godfather of surgery

Chapter 194 The Silent Rescue

After the small class on unpacking surgery, everyone was still not satisfied, and asked to replay the pictures of the surgery at a slower pace.

The thorax is split from the middle of the sternum and opened to both sides, and the spine is explored from front to back, all the way to the back, with no dead ends and no omissions; similarly, the abdomen is also longitudinally incisioned, fully opened to both sides, fully revealing the injured part .

In this case, there were two short nails on the stake, and the nails broke the abdominal aorta. Looking at the picture, when the aortic injury was exposed, the nails were still hooked in the abdominal aorta.

The picture of abdominal aortic injury was enlarged, and everyone was terrified and sighed. If the wooden stake was pulled out directly, the nail would continue to pull the aorta, and the patient who was still breathing died of massive blood loss in an instant, and there was no chance for surgery.

"Time is life! In this kind of surgery, life and death can be determined in a second!" Yang Ping added while standing on the podium.

Hurry up, hurry up, hurry up!It is the rhythm of this rescue operation.

Countless places are bleeding, just like countless faucets are broken and they are all spraying water. It is impossible to turn off all of them at the same time, so a judgment must be made as to which one to turn off first.

Turn off the one with the fastest water spray first, and then turn off the latter in turn. This is the way of thinking, and this is the priority of surgery.

After solving the order problem, the next step is how to stop the bleeding. For example, if the spleen is ruptured, splenectomy is performed. Before the spleen is removed, it still bleeds. In order to reduce the bleeding and control the risk to a minimum, vascular occlusion appeared to solve this problem. contradiction.

Like so many faucets spraying water, I also know which one to turn off first and which one to turn off last.But there is no way, there is water everywhere, I can't see where these faucets are at all?After finally seeing clearly, I was in a hurry and couldn't keep up.

In this way, turn off the main gate first, and stop the water from all the faucets under the jurisdiction of the main gate, so that you can see clearly which is the largest and which is the smallest, and turn off these faucets in order and calmly. Straight off straight off.

The main gate can’t be closed for too long. Others still need to use water, so try to complete the operation within the allowed time. After the completion, open the main gate again, and the faucet will stop spraying water.

Tan Boyun looked at the screen intently. He is best at trauma orthopedics and has made many achievements in this field.This kind of operation is indeed difficult and high-risk. The operator must not only move very quickly, but also be very familiar with the anatomy. In this case, the location of the aortic occlusion is relatively high. Only lasts about 10 minutes.

According to the introduction, this operation was completed within 10 minutes. In just 10 minutes, it involved complex exploration, repair of the aorta, repair of the liver, repair of the pancreas, repair of the duodenum, repair of the diaphragm, and Vascular ligation at multiple sites to stop bleeding.

This kind of proficiency in anatomy is unimaginable to what extent it takes to complete this series of operations in 10 minutes. If you are the main surgeon, you will certainly not be able to complete it in 10 minutes.

Temporary vascular grafting or artificial vascular implantation must be used to stop bleeding from the abdominal aorta, so that there is time to do the next steps slowly.

If it wasn't for the meeting today, Director Tan would not have known that Yang Ping was so good at this case, and that this kind of operation could be performed with such ease.

Fatty raised his hand, he scratched his head and said, "Dr. Yang, you can be so good, but not everyone is so good. After you talk about this operation, even if I encounter the same case, I still can't do it like you Is that so? Is there a set of methods to make the operation of this kind of trauma patients easier, such as taking pictures, professional cameras such as focal length, light alignment, it is extremely complicated, just click with a fool camera, although it is not as good as a professional camera , but it is also a qualified photo."

That's right, Fat Boy got to the point and raised a question that everyone was thinking about. Everyone was waiting for Yang Ping's answer. Fat Boy's eyes narrowed into a line, waiting for the answer.

Director Bai next to him said: "Yes, Xiao Yang, the operation must be replicated in batches. If it cannot be replicated, it cannot be promoted. You must find a way to lower the threshold for this operation, so that more people can be saved."

