I Spent Those Years In the Operating Room Fighting Monsters

"I'm in the operating room to fight monsters in those years novels ( to find the latest chapters!

The hospital is actually a small society, and then each operates under certain rules and regulations.

The main purpose of these systems is to serve patients, but in some cases, they have become a guarantee for doctors to avoid risks from each other!

1. Responsibility system for the first visit; 2. Three-level physician rounds system; 3. Difficult case discussion system; 4. Consultation system; 5. Critical patient rescue system; 6. Surgical classification management system; 7. Preoperative discussion system; 8. 1. Check system; 9. Shift system; 10. Clinical blood management system; 11. Death case discussion system; 12. Basic medical record writing standard and management system; 13. Grading nursing system; 14. Medical technology access system; 15. Doctor-patient communication system; 16. Hospital transfer system; 17. Special diagnosis and treatment notification system; 18. Operation safety verification system!

Why does Zeng Dewei want Chen Bing to come to power? Isn't it just to take responsibility together?

The patient’s blood pressure has been dropping. When the peripheral blood pressure drops, there are only two problems with blood supply and bleeding. The heart function test, naturally, when the cardiology department is in the ICU, he has been called for several rounds without any indication. Signs indicate that in the case of impaired heart function, cardiotonic drugs cannot be used rashly to raise blood pressure.

Unless it is close to death to hang the blood pressure, the anesthesiologist at this moment has already prepared these two drugs, whether it is intramuscularly or pumped, they are always ready at any time, even dopamine has begun to low speed The pump is on, just for fear that the blood pressure is too low and cause shock on the spot!

Tan Yuanwu can't escape, he is the director of vascular surgery, so he must come up to find the blood spot. And Chen Bing is just the director of the orthopedics department. If there is no problem in the orthopedics department, Chen Bing will not impulsively go to the stage to occupy the position of the operating table.

The matter of finding blood spots has little to do with technology. On the contrary, the person who understands the condition best, and the person who participated in the operation for the first time knows what hidden injuries may have been overlooked in the previous operation.

Zhang Yuewei and Fu Yu were obviously the latest to arrive in the operating room, so even if they went up, they could only get blind.

But even so, Zeng Dewei still hoped to get some help and guidance from Zhang Yuewei and Fu Yu, so he said: "Professor Zhang, Professor Fu, the patient was directly pushed to the operating room in the emergency department. There are obvious injuries on the abdomen."

"The most serious is the rupture of the intestine, the slight contusion of the spleen, and the liver, with many bleeding spots!"

"During the operation, I just made an enlarged incision of the original wound, and then the door frame of the lower abdomen was inserted a bit deep."

"After hearing that the blood pressure was unstable, I immediately opened the abdomen again for debridement and exploration. The first thing I looked for was to explore the spleen. I suspected that it was a delayed rupture of the spleen, but no blood was seen in the upper right abdomen, and, I was in the abdomen, and I didn’t find any bleeding points at all."

"So you think, is it possible that this is bleeding in the liver?"

Zeng De looked at the two people asking for help.

However, as soon as Zeng Dewei’s suggestion was put forward, Zhang Yuewei shook his head and said: "Intrahepatic hematoma is possible, but intrahepatic hematoma is generally limited. Even if it is not limited, the blood that oozes is always There must be a place to go."

"Unless it passes through the diaphragm and pleura, and goes directly into the chest cavity."

Having said this, Zhang Yuewei immediately said: "Anesthesiologist, listen to the breath sounds hard!"

If there is blood oozing and blood accumulation in the chest cavity, the real sound can be heard. If it is a special situation, a closed drainage of the chest cavity may be required.

Zeng Dewei's face changed immediately, and he immediately reacted: "On tour, call the thoracic surgery department. Anesthesiologist, please pay attention to the patient's pupils by the way, please pay attention to head injuries."

Intracranial injuries are usually dealt with first. Before I came, I scanned a CT as soon as I came, and I also scanned one before entering the ICU.

It is to avoid intracranial hematoma or delayed intracranial hemorrhage.

When Zeng Dewei shouted like this, he still had a faint gratitude in his heart, okay, there is one more person here, and the strength is a little bit more.

There is also a very low voice saying that another person is coming to bear the pressure.

At this time, Lu Cheng also looked at Yue Nanji with his brows furrowed, his eyes closed, he could be regarded as discovering the defects of these medical equipment.

The glasses he wears are orthopedic glasses, and all he can see is the blood vessels of his limbs, but he can't see the whole body. Therefore, at this moment, Lu Cheng can only confirm that the patient's bleeding point is not within the scope of orthopedics anatomy!

