Doctor’s Life Simulator

Director Pang asked, "However, not long after the 120 ambulance was delivered to the First City Hospital, where did you get the time to complete the abdominal puncture?"

For Director Pang's puzzlement, Director Zhuang is equally incomprehensible.

The client, Dr. Liu is still a little dazed, and he reported to the two directors one by one:

"The situation is like this. Dr. Qin and I followed the car to the scene. Before we landed on the island, Dr. Qin temporarily assembled a simple paracentesis bag from the first aid items. After we landed on the island, the patient The situation is very critical, so Dr. Qin suggested performing paracentesis to identify the specific type of acute abdomen."

While Dr. Liu explained, Director Lin of General Surgery also hurried over, saw Director Zhuang and several people, and asked directly:

"Director Zhuang, what's the situation now, didn't you mean to go to the patient for the identification of ascites and the color Doppler ultrasound test?"

Director Zhuang explained it again, and Director Lin couldn't believe it:

"You mean, you only completed the initial identification with a temporary paracentesis device?"

Dr. Liu nodded, and then summed up Qin Lang's previous judgment:

"Dr. Qin pinpointed hemorrhagic necrotizing pancreatitis according to the patient's dark red and turbid abdominal fluid, as well as the absence of foul odor and **** odor. That is, let me contact Director Pang as soon as possible to inform him Go to Director Zhuang. As soon as he entered the hospital, he went to the ascites for examination, and I arranged for the patient to have a CT examination."

"According to the nature and color, clarity, and smell of the abdominal fluid, combined with the patient's various signs, this possibility is really very high."

After a little analysis, Director Lin came to Qin Lang's general conclusion, but if he had followed the car at the scene, he might not have been as decisive as Qin Lang.

"This kid is really brave. In this temporary situation, he can still think of passing the items on the ambulance in advance to complete a paracentesis. However, this greatly reduces the time we spend diagnosing the disease and provides early treatment for patients. , bought a lot of precious time.”

Director Zhuang also admired in his heart that this Qin Lang is really a good material to be an emergency physician.

At this critical juncture, it takes a great talent to be alert, and have such solid basic skills to be able to identify the appearance, smell, and such meticulousness of ascites.

At the same time, the first time, the gold standard CT diagnosis can be arranged, which is really amazing!

Dr. Liu also added: "Actually, when Dr. Qin was on duty last time, he hadn't mastered abdominal paracentesis, and it was the first lesson I gave him. After returning, he mastered the abdominal cavity through self-study and watching videos. The essence of piercing."

"No way?"

Listening to Dr. Liu's words, several directors were stunned. If this is the case, this Qin Lang's learning ability is too terrifying.

However, this can also explain why in this case, he can remember the appearance of so many ascites, the smell and the corresponding symptoms.

Obviously, after observing Dr. Liu's operation, I went back to systematically supplement the knowledge. These contents are still fresh, so I can bear fruit when I happen to meet this patient.

"It can only be said that Dr. Qin is still very courageous, dare to take responsibility, and can flexibly apply the knowledge he has learned. He is a good seedling."

Director Lin praised and said to Director Zhuang and others:

"Then let's see the patient now and analyze the results of the CT test."

Director Zhuang nodded, and his heart was much more settled. After all, Qin Lang's operation had freed up enough time for them to deal with it calmly.

Soon, Director Zhuang and others joined the radiologist.

CT examination is a relatively advanced medical imaging examination technology. It scans a certain thickness of a certain part of the human body through an x-ray beam, and then processes and analyzes the scanned information and converts it into an image, which can observe the scan more intuitively. part information.

After the completion of the imaging department, Dr. Lu gave the film to the experienced Director Lin.

Director Lin took a look and his face became solemn:

"Director Zhuang, Director Pang, look, there are flaky shadows and low-density spots in this area of ​​the patient, and pancreatic hemorrhage can also be seen from here... It is basically confirmed that the patient is acute hemorrhagic necrotizing pancreatitis."

At this time, Qin Lang also rushed from the laboratory department to the imaging department. Seeing Director Zhuang, Director Pang and several others had already checked the CT results, and they were relieved.

"Director Zhuang, Director Pang, Director Lin, the patient's ascites has been detected."

After Qin Lang submitted the test results to Director Lin, Director Lin combined various signs and the most critical CT test results to determine the patient's symptoms: "Since the symptoms have been confirmed, the next step is to develop a treatment plan. design."

