【My medical skills can add experience points】【】
The first thing to do is look for large blood vessels that have been punctured by a sharp object.
It must be said that when a ruptured blood vessel is large enough, be it an artery or a vein, it is enough to pose a fatal threat to human life.
It's just that the blood pressure in the veins is lower, and the bleeding is not as violent as the arteries.
Relatively speaking, ruptured veins are easier to stop bleeding.
There were a total of eight wounds in the nurse's chest and abdominal cavity, and the knives and knives were extremely brutal, all of which penetrated into the deepest part of the cavity.
"Found a ruptured abdominal aorta!"
After the hemoperitoneum was cleaned up, the large source of bleeding could be clearly seen.
This jet-like hemorrhage is extremely terrifying, and it can lead to a sharp drop in the patient's blood volume in a short period of time, eventually leading to shock and death from blood loss.
"It should be the superior mesenteric artery in the upper abdominal cavity. It can only be ligated first and then repaired,"
While searching, Zhou Can murmured to himself and gave a hemostasis plan.
"Hemostat!"
"Give!"
Qiao Yu quickly handed the hemostat to his hand.
Zhou Can found the blood vessel end near the bleeding point, and clamped it with a hemostat.
"Yang Zhi, hold the hemostat for me. The force should not be too strong nor too small."
This kind of deep artery in the abdominal cavity is pinched during the hemostasis process, and it is easy to form a thrombus or rupture. Necrosis is less likely, but still possible.
Hemostasis is definitely a technical job.
Zhou Can just looked for the proximal end of the blood vessel, which seemed to be done in a few seconds. That's because his hemostasis has reached an extremely high level.
He has a very good understanding of the anatomical structure of the human body, coupled with rich experience in hemostasis, he is so powerful.
Otherwise, if another person were to operate it, just looking at the continuous spray of blood would already be flustered, with trembling hands and feet.
After Yang Zhi freed one hand to hold the hemostat, Zhou Can began emergency debridement.
Arterial repair is far more difficult than imagined.
In fact, with so many deep wounds in the patient's chest and abdomen, there must be more than one bleeding point.
But Zhou Can can only take it step by step.
The superior mesenteric artery, which is visible and bleeding the most, was repaired first.
"Doctor Zhou, the patient's blood pressure is still dropping, and the heart rate is also dropping. When breathing, there is blood foam in the nostrils. Check to see if there is any trauma to the lungs?" the anesthesiologist reminded Zhou Can.
"OK!"
What Zhou Can is opening now is the abdominal cavity. If he wants to move his lungs, the best way is to open his chest.
With the patient's current condition, he dared not open his chest at all.
It is estimated that before he finished opening his chest, the person was gone.
It's definitely not a joke. With such a serious injury, the life of the patient has become very fragile.
"Damn it, the portal vein was also punctured! How can this be done?"
He checked and soon found another large bleeding spot.
The intestines were also punctured, and the contents of the intestines had directly spilled out, contaminating the abdominal cavity. At this moment, Zhou Can especially hoped that there would be two or three chief surgeons to rescue He Juan together.
He alone, no matter how strong the surgical ability is, no matter how fast the speed is, it will be limited after all.
A deep sense of powerlessness kept pounding his heart.
"Immediately ask Director Xueyan from the Department of Cardiothoracic Surgery to bring a surgical team over to help save her. Just say what I said, the sooner the better."
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【My medical skills can add experience points】【】
In order to save people, Zhou Can directly used his personal connections.
The emergency department asked the cardiothoracic surgery department to send someone to rescue the patient, and the cardiothoracic surgery department would not refuse. But it can be business.
If Zhou Can personally invited them to help, the treatment would be completely different.
Rescue is still going on.
He Juan's mouth and nostrils gushed out blood and foam, and her blood pressure kept falling.
Four bags of blood have been consumed in a short period of time.
A bag of 250ml has already transfused 1000ml of blood.
"Pulmonary artery rupture is difficult! The blood vessels and intestines in the abdominal cavity can be repaired one by one as long as I give me a little time, but the lungs are very troublesome. Now I don't know where the bleeding is."
