【My medical skills can add experience points】【】
"Come on, lie down on the stage! The prone position is more convenient to operate!"
Zhou Can guided the middle-aged uncle to lie down on the operating table.
The shape of the foreign body is conical.
How this thing can enter the **** of an adult is really puzzling.
And judging from the photos taken, the diameter of this foreign body is quite large. The possibility of eating it is almost impossible. Among other things, it is impossible for this volume alone to pass through the narrow esophagus and small intestine.
So, it must have been stuffed in.
"Doctor...Does this need to be given anesthesia?"
"If you need to perform surgery to remove foreign bodies in the anorectum, you will definitely need anesthesia. Spinal anesthesia is often used, which is often called subarachnoid block anesthesia, also known as half-body anesthesia. This operation will be very difficult and requires After the abdomen was opened, the intestines were cut open and the foreign body was taken out."
Zhou Can explained patiently to the patient.
It also tells the other party the seriousness of the operation.
"Is your method of defecation useless?" Zhou Can asked.
"It didn't work! I even drank half a bowl of cooking oil, but it didn't work at all." The middle-aged uncle replied weakly. It can be seen from his expression that it must be very painful at the moment.
The heart is full of fear.
"You must be careful in the future. This time, you are lucky. The intestinal tract is not ruptured. If the intestinal tract is ruptured, the feces will enter the abdominal cavity, and infection will be life-threatening. The tearing of the intestinal tract and massive bleeding are also dangerous. "
They are both adults, Zhou Can can only remind the other party in this way.
There is a certain scare element, but his starting point is good.
Intestinal contents entering the abdominal cavity after intestinal rupture can cause severe bacterial infection and even life-threatening sepsis. Intestinal contents into the peritoneal cavity can cause chemical peritonitis, severe pain and even shock.
It can indeed kill.
Even with the current medical conditions, the prognosis of intra-abdominal infection is still poor, and death occurs from time to time.
In the early years, there were not a few cases where the intestinal contents were accidentally splashed during abdominal surgery, contaminating the abdominal cavity, and eventually causing the death of the patient.
Zhou Can first expanded the patient's **** with a dilator, and then clamped the tail of the conical foreign body with a clip.
Fortunately, the pointed part of this thing is facing inward, otherwise it would be much more difficult to take it out.
"Qiao Yu, slowly inject some lubricant into it."
Zhou Can clamped the foreign object and pulled it out slightly.
At the beginning, it was stuck very tightly. As long as I exerted a little force, the middle-aged uncle would scream. Fortunately, after a little looseness, the situation is much better under the action of lubricant.
It took a lot of effort to finally pull the foreign object out.
Zhou Can checked and found that his intestines were not ruptured, so he breathed a sigh of relief.
"What is this?"
Qiao Yu stared at him curiously.
"Kids, don't ask too many questions." Zhou Can found that Qiao Yu was as pure as a piece of white paper.
He put on the trousers for the middle-aged uncle and prescribed a doctor's order, which was actually a box of anti-inflammatory drugs.
"Try to eat more vegetables and fruits after returning home to prevent colon colonization. See a doctor in time if you feel unwell."
"Okay, thank you doctor!"
The middle-aged uncle seemed a little embarrassed, and hurriedly left the operating room under Ma Xiaolan's leadership.
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【My medical skills can add experience points】【】
"Hey, you talked too much just now! What a kid, he is already twenty-five years old." Qiao Yu protested a little unhappy.
"Sorry! Next time I speak, I must be careful with my words. Doctor Luo, don't be dazed, throw that thing into the trash can!"
After Zhou Can apologized to Qiao Yu, he ordered Luo Shishen to dispose of the medical waste.
The first patient was treated and the second was brought in.
This patient had another bowel-related emergency, suffering from acute pyloric obstruction, requiring emergency surgery.
Symptoms of pyloric obstruction mainly include nausea, belching, anorexia, and bloating.
Common pyloric obstruction is mostly treated with drugs.
Like this acute pyloric obstruction, patients have severe adverse reactions, severe vomiting, dehydration, fatigue, oliguria, thirst and a series of symptoms. The internal medicine treatment in another hospital was ineffective, so I came to Tuya yesterday to go to the emergency department.
After evaluation, he met the indications for surgery.
Perform emergency surgery on patients from emergency department.
Surgery like this is a major surgery and is generally an elective surgery.
This patient is also accompanied by gastric ulcer, if it is delayed, it may even become malignant.
After the patient enters the operating room, the anesthetist follows.
It was the Director Dongfang Luoxue of the Department of Anesthesiology.
Zhou Can no longer needs to go to the cardiothoracic surgery department to study with Director Hu Kan. Therefore, since the death of Director Hu, he began to fulfill his promise, at least three or four times a week after work, he went to the anesthesiology department to learn anesthesia techniques and knowledge from Director Feng.
The textbook knowledge of anesthesiology is less, and the medical knowledge of clinical general practice has a high degree of overlap.
