medical simulator

Chapter 133 I Actually Just Want To Be Longer (Please Subscribe!)

After hanging up the phone, Bu Chaodong felt that the old man on the opposite side was really strange!
Turning his head to look at Yan Haihan and the others, he asked angrily, "What is the origin of this old comrade across the way? Is he a doctor?"

I am very angry, but I can't express it. Is this what a doctor should say?

Yan Haihan hurriedly explained: "This is Professor Ding from the Department of Orthopedics at the Affiliated Hospital of Shonan University, and also Dr. Yang's teacher!"

Then he turned his head to look at Huang Shinan, and said, "Director Huang, our orthopedics department may not be able to do anything about this matter, you can find another way, I'll take Yang Yifeng down to rest first."

Yan Haihan's heart was beating drums at the moment, afraid that after Ding Changle came, he would trouble him again!
Through the few words just now, Yan Haihan probably heard that Yang Yifeng, ah, did not have the operation, left the Affiliated Hospital of Hunan University, and came to the Eighth Hospital, there is a deep-seated reason.

It may even be the kind of reason that even Professor Ding is not good at interfering with.

But Yan Haihan can only take one step at a time. He didn't do anything to Yang Yifeng. He was called by Huang Shinan from the Department of Vascular Surgery. Even if Ding Changle lost his nerve, he would definitely not let him go. of blood.

When leading Yang Yifeng down the stairs, Yan Haihan was still insinuating, preparing to inquire about the secrets hidden in Yang Yifeng.

But Yang Yifeng didn't intend to talk to Yan Haihan at all at the moment, he didn't ask or answer or answer, so Yan Haihan couldn't find the slightest breakthrough.

……

On the other side, family members outside the operating room communicate with each other indoors.

Bu Chaodong looked at Huang Shinan again, and asked earnestly, "Director Huang, is it true what Professor Ding said just now about knowing the law and breaking the law?"

Huang Shinan nodded, said with a wry smile: "Yes, there are specific divisions of doctors' practice."

"Surgical authority must also be graded and approved by the Medical Affairs Department. Dr. Yang is an orthopedic doctor. Strictly speaking, he violated the Law of Practicing Physicians by crossing the border to perform vascular surgery."

"And even though the Affiliated Hospital of Shonan University granted Dr. Yang the right to operate in vascular surgery, he is now in our No. [-] Hospital. If his practice certificate has not been transferred, he will not be willing to perform the surgery, and he will abide by the law."

"It would be fine if no one said anything about it. But Dr. Yang himself was reluctant, and he was reported after he was forced to take the stage."

"I don't know what the plot is." Huang Shinan smiled helplessly.

On weekdays, everyone just wants to finish the operation in a friendly manner. Occasionally, there are leapfrog operations to practice, but they are also sneaky and dare not talk about it.

It is a big shackle for newcomers to learn surgery.

But now, it has become the best life-saving talisman for Yang Yifeng not to appear on stage.

He is refusing to violate the law...

Bu Chaodong's face was tugged, and for the first time, he felt that the shabby rules that he used to think that doctors should be strict in management were so annoying now!

After finally finding Yang Yifeng, she watched him leave helplessly——

Seeing death.

just.

Special professions such as lawyers and doctors have their own scope of application of the law.

Yang Yifeng himself is unwilling to be the surgeon, and if the second place of practice is wrong, you can force him again. This is intended to save people, but in fact Yang Yifeng can turn around and report them to force him to practice medicine illegally.

Bu Chaodong didn't know what to say about this point, nor did Bu Chaodong know whether the lawyer knew about it.

But for sure, no matter if the trouble is big or not, as long as it happens, no one will have any good fruit to eat.

And from the conversation with Professor Ding Changle just now, Bu Chaodong also knew one more thing, that is, it seems that this Yang Yifeng may have been treated unfairly in previous encounters, and he really has psychological stress. This is not an act.

That's why, at the door of the operating room, I dare not go in.

However, Bu Chaodong didn't care about Yang Yifeng and Ding Changle right now, he just asked Huang Shinan: "Director Huang, can you find someone else? Or urge Professor Shu?"

"Although the current situation is not optimistic, we have to find a way."

Bu Chaodong didn't want to hastily decide on the amputation of his own person, but he finally found a person who happened to be free and was still around, who could perform this operation, but the other person was still a little nervous.

Unwilling.

Moreover, his teacher knew about it, and instead of helping him persuade him to risk saving others anyway, the first two said that they would call the police if they dragged him onto the stage.

This kind of bullshit simply made Bu Chaodong feel very asshole.

