As Zhou Can loosened the hemostat bit by bit, the dry blood vessels began to fill up. Immediately afterwards, the patient's right lower limb began to recover a little bit of blood. Not so pale anymore.
"The blood flow was smooth and the anastomosis was successful."
Everyone had smiles on their faces.
For a doctor, the happiest thing is to see the patient's condition improve.
Restoring the blood supply to the lower extremity also means that the possibility of the patient keeping the leg is greatly increased. From a medical point of view, if the blood flow of limbs is blocked, death may occur within 20-30 minutes.
If it is cerebral ischemia, it is even more terrifying.
Brain death occurs in as little as four or five minutes.
Even if it is saved in the end, there is a high probability that it will become a vegetable or a mentally handicapped person.
"Doctor Lin, is the anastomosis almost over?"
Doctor Xu asked.
"Hurry up, there will be about five or six minutes."
Dr. Lin is focusing on repairing the broken arteries.
"Based on the patient's current injury, it is not appropriate to move. Please ask the surgeon to come over for a consultation! See if the operation can be completed here."
What the emergency department can do is the initial rescue work.
After the patient's vital signs stabilized, he was transferred to a specialist for further treatment.
After a long wait, Dr. Lin finally completed the blood vessel repair.
"Take a blood test!"
After speaking to Zhou Can, Dr. Lin looked expectantly at the repaired blood vessels and the patient's left lower limb.
Zhou Can still loosened the hemostat bit by bit.
It can be seen that the dry blood vessels are slowly propped up by the influx of blood. However, the complexion of the lower extremities is still pale.
After watching for tens of seconds, Dr. Lin looked at Dr. Xu nervously.
"Don't worry, I think the blood flow is smooth. There are two reasons for the slow return of blood to the left lower limb. First, the repaired blood vessels are narrowed, which reduces the blood supply to the left lower limb. Second, the patient lost too much blood after the injury. Too much, low blood pressure, resulting in insufficient blood supply to the extremities."
Dr. Xu seemed very calm.
No panic at all.
The reason why superior doctors can preside over more advanced operations is not only because of their better medical skills, but also because of their stronger psychological quality in dealing with crises. Coupled with richer experience, the correct solution can be given in a shorter time to deal with some emergencies.
In short, the growth of a doctor is very difficult.
Including academics, medical skills, experience, psychological quality... many aspects.
"Xiao Zhou, watching us perform vascular anastomosis, what do you gain?"
Dr. Xu asked him questions alone.
It made other doctors and nurses look at him enviously. Any fool can see that Dr. Xu is very fond of this new regular trainee.
"The harvest is quite big. For example, in the final stage of anastomosis, the air that may exist in the blood vessel must be exhausted. There is also the extent to which the blood vessel is damaged and needs to be removed, and the method of taking the great saphenous vein. In addition to medical technology , Your calmness in the face of crisis has also benefited me a lot."
Zhou Can roughly shared his harvest.
"Hehe, you kid can even imitate the psychological quality of a superior doctor, so I have convinced you."
Dr. Xu, who has always been strict, showed a rare smile.
"If you were to repair the femoral artery that Dr. Lin just repaired, what would you do?"
When Dr. Xu anastomosed blood vessels just now, he taught him a lot of experience.
Did Zhou Can really listen carefully?
Can you apply what you have learned?
This is what Dr. Xu is most concerned about.
He doesn't like people who are stupid.
"If I were to repair it, I might do a triangular anastomosis. There are two reasons. The circular anastomosis is not so strong, and the triangular anastomosis is stronger. The second point is that the triangular anastomosis can perfectly avoid the small piece of damaged blood vessel wall. , to remove it. In this way, the narrowing of the blood vessel lumen and even secondary rupture can be avoided to the greatest extent.”
Zhou Can gave his own opinion.
Doctor Lin felt ashamed for a while.
Although his suture level is higher than Zhou Can's, the application of surgical plan is obviously not as flexible as Zhou Can's.
"It's okay, it's not in vain. I guess it will take a while for the surgeon to arrive. You can anastomose these two small veins."
This is obviously a chance for Zhou Can to practice.
Even if you mess up, there's not much risk.
Doctor Xu was watching from the side.
Wipe his **** anytime.
Zhou Can couldn't help but be overjoyed, as long as there is an opportunity to get experience points, he likes it.
I just learned a lot of vascular anastomosis skills and key points, and now I can practice it on patients. This is definitely the dream of every low-qualification doctor.
Because this method of combining learning and practice can make learners get twice the result with half the effort.
But I don't know why the apprentices taught by famous teachers are so powerful.
In addition to the high level of the famous teacher itself, the most important point is that the famous teacher can also provide students with various practical opportunities.
