...... of the Ninth People's Hospital

"Who are you looking for?" Wang Wen saw a tall and handsome man standing at the door of Yan Musk's office, and couldn't help but step forward to ask.

"Are your leaders inside?" Zhang Yunhai said.

"You just knock on the door and go in, forget it, I'll take you in. ”

Wang Wen knocked on the door.

"Please come in. Yan Musk said.

"Sister Yan, this gentleman is looking for you, there is a high temperature subsidy here that you need to sign!"

Yan Musk quickly signed, looking at the man in front of him, he looked a little like Chen Xiaochun, he looked mature in a suit and leather shoes, I don't know if he was the boss of a big company or a big company, Wang Wen secretly glanced at it and went out.

"Are you the person in charge of this hospital?" Zhang Yunhai said.

"My name is Yan Musk, the chairman of this hospital, hello, do you have anything to do with me?"

"Of course, my name is Zhang Yunhai, our family is engaged in medical devices, you should have heard of Haide Group, right?"

"Of course Haide Group knows that it has a comparison with Xinlong Group, so are you here to talk about business?"

"No, I'm here to talk about a different business, will you be interested?" Zhang Yunhai smiled.

"What business? You're so sure, let's hear it. ”

"I heard that you and Jin Wenhui are mortal enemies, I have the ability to let your hospital expand and win the surrounding market, how about it, are you interested?"

Yan Musk squinted, there is such a good thing, someone actually came to the door to send money.

"What conditions?"

"I and Jin Wenhui's hospital has an employee named Zuo Mi, we grew up together, originally wanted to talk to her about marriage, but a man named Wind Chime came out, my purpose is very certain, it is said that it is likely that the person called Wind Chime is going to come to your hospital, I want you to take good care of me, give a little hardship, as for Zuo Mi, I will have a way, removing this obstacle is the key, can you understand what I mean? This is a meeting gift, a check for five million, Chairman Yan, think about it?"

This guy wants Zuo Mi to be his wife, and then let me trap the wind chimes and prevent the wind chimes from touching Zuo Mi, and after successfully taking Zuo Mi, the deal will be considered a success.

"Mr. Zhang, it should be the most appropriate transaction between us, it seems that you don't know much about the situation, Zuo Mi and Feng Chime have already got married, but they didn't hold a banquet, don't you know?"

"Of course I know, what is it, I don't care if I like someone or not, as long as I want it, there is nothing I can't get, because I will remove all obstacles. Zhang Yunhai's eyes were very firm.

"Okay, Mr. Zhang, how did you know that the wind chimes would come to our hospital?"

"Chairman Yan, I'm also the heir of the Hyde Group, I don't even know this bit of news, so how can I mix it, not only do I know that kid is coming to your hospital, I also know that kid's identity is not ordinary, is I right, the heir of the copper needle?"

"Then what should I do according to Mr. Zhang's meaning?" Yan Musk said.

"It's very simple, break him up and Zuo Mi, I am also a good citizen, I don't want to affect the interests of our family for this kind of thing, if it causes public opinion, it will be very unfavorable to our family, I don't have high requirements, right?"

"Mr. Zhang, this kind of thing is a bit harmful to others and not to yourself, the wind chimes have a good relationship with me, isn't five million too ......?"

"Oh, the price can be negotiated, if it's not enough, I can add more, how about 8 million?"

"Mr. Zhang misunderstood, the value of the heir of the copper needle is far higher than Mr. Zhang's monetary value, and the influence is also farther, and some things are intangible, such as fame. ”

"Chairman Yan, can you tell me the number? As long as it is within my acceptable range and so on, it is fine. ”

"Mr. Zhang, what I said is not clear enough, I mean, I don't accept this deal, I can't take care of the private affairs of the wind chimes, and I don't have that idle thought, thank you Mr. Zhang for your kindness, I understand it." ”

"Hmph, it's the first time I've seen someone like you, and I don't like money, okay, then don't regret it. ”

Zhang Yunhai got up and left, it seems that that kid is far more difficult to deal with than he imagined, he can't buy eight million, forget it, this one can't be replaced by the next one.

Yan Musk fell into deep thought, not to say how much money Zhang Yunhai gave to make himself embarrassed, this kind of thing is not his own style and he really can't do it.

Wang Wen hurriedly ran in: "Sister Yan, it's not good, something happened in the emergency department!!

"I'll come down right away. ”

When Yan Musk arrived at the emergency department, Su Lin and several doctors were worried, and Li Wanqiu was also silent.

Yan Musk was anxious: "You guys are talking, what's going on? Why are you dumb!"

Or Su Lin said: "It's a postoperative pulmonary embolism, and you can tell me about the specific process in late autumn." ”

Li Wanqiu said slowly: "Surgical disaster post-operative complications, is the ICU doctor's calamity, such as postoperative pulmonary embolism, today at noon, I was drowsy in the emergency room, I answered a phone call, it was Dr. Pu called, it was me who answered the phone, Dr. Su went to take a lunch break, and the phone said this, director, the patient who was transferred back to surgery in the morning had just been intubated and turned back, and the oxygen was very poor, it seemed to be a pulmonary embolism." I immediately stopped drowsing, I jumped up and hurried to pick up the patient. In the case of endotracheal intubation, the oxygen saturation of the machine with pure oxygen hovers at a low level of about 85%. The blood pressure is only 80/40mmHg, the radiologist has just pushed the bedside machine out, the patient moved around at noon, and suddenly the oxygen saturation came down, only 60%, and the tube was intubated, Dr. Pu briefly told Dr. Su about the situation, or you can tell me, Dr. Su?"