And I just checked, Yang Yifeng is a student, his practice certificate is in the Affiliated Hospital of Shonan University, and he came to the No. [-] Hospital to study. He has never been on stage, which is equivalent to an internship.

Internships or trainees, just take a quick look at the flowers, without having to relocate the practice location of the practice qualification certificate.

Therefore, there is no such thing as "doing nothing at all."

On the contrary, it is law-abiding...

Huang Shinan immediately smiled wryly, looked at Bu Chaodong and said, "I'm afraid this is inappropriate. Now that Professor Shu is on the operating table, if he interrupts you repeatedly, the other party will lose his temper."

Bu Chaodong was annoyed and said, "Can losing your temper be more important than saving lives?"

"Professor Shu's life is lying on the operating table right now." Huang Shinan murmured to Bu Chaodong, feeling that it was really bad luck for eight lifetimes to meet such two patients.

If Yang Yifeng's teacher really went to fight with Professor Jin Kaishi from the Affiliated Hospital of Shonan University, Professor Jin would definitely hate Huang Shinan with him. After all, it was because you encountered difficulties, and I will try to solve them for you It was only because of the method that Ding Changle got into trouble.

He might have offended someone secretly, so how could he do something that would offend Professor Shu.

Although Huang Shinan said that he is not proficient in vascular surgery, after all, there is this brand in the department, and he will still be in the circle more or less in the future. The bosses on both sides are offended, so you are still an ass.

"Buju, the only quickest way to solve the problem now is to amputate the limb first to save life."

While Huang Shinan was still talking, Chen Liwei came out and whispered something in Huang Shinan's ear.

Huang Shinan's expression changed immediately, and he asked back in astonishment, "What?"

"The patient has a ruptured liver and may need partial liver resection and liver repair. The bowel is also ruptured. The situation is very complicated now."

"The thoracic surgery department said that the few knives on the chest didn't penetrate very deep because of the cover of the ribs..." Chen Liwei said bravely.

In this way, basically, this patient is left to them for hepatobiliary and pancreatic surgery and gastrointestinal surgery. Can the patient survive?

Just look at Huang Shinan's decision alone.

This caused Huang Shinan's pressure to suddenly increase, and the fine sweat on his head kept oozing——

Huang Shinan immediately said to Bu Chaodong: "Bu Ju, there is no time to waste now, the amputation must be done immediately!"

"The patient's condition is changing now, and his vital signs are not stable. If it continues to be delayed."

"It may be too late to amputate the limb. If we can't save our lives, what can we do? Now that the amputation has to deal with trauma elsewhere, there is only a glimmer of hope." Huang Shinan said anxiously, wanting to go back to the operating room very much. See patients early.

Otherwise, the patient may die at any time.

Although Bu Chaodong was extremely reluctant at this moment, he could only sigh helplessly.

He slammed his fist hard on the table in the family communication room in the operating room, knocked the table so hard that it jumped, and his fist was red.

Then You scratched his hair fiercely and said, "Save your life first, then talk about it."

Obviously, it was extremely difficult for him to make such a decision, and he made a lot of determination!
Limbs!

Life.

These are two aspects that are extremely difficult to choose, but he is required to make the choice.

Fang Yu is the name of the patient who is currently lying on the operating table. He is the descendant of his comrade-in-arms who died. Now he has logically inherited the alarm number sealed by his father.

Now Huang Shinan wished he could beat that Yang Yifeng to death, he would be really crazy.

However, the Eighth Hospital where Huang Shinan is located is also...

Just after Huang Shinan and Li Changhong got Bu Chaodong's informed consent, they rushed directly to the direction of the operating room, and saw that Yan Haihan was meeting Dong Qiansheng who was hurriedly coming out of the operating room at this moment.

Then Dong Qiansheng came to Yan Hanhan and asked anxiously: "Director Yan, how did the family members decide?"

In fact, I have the answer in my heart.

Yan Haihan sighed: "The family members decided to amputate their limbs. Have Huang Yu and Xu Yanlin arrived? If they arrive, let's prepare immediately. We will start the stage at the same time."

Huang Yu was a regular trainee from another department of orthopedics this month, and was assigned to Yan Hanhan's group.

Min Chaoshuo was on duty, which meant that both of them had to be ready to go on stage to participate in emergency surgery at any time.

For ordinary emergency surgery, one person is enough to come to the operating room, but today is special.

Double lower extremity amputation, also known as double lower limb amputation, is not a difficult operation. It is not a problem that Yan Hanhan and Dong Qiansheng need to perform at the same time, but each of them must need an assistant to help.