Zhou Can quickly repaired the blood vessels while introducing the situation.
The anesthesiologist is responsible for stabilizing the life of the patient, while Zhou Can is responsible for surgical repair of blood vessels, intestines, etc.
Now I can't care about the broken intestines at all, I can only let it leak.
Repairing the blood vessels first is the right way.
Not long after, Director Xueyan rushed over with a whole surgical team. This is Zhou Can's energy. As long as you mention his name, Director Xueyan can help you with all your strength.
"I've heard about a family member who stabbed many medical staff in your emergency department with a knife. It's so outrageous."
As soon as Xueyan came in, she sympathized with what happened in the emergency department.
"She is spitting blood, is this... a lung injury?"
"Sister Yan, I just want to ask you to come here to see if the patient can have the chest opened? The wound is on the right chest, this location. Based on experience and feeling, it should be an oblique stab wound."
Zhou Can pointed to the patient's right chest.
It can be seen that the chest has been broken. However, because of wearing a bra and the special body structure of women, the depth of the wound should not be particularly deep.
"Her condition is almost fatal. I suggest opening two small windows for endoscopic surgery, and there may be a chance of survival."
Deputy Director He from the Department of Cardiothoracic Surgery also rushed over.
He owed a lot of favors to Zhou Can, and now that Zhou Can has a call, he must run over to pay back a favor.
Regarding thoracic surgery, Deputy Director He should be the one with the most experience among all the people present.
"Anesthesia, can her condition be transferred to the endoscopy operating room?"
Zhou Can asked the anesthesiologist directly.
"If you don't turn it, you will die. If you turn it, there is still a glimmer of life, so let's give it a try."
The anesthesiologist felt that Zhou Can was desperate to save people, and she was also deeply moved. He also decided to fight with Zhou Can.
Adventure is definitely needed.
"Can you allow me to repair her portal vein and superior mesenteric artery before leaving?"
"I can only try. These two important blood routes have been cut off, it will definitely not work." The anesthesiologist frowned and hesitated for a moment before giving an answer.
The patient's condition is actually very bad.
The injury is too serious.
"Sister Yan, is it okay to transfer the person directly to the endoscopy operating room of your cardiac surgery department?"
"No problem, I'll arrange it right away."
Director Xueyan was very straightforward, releasing all kinds of medical resources for Zhou Can.
The rescue of such seriously injured patients requires close cooperation in all aspects.
Zhou Can quickly repaired the superior mesangial artery.
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【My medical skills can add experience points】【】
Just now, only the debridement and trimming have been completed, and what needs to be done now is to anastomose the blood vessels.
One advantage is that only a little bit is removed during the trimming of the blood vessels, so there is no need to consider the shortening of the blood vessels and the need to extend them with artificial blood vessels. However, this kind of vascular anastomosis is also a test of the doctor's skills.
Especially large arteries.
Also, in actual operation, blood vessels tend to shrink continuously in a short period of time after they are severed.
In medicine it is called vascular collapse.
If the blood vessels are not quickly anastomosed to restore blood supply, the difficulty of anastomosis will increase exponentially.
Zhou Can went all out and began to quickly anastomose the arteries.
[Suture +1, experience bonus +100. 】
[Suture +1, experience bonus +100. 】
The sixth-level suture technique helped Zhou Can a lot at this critical moment. His sewing speed is also getting faster and faster.
And the phenomenon of being able to feel life through stitching reappeared.
This shows that his state at this moment is the same as when he opened his stomach before, and he has entered a wonderful state. That is, when doing one thing, devote yourself wholeheartedly, without any distracting thoughts, with an extremely firm belief in your heart and a high degree of concentration.
"alright!"
The vascular anastomosis of the entire upper artery took three minutes and six seconds, which definitely created a record.
[Anastomosis experience +1, the first time to achieve a perfect anastomosis, reward experience +. Heart of benevolence experience +100. 】
Zhou Can was stunned.
