My medical skills add experience

Chapter 608 Unobstructed low-level nerve center, inexplicable hemorrhage
Anyone who studies medicine knows that the knee jerk reflex is the simplest type of nerve reflex, and its completion process only includes two neurons, sensory neurons and motor neurons.

boom!
After the small hammer hit the stimulating point on the knee, the child's left leg bounced upward.

Zhou Can's face suddenly showed joy.

The nerve center of the knee jerk reflex is the lower nerve center, located in the gray matter of the spinal cord.But at the same time as the knee jerk reflex is being completed, nerves in the spinal cord leading to the brain send this nerve impulse to the brain, making the person feel that the knee has been tapped.This causes the legs to bounce.

The child is paraplegic at a high position. Logically speaking, the nerves below the head and neck are blocked.

Zhou Can has now passed a simple test to prove that there is no interruption between the nerve center of the lower limbs and the brain, indicating that there is still hope for the child to be cured.

Even though it only stimulated the low-level nerve center, it was enough to make him feel excited.

This is like feeling the presence of a pulse in a patient, and basically determining that the patient has a heart rate.

But heart rate is not the same thing as pulse, heart rate is the number of times the heart beats in 1 minute.The pulse is the number of times the artery beats, also known as the pulse rate.When a large amount of blood enters the artery, the pressure of the artery will increase and the diameter of the artery will expand. This expansion can be felt in the shallower part of the body surface, which is the so-called pulse.

Normally, the heart rate coincides with the pulse.

In some patients the heart rate may be higher than the pulse.

The nerve center is more complicated than the pulse and heart rate. Now it is found that the child's low-level nerve center reflex is unobstructed, which shows that the child's nerve damage is not as serious as imagined.

After testing the child's left leg, Zhou Can tested the right leg again.

The knee jerk reflex is also present, but the knee jerk is weaker in the right leg.

After several consecutive tests, he found that the knee jerk reflex of the child's right leg was indeed much weaker than that of the left leg, but the reflex still existed.

At this time, he once again thought of the child's neck stiffness.

The left side of the neck is soft, and the right side is stiff.

Everything seemed to point to a serious problem with nerve conduction on the right side of the child's body.Or, on the contrary, the left side is seriously injured, but the right side is fine?
At least give him a diagnostic direction.

Neck stiffness indicates that there is a pain response or other response in the neck, and the muscles are tense.Just like when a doctor examines a patient's abdomen, soft and hard abdomen are completely two diagnostic concepts.

A soft and flat abdomen means that there is generally no major problem.

If the abdomen feels hard to the touch, it means that the patient's abdomen has severe pain in the pressed part, and the patient can't help but protect himself by tightening the abdominal muscles.

This is a normal body defense response.

First of all, it must be clear that whether it is abdominal muscle contraction or neck stiffness, it is the effect of muscle exertion and tension.

Muscle contraction is stimulated by nerve signals.

Without nerve signaling, the muscle would be a piece of meat without any mobility.

This is also the main reason why Zhou Can was not sure whether the child's right nerve was seriously damaged.

He even wondered, could it be that the child's right neck muscles have been tense, which affects the conduction of the nerves?

There are too many diagnostic ideas that need to be sorted out, and many need to be verified one by one.

If you want to ask for a certificate, the necessary auxiliary inspection is indispensable.

Although the patient had already undergone a lot of examinations in the previous two hospitals, Zhou Can still felt that it was necessary to do some supplementary examinations in Tuya Hospital to clarify the cause.When necessary, even surgical exploration is required.

Of course, many family members were very reluctant when they heard about the surgical exploration, and even resisted this kind of invasive examination.

Just like clinical rescue of critically ill patients, it is often necessary to cut the trachea and use an invasive ventilator, and family members will be particularly resistant at this time.There are not a few people who even miss the chance of rescue because of this.

"Director Zhou, Director Zhou, there is a patient in the operating room who needs emergency surgery, Dr. Xu can't get away, please go over and preside over it."

A nurse hurried over to ask Zhou Can for help.

In the operating room of the emergency department, only Dr. Xu and Zhou Can have the surgical ability of level three or above.

In rescuing critically ill patients, Zhou Can is even better than blue, and his ability in this area has surpassed Dr. Xu.

"Okay, I'll go right there."

The purpose of the emergency department is to save the lives of patients.

Now there is an emergency operation patient, the child with high paraplegia can only be let go first.

Moreover, the diagnosis of this child will not come out in a short time.