Because amputation is not simply amputation of the legs, but also the storage of blood vessels, nerves, muscles and other tissues, which cannot be done by one person.

Dong Qiansheng rolled his eyes as if he had expected it, and explained to Yan Hanhan: "Director Yan, the situation is like this. Just now Luo Yun called and said that there was another open fracture in the emergency department. patient."

"Need to go on stage, Chao Shuo is now having a preoperative talk with the patient."

"I don't know when the operation will end. I will do it in the past? Call Luo Yun down to perform the amputation operation? Or let Luo Yun start the operation first, and I will replace him after the amputation here?"

If the family members decided to undergo limb salvage surgery, then Dong Qiansheng would not dare to say so and change people halfway.

But limb amputation surgery is just a simple level II surgery. Luo Yun can do it, and even Zhou Cheng and Min Chaoshuo can do it. It doesn't have much technical content.

However, the open fracture operation that just arrived in the department needs someone to do it, and we don't know what's going on.

"Call Luo Yun to come down and amputate. The amputation doesn't take a lot of time. He is already tired enough to be on duty."

"You take Xu Yanlin there, and let Luo Yun call someone down by the way."

"Open fracture surgery is not possible without an assistant." Yan Haihan made arrangements, and then walked towards the operating room, presumably because he didn't want to waste time.

The emergency surgery of each group should be arranged and planned in advance in the group, and the people in the group should be selected first to do the work.

Today, there were only two surgeries, and there were enough people in Yan Haihan's team. Yan Haihan took one, and Dong Qiansheng took one, forming two sets of preparation teams, which is usually enough.

Today I can only borrow Luo Yun, and let Luo Yun borrow another subordinate.

Min Chaoshuo is on duty and cannot move!

Dong Qiansheng nodded and called Luo Yun, and also called Xu Yanlin and said: "Yanlin, please help Luo Yun and Director Yan with some chores first, and I will call you over after I am ready to open the stage. .”

Xu Yanlin naturally praised it.

Finally, Min Chaoshuo was on duty and couldn't leave. Pang Dingkun went to the orthopedic department. The newcomer Huang Yu couldn't grab the opportunity.

Because it is an amputation, because the distal end of the limb does not need to be strictly sterilized.

Xu Yanlin therefore took the initiative to ask for help in disinfection.

Huang Yu was new here, so he didn't know the scope of disinfection in the orthopedics department. Yan Hanhan planned to disinfect himself and asked Huang Yu to lift his leg, but after seeing Xu Yanlin come in, he asked Xu Yanlin to complete the disinfection.

……

At the same time, in the locker room of the operating room, Yang Yifeng was talking on the phone with Ding Changle.

Yang Yifeng first explained to Ding Changle what happened in detail.

Ding Changle said: "Yi Feng, come back."

"The eighth hospital is not suitable for you now. They are all old foxes who have been in the workplace for many years."

"It's too early for no profit."

Yang Yifeng replied in a low voice: "It's okay, Master, I think it's actually okay."

"I just wanted to go in, but I couldn't help my parents in my mind. Their expressions and expressions kept spinning in my mind."

"I may really never be able to hold a scalpel anymore."

"That's my father and mother!"

"That's my parents."

"I could have saved my dad. My dad wouldn't have died." Yang Yifeng said this to Ding Changle who was on the other end of the phone.

To be honest, Ding Changle felt extremely distressed when he heard this!

But after all, it is impossible to fully understand that Yang Yifeng watched his mother die on the operating table where he was the chief surgeon, and at the same time, his father was unable to save him because of his own choice.

What will happen in my heart, but it must be very uncomfortable, very uncomfortable.

Don't persuade others to be kind without other people's affairs!
In a person's life, there are four words of loyalty, filial piety, benevolence and righteousness.

Who can tell?
Ding Changle persuaded: "Doctors don't heal themselves, and they don't heal family members!"

"Yifeng, it was Jin Kaishi who made a mistake in the procedure. He shouldn't have let you on stage. It's not your fault."

"In this whole world, who would let the patient's own son stand on the operating table and give his parents the fuck?"

"He himself has been suppressed by Shu Changfa of Attached Second for too long. He wants to pull you to push their department up. He is acting out of selfishness!"

"The old man is useless, so he wants to take the edge of the sword!"

Ding Changle cursed.

Shonan University has three affiliated hospitals, one attached to the other and the second attached to the third.

External relations are fine, but in fact, the competition between them is still very fierce.

If it is said that the neurosurgery and neurology departments of Attachment [-] are so overwhelming that Attachment [-] can't breathe, then it is the opposite in terms of cardiovascular surgery.