Su Lin said: "I looked at the monitor and was stunned for a moment, Dr. Pu was already so anxious that he jumped to his feet and asked me if I could dissolve thrombolysis? Director, there was a lot of purulent sputum in the airway when I was intubated, and I had just checked it with B ultrasound, and the right atrium was not enlarged, and no thrombus was found in the lower limbs, but the D-dimer was increased by 10 times. I think this diagnosis is not reliable, just 24 hours after liver surgery, there must be definite evidence to dissolve thrombolysis, if thrombolysis is successful, the wound bleeding will also be fatal, if there is no embolus at all, and thrombolytic drugs are used for heavy bleeding, it will be even worse. I said to Dr. Pu that thrombolysis is a stressful decision, and usually the pressure will fall heavily on me, the director, and it must be logical, and all the circumstantial evidence that I have obtained at the moment is ambiguous, and this is the situation at that time. ”

"Immediately prepare the transport ventilator, use pure oxygen to see if the patient's oxygenation can be maintained, raise the blood pressure a little more, and immediately go for CTA, I made a decision in a moment, immediately borrowed alteplase from the pharmacy, and now immediately, I asked Li Wanqiu to prepare. Immediately print out the thrombolysis risk notice and add the risk of bleeding from the wound after surgery. I asked the resident to do the paperwork right away and think of all the thrombolysis needs within 20 minutes of doing the CTA. The inferior thrombotic artery is blocked, and there is an incomplete blockage, the patient has not returned, and we can already see the image on the computer. CTA shows severe pulmonary embolism. The radiology department knew that the patient was special, and immediately made a report: the upper branch of the right pulmonary artery, the upper and lower branches of the left pulmonary artery were embolized, and the lower branch of the right pulmonary artery was suspicious. However, there is a layer of fluid near the surgical wound on the liver, which looks like bleeding from the wound. Dr. Pu asked me anxiously, "It must be dissolved, if it is not dissolved, it will die." "I looked at the image and immediately made a second decision, to point out the embolized artery to him, preferring to risk bleeding from the wound and dissolve the thrombolysis. "Okay, let's talk to the family. "The patient has been sent back, the oxygen saturation under pure oxygen has always hovered around 80%, blood pressure needs to be maintained with high-dose vasopressors, ICF doctor and Dr. Pu talked to the family, probably the situation is like this, the current situation is not optimistic, and it is another medical accident. ”

Yan Musk said, "Doctor Su, you come out with me." ”

Su Lin's feet were already unstable, and when he walked and swayed, Yan Musk saw it in his eyes.

Yan Musk said at the top of the stairs: "Even if you are spoken of badly, even if you are spoken of badly of mouth many times, the doctor is still the one who wants the patient to live the most, Doctor Su, I can understand you, this kind of patient's clinical decision-making is like walking a tightrope in the air, do not delay in place, you must take a step forward, but no matter which step you take, someone will say that you are wrong." This is the uncertainty of the doctor, the anxious patient's family, the excited conversation, the eager inquiry, are all a kind of pressure, the ICU patient who was transferred out in the morning, suddenly needs to be rescued, it is inevitable to ask, in this moment of instability of vital signs, of course there is a risk of doing CTA, the risk of rash thrombolysis, compared to the same is not much better, dilemma, must choose, even if the choice is wrong, but also quickly, Dr. Su, I don't blame you, you have done quite well, just do your best, what should come will always come, everything has me。 ”

"Even if there are scruples in my heart, my teammates who have been working together all the year round are used to helping quickly and consistently, and several ICU doctors work together, preparing machines, preparing micropumps, preparing the same road, preparing rescue boxes, and crowding a bunch of people to go to the CT room for examination. In fact, pulmonary embolism is not easy to explain, for this sudden rescue, the family began to be anxious and dissatisfied, the conversation was not smooth, there will always be seven aunts and eight aunts to question the voice, the key point of decision-making thrombolysis is pulled away. The point is not clear, and it falls on the question "why", which lasts for 20 minutes. I took two bottles of thrombolytic medicine out and asked, "Hurry up and think about it, the medicine is here, it does not dissolve thrombolysis, the patient has been deprived of oxygen for a long time, and the heart may stop immediately, sometimes the tone is too fierce and decisive, and if there are complications, you will be blamed as a handle, but no matter what, time can not be delayed." Finally, the family signed in hesitation, and informed informed, a large part of which depends on the doctor's attitude, but the patient's family does not know, making such a clinical decision, the doctor will have a feeling that his hair is all white and the whole person is hollowed out. The uncertainty of medicine, the analysis of data is the first way, or a part of it is left to the invisible and untouchable luck. Alteplase pumped into the blood vessels, all eyes nervously looked at the monitoring, and soon, the dressing of the patient's surgical incision was infiltrated by blood, and the thrombolytic drugs were working, and the lungs were the same? Nervously waiting for an hour, the transcutaneous oxygen saturation on the monitor rose from 80% to 100%, and from the point of view of performance, the embolus of the pulmonary artery was dissolved, and the mood was not relaxed for a moment, because the blood was infiltrated by the gauze on the surgical wound, and the drainage fluid in the drainage tube became thick and bloody. Dr. Pu anxiously checked the drains over and over again, and the ultrasound checked the local effusion over and over again. ”