"Don't rush, take your time. Director Peng, I was halfway through what I said, so please talk about today's surgical process. Wu Mian said.

"Teacher Wu, this is a piece of the cervical spine, you can help me take a look. Director Peng took out his mobile phone, found the prepared picture, and handed the mobile phone to Wu Mian.

There were cervical spine quadruple films and cervical spine CT, Wu Mian looked at the image data and said, "You continue." ”

"The patient had two block anesthesia in a few months. The 1st and 2nd planetary ganglion blocks showed no abnormalities, and this was the third operation. Director Peng continued, "The operation was quite smooth, and after the bolus drug was completed, the patient complained of numbness and dizziness. Then ......"

"Director Peng, tell me in detail about the process of your drug pushing. Wu Mian looked at the film carefully and said.

"The patient is in a supine position with a thin pillow under the shoulder, I stand on the patient's affected side, use the fingertips of the middle fingers of my left hand to press down along the side of the tracheal wall 2.5 cm above the sternoclavicular joint, and push the sternocleidomastoid muscle and its deep common carotid artery sheath outward. ”

"The fingertip is pressed down, the transverse process of the 7th cervical vertebra can be palpated, and the 3.5 cm long No. 7 puncture needle is held in the right hand, and the fingertip of the left hand is vertically pierced into the skin, and the needle is inserted until the bone, which is the transverse process of the 7th cervical vertebra. Withdraw the needle slightly, withdraw no blood, no cerebrospinal fluid, and inject 10 mL of diluted lidocaine. ”

During the whole process, Director Peng could almost recite it backwards.

Now I retell it, and if I think about it carefully, there is no problem with my operation process at all, and every step is clear and clear.

Ten thousand veteran drivers are not something that anyone can achieve.

This is also the stellate ganglion block anesthesia, the time is relatively short, Peng Peng can do nearly 10,000 cases. If surgery had been changed, many doctors would have been able to do thousands of cases in their lifetime.

There will certainly be no problems with the process just narrated!

There are only two withdrawals in the first and second phases of the whole process, and a small amount of fresh blood seems to be a little wrong.

At that time, there was a small amount of fresh blood in the syringe, and he thought that it was a capillary rupture, which should have nothing to do with the vertebral artery. Therefore, Director Peng didn't care, and tried to explain the whole process concisely and concisely.

"What are the complications of stellate ganglion block?" Wu Mian asked.

"Local anesthetic poisoning, total spinal anesthesia, recurrent laryngeal nerve block, phrenic nerve block or spasm, hemorrhage, hematoma formation, and then pneumothorax." ”

"Well, that's pretty much it. Wu Mian nodded.

"Teacher Wu......"

"Needle penetration into the vertebral artery and total spinal anesthesia are dangerous, both of which can cause cardiac and respiratory arrest. However, total spinal anesthesia punctures the arachnoid membrane and inserts the drug into the subarachnoid space, which is mainly characterized by extensive sensory and motor nerve blocks that develop rapidly after injection. ”

"Director Peng, let me ask you something. Wu Mian put down Peng Peng's mobile phone, looked at him very seriously, and said, "Since you know that you have these complications, why is there no ventilator in the outpatient clinic?"

"......" Peng Peng wanted to say something, but his lips moved slightly, and finally swallowed all the words back.

"Patients with severe complications will have manifestations of hypotension and bradycardia, and sometimes respiratory arrest. The patient who had just been injected with planetary ganglion block immediately developed hand numbness, dizziness and discomfort, gradual dyspnea, and respiratory arrest, loss of consciousness, blood pressure, and heart rate decreased significantly after 5 minutes. ”

"Normally, this is all expected, it's just a matter of probability. In this case, immediate endotracheal intubation is necessary. You may say that ventilators are too expensive and hospitals don't provide them. Wu Mian smiled, and tapped the fingers of his right hand lightly on the table, "But once something happens, do you think the superintendent will think it's your mistake?"

"......" Peng Peng broke out in a cold sweat.

At first, he thought that Mr. Wu was just that kind of academic doctor, and most of the doctors who came back from studying abroad were academic, thinking that the machine was not good enough, and constantly complained that he had to take care of things like wearing a glove head nurse.

But the next words prove that Mr. Wu is clear about all kinds of clinical tricks.

"Maybe the head of the hospital who rejected your request at that time has already retired, and even if he doesn't retire, what evidence do you have? Wu Mian said with a smile, "The leaders of the domestic academy are good at turning small things into big things, and there are not many leaders who can do things peacefully." ”

Speaking of which, not only Peng Peng, but even Zhang Zimo and Director Qian all felt confidant. Mr. Wu is really a clinician and knows that clinical work is difficult to do.

"But!" Wu Mian raised his voice slightly, and the fingers of his right hand tapped the table with a little more at the same time.

"The work is not meticulous, this is your problem. If you don't have a ventilator, you can be intubated first. Without endotracheal intubation, a balloon can be used first. Nothing is prepared, feelings you are fighting luck?"

Wu Mian looked at Peng Peng playfully, his eyes met, Director Peng immediately lowered his head, and he didn't dare to look at Wu Mian's eyes.

"It didn't happen, it was lucky. If something happens, the entire business may be delayed. Wu Mian smiled, and his tone was not as stern as when the video guided the rescue, "Many years ago, when painless gastrointestinal endoscopy was first carried out in some cities, it was because of insufficient preparations, which led to the death of patients. ”

This...... It's true, not to mention many cities, even several branches of the provincial medical university.

The profession of a doctor is different from other professions, and it is especially prone to various problems when accumulating experience. The big deal in other industries is economic losses, while the cost of the medical industry is human lives.

We can't expect everyone to be as standard as a machine and reach the world's top level. In that case, the world will not be what it is at all.

But Wu Mian's cognition lies in any operation to be cautious, cautious and cautious, careful, careful, and careful. Even if you have obsessive-compulsive disorder, you can't be too careful, and any preparation is not superfluous.

Peng Peng, a veteran driver like Peng Peng, can't avoid mistakes, so what about others?

However, if the new technology is not developed for fear of complications, it is a passive slack, and the residents within the radiation area of the hospital will have to pay a greater invisible price for this.

"Teacher Wu, you're right. Director Peng lowered his head and said with some frustration.

"Huh. Wu Mian smiled, "I just want to say a few more words, I still have a question I want to ask Director Peng." ”

“......”

Peng Peng's heels are cold.

Unlike the criticism of the leaders of the hospital, those are laymen guiding insiders, which will only oppress people.

Mr. Wu This is another situation, listening to him talk about stellate ganglion block anesthesia, he is more expert than himself, an old driver of 10,000 fields.

Peng Peng was really afraid that Wu Mian and Teacher Wu would scold him if he slapped the table, and it was not strange that he even pasted the coffee cup in front of him on his face.