Shu Changfa ran so fast that he even led his department to the top five in the country, and it would not be too much to go further.

Jin Kaishi moved slowly, seeing that he couldn't catch up, but he didn't find a suitable person, so he grabbed Ding Changle's student to push him up.

Shameless really TN.

In the past, Ding Changle just had an opinion, but he didn't say it out loud, but after that, he and Jin Kaishi did not interfere with each other, and never communicated with each other again.

But today, Jin Kaishi still hasn't given up, and he's going around to harm Yang Yifeng.

It really made Ding Changle angry.

After he settled the matter on Yang Yifeng's side first, he was going to deal with Jin Kaishi over there!
To tear the face is to tear the face.

The reason why Yang Yifeng didn't dare to go to the operating table again, and the reason why his most valued apprentice had to drop out of school, was Jin Kaishi's help!

If he didn't let Yang Yifeng take the stage, no matter how regretful Yang Yifeng was, how could it be that Yang Yifeng would change his career and drop out of school now?
In Ding Changle's heart, he actually hoped that Yang Yifeng would take that step and let go of this knot!
But this knot is too difficult to solve!
At least Ding Changle couldn't solve it.

Yang Yifeng could only solve it slowly by himself. Ding Changle actually hoped that Yang Yifeng could directly overcome the demon just now and walk into the operating room.

But he backed off.

On the opposite side, Yang Yifeng did not reply to Ding Changle's words after listening, but asked: "Master, is mental illness illegal to kill people at any time?"

When Ding Changle heard this, sitting in the car, he felt all the nerves in his body jerk!
It seemed that the many questions in his head suddenly became clear.

Yang Yifeng is Ding Changle's most valued apprentice, and Ding Changle's understanding of Yang Yifeng is beyond anyone's imagination.

Yang Yifeng doesn't smoke or eat betel nuts.

But once in a while, he drank some wine. At the teacher meeting banquet when he first came to the orthopedics department, Yang Yifeng's face flushed from drinking that time, how happy Ding Changle was to see it?

However, Yang Yifeng's parents were hit by drunk driving.

Yang Yifeng vowed never to touch alcohol again.

He did it.

It's just that, at the beginning, it was obviously a drunk driving that killed someone, but it was later proved that he didn't drink much, so I don't know how to create a history of mental illness...

Ding Changle's scalp felt a little numb——

Because since then, Yang Yifeng has always been normal and abnormal, and he often consults with the Psychology Department of the Second Affiliated Hospital of Shonan University...

Ding Changle was very worried for a while.

I chatted with Yang Yifeng countless times, and I also asked someone to explain it to him.

When I was looking for Yang Yifeng, he was always in a normal state.

But if so?
Ding Changle once again thought of a possibility.

Is Yang Yifeng intentionally pretending to be mentally ill in front of other people?

Stress——

It is an objective fact that my parents died on the operating table and I was the chief surgeon.

"Yi Feng, what are you thinking?"

Ding Changle's scalp was tense at the moment: "I tell you, don't go astray!"

"If your parents knew what you were thinking at the moment, they wouldn't die in peace!"

"I will die with peace!"

Is Yang Yifeng smart?

He is very smart, Ding Changle has never seen a few people who can compare to Yang Yifeng.

If he wanted to secretly pave the way for a personal setting, and if he was in the medical field, and even put in the effort to study what mental illness should look like, the professor of psychiatric surgery might not be able to find out that he was pretending.

After the human design is made, the night is dark and the wind is high, killing people and setting fire...

This kind of distant and unfamiliar images and scenes that only appeared in the martial arts novels he had read suddenly burst into his mind.

Yang Yifeng said: "Master, I'm just talking casually."

"I will definitely not do such stupid things myself. My parents only hope that I can live a good life and live happily."

"This is more important than anything else."

"I know it very well myself."

Ding Changle is not sure if Yang Yifeng is clear now.

Not even sure.

In this world, there is only a thin line between a genius and a lunatic.

And Yang Yifeng's title among his classmates is 'Madman', another name for genius.

But whether Yang Yifeng will take this title seriously is unknown.

Moreover, Ding Changle paid attention to every word Yang Yifeng said.He himself would definitely not do such a stupid thing.

What about others?

What does Yang Yifeng want to do?
Before Ding Changle could reply, Yang Yifeng said, "Master, don't come here now, I've made a decision."

"I want to find a quiet place now, to be quiet."

Ding Changle was still worried: "Send me the location of where you are going, and I will be there soon!"

After hanging up the phone.

Ding Changle became very nervous, and then urged the taxi driver to speed up.

