My medical skills add experience

Chapter 498 Reverse Surgery, Congenital Heart Disease Again
Sometimes too much experience may not be a good thing.

If a doctor has too much diagnostic experience, it is easy to form blind confidence.In the diagnosis, it is very easy to make subjective assumptions, so things that get slapped in the face happen.

Director Xueyan was very lucky this time, after all, it was only during the diagnosis that the treatment plan was given too early.

If it wasn't for the fact that the patient secretly broadcast live during the consultation, she could even directly tell the patient that the previous treatment plan was not suitable and needed to be changed.

This is in line with the diagnosis and treatment procedures, and no one can fault it.

Now I feel that I am riding a tiger. In the final analysis, I am worried about the damage to the image of the department.

The patient has at least [-] viewers online during the consultation, and the publicity is not inferior to that of ordinary local TV station interviews.

"The patient has coronary heart disease, myocardial infarction, and his body is weak. For cardiovascular interventional surgery, dredging blood vessels is still the first choice. As for how to operate, I think you can try reverse thinking."

What Zhou Can is best at is reverse thinking.

"How to say?"

She was a little puzzled.

"Under normal circumstances, cardiovascular interventional operations are all entered from the femoral artery. If the blood vessel is too blocked or even calcified, the guide wire may not pass through. Then you can consider entering from the other end of the blood vessel, and the same is true for reverse opening. therapeutic effect."

Zhou Can talked eloquently.

From the films taken by the patient, it can be basically concluded that the blocked arteries of the patient have at least multiple calcified spots.This is also the most common case of severe cardiovascular disease.

The inner wall of the blood vessel is calcified and blocked, which will seriously increase the difficulty of passing the guide wire.

"Get through in reverse?"

Director Xueyan was extremely shocked after hearing Zhou Can's operation plan.

"When the teacher was alive, it seems that he didn't teach us such a treatment plan?"

She thinks that she has been very attentive while studying, and it is impossible for major omissions to occur.

But every time she encounters a difficult case, Zhou Can can always give a treatment plan or a pathological dialectical idea that she has not grasped.

The cardiovascular intervention plan given this time made her feel refreshed.

"When I was training in the Department of Cardiovascular Medicine, I saw Academician Ge perform a similar operation in a medical journal. He was successful, and I think it is at least worth our try. Even if it fails, the trauma of vascular interventional surgery to the patient It is very small and will not cause serious consequences such as patient death."

Zhou Can is full of expectations for this super difficult cardiovascular interventional surgery.

A challenge is often a self-breakthrough.

"Great! We finally have a good plan. Come on, let's continue discussing the implementation and preparation of the surgical plan."

After Director Xueyan heard this, for the first time, she showed a relaxed smile of relief.

As the director of the department, I have to bear more pressure than other people.

……

After more than half an hour of discussion, the two finally decided on the operation plan, and stated that Zhou Can will be the surgeon.

For interventional surgery and endoscopic surgery, Zhou Can indeed has a super talent beyond the reach of ordinary people.

And his current strength is already very strong.

Both implantation and injection are at the fifth level, and they have all reached the level of the deputy director.It is more than enough for interventional surgery of general difficulty.

But this time, it is a very difficult cardiovascular interventional operation. If the injection and implantation can be upgraded to level six, the confidence will be greater.

It is impossible for the patient to wait until he is promoted before coming to treatment.

The only way is to bite the bullet.

Fortunately, the risk of this kind of interventional surgery is low, at most it is a slap in the face if it fails.

He made an appointment with Director Xueyan to start the operation around [-]:[-] pm.

The main reason for choosing night surgery is to cooperate with Zhou Can's work schedule.

Back in the emergency department, Zhou Can immediately threw himself into the crazy operation without mentioning it.

It is already past two o'clock in the afternoon.

Yang Zhi and Pu Dingdong have already started to deal with some minor operations within their capabilities.

Under normal circumstances, Zhou Can attends the consultation in the morning, and the surgical team members will arrive at the operating room on time around [-]:[-] pm.

"Doctor Zhou, come here!"

Yang Zhi is treating a patient with a subcutaneous abscess.Need debridement, Pu Dingdong as an assistant.

Qiao Yu and Ma Xiaolan provided equipment while the other toured the audience.

Seeing Zhou Can come in, they were all very happy.

Zhou Can is the absolute core of this surgical team.

"It's okay, it's okay, do it well!"

Zhou Can stood by and watched Yang Zhi operate.

"Your technique is more exquisite, and the speed is faster. There are many surgical patients outside waiting for your operation. I can't delay any longer. You should come! I will operate slowly when I am not busy next time." .”

