Back in 2002 as a doctor

Page 269

He couldn't figure out why Liu Wei would speak for Zhou Congwen. Is it because of so many chest surgeries?But he is the director of the department and the chief of surgery, what is Zhou Congwen?

The mood is always not going well, Director Wen concentrates on the operation, preparing to teach Zhou Congwen a "little" lesson.

He glanced at it, and Zhou Congwen's laparoscopic poke card had been lowered, and the light source had also gone in. The TV screen was blood red, and Zhou Congwen was asking for a negative pressure suction device.

"It's so good to open it, the surgical field is open and bright, and nothing will fall." Director Wen knew that there was no surgical field on Zhou Congwen's side, so he continued to diss him, "I told Xiao Gao many times, at most, he will have appendicitis, and nothing else will work. Gallbladder In many cases, the adhesion is very heavy, can it be dissociated with a laparoscopy?"

"Guess what's wrong with Xiao Gao, every time I say it, he's stuck in the neck, insisting on thinking about how to use the laparoscope." Director Wen took care of the peritoneal protection, and stretched out his hand, "Aspirator."

Use Alice forceps to lift the peritoneum, make sure there are no viscera underneath, cut the peritoneum with a sharp knife, and insert the suction device immediately.

The hissing sound continued to sound, and the black and red blood was continuously sucked out.

Director Wen didn't wait, and asked the second assistant to support the suction device, and he continued to cut the peritoneum, "For this operation, if Xiao Gao uses laparoscopy, I will suspend him tomorrow. This is irresponsible, and it is a joke about emergency rescue. "

Liu Wei glanced at Director Wen, and was about to refute, when Zhou Congwen said flatly, "Warm salt water."

Um?Is it warm salt water already?

Director Wen felt that he had heard it wrong, and he glanced sideways at the TV screen of the thoracoscope.

The top is still red, you can't see anything, there is no field at all.

It turned out to be a rinse to make the surgical field cleaner, Director Wen sneered.

"If it doesn't work, open the chest and hurry up to stop the bleeding. There is nothing serious about your chest department, but the intercostal artery is broken, the lung is ruptured, and you have to live for two hours."

"Oh, you can't use thoracoscopic surgery for car accident injuries, but this patient has a knife wound and the wound is relatively small, so the thoracoscopy is barely suitable." Zhou Congwen said while washing, "Director Wen, we are done, can you help me?" ?”

"..." Director Wen was taken aback.

Finished? !

How can this be!I just took a look at it just now, and the surgical field on that side was covered with blood.

It must be Zhou Congwen who is young and energetic, and he is angry after hearing a few words from himself. He is talking nonsense here, Director Wen thought to himself.

"There is still a gap, I'll clip it." Zhou Congwen inserted a titanium clip and clamped the wound.

Director Wen opened the peritoneum and reached in to feel it. There was a big hole in the spleen, and he sighed.

"Prepare to cut the spleen. You said that cutting the spleen at such a young age, although it doesn't have a big impact, is it a traumatic blow anyway. Young people can't be angry, why bother."

Just as he was about to cut the spleen, out of the corner of his eyes, Director Wen suddenly saw Zhou Congwen had finished drawing the warm salt water for washing and was packing up the instruments.

"Corner needle No. [-] line, tour, help pick up the breast bottle." Zhou Congwen said lightly.

"..." Director Wen was stunned.

I just opened it and checked it, and Zhou Congwen finished it? !

"Zhou Congwen, you..."

"Director Wen, I'm done with this, can you use me as an assistant?" Zhou Congwen asked gently.

"Uh, done? Really?"

Although he watched Zhou Congwen tidy up the equipment of the thoracoscope and wipe the blood on the lens, Director Wen still couldn't believe it.

"Of course, the intercostal artery was broken, and two titanium clamps were inserted. The lungs were broken twice, and they were both clamped." Zhou Congwen said as it should be, "If I don't need it, I will go down."

"..." Director Wen's heart suddenly tightened.

What I said just now hit my heart like waves.

