When doctors have a simulated operating room

The patient was a tall boy.

His age was 17, but he was as tall as Zhang Yi.

"Where does it hurt?"

Zhang Yi asked after wiping his mouth and putting on a mask and gloves.

"Here." The boy pointed to his thumb with his right hand.

"Where's the film?"

"Here."

Zhang Yi put the film under the reading light and observed it carefully for a while.

There was indeed nothing wrong with the bones.

The problem was the fascia.

This guy's fascia was torn off while playing basketball.

"Doctor, how is my son's hand? Not serious, right?"

Zhang Yi put down the film: "Not serious, just fascia tear. Considering that you are still a student and so young, I suggest you go directly to the surgery to repair the fascia, otherwise, let alone playing basketball, it will be difficult to hold a pen."

When the family heard this, they hurriedly took the child to draw blood, pay the fee and prepare for the surgery, not daring to delay at all.

On the side, the doctor in the emergency clinic had a look of sudden enlightenment.

He picked up the film on the table and looked at it again, muttering in annoyance: "Hey, fascia tear is so simple... Doctor Zhang can see it at a glance, why can't I..."

Zhang Yi looked at him, thought about it and encouraged him:

"If you have time, read more case analysis, learn more and accumulate experience. With more experience, you can also see it at a glance."

It seems that he didn't expect Zhang Yi to suddenly talk to him and encourage him.

The doctor immediately smiled and nodded: "Okay, I understand, Doctor Zhang! I will do my best!"

While the patient was paying the fee for the examination, Zhang Yi quickly stuffed a few chicken legs into his mouth and drank a large glass of water.

His stomach was finally filled with food.

Half an hour later, Zhang Yi entered the operating room again.

Fascia avulsion is a minor operation.

The boy was quite courageous. Zhang Yi showed him the fascia with blood peeled off the skin. He said curiously: "So this is what my hand looks like."

Zhang Yi glanced at him: "Yes, this belongs to the scope of human anatomy. Each finger is connected to nerves, blood vessels, muscles and fascia. If one is missing, you can't even hold the basketball steadily."

"Wow, so amazing." The boy's eyes flickered.

Zhang Yi chatted with him while suturing: "What grade are you in?"

"Second grade."

"Arts or science?"

"Science."

"Sure, I'll try to get into a medical university in the future."

The operation was over after just a few words.

It took less than fifteen minutes, and Zhang Yi was operating slowly while chatting.

The boy was stunned for a moment and said blankly: "Ah? So fast?"

Then he looked at his right hand that was propped up and unconscious.

The wound had indeed been tightly sutured with black sutures.

Immediately, he looked at Zhang Yi with a strong admiration in his eyes.

The instrument nurse next to him couldn't help but smile secretly.

Oh my~

Doctor Zhang, you really have a lot of fans~

Not only have you gained a lot of female fans, but also a lot of male fans.

After bandaging the wound, Zhang Yi took the boy out of the operating room.

The family members didn't react.

"Ah? So soon? Has the operation started?"

Zhang Yi smiled and nodded: "Don't worry, the operation is over. You go to the emergency hospital first. He needs to be observed for a day and given some anti-inflammatory and analgesic drugs."

The family members were surprised and nodded quickly to do it.

When Zhang Yi returned to the office, it was already past one in the middle of the night.

Before he even touched the stool, he saw the nurse on duty hurried over.

"Doctor Zhang, another drunk patient just came. He can't be woken up and his blood oxygen level can't be measured."

Zhang Yi heard it and walked to the emergency room.

As soon as he entered the door, he smelled a strong smell of alcohol.

The whole emergency room was like being soaked in a wine jar.

Zhang Yi frowned and looked at the position of bed 5.

There was a man weighing about 200 pounds lying on the bed.

His face was flushed, his eyes were closed, and he didn't respond no matter how he was called, but his snoring was echoing like thunder.

Especially the smell of alcohol emanating from his nose...

Zhang Yi was sure that the patient must be him.

"Have you done the blood gas analysis?"

The doctor in the emergency room turned around and found that Zhang Yi had arrived. He was a little panicked because he couldn't measure the blood oxygen level just now, but he immediately breathed a sigh of relief.

Oh my God, the boss is here~!

"Not yet. I can't measure blood oxygen even when I'm breathing oxygen."

"Don't panic. Take a blood gas test first."

Soon, Zhang Yi got the results of the blood gas analysis:

PH value: 7.26 (7.35-7.45)

Oxygen partial pressure: 54mmhg (83-108mmhg)

Carbon dioxide partial pressure: 59.8mmhg (32-48mmhg)

Oxygen saturation: 79% (94-98%)

Lactic acid: 2.1moml/L (1-1.8moml/L)

Total oxygen concentration in blood: 14.52vol% (16-21.5vol%)

After getting the results, Zhang Yi frowned inaudibly.

"Decompensated respiratory acidosis, deep coma after drinking, hypoxemia, hypercapnia are all present. How much did this guy drink?!? Don't breathe oxygen, just intubate!"

The two doctors on duty next to him also broke out in a cold sweat after taking a look.

"I heard from the family that he drank a pound of liquor and three bottles of beer! But how could he have hypoxemia? High lactate should be a metabolic problem. The liver malfunctions after a large amount of metabolism. I can understand high lactate, but how can oxygen be low? I also gave him oxygen." The doctor on duty was a little confused.

Zhang Yi pointed to the patient's body shape:

"Did you notice that he is fat? In the case of deep coma, do you consider whether the patient himself cannot breathe oxygen due to tongue prolapse?"

"Ah??!"

The two doctors on duty took a deep breath.

Then they quickly opened the patient's mouth and took a look.

This look gave me goosebumps all over my body!

Damn it! !

It's really tongue prolapse! !

No wonder oxygen inhalation doesn't work!

Zhang Yi looked helpless: "Go and call his family in first. This man looks snoring now, but his breathing and heartbeat may stop in the next second. Then bring the intubation equipment and do the intubation quickly."

"Okay!"

"Okay!"

The doctor on duty immediately trotted out.

After a while, a woman in her thirties came in.

Zhang Yi was also intubating the patient at this time.

Generally, if obese patients are in a coma, they must pay attention to whether there is tongue prolapse.

Some patients do not have obvious tongue prolapse, but as long as there is low oxygen and high carbon dioxide, they must be observed more.

If necessary, intubation is performed to increase blood oxygen.

Zhang Yi looked at the anxious family members standing aside: "Does he have any other medical history? Hypertension, diabetes, etc.?"

"No, he just loves to drink, especially."

"When did he drink this wine?"

"Dinner, it seems to be around six or seven o'clock."

The doctor on duty frowned when he heard it: "Six or seven o'clock in the evening? It's been more than seven hours since now. It should have metabolized most of the alcohol. Why did the situation become worse?"

Zhang Yi said in a deep voice: "That means this person's liver function is not good."

The family members' eyes were red: "Does it mean that drinking hurts the liver? He just loves to drink, no matter how I persuade him, he won't stop..."

After the intubation, Zhang Yi asked them to take the patient to do a cranial and abdominal CT scan, and to complete liver and kidney function and other blood tests.