My Medical Skills Give Me Experiences Chapter 140

Popular recommendation:

After hearing this, the first assistant immediately became furious.

What do you mean?

Isn't it just turning a corner and laughing at him as helpless and unable to help?

"Do you think hemostasis is that simple? Just clamp the blood vessel with a hemostat? Young man, let me tell you ~www.mtlnovel.com~ and actual operation are two different concepts."

Yizhu sneered and taught Zhou Can, a novice, in an old-fashioned tone.

I'm afraid I'm scolding in my heart, these young people always want to show their faces every day.

I don't even weigh how many catties I have.

"Doctor Ou, can I try using a hemostat? It would be the best if it can help you. If it doesn't help, the destructive power of the hemostat is controllable." Zhou Can looked at Dr. Ou.

At this moment, Dr. Ou was very distressed.

The patient's blood vessels were spurting blood. He tried to directly press the blood vessels in multiple parts with his hands, but with little success.

The current situation is extremely unfavorable.

Basically tantamount to falling into an endless loop.

He couldn't stop the bleeding, and the continuous spurting of blood would block his vision, making it impossible for him to find out the real reason why he couldn't stop the bleeding with electrocoagulation.

What doctors are most afraid of when performing surgery is to get important nerves, unexplained bleeding, and complications.

All three scenarios have the potential to have dire consequences.

Nerves are involved, ranging from paralysis to immediate apnea, cardiac arrest, and death.

Unexplained bleeding, the consequence is also death, if the bleeding cannot be stopped, the patient is in danger. Especially this internal bleeding.

Complications may be intraoperative or postoperative.

Why do doctors ask about allergies, high blood pressure, heart disease, diabetes, etc. before surgery? It is to fully consider whether other complications will be caused during the operation.

Some heart patients have extremely low tolerance for surgery.

Maybe he hadn't been operated on yet, and just as he was carried on the operating table, he was frightened into a heart attack. Next, what the doctors have to do is not to operate, but to rescue the patients in a hurry.

As for postoperative complications, it was not taken seriously before.

More and more surgeons now list postoperative complications as the number one killer.

Take spinal epidural hematoma as an example, it may be caused by the patient himself. It may also be caused by anesthesia and poor lumbar puncture during the operation.

Couldn't find it at the time.

After the operation, it was found that the patient was paralyzed, and after an investigation, the epidural hematoma of the spinal cord was discovered.

The location of the hematoma happened to be the location of the spinal anesthesia.

This is the simplest postoperative complication.

Not to mention postoperative lung infection, kidney failure, heart and lung failure, etc.

Dr. Ou was at his wit's end and was about to seek help from his superior doctor when he heard Zhou Can volunteering. For the first time, he looked at this courageous Gui Peisheng squarely.

Zhou Can just said that the patient was bleeding profusely. It may be that he injured the blood vessel under the crest dura mater when he removed the malformed blood vessel, or he just cut at the bifurcation point of the blood vessel.

Neither of these two ideas can be proposed by ordinary people.

Doctor Ou took a second look at Zhou Can's ability.

"Chen Yue, let him try!"

Dr. Ou said to Yisuke.

Basically, it is the mentality of holding a dead horse as a living horse doctor.

As Zhou Can said, the destructive force of the hemostat is extremely small. At most, the blood vessel is pinched. But if it can help him stop the bleeding, it will avoid asking the superior doctor for help.

The face is saved, and the problem can be solved.

Asking the superior doctor to come over to put out the fire is not just asking for it, there is a price.

As a result, points are lost in the minds of superior doctors, the weight of surgery is reduced, and the ability of surgery is questioned.

These will have very bad effects.

It is often seen on the news that a certain hospital has a medical accident. The doctor involved concealed the report, avoided the serious one and ignored the minor one.

Such low-level mistakes can be made.

Do you think the doctor involved is stupid?

In fact, people are very smart.

He just had a fluke mentality, thinking he could handle it well. This was not reported to the superior doctor.

Eventually there was an accident.

Doctor Ou spoke, and Kazusuke could only obediently move out of his seat whether he wanted to or not.

Zhou Can took the hemostat handed over by the nurse, and first carefully searched for the blood vessels and veins of the bleeding point.

However, he also encountered the same problem as Dr. Ou.

The continuous spewing of blood seriously interfered with the vision of the crista dura mater. This is useless even if it keeps sucking up the accumulated blood.

Bleeding too fast.

And to find the blood vessels, we must start from the location of the bleeding point.

Zhou Can has already developed a skill.

You can find out where the bleeding point is through the ripples of the blood. Now, the bleeding point is very clear, all he has to do is to go through the ripples of the blood, 'Looking for the Dragon and Breaking the Pulse'.

All laws in the world are interlinked, and this is similar to the geomancy in Fengshui.

"Bleeding blood vessels, the proximal end should be here."

After saying that, he clamped an inconspicuous submembranous blood vessel with a hemostat.

A miraculous scene appeared.

The bleeding stopped immediately.

"It's amazing, it's amazing!"

Doctor Ou shouted happily.

Kazusuke looked at the showy Zhou Can with a face full of shame.