It is definitely the first time to directly reward experience points.
He doesn't know what a perfect anastomosis is, he only knows that when the blood vessels were anastomosed just now, it was like a god. How to operate each step seems to have been rehearsed countless times. The entire matching animation picture will naturally appear in the mind. It's like setting up a program and step by step. You don't need to think about each step of the operation, just implement it directly.
This feeling is so magical that it is difficult to describe it in words.
If I have to describe it, the anastomosis of blood vessels is like rehearsing countless times in the brain, and I am so familiar that I can't be more familiar with it.
Zhou Can knew very well that the anastomosis of each segment of blood vessel was different. It can only be modified according to the actual situation, and there is no way to preview it.
The reason why the animation picture that has been rehearsed countless times appears in my mind is probably a bit similar to practice makes perfect, plus a blessing to the heart. This kind of wonderful surgical ability only appeared in this rescue process.
[The novel app that has been running stably for many years, comparable to the old version of the book chasing artifact, the source-changing app used by old bookworms, huanyuanapp]
This time, when rescuing patients, the rewards for various medical experience points were soft, and the minimum was 100, and the most this time was as high as experience points. Does it have something to do with special medical skills and benevolence?
Usually, Zhou Can rarely pays attention to this special medical skill.
It also rarely increases experience points.
This time, it directly increased 100 experience points, which was the first time.
Right now is not the time to study these, many ideas just flashed through his mind. He had given up distracting thoughts, and began to debride, trim, and anastomose the ruptured portal vein.
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【My medical skills can add experience points】【】
The whole operation is still smooth and smooth, extremely fast, and all aspects of technical points are also close to perfection.
Including the details of blood vessel desilting before anastomosis, air discharge, etc., he did a very good job.
Five minutes later, the portal vein was repaired.
The patient's blood pressure is still dropping, and the sixth bag of plasma has been hung up. Rehydration is continued.
After the successful anastomosis of the portal vein, he received another high reward of 1000 experience points.
Although it was not as exciting as the reward of 10,000 experience points last time, this super high amount of reward still allowed his anastomosis skills to grow rapidly.
At present, it is approaching the sixth-level anastomosis at an astonishing speed.
Attempts were made to loosen the ligature of the portal vein, and blood flow was restored.
"Hey, not bad! The patient's blood pressure has gone up a bit! But she seems to have a little respiratory failure, and the wound on her lung must be treated quickly. The most fearful thing is that the fluid in the lung is too serious, which will directly cause her to stop breathing."
Lung continued bleeding, it is impossible to discharge all through the bronchi.
At this time, severe effusion must occur.
The breathing of the lungs relies on the contraction and expansion of countless alveoli to complete the inhalation of air and the discharge of exhaust gas. When fluid accumulates in the lungs, it is equivalent to being submerged in water.
If there is only slight fluid accumulation, or fluid accumulation on one side of the left and right lungs, the patient will only feel oppressed and have difficulty breathing.
If the effusion in the whole lung is serious, it is not much better than being choked by someone.
The patient has respiratory failure, which is a very bad signal.
"How about puncture and drainage first! I'm afraid she won't last until the moment of entering the endoscopy room."
Zhou Can glanced at the patient's vital signs monitoring data.
The instrument kept beeping, but there was no way to correct it all at once. It can only repair the broken important blood vessels in the patient's body bit by bit.
This is Zhou Can's main operation in rescuing patients.
If it were another doctor, it would be difficult to reach Zhou Can's level regardless of surgical experience or speed.
"I think it's a wise choice to drain first."
Director Xueyan has been helping to carry out the rescue, including Deputy Director He.
At the same time, the two chief and deputy directors of the cardiothoracic surgery department were asked to help with the rescue. This row was quite large.
The two divided their work, and one ligated the ruptured intestine first to prevent continuous leakage. Then try to clean up to reduce the potential risks of abdominal cavity and wound contamination.
The other performed electrocoagulation and ligation on some small bleeding spots.