"The child needs to be hospitalized first, and the cause of the disease should be found out before treatment. Is the family willing to let the child be hospitalized here? First of all, we can only do our best in Tuya Hospital, and we dare not guarantee that it will be cured."

Zhou Can looked at the family members and the owner of the bouncy castle.

"Yes, yes! Dr. Zhou is extraordinary. I have made some progress in doing knee jerk reflex for my grandson just now. We are very willing to be hospitalized here. I also ask Dr. Zhou to take my grandson's condition into consideration. When he is not so busy , help him heal."

The child's grandfather is quite knowledgeable.

He didn't despise Zhou Can just because he was young.

After seeing Zhou Can's unique diagnosis and treatment methods just now, his confidence in Zhou Can was even stronger.

The name of a man, the shadow of a tree.

This young doctor Zhou can have a great reputation, and even has a certain reputation in the imperial capital, so there must be something special about him.

Don't use people with suspicion, don't use people who are suspicious.

He chose to trust Zhou Can.

"Doctor Zhou, please take care."

The child's mother also had tears in her eyes, begging Zhou Can repeatedly.

The child's grandmother was a little embarrassed, because she showed off her son's official power in front of Zhou Can not long ago, which caused Zhou Can's displeasure.

"Don't worry, I will attach great importance to every patient. Since you agree, I will ask other doctors to handle the hospitalization procedures for the child. I guess the child may need an operation, so he should be admitted to the surgical inpatient ward first!"

After Zhou Can finished speaking, he looked at the boss of the bouncy castle.

This person is also unlucky, with such a big event on the table, his situation may be similar to that of Dr. Xu back then.

Because the child's father has a very special identity.

His only child had an accident while spending money in the bouncy castle. As the boss and the main responsible person, he definitely couldn't escape.

Make every effort to make up for and cure, this is the only means of survival.

Otherwise, it is likely to have been controlled and locked up long ago.

"Judging from the child's knee jump test just now and the results of some examinations he did in the previous two hospitals, it is not particularly bad. At least I think there is a slight chance of recovery. But this chance may only be 10% or lower. If you have medical insurance, try to find a way to reimburse the medical expenses, and when you are hospitalized, please ask Dr. Xie to teach you how to transfer medical insurance in other places."

Zhou Can has seen the bleak situation of Dr. Xu after his accident, so he sympathizes with this unfortunate boss very much.

Minimize some losses for the other party as much as possible.

Most of the residents of the imperial capital have formal medical insurance, and the reimbursement rate is higher than that of the new rural medical insurance and urban and rural medical insurance.

Of course, if the child does not have formal medical insurance, there is no way.

"Thank you, thank you! My friend said that you are benevolent and benevolent, and I have seen it with my own eyes today. I came here from the imperial capital to look for you, and I did not make a mistake."

The boss's eye sockets were a little moist.

At this moment of distress, Dr. Zhou was still able to consider him, the party responsible for the accident, which really moved him.

"My son has bought medical insurance, but he has been worried that he won't be able to get reimbursed in another place. It's great to be able to go to another place for medical treatment." The child's mother can say that, enough to see that she is a kind and wise woman.

Really put all the burden on the bouncy castle owner, he is crushed, it is not good for anyone.

"Don't worry, you can generally switch to medical insurance in other places, at most, the reimbursement rate will be reduced."

Zhou Can has been a doctor for so long, and he knows that the biggest factor hindering patients' treatment is money.

The significance of medical insurance is that people dare to be hospitalized and treated after they get sick.

In particular, there are hundreds of thousands or millions of treatment items to choose from, if you dare to choose, you can use them.

The bouncy castle project itself has purchased commercial insurance, coupled with the child's formal medical insurance, the treatment cost should not be too much in the end.

It is mainly the other costs of medical treatment in different places, and the cost of the child's follow-up rehabilitation treatment.

Many rehab treatments are not reimbursed.

"Dr. Xie, please help them get it done. I'll come back to make a diagnosis plan after the operation. Maybe some supplementary examination items are needed."

After Zhou Can settled the child who had come all the way to him for medical treatment, he hurried to the operating room.

"Director Zhou, the patient is in operating room No. 3."

There are now three operating rooms in the emergency department, one operating room with level [-], one operating room with level [-], and the oldest general operating room.

Zhou Can and Dr. Xu basically perform operations in the 2-level operating room, also known as No. [-] operating room.

The last 3-level operating room was No. [-] operating room.

