Chapter 402 Stepping on the Red Line for Surgery

Accepting patients to the emergency ward, preparing for the operation, and explaining before the operation, this series of tasks is very cumbersome.

Even if the emergency was simplified, Su Yun pushed the patient to the operating room after being busy for at least half an hour if the patient's condition allowed.

When the patient was pushed onto the stage, the patient's high pressure had dropped to 90 mm Hg.

The continuous decline in blood pressure indicates that the patient's condition does not seem to be as simple as it appears.

After anesthesia, Su Yun positioned the patient, spread the first layer of sterile drapes, and then went to brush his hands again. At this time, Zheng Ren put on the sterile gown and began to spread the second layer of sheets.

The operation officially begins.

Zheng Ren stretched out his hand, and a pair of hemostatic forceps was slapped into his hand with iodophor gauze.

Disinfected, put the pliers on the side of the patient's leg, then reached out, and the scalpel came up.

The skin was opened with a 20cm incision, followed by incision layer by layer, blunt separation, and electrocautery to stop bleeding.

Cao Guozhen had already arrived in the operating room, and now he was standing behind Zheng Ren, looking at the operation from the perspective of the surgeon.

The thoracotomy process was almost perfect with very little bleeding.

Although Cao Guozhen was still unconvinced, he complained that if he opened his chest, he wouldn't bleed much.

Opening the chest and opening the abdomen are two completely different ways of opening.

Many years ago, when electrocautery was not commonly used clinically, 500ml of blood was required for chest surgery.

However, in Zheng Ren's and Su Yun's operations, there was no visible bleeding at all, and some larger blood vessels were directly picked out from the tissue with hemostatic forceps and stitched up.

Only after the muscle is severed, the blood in the muscle is burnt with electricity.

The operation was performed neatly, and Cao Guozhen became more and more frightened the more he saw it.

These two monsters in the emergency ward, why are they doing chest surgery so well? Think about the emergency room where you want to rush to the chest department, it's really not just talking casually.

Zheng Ren and Su Yun had a tacit understanding not to do internal fixation of rib fractures, but to open the chest cavity first.

Because there is no strong evidence that a thoracotomy is possible, it can only be said that internal fixation of rib fractures will be performed.

this,

It's already on the line.

Even if the postoperative recovery is not good, and the patient's family members are hypocritical, Zheng Ren and Su Yun may be in trouble.

certainly,

This trouble is of their own making.

The sneer under Cao Guozhen's mask grew stronger and stronger. These two guys in the emergency department are really presumptuous.

Don't they know that the diagnosis and treatment procedures violate the regulations?

The patient's surname is neither Zheng nor Su, so what?

It's still swollen, and I don't know anything about my last name.

Although no problems were found after the thoracotomy, internal fixation of the rib fracture can be done directly, and the family members of the patient do not know about it, and they will not instigate it.

However, there is no reason not to wet your shoes when you often walk by the river.

Just let them continue to be so arrogant, it's not far from an accident.

Cao Guozhen watched intently as the two opened their chests. When Zheng Ren raised his hand, a heavy automatic hook appeared on his hand.

Open the chest cavity, and use the automatic retractor to open the surgical field by about 8 cm.

Under normal circumstances, the surgical field is definitely not that big. However, the patient has a rib fracture. At this moment, the ribs do not have such high elasticity and toughness, and the surgical field is wider than before.

"I first wanted to practice chest surgery, just for this kind of surgery." Su Yun disliked the quietness of the operating room, and began to babble, "It's so bright, and you don't have to rub your intestines and excrement. Boss, you think so."

As the buckle of the automatic hook is unscrewed, the lungs appear in front of you.

The middle and lower lobes of the right lung each have a huge opening with dark red edges, appearing in the operative field.

Zheng Ren and Su Yun let out a sigh of relief.

If there is really a problem, the intuition is not wrong!

Zheng Ren was a little scared, and secretly scolded the system for being a big pig's hoof. He only said it was a ruptured lung, and didn't mark how big it was.

Can a 0.5cm abrasion lung rupture be the same as this 10cm long and 10cm deep lung rupture?

Zheng Ren probed with the hemostatic forceps, and only after all the hemostatic forceps went in did he probe to the end.

The middle lobe of the right lung was almost pierced.

Cao Guozhen stood behind Zheng Ren, stunned.

What's the point?

With such a large ruptured lung, why is there no pneumothorax? impossible!

Can't!

He is lost.

Cao Guozhen has also been a doctor for ten years and has seen countless traumas, but this is the first time he has encountered this situation.

How is this going?

While Zheng Ren was investigating, Su Yun was rambling, "Boss, I guess it was because the steel bars were struck with too much force, and the broken end of the rib was like a dagger, causing trauma to the middle and lower lobe of the right lung, and then due to the elasticity of the rib itself, Shrunk back.

Because the strength is too great and the trauma is too severe, it is still similar to the kind of sharp injury. At the moment of injury, the bronchial arteries were damaged in many places, and a large amount of blood gushed out, directly filling the lungs. "

The process of recalling in Zheng Ren's mind is similar to what Su Yun said, there is not much difference.

"So it looks similar to traumatic wet lung on the video. Because the blood is poured into the bronchi and capillaries of the right lung, there is no pneumothorax. The lung itself is not compressed, the pressure is huge, and the blood cannot come out, so No hemothorax either."

"This case is simply too misleading." Su Yun was very happy after examining the patient's lungs, and the words in his mouth did not stop.

Compared with the cautiousness before, it seems like a different person.

Standing behind Zheng Ren, Cao Guozhen was already petrified.

What Su Yun said makes sense. But if it was me, with such a guess, how dare I open my chest?

He thought about it for a long time, but he definitely didn't dare.

If there is no indication for surgery, if the chest is opened at will, the family members of those patients with malicious intentions may sue the medical investigation committee.

These two people... are simply too courageous.

But continuing to think about it, Cao Guozhen broke out in a cold sweat in an instant.

If it weren't for Zheng Ren and Su Yun's insistence on opening the chest for exploration, and the patient would observe for a few more hours, the blood would not come out of the chest cavity, but would flow from the upper respiratory tract little by little.

It is similar to the process of drowning, except that what affects the patient's breathing this time is his own blood.

This is more of a headache than drowning. Once the blood condenses into a scab, the airway is blocked...

The patient had to die in the thoracic surgery department.

Thinking that the patient was fine when he was hospitalized, and died in the thoracic surgery department without making it through the night... Cao Guozhen was an idiot.

Even just thinking about it is as creepy and chilling as watching the scariest horror movie.

The blood all over his body seemed to be coagulated, and he recalled in his mind a patient with a rib fracture and aortic dissection in the ward. When the CT was performed, the dissection was very mild and was not found. A few hours later the dissection ruptured and the patient died suddenly.

After the patient died, dozens of people came to the house, dressed in sackcloth and filial piety, put the patient's body at the door of the thoracic surgery department, and burned paper to mourn.

Cao Guozhen just thought about that scene, and his legs were already weak.

It's not that the doctor doesn't care, and it's not that the patient's family wants to make trouble. Good people, if they say no, they will be gone. Who can bear it?

But do 10 times 8 times CT in one night to prevent and avoid it?

The chest department has to receive hundreds of fractures a year, and the family members of the patients may have to sue for death.

It's so frightening, thinking, Cao Guozhen's hands were full of sweat.