Yang Zhi's operation speed is far inferior to Zhou Can's.

He didn't dare to occupy the latrine without shitting.

When Zhou Can came in just now, he did see many surgical patients waiting outside.The pre-anesthesia room was already full, not to mention the corridor outside.

"Okay, then you will assist by the side."

After Zhou Can took over, he quickly sucked up the thick liquid that was not sucked up, and then began to debride the patient's wound.

The purpose of abscess debridement is to remove infected necrotic tissue and allow the patient to recover quickly.

Six-level debridement, plus six-level incision and six-level separation, now it is a piece of cake for Zhou Can to clean up this abscess cavity.

In his hands the scalpel became a magic wand for magic tricks.

Wherever he went, the necrotic tissue in the abscess cavity, whether to retain or remove the infected part, was decided in an instant.

Brush brush!
The knife cuts to the flesh, the blood vessels are perfectly avoided, the nerves are easily separated, and the diseased tissue is quickly removed.

[Quick knife method experience value +1, +1...]

His whole body entered an extremely crazy state.

With the support of six-level debridement, incision, and separation, he doesn't even need a steady knife to restrain the magic of the fast knife, and can guarantee the safety of patients.

This is not the first attempt, but after his separation technique has been promoted to level six, he has already started to consciously try in minor surgery.

Keep practicing and exploring.

Steady knife method and fast knife method can be used alone or in combination.

So far, Zhou Can is probably the only one who can combine the fast knife technique and the steady knife technique.

Even Dr. Xu couldn't do it.

Three different knife methods can be applied to different occasions.

It can be carried out according to actual clinical needs.

After the operation, it took six minutes and 58 seconds, which is close to 7 minutes.

"Doctor, have my abscesses been cleaned up? Don't let it recur again! The operation I performed at the county hospital last time relapsed not long after."

The patient was given local anesthesia and was always awake.

Seeing that Zhou Can took over to operate on him, he didn't say anything.

It's just that Zhou Can's operation was too fast, which made him feel suspicious.

When Yang Zhi operated on him, it took nearly half an hour before he cut open the abscess cavity, drained the pus inside, and sucked it out.

Now this doctor, who looks younger than Yang Zhi, actually completed all the operations in just a few minutes.It's really worrying.

"You put your mind at ease. Dr. Zhou Can is the leader of our operation team. If he operates on you himself, the effect is more than ten times better than mine. Take good care after the operation, I believe You will experience what is called fast and good abscess debridement surgery."

Yang Zhi helped Zhou Can speak beside him.

Although there is suspicion of flattering Zhou Can, what he said is basically the truth.

There are many patients outside who really come to Zhou Can for surgery.

"If your postoperative results are good, don't forget to recommend Dr. Zhou Can to your relatives and friends!"

Ma Xiaolan also followed suit.

"Haha, good, good! As long as the operation is effective, I will definitely praise your superb medical skills to others. This time I came to Tuya for treatment, and I came to the provincial capital to find you because I believed in your medical skills."

The patient was a man in his 50s. He couldn't help but smile happily when he heard that other doctors and nurses had confidence in Zhou Can's medical skills.

……

Busy until after seven o'clock, Zhou Can finally finished handling all the surgical patients.

In addition to gaining a lot of experience in medical skills, he also gained exhaustion.As for reaping the gratitude of patients, we have to wait until they recover.

If the patient has an infection or complication after the operation, what he gains is not gratitude, but various doubts and curses behind his back.

Under normal circumstances, patients and family members seldom curse in front of him.

At most, some people secretly complained to the medical department.

"Doctor Zhou, can I trouble you to add another class? A six-year-old girl came to the triage desk. Her face was cyanotic and her blood oxygen saturation was only 61%. The situation looked scary."

Most of the nurses in the emergency department are very familiar with Zhou Can.

He is also kind.

Sometimes, when I meet some critically ill patients and see him, I will ask him to help.

Zhou Can basically never refuses anyone who comes.

"The blood oxygen is so low, have you checked the upper respiratory tract?"

Obtaining oxygen depends entirely on the lungs and upper respiratory tract.

When the child's blood oxygen is so low, the first thing to consider is upper airway blockage.

For example, the baby with a throat stuck in Peanut Mi just rescued not long ago.

"Dr. Xie is on the night shift today. He has limited experience. He has checked everything that needs to be investigated, but he has not found the cause. I am very worried about the child's accident, so please go and have a look."

"Okay, let's go and have a look first!"

Zhou Can followed the nurse to the triage desk and saw a pair of very young parents bringing a six-year-old girl to the clinic.