Moreover, the most uncomfortable thing is that Lu Cheng's current understanding of anatomy is the most important thing in the field of orthopedics. In other disciplines, he has always felt that it is not necessary before, so he has not studied too much.

One is that orthopedics is already vast, and Lu Cheng still feels that there are too many things to learn, and he is not happy about it.

The second is that there are other departments to assist clinically, which is not necessary at all.

Now Lu Cheng can be considered to understand the sentence Min Hong told him. When you encounter a problem in your own discipline, you may have to look for answers from other majors or even other disciplines.

Human beings are a whole, and it is possible that any part of the problem will kill people.

But even so, Lu Cheng lowered his voice and said to Chen Bing, "Director Chen, should I come on stage and help?"

There are reasons why Lu Cheng said this. First, he wanted to get close to the patient. Although his equipment was limited and he could not directly see the blood flow in other places, he had the passive skill, dexterous touch. , So Lu Cheng hopes to feel it and do a favor.

Moreover, Lu Cheng is now a lower-level doctor, it is impossible to be the chief surgeon, but to be a lower-level doctor, the suggestion is still no problem at once.

Considering that there are not too many people on the stage, Chen Bing nodded and said, "Xiao Lu, then you can work hard and help Dean Zeng and Director Tan get the hook."

Chen Bing knew that Lu Cheng wanted to take the stage, but he also pointed out that you just went to help. Don't act aggressively. At this time, if you violate the medical system, Zeng De and the others will not carry you any burden.

This is a matter of life and death, and at this time everyone will immediately become extremely realistic.

Zeng Dewei smiled bitterly. In fact, what he most hopes is that Zhang Yuewei and Fu Yu will come on stage. Lu Cheng, a young doctor, will probably also be familiar with orthopedics, and at most learn a little more about the interdisciplinary disciplines of orthopedics. If there are any problems in this area, Chen Chen Bing came up long ago, why do you want him?

It's just that Zhang Yuewei and Fu Yu don't mean this right now, and they probably don't know what to do, so they didn't want to and didn't dare to take the position of the main knife rashly.

There is no way for Zeng Dewei to let go.

After the anesthesiologist listened for a while, he frowned and said: "I heard the sound of the lungs 20 minutes ago, but it was still very good, but now it seems that there is a real sound, which is also a strange thing."

"It is reasonable to say that if there is a contusion in the lungs, the real sound will be heard the first time!"

The anaesthetist continued, "Dean Zeng, can you open the chest cavity?"

Of course Zeng Dewei can’t, but Zeng Dewei immediately said, “I’m not from a thoracic surgery department, but Tan Yuanwu is. In the past, our hospital had no separate thoracic and vascular surgery department, Director Tan, Director Tan!"

Tan Yuanwu stepped on the door and walked in at this time, staggering with Lu Cheng who went out to wash his hands.

After seeing Qin Yuanwu, the anesthesiologist and Zeng Dewei immediately talked about the need to open the chest. Qin Yuanwu had undergone thoracic surgery before, so he shook his head and said: "If you only do closed thoracic drainage, there is no way to stop bleeding. The purpose of this."

"And if you want to open a full chest, the patient's lungs are not contused, and CT does not support the diagnosis of open chest, just to find the blood spot, is it a bit too much to open the full chest directly?"

Zeng Dewei urged: "Director Tan, when is this? This is life-saving. If the life is not saved, what are the other things?"

Tan Yuanwu's heart is constantly complaining at this moment. If you want to save your life, you have to look at the indications for surgery. What if the blood in the abdomen seeps into the chest? What should I do then?

After opening a large circle of the chest, but still not finding the bleeding point, who is responsible for this?

Even if it is an emergency, you must understand the indications for surgery. If you just open your chest in doubt, what is the difference between the current thoracic surgery and the thoracic surgery fifty years ago?

The advancement of medicine lies in precision and systematization, not roughness.

Otherwise, is the operation indication written?

Qin Yuanwu frowned and said, "Dean Zeng, should we wait for Director Xue? I think we should be more cautious when opening the chest now. I haven't done thoracic surgery for many years. Director Xue must have judged better than me. Be clear."

Tan Yuanwu is not in the position of Zeng De.

Director Xue is the Director of Thoracic Surgery. Although Qin Yuanwu was also born in thoracic surgery, he is now the director of vascular surgery. He does not open his chest and cannot get rid of the responsibility if something goes wrong. If nothing goes wrong, no credit can be taken for it, so a fool would do such a thing.

