Just when Monday was about to go under the knife.

Su Quan on the side suddenly reminded, "Brother, have you figured it out? This is a big deal, do you want to do a pericardiocentesis first to see if he has a heart hemorrhage." ”

The pericardium is a membranous sac that covers the surface of the heart. The pericardium encloses the entire atria and ventricles of the heart and protects the heart. If there is cardiac bleeding, there will definitely be blood in the pericardium.

There are few people in the operating room, and Su Quan doesn't call Team Leader Zhou anymore, but calls brother, which proves that he is a private kind reminder.

Su Quan was worried that if the knife went down, if the patient's heart did not bleed, it would be a big deal.

Doing a pericardiocentesis can check whether there is blood in the pericardium, which is safer.

This is also the normal step in the textbook to judge heart hemorrhage.

Although Su Quan has not had heart repair surgery, he still has this kind of theoretical knowledge.

And there is another point that is very important, Su Quan has never seen Zhou Zhou have had extracardiac surgery. Not to mention this kind of thoracotomy heart surgery. He had never seen even the simplest pericardiocentesis outside the heart.

Su Quan was a little worried, whether Zhou Zhou Zhou had recently become a regular or promoted a leader, and his mind was overheated under smooth sailing.

In order to make a show, I did an operation that I was not capable of.

Pericardiocentesis is an entry-level procedure outside the heart. If this surgery is skilled, it proves that Zhou Yi has studied extracardiac surgery. Su Quan was also more assured.

Zhou Yi was of course a glance at Su Quan's thoughts.

But he didn't have time to deal with Su Quan.

While pushing the scalpel to cut through the skin of the wounded, he said, "If it is not urgent, it is feasible to do a pericardiocentesis." It's an emergency department, but you don't have that much time, you must trust your clinical examination, Beck's triad is the standard for determining pericardial effusion. What the hell is going on, let's open our minds and see. ”

As Zhou Sheng spoke, his hands did not stop, the skin was incised, and then the subcutaneous tissue was ......

Su Quan also shut up at this time.

Before the knife, Su Quan, as the second assistant, brother, has the obligation to remind Zhou Yisheng. But once Monday was decided.

Su Quan did his best to do a good job of auxiliary work.

The process of opening the chest cavity is not complicated.

In particular, the entry point of the left anterior external thoracotomy on Monday also avoided the treatment of the sternum, so the progress was very smooth.

In fact, if Su Quan is allowed to handle this process, it should also be completed.

But of course, Zhou Zhou will not let Su Quan deal with it.

Because it is rescue, will and proficiency are completely two different concepts.

Proficiency is the only way to have speed.

Speed saves lives.

At this moment, Cao Xin is also worried about the position of the third assistant.

It was the first time he had seen Zhou Zhou have surgery, and it was a thoracotomy.

If he hadn't known a little about Zhou Shengsheng before, he would have thought it was incredible, this kind of surgery was outside the heart, and it also required a highly qualified attending physician to complete it.

Unexpectedly, Zhou Zhou, a newly promoted emergency resident, would dare to operate.

Zhou Yi is really a ruthless person!

Thoracotomy heart surgery, Cao Xin has also seen some.

For example, Director Tian did it, his uncle Cao Xiangwen did it, and some attending doctors did it.

So he can also understand one or two.

Monday's operation at this moment, he must have to compare.

Open the chest, there is no danger, it mainly depends on proficiency.

Judging from the speed of opening the chest, Zhou Yi is faster than Director Tian and Uncle Tian.

For that alone, Zhou Yi will surpass them.

This week, it's not only ruthless, but also quite powerful.

When Cao Xin sighed.

Monday has completed the first step of heart suturing and thoracotomy.

Now the heart is exposed to the surgical field.

Su Quan looked nervously to see if it was really a heart hemorrhage.

At this moment, there was a rupture of about 2cm on the injured person's pericardium.

At the site of the rupture, blood is still oozing.

This does not do anything with pericardiocentesis, the situation is already obvious.

There is blood in the pericardium.

The next step is to open the pericardium.

It's a technique about the extra-mental profession alive.

Previously it was said that the pericardium is a membrane.

Not accurate enough, this membrane has two layers, the fiber layer and the serous film layer.

The fiber layer is tough, closely attached to the wall layer of the serous layer, and has little elasticity. The serous layer is very thin, smooth and moist, and is divided into a wall layer and a visceral layer, the wall layer is attached to the inner surface of the fibrous layer, and the visceral layer is attached to the surface of the heart, that is, the epicardium.

There is a cavity between the visceral and wall layers, which is called the pericardial cavity. The cavity contains a small amount of fluid, called pericardial fluid, which is the filtrate of serum and contains a small amount of protein. Pericardial fluid lubricates and reduces friction during heart movement.

Now the condition of the injured person is that there is not only pericardial fluid in the pericardial cavity, but also blood in the pericardial cavity.

The blood must be in the heart.

So if you want to treat a wound in the heart, you need to open the pericardium.

On Monday, the parietal and visceral fiberboards are carefully incised, and the myocardium is pulsating and bulging towards the pericardial margin......

Su Quan's eyes widened, he had never seen the pericardium open before, but today it was an eye-opener, he didn't expect that in the emergency center, he could still see this kind of major surgery. There was a little excitement in my heart.

When the pericardium is fully opened, it is obvious that the right atrium has ruptured by 1 cm, and blood is suddenly ejaculated during the contraction of the heart.

Cao Xin was startled, he screamed: "Blood!

Su Quan didn't call, Cao Xin called first, and there was a reason.

Su Quan hadn't seen the pericardium open at all.

And Cao Xin has seen it on the extracardiac operating table.

However, he has not experienced a ruptured heart.

After the pericardium he had seen was opened, it was all a kind and amiable appearance, waiting for surgery such as mitral valve replacement.

On Monday, the fight began, the scene was grand, and the blood rushed out directly.

So Cao Xin shouted out on the spot.

At this time, Su Quan also realized that something was wrong, "Heart bleeding!What should I do?"

Monday, of course, knows what to expect.

Heart sutures, in the dungeon, also brushed a lot.

Treat this kind of wound, don't be polite, quick hemostasis is the first thing, get started directly!

That's right!

It's just getting started!

Shiatsu to stop bleeding!

Don't think that this method of stopping bleeding is used for trauma.

It can also be used during surgery when it is necessary to quickly deal with hemostasis.

On Monday, he had a quick eye and a quick hand, so he directly pressed the left index finger on the ruptured heart first, and then began to use a full-thickness myocardial suture with spacer noninvasive sutures through the cleft for mattress suture.

Here on Monday, I will do hemostasis and stitches, and I can't do it alone.

Second, Su Quan has a place to play.

According to Zhou Sheng's instructions, when Zhou Sheng's fingertips moved down to reveal the upper end of the cleft, Su Quan immediately tied the sutures to make the cleft close, and so on gradually intermittent sutures.

Suturing this thing is a basic operation in surgery.

Su Quan, who can do appendix surgery, naturally no longer has a problem.

At first, I was a little nervous, but after one shot, I got used to it completely.

Unfortunately, the wound was only 1 centimeter, and after two stitches, the stitches were complete.

Su Quan still has a feeling of unfinished business......

：。 ：