In the operating room, they are all real and real skills, and there is no room for falsehood.

Zhou Can successfully stopped the bleeding, which shows that his ability to stop bleeding is indeed superior to him.

Even stronger than Dr. Ou.

"The blood vessel should not be clamped for too long, otherwise it will easily damage the blood vessel and crest dura mater. Electrocoagulation has been tried many times, but all failed. Do you think it can be ligated to stop the bleeding?"

Anyway, it is a blood vessel with the terminal venous capillary network cut off, ligation to stop bleeding should be a better way.

"Wait a minute, let me check!"

Doctor Ou spoke more politely to Zhou Can.

Absorb the accumulated blood first so as not to obstruct the line of sight.

With no distractions, he quickly found the problem.

"When I removed the malformed blood vessel, I broke the blood vessel. No wonder the electrocoagulation can't stop the bleeding. The distortion of this blood vessel is quite severe, and it has already affected the blood vessel part under the crest dura mater."

The reason was found.

Dr. Ou is very happy.

Sometimes it is like this. Before the problem is found, anything is possible. Only when the fog cleared and the real reason was found, did he suddenly realize. Oh, it turned out that the reason for the bleeding was so simple.

"We have to continue to probe downwards, remove all the diseased and problematic blood vessels, and then ligate them. Otherwise, it will be a ticking time bomb sooner or later."

Doctor Ou said.

"In this case, it is already necessary to cut the dura mater and explore it to the bottom. Completely solve the hidden danger."

According to regulations, the operation process needs to make some necessary records.

Originally, it was only the removal of spinal epidural hematoma, but now the dura mater needs to be cut, which is equivalent to an upgrade of the operation.

A reasonable explanation must be given.

Typically, the surgical procedure is documented by the first assistant. After the chief surgeon read it, he signed it.

It can also be written by the surgeon himself within 24 hours.

Dr. Ou cut open the dura mater, and after some investigation, he found that although the blood vessel was not very thick, the disease was quite serious.

It has been extended for nearly 3 cm, and there is distortion and hardening.

After it was removed, according to Zhou Can's suggestion, the end of the blood vessel was ligated.

"Okay, you can loosen the hemostat."

Doctor Ou said to Zhou Can.

Zhou Can tried to loosen the hemostat slowly, and sure enough, the bleeding stopped.

Everyone showed happy expressions.

"By the way, what's your name? You have outstanding ability to stop bleeding."

Dr. Ou asked Zhou Can's name while suturing the crest dura mater.

If it weren't for Zhou Can's outstanding performance, Dr. Ou might not be able to remember his name after two months of regular training.

May not even ask.

Now, he felt that Zhou Can was qualified to let him remember his name.

"My name is Zhou Can! I have just left the training program outside of God. For the next two months, I would like to ask the superior doctors to take care of me."

Not long ago, Zhou Can had a bit of trouble with Yisuke.

He successfully stopped the patient's bleeding, which was equivalent to slapping Kazusuke in the face.

Lowering your posture now can be regarded as easing the relationship between the two parties.

Then again, he will still fight for the opportunity that should be fought for. Let him come again, and he will also find ways to show his face.

Only by showing strength can one be treated differently by superior doctors.

Have a chance to get started.

Take Jiang Xiaohua as an example, he and Zhou Can are both Gui Peisheng.

Now Zhou Can wants to take advantage of the opportunity to sew the skin, Dr. Ou will probably agree. But Jiang Xiaohua is not necessarily.

This is the difference between showing your face and not showing your face.

"Well, you performed well just now, work hard."

Dr. Ou obviously had never heard of Zhou Can's name.

After boasting a few words, he began to concentrate on surgery.

"Xiao Zhou, haven't you practiced suturing surgical incisions for patients yet? Stand by and watch how Chen Yue sews incisions for patients. When you learn it and the situation permits, I will consider giving you some opportunities to practice. "

Doctor Ou said to Zhou Can in a gentle tone.

The higher-level doctors are basically the same, and if any regular trainee is particularly outstanding, they will train as many regular trainees as possible.

"thank you!"

Zhou Can quickly thanked him.

He has already reached the excellent level of attending medical treatment in terms of skin sewing skills, and he is only short of more than a thousand experience points to be promoted to the level of deputy director.

However, he still followed Dr. Ou's words very low-key.

"Look, suture has strict requirements on the selection of thread and needle size. The grip of the needle holder and the coordination of the sharp tweezers also have extremely high skills. I have practiced for many years before I have a little achievement. "

Dr. Chen Yue lost face when he stopped the bleeding just now, and now he finally has a chance to recover.

I saw him explaining the basic method of suturing the skin with great confidence, and at the same time began to suture the incision skin of the patient calmly.

His suture level is not weak, and he has reached the middle level of a resident doctor.

There is still a big gap from the excellent level of resident doctors.

Zhou Can watched silently from the side.

Jiang Xiaohua just glanced casually, then looked away. He seems to have been familiar with sewing skin for a long time.

For Gui Peisheng, sewing skin is still a rare exercise opportunity.

Even many residents are rushing to do this.