Director Han said with a smile: "This is the topic that Xiao Yang will tell you next, and it is also the improvement we want to make to the entire trauma first aid process. Xiao Yang has spent a lot of effort and made a modular operation process. Come out to discuss with everyone, stay safe and don’t be impatient, let’s watch the video of the large-scale trauma rescue at the Affiliated Hospital of the University of Tokyo, shall we?”

Yang Ping returned to his seat to rest. Dr. Zhong came to the stage and called up the video on the computer: "This is the rescue of a large-scale car accident. The whole video is from the emergency department to the end of the operation. That’s fine, don’t make videos, don’t spread them, because it’s made by friends who are studying there in private, and they make videos to improve their deficiencies on a regular basis and keep improving.”

The doctor who just took a picture and video with his mobile phone put away his mobile phone, and everyone began to watch the video seriously. This represents the world's top level of trauma rescue.

"Play the video at normal speed first, and then slow it down. When it is slowed down, Director Tan will explain it to everyone." Director Han instructed Director Tan.

Director Tan said: "Okay, Director! Everyone should read it carefully, so that I will be able to focus on the explanation later."

The video began to play, and the first aid flat cars for the wounded were sent to the lobby of the emergency center one by one. The patient's clothes had been cut off, and only the special blanket was covered.

The doctors and nurses in the emergency department are already waiting in the lobby. As soon as the wounded appear, they are immediately responsible for their own wounded. The doctor makes a preliminary judgment on the wounded and arranges the next step of diagnosis and treatment; the nurse measures the vital signs of the wounded and performs blood transfusion and fluid replacement.With little pause, everything seemed to be prepared ahead of time, and it was all done as the flat car moved forward.

The flat cars began to be shunted in the lobby and pushed to different areas. Those who needed emergency surgery were sent to the operating area; those who did not need emergency surgery were sent to another area.

The screen follows a wounded person in an emergency operation, entering the operation area, the door is opened in advance, and entering the area, the first stop seems to be the CT room, and the CT scan is performed in the emergency department.

The height of the flat car and the CT platform is the same, which has been adjusted long ago. The flat car and the CT platform are docked, and the wounded are quickly and smoothly pulled onto the platform. The stretcher does not need to be disassembled, and can pass through X-rays and CT.

The wounded began to undergo high-speed CT scanning. After the scan was completed, they immediately transitioned from the other end of the CT platform to the connected flat trolley, pulled the stretcher directly, and arrived on the flat trolley, where they were pushed to the next station—the operating room.

The operating room and the CT room are connected by a corridor, which is connected in a straight line. The wounded come in from one side of the CT room. , It is enough to push the flat cart to the door and hand it over to them.

The connection between the two stations is completely open and straight, without any obstacles, without any roundabouts, unobstructed and direct.When the wounded enters the operating room, the flat car and the bed are flush with each other. The wounded is pulled to the operating bed, and the detachable stretcher is then disassembled from both sides.

The doctors involved in the operation had already put on their surgical gowns and were waiting. The assistants began to disinfect and spread the sheets, and the chief surgeon read the CT scan reports and images of the wounded.

The efficiency is very high. This side has just been disinfected, and the CT room has transmitted pictures and reports. The CT images and reports of the wounded appear on the LCD screen, and the control panel of the screen is covered with a sterile film.

The chief surgeon directly controls and reads the emergency medical records and CT data, reads the report first, obtains the information quickly, and then looks at the [-]D reconstruction image. At the same time, there is also a reference opinion on the operation method, telling you where the damage is, where to do it first, and then do it later Where, including specific surgical procedures have been given guidance.

This patient has a torn aorta, ruptured spleen, and multiple ruptures in the duodenum—the chief surgeon first blocked the aorta, then repaired the aorta, then performed a splenectomy, loosened the blocked aorta, and then repaired the liver. Rupture, duodenal rupture, and other injuries were treated. The operation process was quite scientific, and the operation was successfully completed.

