My Medical Skills Give Me Experiences Chapter 217

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Zhou Can carefully felt the benefits brought by the upgrade to the fifth level of hemostasis.

At the fourth level, it is mainly reflected in the more precise and flexible electrocoagulation hemostasis, and the preliminary ability to analyze the cause of bleeding.

At this moment, he discovered that the electrocoagulation hemostasis is not only more accurate, but also can clearly feel whether the bleeding has been controlled during the hemostasis process.

It seems to be just a small improvement, but it can provide a layer of safety guarantee for him to perform electrocoagulation to stop bleeding on patients.

There is no need to worry about the coagulation time is too short, the bleeding does not stop or the hemostasis is not firm, and bleeding occurs again after the operation.

There is also no need to worry about excessive electrocoagulation, resulting in necrosis of blood vessels and surrounding tissues.

In either case, there will be secondary harm to the patient.

Needless to say, tissue necrosis caused by excessive electrocoagulation occurs from time to time. The wound will not heal for a long time, and the infection and suppuration are considered mild.

It would be terrifying if it directly leads to various postoperative complications and even sepsis in patients.

I believe that when necrosis occurs in a limb, everyone has heard of the need for immediate amputation.

In fact, when any tissue in the body has large necrosis, it should be removed immediately.

Otherwise, the massive absorption of necrotic toxin will often affect the loss of function of other organs. Respiratory failure, liver and kidney failure, etc., can easily take the patient's life.

Therefore, the improvement of the ability of electrocoagulation to stop bleeding during surgery has great benefits.

The tragedy of tissue ischemic necrosis caused by excessive electrocoagulation will not happen.

In addition, incomplete electrocoagulation, leading to re-bleeding after surgery is also a very big hidden danger.

For example, a laparotomy is performed to remove a tumor in the abdomen.

Larger blood vessels will definitely be ligated to stop bleeding. However, electrocoagulation is often used to stop bleeding in small blood vessels.

During the operation, the medium and small bleeding points in the abdominal cavity were successfully stopped by electrocoagulation.

The doctor closed the abdominal cavity of the patient, and the operation was very successful.

The patients and their families were very happy after hearing this.

But after one night, the patient's condition suddenly became worse. The doctor was at a loss, but the operation was clearly a success! After some twists and turns, no fault was found.

After taking the film, it was found that the patient had peritoneal effusion.

The experienced chief doctor saw it and was terrified. Hurry to the operating room for emergency treatment. When he opened the abdominal cavity, he found that it was full of blood. After investigation, it was discovered that the hemostasis was not firm due to incomplete electrocoagulation. Postoperative intrabdominal bleeding occurred.

After hard work, the patient was finally rescued.

All the doctors breathed a sigh of relief.

In the future, they will be extra careful when encountering hemostasis in the abdominal cavity, chest cavity, and cranial cavity.

This is just one of the most common examples.

The patient was very lucky to be able to save his life.

Some patients died directly from postoperative hemorrhage.

Or due to postoperative bleeding and disability, there have been examples of turning into a vegetative state.

This is why many high-risk operations must require the chief surgeon to be the deputy chief physician or chief physician.

Because the doctor's surgical operation level is above the deputy director level, it is completely different from the attending level. Only those who are above the level of the deputy director can ensure the safety of tertiary surgery.

Zhou Can's hemostasis has been upgraded to level 5. In addition to the improvement of electrocoagulation to stop bleeding, the analysis of bleeding causes, diagnosis, and choice of hemostasis methods have also been qualitatively improved.

For some bleeding spots, he only needs to look at them to roughly determine the cause of the bleeding, which is a problem with that part of the blood circulation system. How to solve it?

He has a very clear and intuitive understanding.

Some patients may have internal bleeding, such as intracranial hemorrhage, uterine bleeding, abdominal bleeding and so on. Zhou Can used to rely on examination methods to make a diagnosis.

Now even if the patient does not take an X-ray, he can accurately infer where the patient's bleeding point is based on the symptoms described by the patient, the color of the local skin, whether the patient has blood in the stool, whether he vomits blood, and other symptoms.

It can even be as large as inferring what caused the bleeding.

In addition to improving the hemostatic ability in the above-mentioned aspects, he has a more comprehensive and profound understanding of the entire blood circulation system of the human body.

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Many places that were difficult to understand or did not understand before are now suddenly clear.

This should belong to the improvement of theory.

After hemostasis was upgraded to level five, Zhou Can was not complacent about it, but continued to concentrate on operating on patients.

It seems that it is just an upgrade of basic surgical skills, but it makes him more comfortable and comfortable in the operation.

Surgery is to use a knife on the patient, and bleeding is a problem that must be solved during the operation.

