My medical skills add experience

Chapter 629 Afraid, hit the focus
Surgery has always had extremely strict operating specifications.

Internal medicine treatment is never graded, as long as you have the ability, it is completely possible for Gui Peisheng to treat serious diseases.However, the operating room has strict qualification requirements and grade access system.

Resident physicians can only perform first-level surgeries, and at most participate in second-level surgeries.

There are also preoperative evaluation, intraoperative aseptic management, safety management, strict postoperative care, etc. All medical staff have an insurmountable red line, that is, patient safety.

Zhou Can's surgical ability is extremely strong, and he is proficient in almost all fields.

I am also very careful when performing operations on patients, so there has never been an accident.

It is also because of his smooth sailing since he started his career, coupled with his personality, that he gradually jumped out of the routine process during the operation, and there were some quite risky behaviors.

So far, no matter whether in the emergency department, cardiothoracic surgery, or major surgery in other departments, there has been no problem.

Even if there is an accident during the operation, Zhou Can still has director-level experience in anesthesiology and intensive care medicine, as well as director-level pathological diagnosis and pharmacological syndrome differentiation, which are enough for him to turn the tide and rescue the patient from death at a critical moment.

People are pretty much the same.

With strong strength, it is easy to be overconfident if you are used to going smoothly.Likes to be out of the ordinary when doing something familiar.

Zhou Can usually goes to other departments to help with surgery, and basically follows the surgical plan formulated by others.

He is only responsible for some key parts.

If the pursuit of speed, it is also possible to complete most of the entire operation, and leave the rest to other doctors.

In the emergency department and cardiothoracic surgery, he has a high status, and the chief physicians also highly trust him.

This also led to his question not attracting anyone's attention.

It must be a good thing that Wu Baihe discovered Zhou Can's problem this time.

Those who know shame are brave.

Only by being able to recognize your own mistakes can you make continuous progress and reduce mistakes.

"Director Wu taught me a lesson. I did do what I wanted before. This problem must be corrected." Zhou Can saw that the teacher was criticized, and Director Wu was indeed doing it for his own good.

Immediately follow the good advice and accept criticism and opinions.

"It's a good thing to have a good attitude. No matter how great your ability is, you must abide by the rules that should be followed. Surgical safety regulations and safety guidelines are summed up by the experience and lessons of countless ancestors. It may not be reasonable to you. Or think that these rules can be broken, but I can tell you responsibly that almost all of the Niu B doctors who have accidents are because they feel that they are capable and confident, so they can break the rules.

As a result, the last misstep became an eternal hatred.

Most of those who were electrocuted were electricians, and those who were drowned were mostly swimmers. "

These words are hard to hear, but the truth is harsh.

What he said is indeed very reasonable.

"You check the brainstem directly. What if there is no bleeding in the brainstem? Or even if there is bleeding in the brainstem, but the symptoms are mild, it is not the main cause of the patient's deep coma? The brainstem is called the restricted area of ​​life, let alone you A young man who has only been a doctor for a few years, but I, who has been in the field of neurosurgery for decades, dare not touch it easily."

Wu Baihe scolded Zhou Can so much that he couldn't lift his head.

The consultation room was surprisingly quiet.

Although Director Lou and Dr. Xu did not speak, they were aware of the seriousness of the problem, and they supported Wu Baihe's opinion very much.

Anesthesiologist Qu Zi looked at Zhou Can with a strange look.

This was the first time she saw Zhou Can being scolded so badly.

In the past, all she heard were superior doctors, patients, and nurses praising Zhou Can.

"For any major surgery, you must remember to start from a safe place first, and deal with the identifiable lesions first..." Wu Baihe explained the principle of surgery to Zhou Can.

"This surgery is not a problem with minimally invasive surgery, and it is only suitable for minimally invasive surgery. My suggestion is to deal with thalamic hemorrhage and damage first, and then decide whether to explore the brainstem area after observing the situation. I feel that the brain blood vessels of this patient should be more serious. You can look at the blood vessel spots on the film, although they are inconspicuous, but there are a lot of them. I suspect that there is more severe atherosclerosis in her brain blood vessels."

As expected of a top expert, Wu Baihe actually diagnosed problems that Zhou Can had never discovered from some subtle points.

"The patient's blood lipids are obviously high. This should be the culprit of atherosclerosis. I really haven't found such a serious lesion in her blood vessels. Director Qu, please re-evaluate the patient's surgical risk."