But at this time, it was close to the end of get off work, and the second ring-to-star connection line from the affiliated hospital where he started to catch up to the star area was terribly blocked!

The master said: "Boss, it's not that I don't want to go fast, it's just that if I speed up the accelerator, we won't be able to go at all."

Ding Changle's heart is like an ant on a hot pot, and he can only wait for the turtle to move forward.

I'm a little regretful, I knew I'd better take the subway...

Yang Yifeng.

……

When Luo Yun and Zhou Cheng rushed to the operating room!
Li Changhong and Wang Yaoxiang had already disinfected their upper limbs, Yan Hanhan also arranged for Xu Yanlin to complete the preoperative disinfection, and Huang Yu held the patient's leg with both hands.

Because the patient's body is quite strong, the weight of a pair of legs is not light.

Huang Yu had never experienced such a high-intensity leg raising in neurosurgery and other departments before, and the expression on his face seemed a bit overwhelming, and he barely supported it.

Seeing this, Zhou Cheng first put on a pair of sterile gloves, and asked Huang Yu for a leg so that Huang Yu could swap his left and right hands as a buffer.

Luo Yun washed his hands with Yan Haihan directly, and the two were still talking halfway.

When Luo Yun heard it, Yan Haihan said with great regret that Yang Yifeng actually had a way to complete the patient's limb salvage operation, but he was unwilling to go on stage.Luo Yun felt very surprised, but immediately remembered that Yang Yifeng had told him that he had been to the SVS annual academic meeting.

It suddenly dawned on me.

Luo Yun then turned his head and asked Yan Haihan: "Director Yan, in other words, this patient can actually avoid amputation, but no one dares to complete this operation now?"

Yan Haihan glanced at Luo Yun, his eyes and tone were strange: "Luo Yun? What are you asking this for? Don't get into trouble."

"This patient's situation is quite special, and his status is also special."

Although Yan Haihan knew that Luo Yun's background was quite serious, and he and others underestimated Luo Yun, but Luo Yun was obviously from the orthopedics department. If it is on the body, Yan Hanhan is absolutely not allowed.

Luo Yun quickly explained: "No, Director Yan, I just asked casually out of curiosity. Naturally, I wouldn't rashly go for limb salvage surgery."

"I'm not a graduate student in vascular surgery. Since Director Huang has said that he wants to amputate, I must listen to him. He is a person who knows how to do it."

Then Luo Yun said again: "Director Yan, Zhou Cheng of our group has now obtained the level II operation authorization, limb amputation, which belongs to the authentic level II operation, I let him take the stage, and I will be an assistant, it doesn't matter, right? It will not delay the patient's condition."

"What do you think?"

Amputation is a simple operation that belongs to level II surgery. Zhou Cheng can do it just right. To obtain the authorization of level III surgery, he needs a certain amount of level II surgery as a foundation.It's impossible that the amount of surgery for level II surgery is not enough, so Ding Changle went to arrange for him.

Zhou Cheng had to accumulate the amount of surgery slowly.One more is one.

The patients in the department are not only Zhou Cheng's, but also Cai Dongfan's. Du Yanjun and Zhang Zhengquan also need to learn.

"It's okay, you can tie the artery first later. The most important thing now is to solve the problem of blood loss caused by blood vessel damage." Yan Haihan reminded the key point.

Zhou Cheng's grade II operation was the result of the whole department's efforts to ask the medical department to come, and naturally trusted Zhou Cheng's ability.

Amputation is not difficult, but limb salvage is difficult.

Now the most fatal part of the patient is multiple traumas, severe blood loss, hemostasis, blood transfusion, to the point where the income outweighs the output, this is the key.

It’s just that after a long period of hemostasis, the blood in the arteries and veins will coagulate. If amputation is not possible, the muscles of the limbs will gradually die, and the creatine produced by muscle dissolution will be fatal.

Therefore, this amputation can actually be divided into two steps.

Tie the artery, stop the bleeding, and save your life in an emergency.

Then amputate, save your life!
Amputation can even be done slowly after six hours, it doesn't matter, it won't cause any burden to the body.

"Okay!" when Luo Yun and Yan Haihan re-entered.

I saw that Li Changhong and Wang Yaoxiang had opened the gauze on their upper limbs, and began to expose the brachial artery.

The purpose and process of their surgery are the same as those of Yan Haihan.

Stop the bleeding first, after the bleeding is stopped, Li Changhong can step down.Let Wang Yaoxiang complete the amputation slowly...

The first department of orthopedics is in charge of the upper limbs, and the second department of orthopedics is in charge of the lower limbs.

