The toilet is a place where bad things can be done, Xia Yiwei hid in it and took a deep breath of cigarette, throwing the remaining half of the cigarette butt into the sewer.

No one knew that he was not in the simulated operating room, and the time was tight, leaving him with only two hours.

In the next two hours, he was going to improve his skill of three-lumen two-capsule tube compression to stop bleeding to a master.

Just because the system suggested that Uncle Wu's gastric fundus esophageal vein was still oozing blood, although he had given a doctor's order for triple hemostatic drugs and PPI inhibitors before entering the simulated operating room, the system said that the above drugs only had a 50% success rate of hemostasis.

50%, even if it's 99%, Xia Yiwei doesn't want to take that risk, because it's about human life, not just a disease.

Do your best, obey the destiny of heaven.

He has to do everything in this person, to say that if he doesn't have a system, he can still wait and see, but the result is that now he has a system, if he still looks at it as before, it is called irresponsibility and inaction.

Clinical practice has always been cautious, and any operation and medication pay attention to indications and contraindications.

The three-lumen two-cyst tube is suitable for rescuing patients with gastric fundus esophageal vein rupture and bleeding and ineffective drug treatment, so as to gain time for endoscopic and surgical treatment.

It consists of a three-lumen tube, a gastric balloon, and an esophageal balloon.

The principle of hemostasis is to inflate and compress to stop bleeding.

The first simulated patient was young, with stable vital signs, and also had a ruptured esophageal vein in the fundus and bleeding.

With his previous experience in entering the simulated operating room, Xia Yiwei asked the simulated patient to take a semi-sitting position while wearing sterile gloves.

Emotionless, the simulator sat up, folding the operating table seamlessly against his back.

Many of the skills are interconnected.

Since Xia Yiwei placed the gastric tube to achieve perfection among the masters, the steps such as examination work, measuring the length of insertion, etc., were done skillfully and quickly.

The tube is slowly and gently inserted into the throat of the simulated patient from the right nose upwards, then parallel to each other, and then backward down.

Open your mouth! Xia Yiwei's words were very cold.

The simulated patient opened his mouth mechanically, his face expressionless, and there was not a trace of emotion in his eyes.

It is true to say that the simulated patient has no feelings, but he feels the same as a real person.

If the patient cannot tolerate the procedure, even if he can tolerate it, he will feel a slight expression if he feels a slight discomfort.

The expression of the simulated patient is the same, which shows that Xia Yiwei's movements are in place, and the strength and speed are also very accurate.

This is what a perfect doctor should have.

The patient is asked to open the mouth to check if the stomach tube appears to be coiled in the mouth.

If so, proceed to the next step.

If not, you have to think about where the tube is like the tip of the middle finger to the middle of the wrist.

Swallow saliva!

With a flash of his eyes, Xia Yi did not grasp the moment when the simulated Adam's apple moved, and pushed the three-chambered and two-capsule tubes forward until the predetermined length.

It can be seen that the forehead of the simulated person is slightly wrinkled at the moment of insertion of the tube.

This is not to say that the perfect level of surgery is painless and non-invasive, and having this level can only reduce the damage and pain caused to the patient during the procedure.

The gastric juice mixed with bright red blood was withdrawn, and Xia Yi did not breathe a sigh of relief, indicating that the end of the tube had successfully reached the pylorus.

The above operation is roughly the same as gastrointestinal decompression, but the next operation Xia Yiwei has only done in real simulators.

My hand couldn't help but tremble slightly.

After stabilizing his mind, Xia Yi did not proceed step by step according to his memory.

The speed has slowed down significantly.

Air 250 was injected, reversed bending, and the vascular clamp clamped the three-lumen two-capsule tube and pulled outward. The slightest resistance indicates that the stomach pouch reaches the fundus upward, and Xia Yi did not stop pulling.

When the resistance further increased by two times, Xia Yiwei stopped and fixed it.

He then draws all the blood through the gastric tube, and then connects the gastric tube to the residual negative pressure suction device to understand the effect of compression to stop bleeding, and if necessary, he can inject 100-150ml of air into the esophageal sac.

