godfather of surgery

Chapter 544 Exogenous Branches
There is one needle at the shoulder joints on both sides and under the outside of the clavicle.

This part is where the blood vessels of the brachial plexus enter and exit. The anatomical structure is very complicated, and the nerve blood vessels will be damaged if you are not careful.

It is actually very difficult to remove small foreign bodies from the deep part of the human body.

Because whether it is color ultrasound or X-ray positioning, it is to obtain a flat image, and it is impossible to accurately locate the needle. Sometimes it is seen at a certain position, and there is nothing to cut in, because it is very easy to see which layer of tissue the thin needle is hidden in. hard to find.

There is one in both hip joints and knee joints, and there are also distributions in both upper arms, forearms, thighs, and calves.

These needles are scattered all over the place, and it looks creepy.

It's hard to imagine that there are so many needles hidden in the small body of a ten-month-old baby, and these needles were deliberately pierced by someone.

The footage from the original horror movie actually appeared in real life.

Everyone discusses each needle rigorously, and finally decides on the removal plan.

After discussion, it was decided that if the endoscope can be used, the endoscope should be used, and if the endoscope cannot be used, the small incision should be made as much as possible. The color ultrasound should be used to position the fine needle throughout the operation, so as to achieve the accuracy of the operation and reduce the damage.

The meeting ended, and it was already past eight o'clock, and everyone was still hungry.

Yang Ping paid out of his own pocket and invited everyone to a restaurant near the hospital for dinner.

During the meal, a graduate student felt uncomfortable all over. He was always worried that there would be needles in the food, so he moved the food in the bowl back and forth, chewing every bite carefully, for fear that he would not find a needle and swallow it by himself.

He knew it was impossible, but he just couldn't restrain the thought.

The nurses in the department are very caring, and they spontaneously take turns to feed Xiao Minmin milk powder and change diapers.

Nurses with experience in childcare are naturally proficient in doing these tasks, while those who are not married and have children seem very unfamiliar.

Under everyone's care, Xiao Minmin gradually adapted, and when she no longer saw everyone, she turned her head and fell into her grandma's arms, and then let go of her voice and cried loudly.

But there was one thing that bothered the nurse.

Due to the needs of the operation, a needle needs to be left on Minmin's head, so that in case of accidental rescue during the operation, the medicine can be pushed at any time.

Establishing venous access before surgery is a routine operation, so be prepared.

Just imagine that if there is an accident during the operation, such as an allergic reaction to the anesthetic, it will not only delay time, but also make mistakes during the rush.

If there is an indwelling needle, directly open the temporarily closed indwelling needle pipeline, and push the medicine into the patient's body, saving time. For rescue, every second counts.

But this kind of operation can't be done anyway. No matter how coaxed, as long as the nurse shows the needle, this guy knows there is a needle without looking. As if desperately trying to escape, the heart-piercing cry resounded throughout the ward.

The nurse tried to control her, but she still struggled desperately, her face was blue and her breathing was wheezing like an asthma attack.

In this way, the nurse did not dare to forcefully restrain her, so it was impossible to get the needle.

"Let's keep the needle after anesthesia in the operating room!" Head nurse Cai had no choice but to let the nurse give up.

It took a long time for the little guy to breathe smoothly, and his face turned from purple to red.

But the crying didn't stop, so grandma had to hold her in circles in the ward. Seeing this situation, the nurse was afraid that grandma would not be able to hold on, so she wanted to help, so Minmin cried even louder.

There was no other way, the doctor on duty had no choice but to sedate Minmin and put her to sleep, which solved the problem.

The old lady couldn't help sobbing all the time, and the old man sighed and said, this is all life, all life, with tears in his eyes.

At their age, what will the child do in the future.

The police contacted Sensitive’s own mother. The woman said that she was married and the child was awarded to her ex-husband. She didn’t want to have anything to do with the child, so don’t call her in the future.

What will happen to this child in the future?
The old couple couldn't sleep when they thought of it.

In the middle of the night, the old woman had severe chest pain and tightness, was out of breath, and was sweating profusely, like a boulder pressing her chest tightly.

The old man hurriedly called the nurse. The nurse saw it and called the doctor quickly.

The doctor on duty happened to be Li Guodong. He immediately preliminarily judged that it was acute myocardial infarction. While calling the nurses to rescue him, he performed an emergency electrocardiogram, drew blood to check myocardial enzymes, called the chest pain center to ask for support, and then reported to Yang Ping.

Doctor Yu, the doctor on duty at the Chest Pain Center, came quickly and looked at the electrocardiogram. It was acute myocardial infarction. Combined with the newly released myocardial enzyme spectrum, it was determined that acute myocardial infarction required emergency rescue. Coronary angiography and interventional coronary stent expansion were performed. .

In such a critical moment, it was a race against time, and immediately took the green channel. Doctor Yu led Gui Peisheng and pushed the old woman to the catheterization room of the chest pain center.

Li Guodong typed out the letter of consent, talked to the old man and signed it, and reported to the hospital chief on duty.

In this kind of rescue operation, because of humanitarianism, money is not discussed. Save people first, and then talk about money after surgery.

Regardless of whether the money is paid or not, it does not affect the rescue.

The old man was bewildered and rushed to the catheterization room. The granddaughter was here alone.

Staying here, my wife needs to be rescued now, and his life or death is uncertain.

