Doctor Peerless

Chapter 641
Just when Zhou Sheng was about to use the knife.

Su Quan on the side suddenly reminded him, "Brother, have you thought it through? This is a big deal, why don't you do a pericardiocentesis first to see if he has a heart bleed."

The pericardium is the membranous sac that covers the surface of the heart.The pericardium wraps the atria and ventricles of the entire heart inside, and plays a role in protecting the heart.If there is a heart bleed, there will definitely be blood in the pericardium.

There were few people in the operating room, so Su Quan stopped calling Team Leader Zhou and called Brother, which further proved that he was kindly reminding him privately.

Su Quan was worried that if the patient's heart didn't bleed, things would go wrong.

Do a pericardiocentesis, you can check whether there is blood in the pericardium, it is safer.

This is also the step in the textbook for normal judgment of heart bleeding.

Although Su Quan has never undergone heart repair surgery, he still has this kind of theoretical knowledge.

And there is another very important point, Su Quan has never seen Zhou Shengsheng undergo an extra-cardiac surgery.Not to mention this open heart surgery.He has never seen even the simplest pericardiocentesis outside the heart.

Su Quan was a little bit worried, whether Zhou Sheng had recently become a full-time employee and promoted a leader. With everything going smoothly, his mind was overheated.

In order to show off, he performed an operation that he was not competent for.

Pericardiocentesis is the initial procedure outside the heart.If this operation is proficient, it proves that Zhou Sheng has researched on cardiac surgery.Su Quan was also more at ease.

Of course, Zhou Sheng understood Su Quan's thoughts at a glance.

But he didn't have time to talk to Su Quan.

As he pushed the scalpel and cut open the wounded skin, he said, "If it's not urgent, it's feasible to do a pericardial puncture. Now it's an emergency, but there is not so much time. You must trust your clinical examination. Beck's triple The sign is the standard for judging that there is effusion in the pericardium. Let's have a chest open to see what the situation is."

As Zhou Sheng talked, his hands kept on cutting, the skin was cut, and then the subcutaneous tissue...

Su Quan also shut up at this time.

Before using the knife, Su Quan, as the second assistant, brother, had the obligation to remind Zhou Sheng.But once Zhou Sheng made his decision.

Su Quan tried his best to do a good job in supporting the work.

The process of opening the chest cavity is not complicated.

In particular, the entry point of Zhou Sheng’s left anterolateral thoracotomy also avoided the treatment of the sternum, so the progress was very smooth.

In fact, if Su Quan could handle this process, it should be possible.

But of course Zhou Sheng would not let Su Quan deal with it.

Because it is rescue, knowing and proficiency are completely two concepts.

Only proficiency can make your subordinates have speed.

Speed ​​saves lives.

At this moment, Cao Xin is also worried about the position of the third assistant.

It was the first time he had seen Zhou Sheng undergo an operation, and it was still a thoracotomy.

If he hadn't known Zhou Sheng a little bit before, he would have found it inconceivable that this kind of surgery needs a highly qualified attending physician to complete it.

Unexpectedly, Zhou Sheng, a newly promoted emergency resident doctor, would dare to operate.

Zhou Sheng is indeed a ruthless person!
Cao Xin has also seen some open heart surgery.

For example, director Tian made it, his uncle Cao Xiangwen did it, and some attending doctors did it.

So he can understand a thing or two.

He must compare Zhou Sheng's operation at this moment.

Opening the chest is not dangerous, it mainly depends on proficiency.

Judging from the speed of opening the chest, Zhou Sheng was faster than Director Tian and Uncle.

In this point alone, Zhou Sheng is even better than them.

Life this week is not only ruthless, but also powerful.

When Cao Xin finished sighing.

Zhou Sheng has completed the first step of heart suturing surgery.

The heart is now exposed to the surgical field of view.

Su Quan looked nervously to see if it was really a heart bleed.

At this moment, there was a rupture of about 2 cm in the pericardium of the injured.

There was blood oozing from the rupture.

Don't do pericardiocentesis, the situation is already obvious.

There is hemorrhage in the pericardium.

The next step is to open the pericardium.

This is a technical activity about the extracorporeal profession.

It was said earlier that the pericardium is a membrane.

Not accurate enough, this membrane has two layers, the fiber layer and the serosa layer.

The fibrous layer is relatively tough, closely attached to the wall layer of the serous layer, and has little stretchability.The serosal layer is very thin, smooth and moist, and is divided into a parietal layer and a visceral layer. The parietal layer is attached to the inner surface of the fibrous layer, and the visceral layer is attached to the surface of the heart, that is, the epicardium.

There is a cavity between the visceral and wall layers, called the pericardial cavity.The cavity contains a small amount of fluid called pericardial fluid, which is the filtrate of serum and contains a small amount of protein.Pericardial fluid has a lubricating effect and reduces friction during heart movement.

Now the situation of the injured is that there is not only pericardial fluid in the pericardial cavity, but also hemorrhage.

The hemorrhage must be in the heart.

So if you want to treat the wound of the heart, you need to open the pericardium.

Zhou Sheng carefully cut the pericardial wall and visceral fiberboard, at this time, the heart muscle was beating and bulging towards the pericardial cutting edge...

Su Quan opened his eyes wide. He had never seen the pericardium open before. Today was an eye-opener. He never thought that such a major operation could be seen in the emergency center.I was a little excited in my heart.

When the pericardium was fully opened, it was obvious that the right atrium was ruptured by 1 cm, and blood was ejected immediately during the contraction of the heart.

Cao Xin was startled, he screamed: "Blood! There is blood!"

There was a reason why Su Quan didn't call, but Cao Xin called first.

Su Quan has never seen the appearance of the pericardium opened.

And Cao Xin had seen it on the cardiac surgery table.

However, he has never encountered a broken heart.

After the pericardium he had seen was opened, they all looked amiable, waiting for surgery such as mitral valve replacement.

When Zhou Sheng started the fight, the scene was grand and the blood rushed out.

So Cao Xin called out on the spot.

At this moment, Su Quan also realized that something was wrong, "Heart bleeding! What should I do?"

Of course Zhou Sheng knew it well.

Heart suture, in the dungeon, also brushed up a lot.

You don't have to be polite when dealing with this kind of wound, quick hemostasis is the first priority, just get started!
That's right!

Just get started!

Finger pressure to stop bleeding!

Don't think that this method of hemostasis is used for trauma.

It can also be used during surgery when rapid hemostasis is required.

Zhou Sheng had quick eyesight and quick hands. He pressed his left index finger against the rupture of the heart first, and then began to suture the whole-thickness myocardium with non-invasive sutures with gaskets passing through the rupture.

Here, Zhou Sheng had to stop the bleeding and suture, which could not be done by himself.

The second assistant, Su Quan, has a place to use his skills.

According to Zhou Sheng's instructions, when Zhou Sheng's fingertips moved down to reveal the upper end of the gap, Su Quan immediately ligated the sutures to close the gap, and gradually performed intermittent sutures.

Suturing this thing is a basic operation in surgery.

Su Quan, who was able to perform appendectomy, naturally stopped talking.

At the beginning, I was a little nervous, but after one injection, I got used to it completely.

It is a pity that the wound is only 1 cm, and after two stitches, the suture is complete.

So far, Su Quan still feels a little unfinished...

(End of this chapter)