After Zhou Can watched carefully, he found that the suturing techniques seemed to be different in different departments.

Just like martial arts sects, even if they use the same sword, their styles are very different.

Zhou Can's suture technique should be inherited from the general surgery line, and later incorporated some of Dr. Xu's style. After three months of regular training in orthopedic surgery, he incorporated some of the suturing advantages of orthopedic surgeons.

Generally speaking, he is more like integrating the strengths of a hundred schools of thought, constantly absorbing the advantages of others, and improving sewing techniques.

He found that no matter whether it is Dr. Ou or Dr. Chen, the suturing style tends to be delicate.

The movements are neither too fast nor too slow, and the strength is relatively gentle. The pursuit of stitching is neat.

It may have a lot to do with the surgical direction of the department.

The operations performed by Shenwai are all high-precision, not as rough as orthopedic surgery. When suturing, a slight force may cause the failure of blood vessel or nerve anastomosis.

The operation of the cranium, spine and other areas is even dancing on the tip of the knife, so we must be careful and careful.

Director Wu Baihe is known for his precise and meticulous surgical style.

After more than twenty minutes, Chen Yue finished sewing.

Zhou Can watched and studied the whole process, absorbed the other party's strengths, and then thought, how should he do the stitching?

The self-perceived gain is still quite large.

Chen Yue originally had a lot of opinions on Zhou Can.

But during the sewing process, Zhou Can has been watching and studying carefully, which has benefited him a lot.

"See clearly? That's how skin suturing is done. It's easy to say, but difficult to say. The higher the level of suturing, the faster the patient's wound will heal, and there will be less ugly scars. I heard that the director-level surgeon Doctors, there are even people who can suture seamlessly. Learn hard, you are still young, and there is still a long way to go!"

When Chen Yue said these words, although he still spoke in the tone of an old senior, his gaze towards Zhou Can was obviously not so cold.

"Okay, thanks for the advice!"

The corners of Zhou Can's mouth raised slightly, is the seamless stitching very good?

He seems to have learned it and used it many times on patients.

Although it is not up to Dr. Xu's level, it is quite satisfactory and the sewing looks decent.

"Is the patient's vital signs okay?"

Dr. Ou looked at the anesthesiologist.

This operation, which seems to be risky, is actually a second-level operation.

Moderate difficulty.

"The signs are stable, can you wake up from the anesthesia?"

The anesthesiologist asked for instructions.

"Push it to the recovery room for observation, there is no problem, you can transfer back to the general ward."

Dr. Ou took off his gloves and looked at Zhou Can and Jiang Xiaohua.

"The two of you will push the patient back later. Observe in the recovery room for about half an hour, paying special attention to the patient's breathing and whether he is conscious. Within 24 hours after the operation, you must closely observe the patient's condition. Sometimes secondary hematoma is prone to occur, so we must be vigilant.”

After explaining the precautions, he and the two residents left one after another.

Surgical volume is relatively small.

Not as busy as general surgery and bone surgery.

Three thousand a year, on average, the total number of surgeries per day in the entire department is only about eight.

Forty minutes later, Zhou Can and Jiang Xiaohua pushed the patient back to bed No. 24 together.

After all, the babysitter is a paid hireling.

He didn't wait outside the operating room at all, but lay on the patient's bed to rest.

To put it bluntly, even if the patient dies, it's none of her business.

If it was a family member, they would definitely wait anxiously outside the operating room. As soon as the patient leaves the operating room, family members will immediately gather around to ask about the results of the operation~www.mtlnovel.com~The nanny is soundly asleep.

Zhou Can had no choice but to pat her on the shoulder to wake her up.

"Auntie, Mr. Hao has finished the operation now, and everything is going well."

"Oh! The operation went well, right? I'll call his son and tell him."

The nanny took her mobile phone and went to a distance to make a call.

Zhou Can and Jiang Xiaohua worked together to lift the patient to the bed, waited for the nanny to come back from the phone call, explained some precautions, and then left.

The nurse had to be informed to put the patient on a drip.

The same nurse in charge named Hu Shuiling was sitting behind the nurse's desk.

The nurse in charge generally does less work when someone under him is available.

Unless some patients with serious conditions are worried that ordinary nurses will mess up, they will go to the operation in person.

"The patient in bed 24 has been transferred back to the original bed after the operation. Has the doctor's order come down?"

Zhou Can asked.

"Well, I'll go over and put him on a drip, measure his blood pressure and heart rate."

The arrogant female nurse looked up and saw that it was Zhou Can.

There was a trace of warmth on the cold face.

It seems that she still knows good and bad.

Before, she quarreled with the female nanny. If Zhou Can hadn't helped her in time, she would have been complained 100% of the time.

even worse results.

Therefore, she should be grateful to Zhou Can in her heart.

"Two of you, one went to bed 31 to have a look. The nurse responded that the patient vomited badly just now. The other followed me to bed 22."

Doctor Cheng hurried out of the office.

"I'll go to bed 22 with Dr. Cheng!"

When Jiang Xiaohua heard the patient vomit, she frowned slightly, and immediately pushed the work to Zhou Can.

Chapter end