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The low level of the first orthopedic surgery should be related to his lack of any orthopedic surgery foundation.
Separation and anastomosis are grade 3 once obtained, because they are advanced medical techniques derived from basic surgical techniques such as incision, suture, and ligation.
For osteosynthesis, he does not have any surgical basis.
He was able to set bones successfully for the first time. One is that he is very talented, and the other is that all laws in the world are interlinked. His four major surgical basic medical skills are already at the attending level, allowing him to comprehend by analogy.
Definitely much stronger than a true novice when it comes to bone setting.
"Orthopedics is an unavoidable hurdle in surgery, and there are many application scenarios. Now that I have acquired this medical skill, it is not bad to find opportunities to improve it a little bit."
Zhou Can always likes to plan for a rainy day.
Instead of asking for help for surgery in the future, it is better to find a way to learn more medical skills.
The field of surgery is very finely divided, and there are almost no universal doctors.
In the face of complex operations, it is often a multi-disciplinary joint operation.
For example, if the ribs are completely broken and there is a risk of stabbing the heart or other important organs, open chest surgery may be required.
At this time, the cardiothoracic surgeon and the orthopedic surgeon often work together.
Every time Zhou Can adds a new medical skill, there will be fewer chances to ask someone for surgery in the future.
Moreover, all kinds of medical skills are inextricably linked and complement each other. Learning a few more medical skills will also be of great benefit to his comprehensive medical skills.
…
"Teacher, do you think it's okay to join the phalanges?"
"Well, the connection is very good, hurry up and complete the follow-up part of the operation!"
Doctor Xu nodded in satisfaction.
It is very good to be able to receive it so well for the first time.
In the replantation of amputated fingers, connecting the patient's phalanx is only the first step in the operation.
The following tendon suturing, vascular anastomosis, and nerve anastomosis are all difficult steps. If any step is not done well, it may cause the failure of the severed finger replantation operation.
Fortunately, Zhou Can is fully capable of doing them well.
Tendon suturing mainly tests the two medical skills of suturing and ligation, as well as the related knowledge of tendon repair.
A resident doctor with an intermediate level can be fully qualified for this job.
Zhou Can's two medical skills are both at the attending level, which is enough to sew up a severed tendon very well.
Nearly forty minutes later, the tendons and blood vessels were all anastomosed.
In the blood test, in less than 30 seconds, a trace of rosiness appeared on the tip of the severed finger.
Perfect.
Seeing this, Dr. Xu was very relieved.
He smiled and went back to work.
Zhou Can continued to complete the follow-up nerve anastomosis and skin sewing for the patient.
After more than an hour of hard work, the replantation of severed fingers was finally successfully completed.
He also earned more surgery experience points.
Also harvested an orthopedic medicine.
It's a great feeling to be steadily improving.
The growth of a famous doctor is such a step by step, through countless operations, rescue and diagnosis experience, continuous learning and accumulation.
The operations continued one after the other.
Tian Tian still chatted with Dr. Lu and Li Shishi from time to time.
She wanted to chat with Zhou Can, but it was a pity that Zhou Can didn't talk to him at all because of his serious work.
After getting bored a few times, she changed the chat target.
Around three o'clock in the afternoon, a surgical patient with traumatic sutures came. He broke his jaw and cut a hole. He was very young, only nine and a half years old. He was a boy.
There were still wet tears on his face.
Children of this age are in the naughty stage of going up to the house to uncover the roof tiles and going down to the ground to play in the mud.
Playing around, falling and getting injured is a common occurrence.
Considering that the suturing is the face, and it is a child, the requirements for suturing are relatively high.
Dr. Xu handed the patient over to Zhou Can.
Dr. Lu's sutures were too sloppy. If an ugly scar is left on the child's chin, it may affect the child's life.
Zhou Can learned the seamless suture method from Dr. Xu very early.
In the past, because of the low suture level, I couldn't try it.
Since the level of suturing has risen to the attending level, he has started to look for opportunities to try the seamless suture method.
After practice and many consultations with Dr. Xu, he has been able to do quite well.
After Zhou Can took over the operation, he first checked the child's examination report.
No bone damage, just skin trauma.
not bad.
The amount of bleeding was not large, indicating that no larger arteries were injured.
This operation can only be regarded as a very small debridement operation.
Tian Tian and Li Shishi are chatting happily.
I don't know why she is so happy today?
She said that she will be able to take the mid-level nurse exam this year, and she has great hopes.