With powerful hemostasis, it is equivalent to having a strong security guarantee.

This also made Zhou Can more confident and confident during the operation.

After this operation, a more special patient was sent in soon.

It's a 21-year-old guy.

There was a huge lipoma on the left face. Because it could not be treated in time, the tumor is now too large and has caused a series of serious symptoms.

Not only did it make the young man's left face look like a monster, but his left eye was almost blind.

The teeth in the mouth were also severely damaged, and there were not many left.

According to the patient's readme, eating is a problem.

Can't eat some slightly chewy food. He dare not eat fish or meat with bones.

Because this huge tumor oppresses the mouth, it is easy for him to be stabbed in the mouth by sharp food during eating, causing severe pain.

In addition, the tumor would press on the airway while he was sleeping, making it difficult to breathe.

He couldn't sleep on his side, so he could only sleep on his back.

Turning over unconsciously at night may cause great danger to him.

Even when the young man entered the operating room, he wore a mask on his face. This tumor made his appearance extremely ugly and ferocious, causing him to have serious inferiority complex.

"Doctor, will my face return to normal after the operation?"

The young man asked Mr. Liu hopefully.

"It can basically return to normal, at least it will be much better than it is now. However, your facial lipoma is particularly huge, and the risk of surgery is very high. It may bring a series of complications, even life-threatening. You need to be mentally prepared for this .”

Old Liu said seriously.

The resection of superficial lipoma is usually only a minor operation.

This is the type of patient most junior surgical residents like to encounter. Because you can practice with them.

Surgical removal of superficial lipomas is less difficult and carries little risk.

The superior doctors are also happy to leave the exercise opportunities to the rookies under them.

The current operation is an extremely difficult three-level major operation. Infinitely close to level four.

General deputy chief physicians dare not perform such an operation.

Mr. Liu is a veteran of the deputy chief physicians, with extremely rich surgical experience and extremely high surgical ability.

Although the professional title is the deputy chief physician, but the surgical ability is a real director level.

"This tumor has been with me since I was a child. At that time, because my family was poor, there was no treatment. Now I like a girl, and she also has a good impression of me. But after the girl's family knew about my situation, they firmly disagreed with their daughter. Stay with me. I haven't made any money these years. With the help of the media and caring people donating money for me, I have the opportunity for this operation. No matter how risky the operation is, I am willing to try it. Living now is a kind of pain, life is worse than death.”

After listening to the young man's story, the doctors and nurses were deeply sympathetic.

How many people there are whose greatest desire is nothing more than to be an ordinary human being. able to live like a normal person.

Physical disabilities, or certain defects in the body, or chronic diseases that cannot be cured, all make patients live in pain. They need to face all kinds of discrimination, ridicule and even bullying from society.

Studying, finding a job, and talking about a partner are much more difficult than ordinary people.

As medicine continues to advance and technology becomes more and more advanced, the solutions to these patients' physical defects or diseases are gradually enriched.

People who have lost a leg, if only a low amputation, can be fitted with a prosthetic.

After a long period of training, they are able to walk like a normal person, or

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The patient uses a prosthetic limb to pick up objects.

Not everyone can be born with nothing to worry about.

Like this young man, because of his poor family, if it weren't for the help of media reporters, he would report on his affairs. It may be difficult for him to have a chance to change his destiny in his whole life.

"Since you have thought about it, let's start the operation! Our doctor will definitely do our best to treat you."

Liu Lao asked the patient to lie down on the operating table.

An anesthetist prepares a patient for surgery under general anesthesia.

Zhou Can's anesthesia is only one point away from being promoted to the third level. This is a very good opportunity. He immediately went to help.

Although this operation is only a third-level operation, the anesthesiologist is Zhou Can's half-master, the silent and serious Doctor Feng.

It is also enough to explain the danger of this operation.

Generally, the anesthesia surgery that requires Dr. Feng himself is very risky.

"Lipoma is never a simple disease. It is generally closely related to organs. During anesthesia, various risks in the operation must be considered. For example, breathing and cardiac arrest caused by accidental anesthesia, and damage to the surrounding large blood vessels during the operation, resulting in Bleeding, life-threatening, etc."

Dr. Feng taught him some very practical dry goods knowledge.

A truly brilliant anesthesiologist, like Dr. Feng, can not only do his job well. Moreover, there can be a comprehensive prediction of all kinds of accidents that may occur during the operation of the patient.

Even an official doctor is much lower than Doctor Feng.

During anesthesia surgery, doctors can only predict some common surgical risks.

It is far from being as brilliant as Dr. Feng. When encountering any major surgery, Dr. Feng can have unique insights.