The improvement of anesthesia technology mainly depends on practice and is obtained from clinical experience.
Each of the operations Director Feng participated in was a major high-risk operation of level three or four. His strength is beyond doubt, and he is the top anesthesiologist in Tuya Hospital.
Qualified old, experienced, skilled.
Many people think that his personality is weird, difficult to get along with, and they are afraid of dealing with him. Zhou Can felt that Director Feng had an extremely passionate heart for anesthesiology, and devoted his whole life to the study, accumulation and improvement of anesthesiology.
In ancient times, people who devoted themselves to martial arts and didn't care about worldly affairs were described as martial idiots.
Director Feng is a 'medical idiot' in anesthesia.
In this world, the scariest thing is that a person concentrates on doing one thing all his life. The accumulation of ten years and decades is very terrifying, and they are often able to achieve extremely high achievements in the field of study.
Zhou Can was not very enthusiastic about anesthesiology at the beginning, he just learned from Director Feng simply because he felt that there were too many skills to overwhelm him.
[In other words, currently the best app for reading and listening to books, change the source app, and install the latest version of .huanyuan app. 】
Later, he learned a lot, especially after studying the knowledge of cardiothoracic surgery and diagnosis and treatment in depth with Director Hu Kan, he gradually discovered that anesthesiology is good.
First of all, anesthesiology has a thorough understanding and research on the three major circulations of the human body, as well as internal and external circulation. Secondly, it has in-depth research and actual combat accumulation on the nine major systems of the human body, especially the research on the nervous system, respiratory system, circulatory system, and exercise system, which is extremely in-depth.
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【My medical skills can add experience points】【】
It can be said that internal medicine is the group of people who understand the mechanism and pharmacology of the human body best.
But anesthesiologists are the group of people who know life best.
How to support life and ensure life maintenance, anesthesiologists ranked second, and no one dared to rank first.
After learning the knowledge of anesthesia, Zhou Can can obviously feel the huge benefits in clinical practice. Even the idea of surgery will change because of anesthesiology.
He also found that the various disciplines of medicine have a certain degree of interoperability.
Medicine is somewhat like a circle, and without any of its segments, the circle would no longer be coherent.
Learning anesthesiology well can greatly improve the depth and coherence of the overall medical understanding.
For ordinary people, it is good to learn one medical field well in a lifetime.
Because Zhou Can has an experience point system, he has a great advantage in this regard. What other people can only complete in ten years, he may be able to accumulate experience points in two to three years, or even shorter time, from quantitative change to qualitative change.
With this huge advantage, he is destined to have the time and energy to learn more medical fields.
It is impossible to thoroughly study all medical fields.
But it should not be difficult for him to reach a certain height in multiple medical fields.
At least he has already reached a fairly high level in most fields of general surgery, critical care medicine, cardiothoracic surgery, nephrology, and gastroenterology.
I believe that as long as he continues to accumulate, he will continue to climb to new peaks in more fields of medicine.
Dongfang Luoxue was as cold as ever, like the legendary iceberg beauty.
Because she is over forty years old, given her age, at most she still has charm.
"Do you need help?"
Zhou Can greeted her with a smile.
"good!"
She only answered one word, and at the same time, she tried to respond with a smile on Zhou Can's face.
Perhaps because he is used to having a cold face, the smile he squeezed out was particularly stiff.
But for her, it was not easy.
"Director Dongfang still looks better when he smiles, he looks more kind and beautiful!"
Zhou Can did not hesitate to praise her.
In the past year, before Director Hu Kan passed away, he would go to the anesthesiology department to study with Director Feng at least once a week. Gradually, I basically got acquainted with the doctors in the anesthesiology department.
The doctors in the anesthesiology department regarded him as half of their own.
Dongfang Luoxue's attitude towards Zhou Can is so friendly. Even though she is a chief physician, she treats a resident as an equal. That's because she has seen Zhou Can's strength.
Not convinced.
After receiving Zhou Can's praise, she had no expression on her face. The eyes betrayed her, at least it could be seen that she was very happy in her heart.
Zhou Can helped to give the patient general anesthesia while understanding the patient's condition.
Before Dongfang Luoxue signed the anesthesia consent form with the patient, he must have had a deep understanding of the patient's situation. Zhou Can understood it again because of his own learning needs.
It is also to ensure that there will be no major mistakes in the operation and eliminate potential safety hazards.
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【My medical skills can add experience points】【】
"Come on, lie down! You will be placed in the supine position when you are operated on. Relax, it is equivalent to sleeping. After waking up, your disease has been solved by us."
Zhou Can comforted the patient and guided him to lie flat.
Pyloric obstruction surgery is generally done in a supine position, with an incision made from the midline of the upper abdomen or from the upper left through the rectus abdominis muscle.
Patients sometimes prefer to lie on their side because of pain.
The entire general anesthesia process went smoothly, and the patient soon fell into a coma with normal signs.