In general, nurses are promoted differently than physicians. After graduation, you can work for one year to be a junior nurse. After you get the junior nurse certificate, you can work for four years to be an intermediate nurse.
She said that she will be able to take the mid-level nurse exam next year, which means that she has worked for at least five years.
No wonder Qiao Yu was bullied to death by her.
"Local anesthetic!"
Zhou Can had to remind her.
"OK!"
Tian Tian agreed with a smile, quickly prepared the anesthetic, and handed it to Zhou Can who was carefully examining the child's wound.
Since there was a lot of blood in the wound, and some of it clotted, it was impossible to see the specific situation of the wound clearly.
The best suture plan can only be formulated after the anesthesia is performed and the wound is cleaned and disinfected.
Zhou Can took the prepared anesthetic and injected it around the child's chin wound.
With his attending-level injection technique, he is probably better than most attending doctors in administering local anesthetics.
Not long after the beating was started, the child's wound bleeding suddenly increased.
The child complained of a headache, chest discomfort, and shortness of breath.
This frightened Zhou Can.
Jin Mingxi had an accident last time, and he is still being punished.
"Teacher, after the local anesthesia, this child showed many abnormalities. Could it be an allergy to anesthesia?"
It was the first time Zhou Can encountered such a situation, and he panicked.
Hurry up and ask Dr. Xu over there for help.
"What is the dosage of the medicine?"
"About 20mg!"
Zhou Can injected the child with a superficial anesthetic, reducing the dosage by at least half.
"What anesthetic was used?"
Doctor Xu looked at Tian Tian.
At this moment, Tian Tian was very calm. When something goes wrong, nurses generally don't have to take too much responsibility, and doctors stand in front of them.
Unless it is found out that it is the nurse's negligence or mistake, it is the nurse who takes the main responsibility.
The biggest risk for equipment nurses is that when they participate in major operations, they fail to count the consumables, resulting in gauze, vascular clips and other things left in the patient's body.
In such a minor operation, the probability of nurse error is very small.
So Tian Tian showed that it had nothing to do with him, and was quite calm.
"I used tetracaine! It was diluted strictly with normal saline."
she replied.
While talking, the child's situation took a turn for the worse.
Any surgery has risks.
Once danger occurs, sometimes doctors and nurses don't even have time to respond.
The situation at the moment is extremely dangerous.
"Tetracaine is almost impossible to cause a severe allergic reaction. Procaine needs to be tested for allergies before use." Dr. Xu frowned.
Delegating power to allow Zhou Can to operate independently is actually against the hospital's regulations.
But as long as he, a teacher, is willing to take this risk, it can be justified in terms of procedure. At least there is no legal risk.
If nothing happens, nothing happens.
If the people don't raise it, the officials don't investigate.
But now the child's situation is so dangerous that even the experienced doctor Xu didn't know what the problem was for a while.
Then there is no way to accurately rescue it.
time is life.
For every second of delay, the patient's risk of dying from this procedure doubles.
Sweat dripped from Dr. Xu's forehead, and his eyes were extremely sharp, staring at the child closely, observing some of his symptoms.
"Suddenly increased bleeding from the wound? This indicates that the patient's heart contraction has increased, and the blood pressure may have increased. Measure his blood pressure immediately."
After measurement, it was 190/110mmHg, and the systolic blood pressure was frighteningly high.
Such a sudden high systolic blood pressure indicates that the heart is contracting rapidly and its pumping capacity is far beyond normal.
"Teacher, do you think there may be a problem with the anesthetic?"
Zhou Can has quickly calmed down from his panic.
The most important thing right now is not to think about being suspended or even sentenced after an accident.
Instead, try to find out the reason against time and save the child.
Zhou Can's diagnostic ability is very strong. After testing his blood pressure, he can think of the cause and effect. It was the abnormality that appeared after the anesthesia was injected.
That must be an anesthetic problem.
"Show me the bottle of narcotics."
Needless to say, Dr. Xu's strength, he also realized that it might be an anesthetic problem.
Tian Tian immediately squatted down to look for the anesthetic bottle.
I saw her face change slightly.
Then take out a medicine bottle from inside.
"Here, here's the pill bottle."
Her eyes were a little evasive, and her face was a little abnormal.
After dealing with her for so long, Zhou Can knows that this woman is a scheming whore.
I don't quite believe her words.
A lot of medicine bottles have been thrown in it.
Almost all bottles of local anesthetic.
One of the vials was buried under the others, but it was still found to be slightly different from the other anesthetic vials.
