My medical skills can add experience points Chapter 122 Eye-catching hemostasis and suturing, the status has risen in a straight line
"You two can actually be more confident, because your diagnosis is correct. The patient is a ruptured finger extensor tendon. As for the rheumatoid arthritis you mentioned, it is still in the early stage, and you can see the unique symptoms of synovitis. Minor cartilage destruction. Can anyone tell me the treatment options?"
Dr. Shan's ability to diagnose these interns has basically been established.
Zhou Can and another Gui Peisheng performed well, while the others performed mediocre.
Pathology and etiology have been diagnosed.
Next comes therapy.
Diagnosis and treatment are equally important.
The clearer the treatment idea and the better the treatment plan, the greater the potential of Gui Peisheng.
"I think it's a matter of operating directly on the patient and suturing the ruptured tendon."
"In addition to suturing the tendon, I think rheumatoid arthritis should also be treated."
Several people have expressed treatment opinions one after another.
Zhou Can kept silent.
Several competitors breathed a sigh of relief.
Fortunately, this evildoer finally has a shortcoming. He doesn't seem to be very good at healing.
Doctor Shan was a little puzzled, looked at him and asked, "They have all expressed treatment opinions, why don't you speak? Are you unfamiliar with the treatment of this type of disease?"
Everyone has an area of expertise.
It shouldn't be difficult to provide some basic treatment options, though.
"I can't provide a treatment plan because there is too little information about the patient. The specific treatment plan can only be given after a comprehensive consideration based on the patient's age, physical fitness, whether there is an underlying disease, the patient's ability to bear, and the patient's own wishes. Formulate the optimal treatment plan. It is too one-sided to formulate a treatment plan based on only a few inspection reports."
Zhou Can has a personal opinion.
Medicine must be rigorous and prudent.
It is extremely irresponsible to formulate a treatment plan without even knowing the patient's condition.
After Doctor Shan finished listening, his facial expression became a little stiff.
This is indeed her negligence.
It's just that she was a little annoyed to be educated about safety issues in public by a regular trainee.
"What Dr. Zhou said makes sense. It is true that all the information of the patient should be integrated to formulate the most suitable treatment plan. However, Dr. Shan is only trying to test your treatment ideas, so he deliberately asked you to provide treatment based on the diagnosis results. Solution."
Dr. Tang excused Dr. Shan.
This young man is sure to have a bright future.
"Bring the patient into the operating room and prepare for the operation!"
Dr. Shan did not want to continue talking about this topic.
The patient was quickly taken into the operating room.
This is a woman in her fifties with tanned skin and wrinkled face. The ten fingers of both hands have been bent due to rheumatoid arthritis.
Ordinary people's fingers can be bent or straightened at will.
But her ten fingers could only remain bent and could not be straightened.
His right hand was even hung with a bandage around his neck.
Judging from her dress and temperament, she should be a rural woman. After tendon rupture, a primary diagnosis may have been made at the local township health center.
Township health centers are not capable of treating this disease, so they can only go to county-level hospitals or large hospitals like Tuya for treatment.
For the doctors at Tuya Hospital, this is just a minor operation.
The difficulty is not great.
"In this case, general anesthesia is generally not required, only brachial plexus anesthesia is enough."
While explaining to several people, Dr. Shan directed Dr. Tang to give the patient anesthesia.
Zhou Can was envious for a while, but it was a pity that he lost four injection experience points.
If he were to inject the anesthetic, at least four injections would be given to the patient.
At this time, Gui Peisheng and Dr. He, who had gone outside to put on plaster, came back.
Dr. Shan has instructed Dr. Tang to do a second skin cleansing on the patient's surgical site.
Then draw the knife position, mark the location of the tendon rupture with a red line, and finally cut the skin of the hand carefully.
Blood gushed out immediately.
"Stop the bleeding!"
She shouted to Dr. Tang.
Zhou Can stood by and rubbed his hands. He felt itchy when he saw the operation.
Hemostasis is his forte.
That Dr. Tang's ability to stop bleeding is really not flattering, at most it is inferior to that of a resident doctor. It is far worse than his inferior level of attending.
On the contrary, Doctor Shan's surgical ability is quite powerful.
When cutting the epidermis of the patient's hand, it is slow, steady and accurate. Larger blood vessels and nerves are well avoided.
It's like peeling the bark off a big tree.
Her incision technique must have reached the inferior level of attending.
No wonder the Orthopedic Surgeon let her take someone to do primary and secondary surgeries with confidence. There is something really important.
Dr. Tang's hemostasis is really slow.
The patient's wound bleeding has blocked the subcutaneous tissue.
Zhou Can took the blood sucker and sucked up the accumulated blood.
Doctor Tang glanced at him gratefully, while Doctor Shan showed admiration.
The operating room needs someone like Zhou Can who can take the initiative to do things.
The other Gui Peisheng would just watch stupidly.