"Dr. Luo, the incision for this kind of pyloric surgery must be based on the actual situation of the patient. Don't copy it mechanically. You just need to remember one principle, whichever incision method is more convenient for the operation and better for the patient's prognosis, you can choose which one." When the two cannot be considered, weigh the pros and cons and choose carefully. If the technology is not up to the mark, then choose an incision that is more convenient for surgery.”
Zhou Can was very careful in cultivating and teaching Luo Shigent.
It's basically a word of mouth.
As for how much he can comprehend and remember, that is his own business.
Dr. Xu stood by the side without saying a word, guarding and sitting in charge for Zhou Can.
Now, he is basically in the freeing stage for Zhou Can.
As long as Zhou Can can do it himself, he will not intervene. It is also this kind of bold decentralization that gave Zhou Can a very valuable opportunity to exercise and improve alone.
"Stop the bleeding!"
After Zhou Can cut open the patient's abdominal wall, blood gushed out.
In fact, he has avoided the larger blood vessels.
As long as it is an operation, bleeding is inevitable. Especially in laparotomy and thoracotomy, the potential risk of massive bleeding is extremely high.
Surgeons who are not experienced enough and whose knife skills do not reach a certain level dare not operate on vital parts such as the chest and abdomen of patients at all.
If you don't have that certainty, if you force the operation, there is a high probability that something will happen.
Luo Shigen frantically applied electrocoagulation to the patient's wound to stop the bleeding.
"Xiao Luo, you need to practice more when you get home. Let me do it!"
Dr. Xu couldn't stand it anymore.
With his strict requirements on junior doctors, this frizzy operation is simply challenging his bottom line.
This is why interns are not qualified to be assistants at all.
If it is only a first-level or second-level operation, the intern may be barely competent as a medical assistant.
Third-level and fourth-level surgeries, let alone interns, even senior residents may not be able to perform them.
Monsters like Zhou Can are still in the minority after all.
Even Du Leng, a returnee doctoral student, is far behind Zhou Can in the field of surgery. To put it bluntly, he wasn't even fit to carry his shoes.
It's not hubris, it's genuine unworthiness.
It was not wise for Du Leng to enter surgery at the beginning.
With his profound medical knowledge, he should enter internal medicine, and his development may be better.
The road is chosen by oneself, and sometimes it depends on a little luck.
More than three years have now passed. Du Leng is already the attending physician of Shenwai, and it is said that he has devoted himself to training in general surgery for nine months. Zhou Can really doesn't know what's going on now.
It's true that it's not as loud as it used to be.
Without that strength, the departments and doctors would not give him high-profile opportunities.
The few geniuses who entered Tuya Hospital at the same time as Zhou Can are basically silently working hard to improve. Including Gao Jian, who has entered the internal medicine department, I heard that the outpatient number has been opened not long ago, and he has started to see patients.
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【My medical skills can add experience points】【】
But compared with Zhou Can, it is definitely not at the same level.
Zhou Can has been in pediatrics for more than a year.
The accumulation of popularity and experience is not comparable to good ideas. Diagnosis level, medication, treatment plan, prognosis assessment, etc., even if Zhou Can does not make progress in lying down, it will take at least ten years for Gao Jian to catch up with him.
It's not bragging.
It is just the level of pathological diagnosis and pharmacological syndrome differentiation at the deputy director level. Many doctors will never reach it in their lifetime~www.mtlnovel.com~Most talented doctors want to reach this level, at least twenty years to go up.
Tuya Hospital included Zhou Can, an undergraduate student, in the reserve quota of Famous Doctors Hall, and Zhou Can was still in the stage of regular training at that time, and he hadn't even obtained a certificate of completion of the regular training. It is enough to explain his extraordinary.
The hospital's decision-making on such matters has an extremely strict review mechanism.
With Du Leng's dazzling education, he has not even seen a shadow of being admitted to the reserve quota of famous medical halls.
You can know how difficult it is for the reserve army who wants to enter the famous medical hall.
…
The operation went very smoothly and was completed in less than two hours.
However, because of the two most powerful knives in the emergency operating room, both Zhou Can and Dr. Xu were operating on this patient, resulting in a backlog of other emergency surgery patients.
In another operating room, Dr. Cui, who is actively seeking the employment contract of the attending physician, is working **** the operation.
His surgical level has reached the level of attending.
In terms of speed, it is far behind Zhou Canke.
It is worth mentioning that Dr. Xu's operation speed is not particularly fast. On the one hand, he was afraid of another accident, so he became cautious in the operation. No longer blindly pursue the speed of surgery. On the other hand, Dr. Xu is old after all, and his physical strength and energy cannot keep up.
After a man reaches the age of thirty-five, his physical strength and energy will be obviously inferior to that of a young man in his twenties.
Men over the age of fifty, called old men, will have worse physical strength.
Therefore, the absolute main force in the emergency operating room is Zhou Can.
The surgery was done quickly and well done.
And meat and vegetables are not taboo, almost general surgery can be done.