This is amazing!Director Wen scolded in his heart, but he had some doubts whether Zhou Congwen's actions were stable or not.

Once there is a problem after surgery...

Chapter 0468 Tourniquet

"Zhou Congwen, it's okay, don't just try to be quick." Director Wen persuaded him kindly.

He has no faith in thoracoscopy at all.

In particular, Zhou Congwen did it too quickly. He had just opened the server to investigate, and found that his spleen had ruptured, and before other organs could be seen, Zhou Congwen had already completed the operation.

how can that be.

"The operation is very simple. Didn't you say that just now?" Zhou Congwen squatted down to look at the chest bottle, "Brother Liu, help inflate the lungs."

"Congwen, it should be fine, you are really cautious." Liu Wei smiled and said while looking at Director Wen while swelling his lungs, "I saw very clearly just now, there is no gas overflowing, and there is no blood in the salt water."

That is to say, it is mainly for Director Wen, the lungs should be inflated and the lungs should be inflated.

The remaining fluid flowed out along the chest tube, the amount was not large, and the color was very light, and there was no sign of bleeding.

"Okay, that's it." Zhou Congwen turned around and stepped down.

"Zhou Congwen, wait." Director Wen shouted.

"Huh? Didn't I not be used as an assistant just now? The clothes are all polluted." Zhou Congwen said.

"I didn't ask you to be an assistant. You wait for 10 minutes, and then inflate your lungs to see. If there is nothing wrong, you go down, and if there is something wrong, open your chest." Director Wen didn't believe that Zhou Congwen used thoracoscopic exploration to complete the operation so quickly .

"Alright." Zhou Congwen smiled slightly, and stood behind Director Wen to watch him perform the operation.

"Director Wen, you are really cautious. You are even careful about the chest department." Liu Wei sarcastically.

Director Wen lowered his head to perform the operation, not in the mood to argue with Liu Wei.

The doorbell rang, and the itinerant nurse ran to open the door.

"Emergency! Is Lao Liu here? Let's inject a deep vein first!" A hurried voice came from the door, accompanied by the sound of a flat car.

"What patient?"

"Injured by a chainsaw, incomplete amputation. Hemorrhagic shock, high pressure measured below is 60."

Liu Wei immediately told his assistant to take care of him, and hurried out.

"It's really busy today." The doctor in the general surgery department said, "It's only what time, and the emergency department has trauma one after another."

"Did you know that a family member of a patient jumped off a building a few days ago?" Zhou Congwen asked.

"I know, the operating room was boiling that day, and we had 6 appendices removed, as well as a gallbladder."

Sure enough, any ER night has general surgery involved.

"By the way, what happened to the patient who jumped off the building?" asked the general surgery doctor.

Zhou Congwen shook his head, indicating that he did not know.

But he immediately thought of Shen Lang, that guy should know about the patient's fate, but he didn't tell him all the time.

Thinking back and asking Shen Lang, Zhou Congwen thought.But he also knew that there was a high probability that he would forget about it.

He's not a chest patient, and he's not Shen Lang, so he definitely won't worry about these gossips.

There was a chaotic sound outside, and Liu Wei had already started to roar.

"Deep vein kit, hurry up!"

Zhou Congwen's heart moved, he turned around and glanced at the chest bottle, told Liu Wei's assistant a few words, and then left the operating room.

Director Wen glanced at Zhou Congwen's back, then took half a step back, and glanced at the chest bottle with his eyes.

The water column fluctuates well, no gas is drawn out, and the drainage fluid in the chest tube is light red, and it does not look like bleeding, but warm saline that remains after washing.

Really done?And it's all right!

Director Wen couldn't believe it.

Wait for 10 minutes and then inflate the lungs to see. If there are still untreated traumas, the problem will definitely be seen in 10 minutes.

……

……

Zhou Congwen strode to the surgery room next door and saw Liu Wei busy.

The patient had a dehiscence wound on the left thigh with deep bone visible.The muscles were broken, crushed into a mess, and the gauze pressed on the wound was soaked.

