godfather of surgery

"Old Xu, you should come."

Zhang Lin looked at Xu Zhiliang while listening to the phone, asking for help. Obviously, the matter on the phone was beyond Zhang Lin's decision-making ability.

At the emergency scene, life and death are at stake, and a judgment is a matter of life. Zhang Lin dare not act recklessly, dare not say a word indiscriminately.

Xu Zhiliang answered the phone calmly, and when he heard that it was emergency, he seemed to be a different person in an instant, without stuttering at all.

The emergency doctor on the other end of the phone is also well-trained, with a clear and calm tone:
"Car accident, 17 years old, male, stuck in a deformed car, preliminary diagnosis: dislocation of the atlanto-occipital joint, separation of the head and cervical spine, no bony and ligament connection, only muscle-skin connection, hands and feet can still move, considering that the spinal cord is temporarily absent Severe damage, the space in the car is too small to install a neck brace, and now the rescue team is going to cut the car, what should I do?"

For this situation, the emergency doctor is inexperienced and must turn to a surgeon who specializes in cervical spine surgery.

Dislocation of the atlanto-occipital joint, a fatal injury, is equivalent to losing the real connection between the head and the cervical spine, and the remaining skin-muscle connection has no meaning.

As an emergency doctor, many people will never be able to meet them in their lifetime, because such wounded people are often labeled as black at the scene, and there is no possibility of rescue.

"Listen to me clearly. During the entire cutting period, you can only rely on bare hands to maintain the fixation and traction of the head and cervical spine. There must be no secondary injury, absolutely no! Once the cervical spinal cord is damaged, the heartbeat and breathing will stop." Xu Zhiliang The tone is confident and calm.

He speaks clearly without any stuttering, making people suspect that his stuttering is usually fake.

"Understood!" the emergency doctor replied, and took a deep breath.

"Do you need to wait for us to rush over?" Xu Zhiliang asked.

The other party refused very firmly: "It's too late, the wounded body has active bleeding, and the rescue will start immediately. I will try to fix the head and cervical spine with my bare hands."

There is no other option other than to fix it with your bare hands.

The other end of the phone happened to be Dr. Lu, who is very familiar with general surgery doctors and often cooperates with them, but he has never encountered such a case in his career. This is the first time, and it may be the last time. He is not sure he can Can't do it well.

"There can be no rotation, keep the axis of the head in line with the cervical spine; maintain proper traction, too big or too small is very dangerous; everything can only rely on the feel of the hand; the hands must be very stable, when carrying—" Xu Xu Zhiliang didn't say any more.

Because if Dr. Lu can successfully put the wounded on the stretcher alive, he will face an equally difficult problem: how to fix the cervical spine to facilitate transportation.

It is impossible to rely on bare hands all the time, there is no other choice, and it is very dangerous to perform short-term fixation, let alone long-term fixation, but the neck collar cannot provide stable fixation.

Without reliable fixation, any slight movement during handling could be fatal.

"How long does it take to cut?" Xu Zhiliang asked.

"It's ready to start now, and it's expected to be at least an hour." Dr. Lu's breathing was a little rough.

"Can we wait until we come over to start cutting and rescue?" Song Zimo reminded.

Xu Zhiliang shook his head: "I can't wait, the wounded has active bleeding."

"Is there any vital signs?" Song Zimo asked suspiciously.

"Still awake!" Xu Zhiliang nodded.

It's very rare, it's really lucky, this kind of atlanto-occipital joint dislocation usually dies on the spot, there is no chance of rescue, and now he is awake.

"The wounded was stuck in the back seat. Dr. Lu saw that the head of the wounded was moving abnormally. He stretched out his hand and touched it. It felt wrong. He felt that the upper cervical spine was close to separation from the skull. Only the skin and muscles were connected, and there was no connection between bones and ligaments." Sitting down next to the phone, frowning.

"I wonder if Dr. Lu can handle it?" Song Zimo was quite worried.

Xu Zhiliang was born in the emergency department, and he is very familiar with Dr. Lu: "It should be possible. This person is more calm and meticulous in his work."

"A living traumatic atlanto-occipital dislocation?" August's eyes widened in surprise, he couldn't believe it was real.

After all, at the scene of a car accident, it is very rare for a living victim of atlanto-occipital joint dislocation, and doctors have only seen it in the literature.

The spine skeleton model was placed on the square table in the office. Song Zimo, Xu Zhiliang, and August surrounded the model and began to study it. Robert also joined in the fun.

"The wounded man's life is in Dr. Lu's hands. I hope he can hold it steady. Whether it is a neck brace or a headband vest, it will not be able to provide reliable fixation."

Song Zimo expressed concern.

Xu Zhiliang also thought of this point. This is not an ordinary cervical spine injury, but a dislocation of the atlanto-occipital joint. A slight fixation is not good, and even slight movements are fatal.

"He will die on the spot!" August said bluntly.

How to prevent joint dislocation and cervical spinal cord injury in the process of carrying the wounded is a serious problem, a very serious problem.

"For this kind of wounded, ordinary neck braces are useless at all, and cannot provide reliable fixation." August frowned.

"Unless a custom-fit brace can be customized on site, or a perfect head, neck and chest cast can be made on site."

Song Zimo looked at the spine model and said while thinking, suddenly, a flash of light flashed in his mind.

"Can the brace room go to the scene of the car accident to customize a protective brace? Through on-site rapid prototyping, it can be fitted and fixed to the head and upper body of the wounded for temporary protection?" Song Zimo suggested.

"Good idea, if this is the case, the equipment in the brace room needs to be moved to the scene of the car accident." Xu Zhiliang was awakened by Song Zimo.

At critical times, creative thinking is really needed to break the stereotype of thinking.

"Call the old Wei from the brace room, let's go?" Xu Zhiliang got up, "Zhang Lin, tell Lao Wei to bring all their guys with him, and call the emergency department to start the car."

"Let's go, I'll report to the professor right away, and I'll wait for you at home!" Song Zimo was about to split up with Xu Zhiliang.

Old Wei in the brace room, in his 50s, with a college degree, used to be a plasterer in the orthopedic plaster room. Lao Wei's plaster room was upgraded to a brace room and became an independent department.

Moving the entire studio to the scene of the car accident was something Lao Wei had never done before. When he received a call from Zhang Lin, he cut off the cigarette in his hand.

"Inventory the equipment and materials, move them into the car, and go to the emergency scene to make braces."

Hearing that the task was to make braces on the spot, Lao Wei's eyes were shining brightly. He had been doing this job for half his life, making plaster braces. He felt that he was the best in the world, and no one was better than him.

Moreover, when he heard that it was a life-saving thing, Lao Wei was even more excited. He had worked in the hospital for half his life and had to deal with plaster braces every day. He never thought that this thing could save lives.

"Bring a pail of water!"

Old Wei directed two apprentices to move things.

"The incubator needs to be connected to a power source, so how can there be a power source at the emergency site?" said one apprentice.

Old Wei scolded: "My BYD Tang can be discharged, what are you afraid of?"

"Hurry up!"

Old Wei urged the two apprentices.

PS: Everyone has been waiting for a long time. Through the hard work during this period, the second-tier class has finally been turned into a third-tier class. In the future, there will be more time for coding. Thank you for your perseverance, continue!