Therefore, Luo Yun and Yan Hanhan didn't go to see what Li Changhong and others were doing, but told Zhou Cheng and Xu Yanlin to wash their hands quickly, and then came to the stage to help.

Zhou Cheng nodded. As a pure tool man, he left his position before going to look at the patient's other conditions at the same level.

The right upper abdomen was stabbed, probably directly on the liver.The edge of the hole is neat, so it should be pretty easy to repair.

The edges of the openings of the jejunum and ileum are also neat. It seems that the wounder didn't stir it after stabbing the knife cruelly.

If you really do this, I'm afraid it's really hard to save the gods——

But even so, the abdominal cavity still exudes a very pungent smell.

The intestines are broken, and the taste is ecstasy.

Zhou Cheng frowned involuntarily...

When Zhou Cheng and Xu Yanlin washed their hands and walked in, they saw that Yan Haihan was already cooperating with Luo Yun to strip the femoral artery of one lower limb, and the four people from the Department of Orthopedics had already divided into two teams and started to search for it separately. arteries, hemostasis.

Because amputation is required, the brachial artery and femoral artery can be directly found and then tied off.

Zhou Cheng changed into a sterile surgical gown and walked around Luo Yun.

Luo Yun turned around and said, "Zhou Cheng, you take Xu Yanlin to do the other side. The femoral artery exploration and ligation is just a simple grade II operation, which is part of the amputation. It shouldn't be difficult for you to complete it, right?"

Zhou Cheng nodded and looked at Yan Hanhan.

The exploration of the femoral artery is only a grade II operation, and it is also a part of the amputation. This is naturally not difficult. Zhou Cheng has a perfect level of anatomical experience, and he can do it with experience.

It is much simpler to ligate the artery, just take the silk thread and tie it off.

Yan Haihan said: "You and Yan Lin should do the femoral artery detection over there, remember to be careful. After finding the breach, you must firmly press down on the proximal end of the femoral artery."

Blood vessels are similar to water pipes, but not exactly the same as water pipes. The same thing is that they can pass liquid.

The difference is that the water pipes can be on the surface of the body, and the blood vessels are generally buried deep.

There is a break in the water pipe, you can stop the water first, and then slowly find the opening, but the blood vessels are not good, the main switch of the blood in the blood vessels is the heart, if it stops beating, the person is gone.

Therefore, it is necessary to quickly find the proximal end of the blood vessel, and then press it to control the bleeding.

Everyone in the department knew about Zhou Cheng's Grade II surgery, so Xu Yanlin didn't say much, but looked at Zhou Cheng with a little envy.

He also stepped forward and said, "Brother Zhou Cheng, let me help you suppress it first."

Zhou Cheng nodded.

Then while the right hand slowly tore off the gauze, the left hand reached the abdomen. After touching it flat for a while, it pressed down tightly!

This is on the body surface, press to stop bleeding according to the shape of blood vessels!

It comes naturally from anatomical knowledge and is not a very advanced skill.

The intraoperative application of manual pressure hemostasis is another level, not the same.

However, after pressing the more proximal end of the arterial tear in this way, the amount of bleeding can be greatly reduced.

Because the patient's blood pressure was not high, coupled with Zhou Cheng's pressure, after Zhou Cheng removed the gauze, there was not much bleeding!

Then Zhou Cheng grabbed the proximal end of the femoral artery before Yan Hanhan.

"silk!"

The right hand changed into a style of grabbing loach, and a section of the femoral artery was neatly pulled out from the inside.Pinch your thumb and index finger tightly.

Then change the cost to pinch the thumb and index finger of the left hand that is pressing the groin!
Pull it out a little, and then quickly walk the two silk threads prepared in advance around the blood vessel in a circle, wrap them tightly and tie them into a half-dead knot (refer to tying shoelaces, which are tighter than shoelaces).

This puts the femoral artery down!After flicking the blood vessel stump a little, he let out a long sigh of relief when he saw no bleeding.

He said to Xu Yanlin, "You release your pressure first, and I'll see if there is any other bleeding."

Yan Haihan's brows were raised immediately, and after realizing that Zhou Cheng had performed an operation and got ahead of him, he couldn't help but slightly speed up the movements of his hands.

But just being so frizzy, Yan Haihan didn't have time to grab the stump of the artery!
Immediately, the arteries began to bleed!
Big Bund!

Then it sprayed down, and part of it even hit Yan Haihan's eyeglasses directly.

Zhou Cheng was still looking for other blood vessel openings. Seeing this scene, he immediately stretched out his hand across the operating table, and directly used his thumb, index finger, and middle finger to grab the stump of the femoral artery on the opposite side.