In the future, this type of wound should be assigned to the Department of Traumatology, but now there is no Department of Trauma in the third hospital, and all limbs are assigned to the Department of Orthopedics.

Director Sui of the Department of Orthopedics stood aside with an unhappy expression, gesticulating and saying something.

Zhou Congwen lifted the clothes covering the wound and saw a tourniquet strangling the upper edge of the wound to stop bleeding.

it is as expected.

This is a routine operation, and the tourniquet should have been left by the doctor in the 120 ambulance.

If a large gash like the one in front of the patient kept bleeding, the person would be gone. The tourniquet is indeed a useful thing.

But the tourniquet...

I hope there are no problems, Zhou Congwen thought to himself.

He touched his skin, and the skin temperature was okay, so it probably didn't take long.

When Director Sui saw Zhou Congwen coming in, he originally wanted to give him a look, but he still looked away without saying a word.

The last time Zhou Congwen scolded him and Wang Chengfa like dogs, Director Sui suffered [-] points of crit damage to his mind, and now he still trembles when he sees Zhou Congwen.

Liu Wei moved swiftly and quickly completed life monitoring.

Anesthesia was induced smoothly, and endotracheal intubation was completed under visualization.

Immediately, Zhou Congwen assisted him in puncturing and placing catheters in the patient's right radial artery and right internal jugular vein to improve arterial monitoring and ensure infusion channels.

This is already the highest level of the third hospital. Arterial blood pressure monitoring equipment has just been introduced, and it is rarely used. Usually, blood pressure is measured with a cuff.

"Go ahead." Liu Wei heaved a sigh of relief when he saw the liquid slipping in.

Director Sui began to debride and suture the wound, and with the infusion of fluid and whole blood, the patient's vital signs further improved.

Arterial blood pressure was monitored during the operation, body temperature was protected, arterial blood gas was analyzed in time, and the vital signs and internal environment of the patient were maintained during the operation. The blood pressure was maintained at 100/55mmHg and the heart rate was 70 beats/min.

"Remove the tourniquet." Director Sui said to Liu Wei seeing that the patient was in a stable condition.

"Wait a moment." Zhou Congwen stopped Liu Wei.

Director Sui was taken aback.

He was a little angry immediately, Zhou Congwen was too much, is he the director of the anesthesiology department?If I don't provoke him, he actually comes to provoke me.

What the hell, I don't know what my last name is.

"Get ready for epinephrine, dopamine, methylprednisolone, prednisone, defibrillator."

Zhou Congwen talked about a bunch of emergency medicine and equipment in one breath.

Liu Wei was stunned for a moment, and he looked at the patient's ECG monitoring.

Blood pressure 110/60 mm Hg, heart rate slightly faster, but still within the acceptable range.

What are you doing to prepare these things?

Although he didn't understand in his heart, Liu Wei didn't say much, but prepared various emergency medicines according to Zhou Congwen's intention.

The recent situation has become very clear. Liu Wei's attitude towards Zhou Congwen has changed again, and he is more respectful than before towards Wang Chengfa.

It is necessary to prepare emergency medicine, and Liu Wei found a reason for himself in his heart.

"Remove the tourniquet." Director Sui said in a deep voice, "Are you responsible for limb necrosis after a long time?"

"Not less than one minute." Zhou Congwen replied coldly as he helped Liu Wei prepare things.

Chapter 0469 Be Prepared

At 18:20, the tourniquet was released, and Liu Wei's eyes were fixed on the ECG monitor.

Director Sui also looked at the ECG monitor without blinking.

He just complained a little bit, and didn't say too much. It's not that he can't, but he doesn't dare.

The last time Zhou Congwen almost pointed at him and Wang Chengfa's noses, from the beginning to the end, Director Sui was speechless after being scolded.

As a doctor, I don't know if I have medical ethics, but I really can't get back when I get scolded about professional matters.

The more you argue about this kind of thing, the more embarrassing it will be. Everyone who makes a fuss knows that in the end, you will be the one who shames you.

With the previous experience, Director Sui only complained a little, not even loudly.