For example, the current venous and vascular anastomosis, if ordinary Gui Peisheng wants to get it, he wants to eat it.
…
After about twenty minutes, an orthopedic surgeon rushed over.
"Old Xu, is this patient?"
He nodded to Dr. Xu as a greeting.
Eyes then fell on the patient.
"Hmm! The injured man's legs were crushed very badly by the car. The femoral artery has been temporarily connected, and the rest of the operation may have to be handed over to your surgery department. Personally, I suggest that you ask your surgery specialist to After the operation is completed for the patient here, is it transferred to the ward?"
Dr. Xu briefly introduced the situation.
Zhou Can is still concentrating on anastomosis of veins.
His speed is extremely fast, and he has successfully matched one.
The one that is being stitched together in the hand is more complicated, and the broken section needs to be cut off, and then stitched together.
"Your operating room is relatively simple, and the connection and repair of bones are very complicated. I'm afraid it can only be done in our orthopedic surgery operating room. Also, I see that the patient's thigh muscles and bones are severely damaged. These two It is hard to say whether the leg can be saved. You are the first doctor, so you need to communicate with the family. In addition, the cost of treatment will not be low, and the family must be clear about whether to save the leg or amputate."
This kind of crushing injury can easily lead to necrosis of the muscles and skin of the legs.
It's hard to see with the naked eye alone.
Only after a few days of observation can a final conclusion be drawn.
"That's fine. After we have communicated with the family members, we will transfer it to your orthopedic surgery department for further treatment."
Doctor Xu didn't say anything more.
He is just an attending doctor in the emergency department with limited abilities. Many things are out of his control.
Before leaving, the orthopedic surgeon glanced at Zhou Can who was stitching up.
"Old Xu is planning to train a successor?"
"What is there to take over from my class? Attending is my end."
There was a hint of loneliness in Dr. Xu's tone.
"Old Xu, let me tell you something you don't like to hear. The environment and conditions of the emergency department make it impossible to cultivate high-level talents. You might as well let go of some obsessions and focus on emergency rescue. With your talent, you It’s really possible to make a difference.”
The attending doctor of orthopedic surgery also seemed to know about Dr. Xu's past.
Zhou Can couldn't help being even more curious. Dr. Xu's medical skills are obviously not weak, so why was he placed in the emergency department, the worst department, as the attending doctor?
What happened back then?
"What kind of talent do I have, I'm already a useless person."
Doctor Xu laughed at himself.
"But don't say that, at least in the minds of many of our surgeons, you are still the legendary Xu Yidao. Don't say anything, let's go!"
The attending doctor of orthopedic surgery waved his hand and left quickly.
Orthopedic surgeons should be one of the busiest clinicians in the department.
At this time, Zhou Can finally completed the anastomosis of the second vein.
[Stitching experience +1, ligation experience +1, anastomosis experience +1. 】
Earning experience points now is like flying at a speed.
For anastomosis of two veins, UU Reading www.uukanshu.com earned 30 experience points for suturing, 4 experience points for ligation, and 2 experience points for anastomosis.
The attending doctor of orthopedic surgery said that the emergency department could not train high-level doctors, Zhou Can expressed his dissatisfaction.
According to the current rate of progress, I am afraid that within three years, a master surgeon will be born in the emergency department.
After the anastomosis was completed, Zhou Can tried to drain the blood.
not bad.
At least they all fit together.
Dr. Xu checked it carefully for a while, and then said, "The anastomosis method is okay, but the level of suture needs to be improved. For example, here, it is because your suture has not reached a high level, resulting in the narrowing of the lumen of the blood vessel. And this, you It should be selected as the starting point for stitching. In the future, these details must be paid attention to.”
It was a great benefit for Zhou Can to get Dr. Xu to point out the problems in the suture one by one.
Father, like son.
Many problems are hard to find by yourself, and a clever teacher can point them out sharply, which can avoid detours.
"Doctor Lin, please communicate with the family members again. He said that the patient's hemorrhage in both legs has been controlled, and now he needs to be transferred to the orthopedic surgery department for further treatment. The cost of limb salvage needs to be prepared at least 200,000 yuan, and there is a possibility of failure. Ask clearly After the family wishes, we will proceed to the next step of treatment.”
Doctors can only give medical advice.
As for the final choice of patients and their families, doctors have no right to interfere.
Zhou Can has seen family members directly choose to give up the 20,000 yuan treatment fee.
The injured man was about fifty years old. Judging from his clothes, tanned skin, and rough hands, his family should not be rich. It is hard to say whether the family members are willing to spend hundreds of thousands to choose limb salvage.
Everyone waited patiently for Dr. Lin's communication results.