It can be said that it is steady, accurate and ruthless!

The bleeding stopped immediately.

The spray of blood, which could be sprayed out, kept falling down at this moment, and landed on the floor of the operating room and on the heads and shoulders of everyone.

But even so, everyone just glanced at Yan Haihan and saw that there was no more bleeding there.

He didn't walk away, but continued to start the operation without seeing this scene.

What are you afraid of being sprayed with blood during the operation?As long as the scalpel is not placed on the neck and the patient does not have any infectious diseases, the operation needs to be performed.

This is the normal concentration that a surgeon should have.

Naturally, Yan Haihan couldn't be so calm, so he immediately took a few steps back, and then said: "Xun Xun, come and help me take off my glasses!"

The lens was already blurred, and the blood in the air immediately oxidized and turned black, blocking Yan Haihan's sight.

After Yan Haihan's glasses were taken off, he approached again, and he didn't feel embarrassed, but he took the proximal end of the artery pinched by Zhou Cheng's right hand with a little blushing at the base of his ears and cheeks, and then began to ligate!
Cursing secretly in my heart, today is simply bad luck.

Although the others didn't move, Li Changhua and Wang Yaoxiang from the Department of Orthopedics looked at each other, and there was a mockery in their eyes!
Yan Haihan actually made such a mistake, and he didn't know what he was thinking!

But I didn't really take it to heart.

The femoral artery of the lower limbs is not smaller than the brachial artery of the upper limbs. One person can find the right place by directly pinching the armpit.

After strictly binding the two silk threads, Yan Haihan couldn't help looking at Zhou Cheng who had helped him.

I found out that Zhou Cheng opened the wound, exposed the wound of the femoral artery, and was still 'playing' with the femoral nerve and accompanying femoral vein...

In fact, it is checking whether these two things are injured.

It's just this skillful technique that made Yan Haihan become the second monk.

MLGB's is undergoing surgery now, you are tossing and turning.

Only at this moment, Yan Haihan saw again that the vascular forceps in Zhou Cheng's hand seemed to be fine, and he did not know where to pry it, and it seemed that the inner great saphenous vein was pulled out from the wound, and the wound was healed. After the pressure, blood gushed out.

Zhou Chengcheng said, "Are there any sutures for vascular surgery? Open a few."

"Yes!" The itinerant nurse replied immediately. Although she didn't know which department and which surgeon wanted it, she just wanted to obey orders and didn't bother to care about it at all.

Yan Haihan and the others immediately glanced at Zhou Cheng when they heard the words.

This patient is going to be amputated. What do you do with vascular sutures?
Of course, it also includes Li Changhong from the Department of Orthopedics.

Zhou Chengcheng said: "Director Yan, I think the plane of the amputation can be slightly lowered, so that the prosthesis can be installed in the future, and the arteriovenous tear here is not big, so it can be sutured."

Although it is an amputation, how much is left and how much is amputated is completely different.

Amputation from the base of the thigh is amputation, and amputation from the ankle is also amputation. The degree of function preservation is completely different.

Yan Haihan heard the words and thought it made sense.

Without saying anything, Luo Yun secretly gave Zhou Cheng a thumbs up.

Although amputation is cruel, as long as possible, stay as long as possible. This is also for the benefit of patients. I'm afraid that's all that can be done now.

People in orthopedics are not very proficient in vascular surgery. Vascular surgery cannot solve the problem of blood vessels, so the orthopedics can only leave as many stumps as possible to make up for it.

After Zhou Cheng got the blood vessel sutures, he quickly sewed up the great saphenous vein first. The great saphenous vein has only a small opening, and there is no need for the three-point blood vessel suture method of amputated limb replantation. The saphenous vein was replenished.

The same goes for the femoral artery...

After hearing Zhou Cheng's words, Yan Haihan's heart ached secretly. If Zhou Cheng hadn't said this, then he really planned to amputate his limb from the injured place. It was simple and rude, but Zhou Cheng said so.

As the director, Yan Haihan was embarrassed to say that the range of amputation here was shorter than Zhou Cheng's, so he also ordered blood vessel sutures, and then began to sew them up.

However, when Yan Haihan finished stitching, he was about to see what Zhou Cheng was doing.

Suddenly found something not quite right——

Because Zhou Cheng is now using a knife on the back of the patient's shin!
And skillfully--

What is he doing?
After Zhou Cheng used the round knife to cut the skin, he didn't use the sharp knife to go deep. Instead, he used blood vessel forceps, as if entering his own house, bluntly opened the muscle layer, and went straight to the posterior tibial artery...