Can provide a lot of very practical knowledge, so that Zhou Can can prevent various surgical risks in advance in future operations.

He studies very seriously.

Helping work is also very diligent.

Not long after, the preparations for intubation and establishment of extracorporeal circulation channels were all completed.

"Can I administer anesthesia to the patient?"

"Um!"

Dr. Feng nodded slightly and snorted, which was his agreement.

Zhou Can has long been accustomed to his "unique" conversation style.

Immediately and carefully administer inhalational general anesthesia to the patient.

Fortunately, nothing happened until the patient lost consciousness. During the anesthesia process, there were no horrible events such as breathing and cardiac arrest.

[Anesthesia experience +1.]

[Congratulations on your promotion to the third level of anesthesia. You can independently provide general anesthesia or spinal anesthesia for ordinary patients. You can better ensure the stability of the patient's vital signs during the anesthesia process. Special management of mechanical ventilation and critically ill patients. It can be better rescued in patients with shock, perioperative acid-base balance disorder, acute heart failure, multiple organ dysfunction syndrome, sepsis, acute renal failure, oxygen therapy, cardiac defibrillation, cardioversion and pacing operate. 】

The advancement of anesthesiologists should be the most difficult.

Because the field involved is too broad.

Many anesthesiologists say that promotion to attending physician is simply hell-level difficulty.

Zhou Can is not sure how difficult it is to be promoted.

It took nearly a year for him to rise from the practice level to the residency level.

And up to now, he feels that he has learned very little in the field of anesthesia, and he can only be said to have learned some superficial things.

If one wants to reach Doctor Feng's level, it may be difficult to achieve it in less than ten or twenty years.

Fortunately, this is just a side job, not a medical skill that must be promoted.

So he is not in a hurry.

The upgrade of anesthesia still brought him many unexpected benefits.

For example, the ability to predict risks in surgery.

At this moment, when he looked at the patient's operation again, he felt a sense of dismay.

I can't say it, but I feel inexplicable psychological pressure and mental pressure.

You know, before the anesthesia was upgraded to the third level, he was full of confidence in this operation.

Now, instead, I feel a little embarrassed.

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It's not that he has become timid, but that after the upgrade of anesthesia, he has a deeper respect for life and a sharper prediction of danger.

"If there is no problem, let's start the operation!"

Elder Liu obviously didn't realize the danger, but as before, he planned to hand over this operation to Zhou Can for training. He will only act when Zhou Can encounters an uncompetent part of the operation.

"Old Liu..."

Zhou Can was somewhat hesitant.

His abnormal state was also discovered by Wu Ziyu.

Women are careful and are often very sensitive to changes in other people's emotions and mentality.

She just looked at Zhou Can curiously.

I don't understand why Dr. Zhou, who has always been full of confidence, suddenly looks like he is facing an abyss and a cliff, and seems to have a trace of fear that he dare not move forward.

This was the first time since she came into contact with Zhou Can that Zhou Can had such emotions.

"What's wrong?"

Elder Liu stared at Zhou Can with doubts in his eyes.

"The risk of this operation is very high, please check for me more. If you encounter a part of the operation that is too risky, you may need to complete it yourself."

Zhou Can said with some anxiety.

"Of course. At any time during the operation, as long as you feel unsure, stop immediately and leave it to me. Safety comes first in any operation."

Liu Lao's words have been said to him countless times.

Safety first is the most frequently spoken word by superior doctors.

Because there was an accident during the operation, the person responsible was not the subordinate doctor, but the chief surgeon himself.

For example, in this operation, the actual surgeon is Zhou Can, but the nominal surgeon is Liu Lao.

If something goes wrong, Zhou Can will be affected to some extent, but the one who is most unlucky is Mr. Liu.

The superior doctors are willing to give some opportunities for surgical training to the subordinate doctors, so we must cherish it at this time. Don't be wicked and think that the superior doctor is responsible for the accident anyway.

This trust is actually very precious. UU reading www.uukanshu. com

Many surgeons have been residents for more than three years, but the superior doctors never let them hold the knife. At most, only give a retractor and a chance to sew the skin.

In fact, it was not that the superior doctor had any prejudice against this person.

It's that this person does not perform well in his usual work, which makes the superior doctors dare not delegate power.

Zhou Can took two deep breaths to calm down his slightly nervous mood, then asked the nurse to help him put on sterile gloves and began to operate on the patient.

It must be mentioned here that before the operation, the doctor may need to wear sterile gloves when performing some special operations or inspections.

If the doctor happens to be the chief surgeon, at the beginning of the operation, as long as the sterile gloves on his hands feel contaminated.

Then it must be replaced with a new one immediately.

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