[Congratulations to the host for completing the task. Through the ability to identify the abdominal puncture fluid, the patient's symptoms can be diagnosed, so that after admission, surgical treatment can be performed as soon as possible. Rewards: 1.1 life simulation points, 2. sense of smell +1]

"Qin Lang, Dr. Liu, thank you for your hard work. Thank you for giving us enough time for treatment, and we will leave it to us. After a while, you two will learn with us about the treatment of acute hemorrhagic pancreatitis. operation treatment."

Director Zhuang thanked Qin Lang and Dr. Liu very solemnly, and immediately arranged the operation with Director Lin.

Acute hemorrhagic necrotizing pancreatitis is not uncommon in clinical surgery, accounting for about 20% of pancreatitis. Generally speaking, the cause of death is due to missed diagnosis, misdiagnosis and delay in the early stage. As long as the cause is identified as soon as possible and the right medicine is prescribed, there is still a great hope that the patient's life will be saved.

Director Zhuang and Director Lin, while preparing for the operation, discussed:

"Pancreatic necrosis is an irreversible pathological change, and the necrotic tissue is difficult to absorb. Among them, toxic substances and vasoactive kinin, elastase and phospholipase a2, etc., form a toxic culture basis in and around the pancreas. Therefore, its removal is a treatment The theoretical basis for surgical treatment and lavage treatment of this disease..."

"The purpose of the operation is to fully and thoroughly decompress the pancreatic capsule in the early stage, remove completely necrotic tissue, fully and effectively drain, and promptly remove the toxic exudate rich in pancreatic enzymes, so as to improve the blood supply to the pancreas and prevent the spread of pancreatic necrosis and inflammation. ..."

The two quickly reached a consensus and formulated a surgical plan:

The omental sac was fully opened, the pancreatic capsule was fully incised, the pancreas was dissociated, the necrotic tissue was removed, the pancreatic bed was drained with 3-4 root canals, and the postoperative pancreatic bed was lavaged.

Due to Qin Lang's decisive response, Director Lin, Director Zhuang and others also started the operation very calmly. As for Qin Lang and Dr. Liu, of course, they could only watch from the sidelines.

After all, pancreatic incision and drainage is already a third-level operation. If the intraoperative observation shows that the situation is serious, partial pancreatectomy is a fourth-level operation.

Far from being a first-class surgery like appendectomy!

Although Qin Lang has shown great talent in basic surgical skills, after all, he is still only the main surgeon for first- and second-level minor operations in the presence of a superior doctor. It's still early for this kind of third or fourth-level surgery!

This is also the charm of medicine. There are too many departments, too many diseases, and a vast ocean. In modern medicine, basically one field is enough for a top doctor to be exhausted. If you want to make achievements in several fields, That is basically impossible.

Therefore, there is a specialization in surgery, and Qin Lang has made achievements in the field of burns, but in the field of general surgery, there is still more to learn.

Qin Lang's mentality is also very good, and he watched with gusto next to Dr. Liu.

Director Lin is the head of the general surgery department of the city's first hospital. There is no doubt about his strength, and he and Director Zhuang started the operation.

First of all, they chose the path of surgery. Soon, Director Lin determined the path through the abdominal cavity.

In the middle incision of the upper abdomen, he chose the incision technique with one hand, which already has the nine-success power of Qin Lang.

"Amazing."

Qin Lang also observed carefully, and soon Director Lin opened the lesser omentum and retroperitoneum, and entered all areas of pancreatic necrosis and fluid accumulation.

As expected of Director Lin, due to the accumulation of pancreatic necrotic tissue and exudate in the lesser omentum, in order to reach all areas of pancreatic necrosis and fluid accumulation, he adopted a combination of several approaches. First, the hepatic flexure of the colon was dissociated, and the spleen flexure was used to enter the peritoneum. , and when freeing the rear of the pancreatic head, a kocher incision was used.

Qin Lang and Dr. Liu both seriously appreciated it.

"Doctor Qin, how long do you think it will take us to learn these techniques? I really want to perform this type of surgery."

Qin Lang said casually: "Learn for a lifetime, it should be enough."

Dr. Liu was taken aback for a moment, is Dr. Qin in such a good mood?

Then, after being ashamed, Doctor Qin's talent is capable of learning a technique with a lifetime of seriousness, and he even dares to hope for a quick success in a few years.

It seems that he also has to learn from Dr. Qin, not in a hurry or impatient.

ps: Thanks for the 500 coins for the **** Hummer, thanks to the big guy~

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