurt out immediately.

The femoral artery, like the carotid artery, is a direct coronary artery.

This hemorrhage is very scary.

Second only to the heart being pierced by a sharp weapon.

On the contrary, it is a common suicide by cutting the wrist in TV dramas. The bleeding is actually not that terrible.In some environments with strong coagulation function or low temperature, it is likely to stop bleeding automatically.

Dr. Xu carefully debrides the crushed part of the patient's leg.

I saw a stream of blood gushing out like a spring.

"Hemostatic forceps!"

Before Dr. Xu finished speaking, Zhou Can had already clamped the proximal end of the bleeding blood vessel with a hemostat.

Intermediate-level hemostasis for residents is not free.

The first assistant, Dr. Lin, looked at Zhou Can in a little surprise.

"I heard that the emergency department recruited two go-getters. I still don't quite believe it. After seeing Dr. Zhou's hemostasis level, I believe it now."

As soon as the master makes a move, he will know if there is any.

Zhou Canlu's ability to stop the bleeding immediately won the respect of Dr. Lin.

Surgery is not like writing a dissertation. Many attending doctors will spend money on dissertations or even projects in order to gain the title of associate senior.Or use various means to reduce the difficulty of evaluating deputy senior titles.

Even if it is rated in the end, the level can be imagined.

There is only a false name, but it is actually very watery.

Surgery can't be faked.

It's okay, if you don't, you will be exposed immediately.

"I don't dare to take the title of general. I will ask Dr. Lin to take care of me in the future."

Zhou Can lowered his posture as much as possible.

For newcomers, the lower the profile, the better.

As long as he earns experience points silently, he will be able to leave opponents like Dr. Lin and Jin Mingxi far behind in a short time.

"Since the bleeding point on this side has been found, Dr. Lin, you clean up the wound on the other side. Xiao Zhou maintains the hemostatic position, and I will perform the anastomosis."

This is an anastomosis of the femoral artery. Although the difficulty is not too high, it is a test of the doctor's anastomosis level.

Dr. Xu is not at ease to let Dr. Lin do it.

Choose to match in person.

Zhou Can was jealous for a while, but unfortunately his current anastomosis level is only inferior to that of a resident doctor.If it can be promoted to the excellent level of a resident doctor, it should be able to anastomose the femoral artery well.

In the patient's other leg, the muscles and bones inside were destroyed, but the skin was still attached.

Dr. Lin carefully cut the epidermis.

I saw that the muscles under the skin had rotted away.

There were hematomas and gores everywhere.

There are even bone fragments.

It's too awful.

The injured should have been run over by the rear wheels of a large truck over his legs.

On the other side, there was a hole in the femoral artery.

Blood is being sprayed out.

Zhou Can had to use two things at once, freeing up his left hand to hold the hemostat to control the bleeding point.

"Thank you!"

Without Zhou Can's help, Dr. Lin would not be able to operate alone.

This ruptured femoral vessel needs repair.

"Doctor Xu, the femoral artery here is also broken. It's in good condition. Can you let me repair it?"

When Dr. Lin asked this question, Zhou Can probably deduced his suturing skills.

If you are exhausted, you will not exceed the excellent level of a resident doctor.

It seems that the gap with Dr. Lin is not that big.

Zhou Can's current suture level is inferior to that of a resident doctor. He only needs to spend a few months in the operating room, and he may overtake Dr. Lin.

Others can only improve their medical skills step by step and at a slow pace.

For the vast majority of surgical residents, it takes at least five years for the suturing level to be improved from inferior to excellent.

This has to be the case that the amount of surgery is sufficient.

If it takes three or four days to get a suture opportunity, and then practice in private without being too diligent, it may not even reach an excellent level in seven or eight years.

So in comparison, Zhou Can's advantage is quite large.

"You can try it. The suture gap should be tight, and the arterial pressure needs to be fully considered."

Doctor Xu agreed.

On the one hand, he was too busy.

On the other hand, as long as the risk is not particularly high, he will try his best to delegate power to his doctors to help them grow quickly.

"clear."

Dr. Lin nodded and quickly began repairing the ruptured femoral artery.

Thanks to the protection of skin and flesh, the damage to the femoral artery was not particularly serious.

Otherwise, just blood vessel repair will be very troublesome.

"Dr. Lin's suture level should be at the middle level of a resident doctor."

After seeing Dr. Lin's blood vessel repair, Zhou Can has a bottom line in his mind.

It seems that it doesn't take too long to surpass Dr. Lin in suture level.

Be proactive, maybe you can surpass him in ten days and half a month.

"Xiaozhou, large artery anastomosis, in addition to ensuring that the suture gap is tight, you must also pay attention to distinguishing whether the blood vessel is damaged. Like this, it must be cut off. If the distance between the two blood vessels is too far after the cut, the pulling force is too large. Do not forcibly anastomose. You can take a section of the great saphenous vein or replace it with an artificial blood vessel."

"It is generally best to consider using the patient's own blood vessels. Although the technology of artificial blood vessels is very mature, it is still a minefield. Especially when operating on young patients, it must be considered that they will live for decades. Using any artificial organs and tissues Be careful when replacing it."

While operating, Dr. Xu carefully passed on his valuable surgical experience to him.

"remember."

Zhou Can nodded with an extremely sincere attitude.

Modesty and eagerness to learn are one of his great strengths.

In the operating room, Jin Mingxi and Dr. Lu came in one after another.

It's shift time.

Dr. Lin worked the night shift, while Dr. Xu and Tang Ling came to help after receiving a call from the hospital.

After more than 20 minutes, Dr. Xu has successfully anastomosed the severed femoral artery.

Dr. Lin is still busy.

Depending on the level, the speed of the operation will also vary greatly.

A powerful surgeon, not only the operation time is short, but also the operation quality is particularly high.

"Xiao Zhou, let go of the hemostat here and try the blood flow."

Zhou Can slowly loosened the hemostat.

Instead of frizzy direct release.

From this point, it can also be seen that his level of hemostasis is quite good.The real high level is not only reflected in the wonderful technology, but also needs to pay attention to many details.

Like this kind of artery and large blood vessel, just after the anastomosis is successful, the hemostatic clamp is suddenly released.

It is equivalent to suddenly opening all the gates when opening the gates for flood discharge.

It is easy to cause adverse consequences.

(End of this chapter)