After Zhou Can heard this, he was slightly startled.

Fortunately, Wu Baihe was invited to come over for consultation. If he followed his original operation idea and directly took the brainstem area as the first stop of the operation, the consequences would be unpredictable.

It is not to say that there will be danger, at least in the case of a patient with a large area of ​​atherosclerosis in the cerebral arteries, the risk of surgical safety is doubled.

He couldn't help being afraid for a while.

Every time I think that I am very strong, but in fact I still have a lot to learn.

Accumulate small steps to thousands of miles, and accumulate small streams to form rivers and seas.

In the future, I have to be more humble, keep studying every day, and must not be complacent.

"Now there is a new discovery that there is a large area of ​​atherosclerosis in the patient's intracranial arteries, which will increase the risk of intraoperative bleeding and the difficulty of hemostasis. However, Director Zhou's surgical ability is enough to greatly reduce this potential risk, so I Surgery was assessed as still possible."

Qu Zi is also in the growth stage.

After the restructuring of the anesthesiology department, she signed a one-on-one cooperation agreement with the emergency department.

Basically became the queen anesthesiologist in the emergency department.

In fact, Zhou Can and Dr. Xu used her the most.

At present, only these two people in the emergency department are capable of actually presiding over tertiary operations.

Physician Tang Wangnian is sprinting for the title of deputy senior professional, and because of the support of the department, it is basically a certainty.His own conditions are also not bad, and he has basically completed all the thesis and medical achievements required for the deputy high school evaluation.

The only thing missing is the achievements in surgery.

This is not the key to judging the deputy high school, the department will also help him smooth things over to make this matter happen.

So it should be no problem for him to be rated as a deputy high school this year and become the deputy chief physician in the field of surgery in the emergency department.

Even if he was promoted to deputy high school, he still couldn't preside over a third-level operation immediately.

Even a less difficult third-level operation will not work.

You have to practice and practice to have this ability.

"Director Wu, what's your opinion?"

She looked at Wu Baihe with respect in her eyes.

"The anesthesia is in charge of life, and the doctor is in charge of illness. Isn't this a rule that has been established in the operating room? You, an anesthetist, have said it's okay, so I naturally have no objection. But there is one thing I have to say to you, and it can't be too much." He is superstitious about the surgical ability of the chief surgeon. He usually performs stably and has strong surgical ability, which can only be used as a small part of the surgical safety reference, and must not be a key part of the evaluation.”

Although Director Wu is a straight steel man.

But he was gentle when dealing with female doctors and nurses.

Even if it is criticism, it is only a tactful point.Scolding Zhou Can just now really didn't save any sympathy.

Male doctors usually take into account the psychological endurance of lesbians.

If they scolded too hard, they would cry.

They don't cry face to face, many of them cry in the bathroom or office.This is the weakness of male doctors, no male doctor likes to make female colleagues cry.

"understand!"

Qu Zi stuck out her tongue playfully.

She knew what Wu Baihe was referring to, and she just warned her, don't think that Zhou Can's surgical ability is strong, and he has never had any accidents, so take this as a key element in evaluating the risk of surgery.

Instead, this proportion should be reduced.

"Well... Now that the surgery plan has been finalized, the anesthesia risk assessment, and the surgery safety assessment have passed, can we have the surgery done tonight while Director Wu is here?"

Zhou Can suggested.

"You kid is really scheming! You have made this idea a long time ago, haven't you?"

Wu Baihe couldn't help shaking his head and smiling bitterly.

She thought of this kid so much, but was tricked by him instead.

"Hey, it looks like you are very busy every day! It is not easy for you to come here, and I dare not waste too much of your time. This patient's family is relatively difficult, and her daughter is eager to save her mother. I just want to So, if the operation can be done tonight, the patient's injury can be further reduced, and at the same time, some treatment costs can be saved for the patient's family."

Zhou Can didn't shy away from it, and said what he had directly.

Cheng Xiaolu's father is disabled, and her income is not particularly high.It is estimated that the monthly salary is around six or seven thousand.

The pharmaceutical department has been losing money year after year, and there is no such thing as a year-end bonus.

In fact, any company is similar. In the case of serious losses, not to mention paying year-end bonuses, it is considered good to be able to pay wages.