The nurse on duty is quite experienced. Fortunately, there are intern nurses in Corey. The nurse on duty left an intern nurse to help look after the baby, and sent another intern nurse to push the old man to the catheterization room in a wheelchair, and then comfort him, don't worry.

Head nurse Cai received a report from the nurse on duty, and rushed to the department from home in the middle of the night to send additional staff urgently.

Yang Ping, Song Zimo, and Xu Zhiliang also rushed to the department respectively, and then went to the catheterization room of the chest pain center.

Minmin's grandfather was sitting in a wheelchair, supporting the wheelchair with both hands, staring at the door of the catheterization room, tears streaming down his face.

How can I live so hard in this life? People in their 70s who are about to enter the soil still suffer from this crime.

People say to raise a son to guard against old age, but this son not only failed to guard against old age, but also tossed the two old people so that life would be worse than death.

Head nurse Cai was afraid that the intern nurses would not be able to take good care of the old man, so she sent a nurse from home to the catheterization room to take care of the old man, so that the old man would not have any more problems.

Yang Ping was preparing for the cath lab to see what was going on. At the door, he met Director Guan of the Chest Pain Center. He had just received a call and came from home. Director Guan lived nearby.

"Doctor Yang, let's go in and have a look together!"

Director Guan does not know the specific situation now.

Everyone followed Director Guan to quickly change their handgowns and lead clothes, and entered the catheterization room. Dr. Yu was performing an interventional operation and had just completed the puncture and catheterization to push the contrast medium.

"Acute myocardial infarction, cardiogenic shock, loss of consciousness, left ventricular assist device to maintain blood pressure, ventilator to assist breathing—" Dr. Yu saw his superior doctor in charge and reported immediately, but the operation did not stop.

The contrast agent diffuses along the blood vessel, and the image of the branches of the coronary artery is immediately displayed on the screen. The contrast agent stops at the beginning of the left main trunk of the coronary artery and does not extend downward.

"My God! The beginning of the left trunk is completely blocked!!!"

Director Guan didn't care about brushing his hands, so he immediately found a pair of sterile gloves and put them on, put on his surgical gown, and went on stage in person.

The left main artery refers to the proximal part of the left coronary artery from the left coronary sinus to before its branches, and together with its branches, it innervates 60%-90% of the myocardium of the heart.

When the left main coronary artery is completely occluded, the patient is at high risk of fatal left ventricular dysfunction and malignant ventricular arrhythmias!

This type has the highest risk and the lowest survival rate in acute myocardial infarction. The vast majority of patients die suddenly outside the hospital. Even if they have the opportunity to receive emergency coronary intervention, there are still very few cases of successful rescue.

"Hold on, don't panic, look for the opening of the left trunk—stand back, I'll come!"

Director Guan had already put on his surgical gown and asked Dr. Yu to get out of the way, and he stood at the chief surgeon's position.

Jiang is still old and hot. Director Guan relied on his rich experience, strong psychological quality and precise techniques to find the opening of the left main coronary artery at the first time, quickly open the occluded main artery, and restore the blood flow of the occluded vessel.

Director Guan is a Ph.D. recruited by Dean Xia in the early years. He is the academic leader of the Chest Pain Center. Under his leadership, the Chest Pain Center actively carries out various high-risk and complex cardiac interventional surgeries, and implements the concept of cardio-multidisciplinary intensive care unit. Combining heart assist device treatment and multiple organ failure severe treatment with high-risk complex coronary technology has greatly improved the treatment level of emergency, critical and severe cardiovascular diseases.

If Dr. Yu hadn't followed the treatment procedures and put on the left ventricular assist device and ventilator in time, this patient probably wouldn't have had a chance to be rescued.

"What did you do just now? I usually don't pay attention when I do it, but I panic at critical moments. Can you hesitate in this case? Find the opening of the left main coronary artery at the first time, open the blood vessel quickly, and restore the blood supply to the heart muscle. You hesitated just now. what?"

Director Guan severely criticizes Dr. Yu, who is a young Ph.D., attending doctor, and Director Guan's proud student.

The more important it is, the stricter the requirements.

"Review the rescue just now to see if there are any loopholes? Is there anything that needs to be improved? Your hesitation just now shows that you are not proficient in surgery. At the critical moment, proficiency is the test. There is no time for you to hesitate."

Director Guan still criticized Dr. Yu, and was very dissatisfied with the hesitation at the critical moment just now.

In fact, Dr. Yu is already fast enough. It only took 15 minutes from the on-site examination of the patient to the operation table.

It's just that I lack experience, and I'm a little timid at critical moments, and I dare not make quick judgments.

Director Guan left the finishing work to Dr. Yu: "Come on, this case, write a report for me tomorrow, remember next time, don't hesitate, this is a moment of life and death in a second."

Dr. Yu took over the work from Director Guan, and Director Guan stared at the screen: "Sent to CCU after surgery, pay attention to acute heart failure, lung infection, and metabolic acidosis after surgery."

"Professor Yang! This patient has been temporarily rescued. Whether he will survive in the future is still uncertain, but there is great hope."

Director Guan knew that Yang Ping was a young talent in the hospital and respected him very much, so he spoke very politely.

"Thank you, Director!"

Yang Ping said politely.

Director Guan waved his hand: "Xiao Yu's actions are fairly fast. It took less than half an hour since he went to the scene to see the patient and now opened the coronary artery. It would not be possible if it was later, and the left ventricular assist device and ventilator were used in time."

The criticism should be criticized, and the affirmation should be affirmed. Director Guan is very pertinent.

(End of this chapter)