"This bleeding point is a bit difficult to deal with! Why can't it be stopped!"
Dr. Tang coagulated one of the bleeding points several times, but the effect was extremely poor.
"It should be that the blood vessels have retracted. I happen to have experience in this area. Can you let me do the operation?"
Zhou Can has long wanted to apply for a job.
After finally catching the opportunity, he opened his mouth immediately.
"You... can you?"
Doctor Tang hesitated.
The difficulty of this hemostasis is quite high. Even he can't handle it, Zhou Can can do it with a regular trainee?
Thinking of Zhou Can's excellent performance in puncturing the knee joint cavity before, he finally chose to trust Zhou Can once.
After receiving the electrocoagulation knife, Zhou Can took the sharp tweezers, scraped away the fat around the bleeding point, and then tapped the electrocoagulation knife with great precision.
Zizi!
The whole process is smooth and clean.
The bleeding was finally stopped successfully.
This kind of master-level operation level made everyone around me stunned.
This is just one of the bleeding points.
There are at least five or six bleeding points that have not been dealt with.
The main reason is that Dr. Tang's hemostatic efficiency is too low.
Zhou Can held the electric coagulation knife in his hand, like a legendary acupressure master.
Point by point.
It only took five or six seconds to get everything done.
Really fast and good.
"Gu Peisheng, who came out of the emergency department, when did he become so strong? Didn't everyone say that the doctors in the emergency department are very good?"
Everyone was shocked, and couldn't help but think of Zhou Can's background.
He's from the emergency department.
At present, it has only been trained in the emergency department.
"alright!"
Zhou Can returned the electrocoagulation knife to Dr. Tang.
This time, Doctor Shan quit.
Her eyes are not blind, Zhou Can's ability to stop bleeding is so good, it is natural for Zhou Can to continue to stop bleeding.
To ensure higher operation efficiency and shorten operation time.
In addition, good hemostasis has an additive effect on the prognosis of surgery. It can make the patient's wound heal faster and reduce other tissue damage during the electrocoagulation process.
"Zhou Can, you will be the assistant. Doctor Tang will take a rest first."
She changed players on the spot.
"OK!"
Doctor Tang had no complaints, but was a little disappointed.
Being compared by a newcomer, Gui Peisheng, he must feel a little uncomfortable.
Dr. He, standing under the operating table, looked at Zhou Can in surprise and envy. If Zhou Can's meritorious service in front of Director Shen yesterday was regarded as a meticulous observation, his performance in the operating room today is definitely a demonstration of his strength.
He couldn't help but sigh, this Gui Peisheng is so strong.
Zhou Can was not hypocritical, nodded to Dr. Tang, and stood in the first assistant position that Dr. Tang vacated.
Doctor Shan continued to cut the subcutaneous tissue, looking for the ruptured tendon.
Blood gushed out again, and this time it was Zhou Can who stopped the bleeding. Compared with Dr. Tang, it was completely two levels.
I saw Zhou Can's extremely precise electrocoagulation to stop the bleeding, which was fast and good.
Total bleeding was pitifully small.
You don't even need an aspirator. Because there is no pool of blood that needs to be aspirated.
"The broken tendon seems to be coming out!"
Zhou Can spotted the ruptured tendon with sharp eyes.
The situation is relatively ideal.
Without doctor Shan's orders, he had taken the hook from the nurse on his own initiative to open the surgical wound.
Provide convenience for the next repair operation by a single doctor.
"Did you see it? This is the patient's ruptured tendon."
Dr. Shan was worried that the other Gui Peisheng would not know him, so he deliberately pointed them out to them.
"What we have to do is find the proximal and distal ends of the broken tendon. In this case, we can use the assortment of 5ml syringes to fix them."
After fixing it, Dr. Shan began to sew up the tendon.
"This generally uses No. 4 absorbable thread, and the cross stitching method is more stable."
Subcutaneous sutures are now mostly made of absorbable sutures.
The advantage is that there is no need for a second surgery to remove the stitches.
Her stitching level is also at the inferior level of attending, not as high as Zhou Can's stitching level.
The ruptured tendon was quickly sewn up.
"After the sewing is finished, continuous reinforcement must be carried out around the stump of the tendon."
As she sewed, she taught other junior doctors.
This is the end of the tendon repair when the suturing is complete.
The inspection is correct, and it can be finished.
"Doctor Shan, can you leave the rest of the stitches to me?"
Zhou Can was not greedy for this opportunity to sew skin.
For him, if he wants to sew skin, he only needs to work overtime in the emergency department operating room after get off work. Give him plenty of opportunities to exercise.
He took the initiative to fight for this opportunity to stitch skin in order to show off his strength in stitching.
Next time there is tendon suturing and blood vessel anastomosis, he will have a chance to fight for it.
It's just skin stitching on the hands, and the risk factor is very low.
Dr. Shan readily agreed to Zhou Can's request.
But she was still a little worried. Watch Zhou Can's movements closely.