Those companies that give out millions of year-end bonuses, or reward cars and houses during the Chinese New Year, have made a lot of money, and use part of it to motivate employees and strive to create greater brilliance.

"I just like your virtue of caring about patients and being able to sympathize with poor families and the weak. Hurry up and arrange it. I have to go to the outpatient clinic tomorrow morning. I am old and must go home early to rest."

A rare smile appeared on Wu Baihe's face.

The eyes looking at Zhou Can are also much softer.

The human heart is fleshy.

Zhou Can always considers the patient and the economic consideration of the patient's family. These words and deeds make many doctors and nurses love and respect him from the bottom of their hearts.

With Wu Baihe's smile, the atmosphere in the consultation room suddenly became much more relaxed.

Next, quickly talk to the family members, go through the operation process, and send the patient to the operating room.

When the patient was admitted to the hospital yesterday, Zhou Can explained to the doctor in charge of the bed.

Always be ready for surgery.

Now it comes in handy.

The patient was successfully sent to the endoscopic operating room.

……

In order to improve the safety and success rate of the operation, Wu Baihe called his professional team over.

It's temporary overtime.

Of course, for those doctors and nurses, this is also a good learning opportunity.

According to strict surgical procedures, after the patient's head is drilled, the endoscopic surgery officially begins.Zhou Can was the chief surgeon, and Wu Baihe and another miraculous senior nurse assisted.

Everyone else does their job.

The patient's physical condition is not very good, which is the biggest risk.

Human life is sometimes very tenacious. During an earthquake, some people were crushed underground, without water, food, injuries, and immobility. However, they survived tenaciously for more than 100 hours and were finally rescued successfully.

Sometimes, human life is extremely fragile.

This is especially true in the operating room, where some patients are still alive and well before being pushed in.But there was an accident during the operation, and he died in the operating room.

Many people think that surgery in large hospitals is safe, but in fact it is not absolutely safe.

Take the general surgery and gastrointestinal surgery of Tuya Hospital as an example. This sub-department should be recognized as a department with a high surgical safety factor and relatively low risk.However, more than [-] patients die from surgery every year.

This does not include patients who survived beyond three days postoperatively.

What do you mean?

That is, after the operation, the patient lived for three days, and may die within a week, or half a month, or even a little longer.

But the cause of death was definitely surgery related.

After all, there are huge risks in any operation. While removing the lesion, it will also cause serious harm and impact on the patient's body.

Take the thymus, for example.

In the eyes of ordinary people, the thymus is a dispensable small organ.Few people have even heard its name.

Moreover, in many thoracotomy operations, thymus removal is more common.

especially cancer patients.

Generally speaking, the thymus of infants and young children is only about 10 grams, not more than 15 grams.Adults, and adult men and women in the prime of life, only twenty or thirty grams of thymus, not more than 40 grams.

After old age, the thymus will degenerate and become about 15 grams again.

Such a small organ weighs less than a larger tumor.

But the thymus is the largest immune organ in the human body.

After cutting it off, the body's immune system will have major defects, and you can imagine it with your toes in the days to come.

Everyone knows that AIDS is terrible.

Why is it scary?
That's because it attacks the body's immune system.

The reality is that some people are unfortunately infected with AIDS, and they are dying. They are terrified in their hearts, and they always think that they will not live long.Patients whose thymus or other immune organs and tissues have been removed have no psychological pressure at all.

For example, lymph, this cuts a lot, right?
Not to mention the removal of lymph nodes in some tumor operations, there are also various lymph nodes that are too large, causing pain, or patients are worried that they are cancer, so they are removed.

In fact, lymph is also an important part of the immune system.

Lymphocytes are one of the most important fighters in the human immune system.

The fire of this patient's life is already flickering, and may be annihilated at any time.Coupled with the fact that the patient is too old, the risk of performing a craniotomy on her can be imagined.

Both Qu Zi and the anesthetist nurse were fully motivated and did not dare to slack off for a moment.

Zhou Can manipulated the pliers of the endoscope, carefully removed some brain tissue, and hit the bleeding point.Because the shadow was very obvious when taking pictures of this area, so based on his craniotomy experience, he found the target without much effort.

"Director Wu, can you drain the accumulated blood first?"

"nonsense!"

Wu Baihe hates asking for instructions from the left and asking from the right the most.In fact, with him watching and assisting, if there is any problem, Zhou Can doesn't need to speak at all.

(End of this chapter)