From the time when the emergency flat car appeared in the emergency department, the cooperation between doctors and nurses was like a precise gear in the whole process, as if it had been rehearsed repeatedly. No matter how you look at it, you can’t see any unreasonable, improper connection, or wasted time.

The whole process took a little over an hour, and most of the time was spent on the operating table, and the time was concentrated after the completion of the aortic occlusion. Therefore, most of the time, the patient was in a controllable state, that is, in the hands of the doctor. Afterwards, the patient stabilized.

From the emergency room to the operating table, including the CT scan in the middle, it took less than 10 minutes, that is, a few minutes to be on the operating table, and an examination was performed to clarify the injury and designate a mature operation plan.

This is just a rescue operation for the wounded, and the other rescue scenes were also switched out one by one. The rescue of each wounded was almost as fast as possible without any delay. It was filmed deliberately. The whole process, The whole picture is smooth and tidy, without any clutter. Even after the operation, even the garbage in the operating room is put into the bucket separately, without any clutter.

One wounded, as soon as he entered the emergency department, used balloon interventional aortic occlusion for temporary hemostasis; another patient with multiple rib fractures, tension pneumothorax, and cardiac arrest had his chest opened directly in the ambulance. Perform chest compressions.

After the screen was played, everyone gasped, and the whole venue fell silent. The doctor who was joking just now said impatiently in private: "Watching a Japanese video---" and stopped talking.

Some people suspect that this is a fake, and it was deliberately photographed for everyone to see, right?How could it be so fast and the cooperation so perfect? ​​The rescue would be a bit messy and a waste of time.

"This is one of their daily trauma first aid surgery videos!"

Director Tan's words broke the silence and dispelled everyone's doubts.

"It was only their general doctor who participated in the operation. There was a scene just now, rescuing a ruptured liver and spleen. The surgeon was only a lecturer, equivalent to our attending physician. His operation took twelve minutes; the one who performed the operation just now, the aortic rupture , rupture of the liver and spleen, and rupture of the duodenum, the operation took an hour and was performed by a lecturer."

"Every one of their doctors of this level has this level. Professor Da Niu's level, Fujiwara Masao, this kind of operation has not yet been performed on stage. He simply repairs the aorta, and it never takes more than 2 minutes!"

"If there is no comparison, there will be no gap. It is not scary to have a gap. What I am afraid of is that I cover my ears and steal the bell and refuse to admit the gap. Just now I heard someone say that the surgery is very busy. What Japanese surgery videos are better than us? ? See it now? Do you know where Niubi is?"

Director Han stood up and spoke word by word.

"To surpass others, to be strong, you have to do it with your hands, not with your mouth, you know?"

　Thanks to the leader of the wolf sled for the reward!There is pressure, and the update can't keep up, but I will still work hard. Please take your time to add updates to the leader. I hope you understand, really, there is no manuscript!

　　Thank you George Suiyuan for your multiple rewards of 5000 coins!
　　Thanks to Chenxi Muyan, --- ooooo for the reward (I can't type your name, I don't know where to copy it, so it looks a bit similar, forgive me)!

　　Thanks for the valuable comments put forward by the nuclear bomb infantry. Indeed, those details are too rough and have been revised. I hope to give more opinions to help improve the work.

　　In the previous chapter, the double penetrating steel bar injury appeared in "Grey's Anatomy", not "Doctor House". After watching it for too long, I got confused, and it has been corrected.

　　Yang Ping’s penetrating wooden stake injury was restored from a real case, a masterpiece of a senior teacher, the operation time was shortened, and the operation process was almost restored according to the original operation records. In order to restore the details, the senior helped to read the medical records more than 20 years ago .The wooden stake is still kept in their hospital. At that time, the means were very limited, and it was not easy for this kind of operation to be successful. Even now, rescuing this kind of case is extremely challenging and requires rich experience and superb surgical skills.Salute to this esteemed teacher!

　　
　
(End of this chapter)