Zhou Can felt that something was wrong and was about to dig it out.
Tian Tian said with a concerned face, "Doctor Zhou, those glass bottles are broken, be careful."
Zhou Can didn't speak, but used a bottle to pick apart the top bottle, and then turned out the medicine bottle that was pressed down.
At this moment, Tian Tian's face turned pale.
Still pretending to be calm.
"Isoproterenol!"
Zhou Can saw the name of the medicine on the bottle, and suddenly realized that he wished to greet the eighteenth generation of Tian Tian's ancestors.
What is a femme fatale?
Tian Tian is.
"I did not use isoproterenol in today's surgery, where did this bottle come from?"
Zhou Can questioned Tian Tian coldly.
Dr. Xu has a wealth of experience, and has seen all kinds of tricks, ghost tricks, monsters and monsters.
His gaze was also staring at Tian Tian with an incomparably cold gaze.
"I-I don't know about this either! Maybe it was left by the doctor who worked the night shift yesterday!"
Tian Tian is still trying to quibble.
If Zhou Can hadn't seen her as a woman, he would have wished to slap her to death.
It's all this time, and I'm still lying here.
She only worries about being punished after admitting her mistake. However, he ignored the danger of the patient and ignored the fact that the patient might die at any time.
I can't imagine such a vicious and stupid woman in the world.
Looking at that pretty face at the moment makes people sick.
"Isoproterenol can enhance myocardial contractility, increase heart rate, and expand peripheral blood vessels and smooth muscles. It is clinically used to treat bronchial asthma, cardiac arrest and shock. It is a rescue drug that is always available in the operating room."
Zhou Can gave her a scientific explanation of the use of this drug with a cold face.
In fact, there is no need to popularize science, she is also a professional, and must know the use of this medicine.
Otherwise, when she squatted down to look for the medicine bottle in the trash can just now, she wouldn't have deliberately buried the medicine bottle under many bottles.
Doctor Xu has almost understood the cause of the accident.
There are many things that cannot be said in front of the patient.
He hurriedly brought Zhou Can and Tian Tian into the dressing room outside.
"Tian Tian, human life is at stake, are you treating this medicine as an anesthetic?"
Dr. Xu's face was so cloudy that water dripped out.
The eyes are also extremely terrifying.
"I, I don't know, there is such a possibility."
At this point, she is still hiding her secrets.
This woman is really stupid and bad.
If a person studying medicine has a problem with his moral character, it will be a disaster for both the patient and the hospital.
They are like a ticking time bomb, ready to explode at any moment.
"I'll ask you one last time, isn't it?"
Dr. Xu seldom yells at filial nurses like this.
I was really angry at the moment.
This stupid woman, she didn't know how serious the consequences of this matter would be. It is very likely that Xu Yi and Zhou Canquan were killed.
And the child's life was at stake.
Of course, the child may not die, but how do the parents explain it?
Sew a superficial wound, and you make the child like this for me.
I'm afraid no parent will agree.
Tian Tian couldn't be sure whether she had taken the wrong medicine, so they could only draw blood for a test first, and then determine the rescue plan.
By then, the day lily will be cold.
"Yes! I made a mistake. I was chatting with Li Shishi and the others just now. Doctor Zhou urged me suddenly. I was negligent, so I took it wrong." Facing Doctor Xu's fierce eyes, she finally dared not avoid the important thing.
"You, you, let me tell you what's good about you?"
Emergency medicines and anesthetics are stored separately.
I really don't know where her mind wandered to make such a serious low-level mistake.
"Immediately use 100 mg of α-receptor blockers to reduce the drug damage!"
After clarifying the reason why the child was in danger, Dr. Xu immediately tried to rescue him.
Alpha blockers have specific effects on isoproterenol. Some patients have this blocker naturally in their body, making isoproterenol ineffective.
After a series of rescue measures, the child's condition finally improved.
Doctor Xu also let out a long sigh of relief.
This matter must not be concealed, and must be reported to the superior according to the regulations.
"Xiao Zhou, you continue to sew up his wounds, and I'll report."
Dr. Xu is only an attending doctor. This matter needs to be reported to Director Lou first, and then Director Lou will report to the relevant departments of the hospital.
Fortunately, there were no serious consequences. It should be stabbed at the level of the medical department, and the fire will be turned off.
There will naturally be an experienced doctor to explain to the child's parents.
Sometimes it is a good thing that family members and patients do not understand medicine.
As for the sudden situation of this child, as long as the explanation is reasonable and the child is fine, parents can generally accept it.