Zeng Dewei scolded Tan Yuanwu for procrastination, but he didn't dare to call the shots without authorization. He was the dean. He can give emergency authorization on behalf of the chief on duty. If he repeatedly asks, Tan Yuanwu can go beyond his authority to perform the operation, and the responsibility is his.

He originally wanted to push the responsibility out, how could he still take responsibility on himself?

"I'd better look for the branches of the femoral artery and abdominal aorta first to see if there are any bleeding points." Tan Yuanwu said and began his professional work.

I don't care about the chest part for now, but I still need to do things like the abdominal aorta, renal artery, and iliac artery.

Professional people do professional things, which is the origin of the consultation system.

After a while, Lu Chengcheng arrived on the stage and saw Zeng Dewei and Tan Yuanwu separately find out the blood spots. Chen Bing and Zhang Yuewei were watching the operation seriously, eyes unblinking.

He just went to help Tan Yuanwu grab the hook, and then his right hand was a little restlessly probing in various places.

It's just that, the structure of the abdomen is too complicated. Lu Cheng's dexterous touch still feels very difficult. It seems that he can only feel the arterial pulsation weakened or disappeared little by little.

Arteries are continuous, and arterial pulsation can be conducted. If there is a bleeding point, there must be local arterial pulsation weakened or disappeared.

This is not a special function of any skill, but an attempt by Lu Cheng through his existing skills and common sense.

Abdomen, there are no bleeding points, at least not so obvious bleeding points and the location of interrupted arrest.

Lu Cheng could only explore his chest.

The chest was covered by surgical cloth again, so this made it more difficult for Lu Cheng to find the bleeding point.

However, I don’t know if it was Lu Cheng’s luck or Yue Nanji’s luck. When Lu Cheng touched the fourth intercostal space of his left chest, he suddenly felt that it was about two centimeters to the left from his **. , The pulsation of the supracostal artery seems to have disappeared for a segment.

When he touched this point, Lu Cheng immediately descended another segment, and he also noticed that the arterial pulsation in the next intercostal artery was slightly weakened. Then he walked toward the chest, and there was no fluctuation of the intercostal artery.

Obviously, it may be that the second, third and fourth intercostal arteries have problems.

However, the weakening of the arterial pulsation here is extremely difficult to find, because there is a heart on the left, and the heart pulsation will cover the pulsation of the intercostal artery, and the bleeding point here, even if it causes blood to accumulate in the lungs, it will be caused by the heart. The pulsation and cover up.

Moreover, this blood accumulation may not puncture the mural and visceral pleura!

At this moment, Lu Cheng's eyes twitched, and he leaned over and whispered to Tan Yuanwu: "Director Tan, should we give the patient a chest puncture?"

If the hemorrhage of the intercostal artery leads to the accumulation of blood between the parietal pleura and the visceral pleura, this will make the left lung relatively atelectic, and if the left lung is atelectasis, the blood volume of the left heart circulation will be relatively reduced, which will also cause the patient to be low. A possibility of blood pressure!

Moreover, when in the ICU, this external pressure may not be too heavy, and with the passage of time, it will become larger and larger, so that the amount of blood that can be pumped is getting smaller and smaller!

And when in the ward, because the amount of bleeding is small, it may not be possible to find a small amount of internal blood.

It seems that everything can be explained.

After listening to Qin Yuanwu, he was a little stunned. Instinctively, he believed Lu Cheng~www.wuxiaspot.com~ and Lu Cheng’s suggestion was only for puncture, not for thoracotomy. Even if it was puncture, at most it was just It's just a pneumothorax.

Tan Yuanwu looked at the patient's vital signs again, and said, "Then let's do a puncture."

"Xiao Lu, what you just said was piercing from the chest? Where do you think you can wear it from?" This is already Tan Yuanwu's greater trust in Lu Cheng.

Just kidding, people who can even take the thrombus from the dorsal artery of the foot from the femoral artery, Lu Cheng is a problem, of course he will choose to listen to what Lu Cheng has to say!

He has to take it seriously.

Lu Cheng's eyes turned a little, and said, "Then wear it slowly."

In fact, what Lu Cheng wants to say is, or just wear it between the visceral peritoneum and the parietal peritoneum, but this is too detailed, it is not scientific!

In order to facilitate the next reading, you can click on the "Favorites" below to record this time (Chapter 228 Xiaolu's opinions are important!) Read the record, and you can see it next time you open the bookshelf!

Like "My Years in Fighting Monsters in the Operating Room", please recommend this book to your friends (QQ, blog, WeChat, etc.), thank you for your support! ! ()