One minute later, the sharp knife pierced the blood vessel wall of the posterior tibial artery, and pulled out a thrombus the size of a little finger from the blood vessel cavity like a carrot, like a black loach...

Obviously, this is the arterial embolism that Zhou Cheng found from the branch of the downstream artery of the femoral artery!

He's doing an arteriotomy!
The expressions of Yan Haihan and Luo Yun changed immediately, and even the expressions of Li Changhong and Wang Yaoxiang were a little unnatural.

Zhou Cheng is doing arteriotomy and thrombectomy, how does he know where the thrombus is?

This is the first point.

The second point is, if Zhou Cheng now saves his limbs below the knee joint, what should they do?

Can I amputate above the knee joint or above the elbow joint?

Doesn't this mean that he and others are inferior to Zhou Cheng?

However, what can be done if the amputation is not here?Will they know what Zhou Cheng is doing now?
will not.

Yan Haihan regretted it, regretted why Luo Yun was brought down, and regretted why Luo Yun brought Zhou Cheng.

Zhou Cheng discovered that Yan Haihan and Luo Yun were looking at him.

Thrombectomy of the femoral artery is a branch of level II surgery, so Zhou Cheng really knows how to do it!
In terms of surgical authority, arteriotomy and thrombectomy are also authorized in the category of orthopedics.

After Luo Yun took a deep breath, he asked, "Do you know how to perform arteriotomy and thrombectomy?"

This is not asking, this is affirming.

Zhou Cheng was suturing the incision of the posterior tibial artery where the thrombus was taken out, nodded, and replied naturally: "Yes, Mr. Luo, after I got the level II operation permission, I went to watch the video to learn this operation."

"Arteriotomy and thrombectomy is the 2011nd item in the 22 surgical classification list in my country, the orthopedic classification II surgical classification table..."

"So I thought I might encounter such an operation, so I went to video school."

Although Zhou Cheng's words were very straightforward and direct, they were even well-founded.

Even the National Health Commission was not called this name back then, it was the contents of the official document issued by the Ministry of Health that told it.

The first few items have been told to you.

creak!

When Zhou Cheng was speaking, he could clearly hear several screeching sounds of rubber slippers rubbing against the ground!
Such a fresh and refined reason!

Indeed, Yan Haihan, Li Changhong and others were caught off guard.

Myocardium almost died.

After you got the level II surgery permission, you went to learn one by one according to the list of level II surgery from the Ministry of Health?
Is this too much?

Actually not too much.

It's just that I don't know how to say it.

……

The muscles at the corners of the mouths of Yan Haihan and Li Changhong, like heart muscle, became integral and began to twitch at the same time.

Either twitch or not, very uniform.

Luo Yun took a step back, not standing still.

Zhou Cheng really dares to say——

The reasons for prevaricating yourself are spoken out on this occasion.

Then I saw that Yan Haihan and Li Changhong glanced at Huang Shinan intentionally or unintentionally, their eyes were full of strangeness and complexity...

Brother, why don't you come and see if this is an operation in your department?

Huang Shinan felt that today must be his doomsday. First, a lot of unlucky things fell from the sky like money.

Then, an orthopedic doctor, Yang Yifeng, appeared in the middle, acting as the savior for half a minute.

After asking him to be the chief surgeon, he forcibly refused.

Now a little orthopedic doctor has come out to make a fuss!

Damn, which god did I offend today?
I followed the surgery videos on the Internet, so I will.

It means that Huang Shinan didn't follow the surgery videos on the Internet, so I can't?
Then, Zhou Chengcheng continued to the next step, first to sew up the opening of the artery!
Then he let go of the ligated silk thread, and it turned out that the posterior tibial artery began to fill, and no blood leaked out.

Immediately follow the shape of the posterior tibial artery with both hands and feel the beating of the artery from top to bottom!

The shape of the femoral artery is from the upper outside to the lower inside, and the beating of the posterior tibial artery extends from the rear to the lateral malleolus.

Therefore, when Zhou Cheng's hand reached down to the dorsalis pedis artery, he was startled immediately.

Then he retracted his hand in disbelief, and tried again with his left hand.

I also felt the pulse of the dorsalis pedis artery!

Now Zhou Cheng began to struggle, and whispered to Luo Yun, "Mr. Luo, I just want to stay longer."

"But now the dorsalis pedis artery is pulsating."

"Is it still possible to amputate?" Zhou Cheng asked Luo Yun sincerely.

But when Luo Yun heard this, his eyes almost rolled to the top of his head...

NMB!

(End of this chapter)