The little girl's face and lips are deeply cyanotic, including the skin on her body.

Very scary.

The patient's mother was lame in one foot, standing there in an obviously unnatural figure.

Zhou Can immediately realized that the child's mother was probably a person with a leg disability.

The patient's father was tall, with a normal body, and his face was full of anxiety.

Zhou Can squeezed forward, and Dr. Xie immediately seemed to see a savior.

"Doctor Zhou, this child's blood oxygen level is only around [-], but no foreign objects have been found stuck in his throat. Please help."

For some doctors who grow slowly, even if they have worked for five or six years, they will still panic like a child who has not grown up when encountering such acute and critical cases.

Because sometimes, the patient's death is only in an instant.

"How did the child become like this?"

Zhou Can has already begun to check on the child's condition.

Her chest can be seen collapsing as she breathes.

It means that it is very laborious to inhale.

The little girl has delicate features, lying quietly on the flat bed, looking innocently at Zhou Can with a pair of lively eyes.

At this moment, in the little girl's mind, these doctors and nurses in white clothes are the angels who saved her.

"Umm... ah..."

The patient's father gestured with his hands and made an indistinct sound.

It turned out that it was a mute.

Zhou Can looked at the patient's mother.

"Huh huh..."

She is also dumb.

The patient's parents are both dumb and belong to disabled persons.

I don't know if their daughter has genetics?

"Children, do you feel uncomfortable now?"

Zhou Can asked the little girl gently.

"Uncomfortable! There seems to be something suppressing me here!"

When she spoke, the words were clear.

It shows that there is no problem with hearing and vocalization.

"Um..."

The patient's father wrote two sentences in the notebook with the pen he carried with him.

"My child's mother and I are dumb, and I am also deaf. My daughter was born with a little purple face, and today she suddenly fell to the ground. Please save her!"

Only then did Zhou Can discover that the child's father was wearing a hearing aid.

Just now, his attention was all on the child, and he didn't notice it.

Today's hearing aids, taking into account the feelings of the disabled, in order to minimize their probability of being discriminated against, mostly use skin color design.

Wearing it on the ear, if you don't look carefully, it is generally difficult to find.

The patient's father is a deaf-mute, and his mother has a leg disability and is dumb. This is a vulnerable family.

"Don't worry, we will do our best to treat your children."

Zhou Can comforted the two, and then quickly began to give the child a preliminary physical examination.

For patients with such poor blood oxygen, it is very necessary to listen to the chest sound and auscultate the breathing sound of the lungs.

With the help of a stethoscope, Zhou Can found that the patient's lung sounds were clear and there were no murmurs.

Next, he went down to auscultate the patient's heart sounds.

An indescribable noise was heard.

Every time the heart beats, it makes this murmur.

His face changed slightly, bad luck only seeks the poor.I thought that the child might have a problem with the upper respiratory tract or lungs, but now it seems that the lesion is likely to be in the heart.

The patient's father responded that the child's face had turned purple since he was a child, indicating that the course of the disease had lasted for many years.

Not surprisingly, it is likely to be a congenital heart disease.

Zhou Can has rich diagnostic experience in cardiothoracic surgery and pediatrics, and he has encountered not a few patients with congenital heart disease.

Even without any auxiliary examination now, he can preliminarily conclude that 90.00% of the patients have congenital heart disease.

"Kid, don't be afraid. Uncle wants to check your chest and ribs. You need to take off the clothes on your upper body!"

Consider the patient is a girl.

Before the examination, Zhou Can tried his best to obtain the consent of the patient himself and his family members.

In fact, in the eyes of doctors and nurses, as long as they enter the hospital, there is really no big difference between men and women.When entering the operating room for a slightly larger operation, you basically don't wear any clothes, or wear a surgical gown issued by the hospital.

If you are admitted to the ICU, 100% of your clothes will be taken off.

Sometimes the patient may be given a hospital gown, depending on the situation.

So, if you want to say that when a male doctor examines a female patient's sensitive parts of the body, he will have oblique thoughts or the like, which is basically impossible.At most, seeing young and beautiful female patients brings some visual enjoyment.

When many male doctors perform electrocardiogram and other examinations on female patients, they often ask the patient to untie their clothes and tell her how to do it.Male doctors will deliberately turn around and fiddle with the examination instruments, so as not to cause embarrassment to female patients.

Then, after placing the detection probe on the examination site of the female patients, it will quickly and proactively help them cover their clothes to cover the sensitive parts.

In order to reduce the embarrassment of female patients.

(End of this chapter)