I saw Zhou Can take the needle holder and threaded needle thread, and then began to sew the wound on the patient's hand.
Just after two stitches, Dr. Shan's eyeball almost fell out.
I was worried that Zhou Can could not sew well.
Unexpectedly, Zhou Can is much more powerful than she imagined. Even better than her attending doctor.
"So strong!"
Dr. Tang and Dr. He, both residents, felt their faces burning hot.
Because compared with Zhou Can, their suturing skills are far worse.
"How can a regular training doctor be so strong? Could it be that this kid has been practicing suturing since his freshman year?"
Even the attending doctors and residents were so shocked.
Not to mention the other five Gui Peisheng. While feeling desperate in their hearts, all they could think of was the word "Monster".
Zhou Can finished sewing quickly and neatly.
"Doctor Shan, please check for me!"
"Excellent sewing."
Doctor Shan praised him without hesitation.
"You're over the top! Is her rheumatoid arthritis treated with anti-inflammatory and rheumatoid drugs?"
Zhou Can knew very well that the patient's tendon ruptured, and lifting heavy objects was only an inducement.
The real cause was rheumatoid arthritis in the hands.
Suturing the tendon is only a temporary solution.
Drugs must be given to treat her rheumatoid arthritis in order to treat both symptoms and root causes.
"I will prescribe the medicine into the doctor's order, push the patient out of the operating room, and prepare for the next operation!"
Her attitude towards Zhou Can changed significantly.
Speak very politely.
It's almost the tone of a conversation at the same level.
Strength is always the easiest hard condition to win respect.
Zhou Can is not only extremely capable of surgery, but also can give precise prescriptions for drug treatment. This shows that he does not have any shortcomings in treatment.
Currently, he is far ahead of the other five Gui Peisheng.
But this is just the beginning.
Although this operating room is only the worst operating room in orthopedic surgery, the number of operations in a day is still amazing.
The examination report of the fourth patient appeared on the light curtain again.
The shot is of a patient's knee joint.
Two kinds of examinations, X-ray film and B-ultrasound, were done respectively.
"This is a typical suppurative infection of the knee joint!"
The Gui Peisheng who is very good at watching movies rushed to answer.
"I agree with his diagnostic point of view. Incision, drainage and lavage may be needed." Zhou Can has dealt with similar suppurative infections in the emergency department, and has extensive treatment experience.
"It's all very powerful! This patient is indeed a suppurative infection of the knee joint. The surgical plan is what Dr. Zhou said. It needs to be cut and lavaged."
"The Great Era of Rebirth"
Dr. Shan found that the two Gui Peisheng were very eye-catching, and a happy smile appeared on her face.
The vast majority of superior doctors actually hope to see successors.
People like Dr. Lu in the emergency department who are extremely selfish and selfish are in the minority after all.
The patient was quickly wheeled in.
Zhou Can was happy for a while.
Here comes another chance to perform.
At the same time, you can also earn a lot of experience points.
Since it was a competition, he was not polite.
Ask Dr. Shan directly for treatment authority including incision.
With the excellent performance of the three medical skills of hemostasis, suture, and puncture, he has initially established a foundation of trust in Doctor Shan's mind.
At this time, she should not refuse to ask for a medium-risk operation permission.
"It's up to me to cut it open! I can leave the rest to you!"
She didn't dare to let Zhou Can operate~www.mtlnovel.com~Almost all the senior doctors are similar. The risk of incision is the highest, and he will not easily delegate power to the doctors under him.
Zhou Can was not discouraged.
It is already very good to be able to grab the remaining exercise opportunities.
As for the chance of higher risk and more difficult surgery, as long as you can get a place for regular training in the operating room, you will have a chance to fight for it in the future.
…
In this way, they performed almost a dozen primary and secondary operations in one morning.
When it was time to eat at noon, Zhou Can deeply felt the busyness of the operating room once again. Everyone takes turns to eat. There are no breaks.
"Zhou Can, Dr. He, and nurse Wang Xiaohong stayed with me to continue the operation. The others took the time to eat and return to the operating room as soon as possible."
Doctor Shan made arrangements.
She didn't keep Dr. Tang, but Zhou Can.
It seems that this is the plan to let Zhou Can help her all the time.
But also understandable.
After all, with a powerful assistant assisting in the operation, the operation is not only much easier, but also the operation efficiency is extremely high.
Just like Zhou Can especially likes to perform surgery with Qiao Yu.
Nothing else, just because of her tacit cooperation, the work of the equipment nurse is very professional.
Dr. Shan did not ask the resident doctor, Dr. He, to be his assistant.
Instead, let him be responsible for putting plaster on patients and doing odd jobs in the operating room.
She was definitely worried about letting the other Ji Peisheng cast alone.
She was relieved to leave this kind of matter to Dr. He.
Zhou Can's status in the operating room also rose sharply. Competent surgical tasks are constantly increasing. +Bookmark+