Of course, when explaining, you will definitely not foolishly say that the medicine is wrong.
Tian Tian was immediately suspended from the operation.
Temporarily called Li Shishi to work as a nurse for Zhou Can, while Dr. Lu stopped operating independently.
…
That kid was doing well after the stitches were done.
After taking the wrong medicine and being rescued, there is no serious problem.
The end result was alright.
This is the only place to be gratified and thankful.
The matter is not over.
A special person came out to explain and communicate with the family members, and the family members accepted the hospital's explanation. Went home with the baby.
In the emergency department office, Director Lou's face was as heavy as water, and Dr. Xu's face was also ugly.
Zhou Can was cautious.
Tian Tian lowered her head, fiddling with the hem of her clothes.
Soon, the nurse in charge of Tian Tian and the head nurse of the emergency department nurse station also walked in.
"Today's medical accident happened very wrongly. Due to the negligence and carelessness of the equipment nurse Tian Tian, it almost caused irreparable and serious consequences. We originally wanted to compete for excellence in the operating room of the emergency department this month. Now this happened. This matter, not to mention the excellent evaluation, will definitely attract criticism and punishment from the superiors."
Director Lou's temperament was a little anxious.
After such a big thing happened, he slapped the table angrily.
"Director Lou, calm down. Tian Tian really shouldn't have made such a serious mistake. I will definitely strengthen her education." The nurse in charge
Still very protective of his nurses.
So do doctors.
Protect the cubs, many people have this behavior.
The two professions of doctors and nurses have a high probability of making mistakes.
Without the care of superior doctors and nurses, less than one in ten would have survived.
Whether it's Director Lou, Director Tan of the Department of Internal Medicine, Dr. Xu...the elders of these hospital departments, each of them has made mistakes. No one remembers exactly how many mistakes he made.
Because there are too many.
It is also a good thing that interns and training doctors are sometimes scolded.
Only by being scolded can we have a long memory.
"This incident deserves every nurse's vigilance. I will hold a safety meeting for nurses on this site as soon as possible. Take this incident as a typical example and educate all nurses to strictly abide by relevant regulations and put safety first. .”
The head nurse is sitting when she speaks.
From this point, it can also be seen that her status is quite high.
Basically, being able to become a head nurse is at the level of a chief nurse. In terms of nursing and management, they have a very high level.
Director Lou's face softened slightly.
"Niu Lan, how do you think Tian Tian will deal with this?" Director Lou is showing face to the head nurse and showing respect to her.
"Deduct the bonus of the month, cancel the qualification for the annual appraisal, and write a deep reflection and self-criticism. Do you think it is okay?"
The name of head nurse Niu is really unique.
Ordinary parents would never come up with such a name. After all, it is homonymous with the bullpen, and it is easy to be misunderstood.
She speaks very steadily, without rush or delay, calm and calm, modest but independent. UU reading www. uukanshu.com
"Well, I think these punishments are enough for her to remember deeply."
Director Lou affirmed her decision.
When this matter comes to this point, it basically comes to an end, and we can leave.
The person in charge has been put in place, and Tian Tian will bear it alone.
"Nothing else, go get busy!" Director Lou said to everyone.
Zhou Can deeply felt the art of being a leader.
Not long ago, it was thunderous, and he slapped the table angrily. Now it is picked up high, put down gently, and the clouds collect the rain.
Probably just a tap on the emergency department nursing department.
So as not to poke out the basket next time.
"Major Nurse Niu, please stay. There is one thing I want to discuss with you in front of Director Lou and Dr. Xu."
After Zhou Can waited for so long, the opportunity finally came.
Originally, he thought that it might take two or three months until he had learned most of the primary and secondary operations before he would have the opportunity to mention this matter.
I didn't expect Tian Tian to commit suicide and cause such a big disaster.
You really answered that sentence, if the sky wants you to die, it will make you crazy.
Tian Tian may be very happy because she cleaned up Qiao Yu yesterday and established her position. In a good mood, I chatted with Li Shishi, Dr. Lu and others.
It just so happened that they were talking about being able to take the mid-level nurse exam this year. She felt that the future was bright and everything was going well.
Get carried away.
End up making a low-level mistake that is easily overlooked.
Zhou Can was still a little worried that she would go back to the operating room, and she would be hired as an assistant at that time, and she would have to suffer a lot.
It's better to seize this opportunity and help Qiao Yu up.
Although there was suspicion of falling into trouble, he didn't care.