Generally, doctors of other attending levels lead people to perform operations inside.

Mostly secondary surgery.

"Why not send the patient directly to operating room 2?"

Zhou Can asked a little puzzled.

Since it was an emergency operation, and he, the deputy head of the operating room, had to be asked to do it himself, it meant that the patient's condition was very serious.

There must be some differences between a [-]-level operating room and a [-]-level operating room.

The most well-equipped one is also the [-]-level operating room.

When hospitals purchase some of the more expensive equipment, it is really all used wisely.

It is absolutely impossible to equip every operating room.

In the entire emergency department, there is only one set of many surgical equipment, which is basically placed in No. 2 operating room.Of course, the current endoscopy room in the emergency department is also well established.Endoscopic surgery or diagnosis has been carried out one after another.

This itself is also a big development trend.

However, it is basically impossible for endoscopic surgery to replace traditional surgery.

For many serious diseases or complex major operations, it is more beneficial to use traditional laparotomy, thoracotomy and craniotomy.

For any operation, in addition to considering the harm caused by the operation to the patient, the success rate and curative effect of the operation must also be considered.

For example, in cardiac surgery, even if it is just a simple right ventricular hypertrophy, it is often safer to open the chest for treatment.

After all, endoscopic operation has certain limitations, which will limit the doctor's medical skills, and will hinder many surgical projects.

Therefore, it is basically impossible for endoscopic surgery to completely replace traditional surgery.

"The patient was originally undergoing subcutaneous tumor resection, but unexpectedly, she suffered a sudden hemorrhage from her lower body during the operation, and she is currently being rescued."

Nurses don't know much.

Because she didn't work in the operating room, she was only in charge of managing surgical patients outside.

"Go and get busy!"

Zhou Can's heart sank slightly, and his face became serious.

As the deputy director of the department, he is also the deputy head of the operating room.The occurrence of such a medical accident inevitably made his nerves tense.

If something goes wrong, the doctor involved will be punished for sure.

However, the heads of the operating room and the department will also be affected, and it will have a negative impact on the reputation and image of the department.

After pressing the door of the operating room with his foot, he changed into a sterile surgical gown and walked quickly into the operating room inside.

When he came in, he felt a dignified atmosphere.

Some medical staff were running non-stop, looking nervous.

"What's the matter with the patient?"

Zhou Can asked blankly.

"It was just a subcutaneous tumor removal, which was a simple secondary operation. Who would have thought that during the operation, the patient would suddenly bleed heavily. His blood pressure kept dropping, and his breathing became short and heavy... Director Zhou, look What to do now?"

Tang Wangnian is the doctor in charge, and this incident happened at the critical moment of his pursuit of the deputy senior title. He is afraid that he wants to die.

In the past, seven people were dissatisfied with Zhou Can, and eight people were not angry.

Something happened at this moment, seeing Zhou Can coming, it was like seeing an ancestor.

He just missed kneeling on the ground and begging Zhou Can to help him.

"What else can I do? I must first try to save the patient's life."

Zhou Can glared at him angrily, and walked directly to the operating table.

The patient was a young woman, in her 20s.There was a subcutaneous tumor on the inner left thigh, and it had been increasing recently. She was afraid that it might be cancerous, so she came to Tuya Hospital for treatment.

Because of the good reputation of the emergency department, she chose to perform this subcutaneous tumor resection in the emergency department.

Originally, general surgery could also be done.

Gynecology is also capable of handling it.

Subcutaneous tumors, as long as they are not too complicated and the surgical risk factor is not particularly high, basically most surgeons are competent.

It stands to reason that cutting the tumor on the thigh would not cause the patient's lower body to bleed heavily.

There were many doctors and nurses at the scene, and it was almost impossible for Tang Wangnian to do anything wrong while the patient was under anesthesia.

So what is the cause of the bleeding?

At this moment, the patient's breathing is very scary, short and heavy, and the chest rises and falls violently.

Explain that she has to work hard to get fresh air.

Also, her blood pressure was terribly low and dropping.

The patient's abdomen is fairly flat.

Zhou Can slightly pressed her abdomen with his hands, and a large amount of blood gushed out from his lower body.The color is more bright red.

It shows that the bleeding is still happening, and there is a lot of blood in the abdominal cavity.

"Has the patient had a pregnancy test before the operation?"

After Zhou Can stared at the patient's body and face, he asked Dr. Tang Wangnian.

Her physical appearance resembled that of a pregnant woman.

(End of this chapter)