It was also under the joint efforts of several people that the patient's condition began to improve.
Thoracic drainage is also a technical task with high risks and difficulties.
Many regular trainees may barely master the technical points of chest piercing until the end of the regular training.
For new doctors, catheterization and four major punctures are tasks that test their skills.
For example, catheterization, meeting elderly patients, especially elderly patients with diabetes, will definitely make novice doctors cry. Even some senior resident doctors are also apprehensive when completing operations on this special patient.
Elderly male patients commonly suffer from enlarged prostate.
This can seriously increase the difficulty of catheter placement.
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【My medical skills can add experience points】【】
If the patient also suffers from diseases such as syphilis and acuminate eczema, it will make the doctor collapse even more.
Zhou Can's injection technique is currently at the fifth level, that is, the level of the deputy chief physician.
Getting a chest piercing was a piece of cake for him.
After he found the correct position and inserted the puncture needle into the patient's chest, dark red blood flowed out of the catheter quickly.
"Fluid has flooded half of the lung."
He is very particular about where he pierces.
According to the drainage speed, puncture site, and puncture depth, experienced doctors can deduce the fluid accumulation in the lungs.
It should be mentioned that fluid in the lungs is not necessarily blood.
Sometimes it may be body fluids, or even viscous liquids such as purulent sputum.
For example, in patients with early new crown infection, the lungs are all full of sticky and thick liquid, and the entire lung becomes as hard as a stone. This is the main reason for their death.
The lungs became hard as rocks and it was impossible to breathe.
It can no longer shrink and expand.
…
In the endoscopic operating room of cardiothoracic surgery, Zhou Can has chosen to discuss with Deputy Director He, Director Xue Yan and others to locate the possible damaged location of the pulmonary artery. Then three small windows were opened, and endoscopic exploration was started.
"The lobe of the lung was damaged and there were two ruptures in the pulmonary artery, one of which was the most severe."
Zhou Can's endoscopic surgery ability is also top-notch.
Under his control, he quickly found out the bleeding in the lungs.
The next step is to complete hemostasis and blood vessel repair. Unlike open surgery in the abdominal cavity, hemostasis and blood vessel repair in the lungs can only be done through endoscopy. It is done in the narrow chest cavity.
"The blood volume must be insufficient again, and the blood pressure has started to drop again. How many bags of plasma are there?"
"There's only one bag left."
"Contact the blood bank and ask them to think of a way. It is estimated that they will support the completion of the rescue operation ~www.mtlnovel.com~ and definitely need blood transfusion."
The anesthesiologist frowned anxiously as he watched the patient's signs drop.
Sweat dripped from Zhou Can's forehead, and the clothes inside were already drenched with sweat. He didn't care about these things, he only had one belief in his heart, and he must do his best to save He Juan.
Her one-year-old child is still waiting for her mother to come home.
Her husband, parents, and relatives didn't know how distressed she would feel after knowing that she was injured like this by her family members in the hospital.
Nearly half an hour later, Zhou Can finally completed the hemostasis of the lungs, blood vessel repair and anastomosis, and wound suturing.
Try to restore blood flow to the lungs.
Perfect.
The blood circulation was smooth, and no stasis or thrombus occurred.
"Her breathing seems to be recovering, and her blood oxygen level is increasing a little bit. Dr. Zhou, you are amazing!"
The anesthesiologist Qu Zi raised her brows for the first time, with excitement, relief, and a smile in her eyes.
The patient's blood pressure also rose a little bit.
The rescue work was not over, because he was stabbed eight times in total, and there were too many injured parts.
It's just been dealing with some seriously life threatening bleeding locations. There is a lot of work to do in the repair of the intestinal tract, the debridement and cleaning of the abdominal cavity, as well as the hemostasis and suturing of other injured parts.
Zhou Can ignored the exhaustion and physical exertion, and quickly continued the rescue work together with director Xueyan and others.
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【My medical skills can add experience points】【】
Deputy Director He knew that his work was sloppy and slow, so he stopped and gave up his position to Zhou Can.