Xia Yiwei did not do this, first, it was not necessary, and second, it was difficult for patients to tolerate after the esophageal sac was inflated.

Fixed continuous traction.

After doing this last step, Xia Yiwei wiped the sweat off his forehead, and then prepared to listen to the system's evaluation.

Drip!

- 5 minutes;

- effective hemostasis;

- tolerated by the patient during and after the operation;

——Three-lumen and two-cyst tube score of 70 points;

- Intermediate level.

Intermediate!

To say that Xia Yi can get 70 points before completing the three-lumen and two-cyst tube hemostasis for the first time, he should be very happy, which is equivalent to the level of the attending physician of the Department of Gastroenterology.

But he didn't, but was worried, just because the simulated patient's condition was relatively mild, and most importantly, young.

Don't underestimate your youth, he is a magic weapon to overcome many diseases.

"Lower the pain threshold of the simulated patient and increase the fragility of the blood vessels of the simulated patient. Xia Yiwei's tone was as cold as the system, "Increase the difficulty of hemostatic operations." ”

There is no rejection from the system.

As soon as his eyes were closed and opened, he was still the same simulated patient, but from the depth of his forehead lines and the degree of pain in his expression, it could be seen that he was older and sicker.

Another operation begins.

Xia Yiwei's speed was significantly faster than before, and he completed this hemostasis operation in less than 4 minutes.

Just as he was about to wait for the system's evaluation, a large amount of bright red blood flowed into the negative pressure drainage bottle.

Xia Yiwei was a little panicked, but he didn't mess up, he didn't hesitate, he picked up the syringe and injected 150ml of air into the stomach pouch.

However, the hemostatic effect had little effect, and the blood in the drain was still flowing.

Not only that, but the simulator was also extremely irritable and began to fiddle with the catheter in his nose.

Looking at his teeth and claws, he wanted to pull out the three-chambered two-capsule tube from his nose entirely.

Xia Yiwei really wanted to give him a stabilium, but so what?

Naturally, the air bag is not good, the pressure is bleeding, and once the pressure is reduced, it will not directly vomit blood.

Seeing this situation, Xia Yi was at a loss, and he didn't know what to do for the first time.

The helpless and panicked expression was no different from Lai Ming, who came from Uncle Songwu just now.

A flash of white light flashed, and the agonized simulator disappeared from the operating table.

The system also gave a score of 0, which is not low for a patient whose outcome was death.

Xia Yiwei sat on the ground like mud, and frustration arose.

How so?

How so?

How so?

How?

How?

......

His voice grew lower, so low that he could barely hear what he was saying at the end.

Another flash of white light flashed, and he looked up, revealing a picture directly across from him.

That's the picture he gave to the simulator just now.

The speed of the operation was indeed fast, but the gentleness was extremely low, and he did not notice the changing expression of the simulated patient like a flip book.

When the tube passed through the throat, the simulated patient's expression was already painful, hideous, and obviously intolerable.

"Why didn't he scream? If he did, I'd slow down...... "Xia Yiwei is also a mortal, and when he encounters problems, he first finds objective reasons, and even if he realizes it, he will put it on the back burner.

It's not that the simulated patient doesn't want to scream, but the system doesn't let him call, and the purpose of the system is to make Xia Yiwei remember this painful lesson.

A doctor's career cannot grow without the baptism of death.

If you want to be fast, the condition of the simulated patient is already heavier than before, with more bleeding, brittle blood vessels, poor physical fitness, and it is easy to be irritable if the operation process is simple and rude.

Once the sympathetic nerve is irritable, it will be excited, and the sympathetic nerve will cause the heart rate to increase and blood pressure to rise, even if the sympathetic excitement will cause the gastric blood vessels to constrict, but it will not be able to stop the heart from pumping blood violently and violently.

Prompting hematemesis is no longer inevitable.

I was wrong!

What a painful realization.

Xia Yi did not realize his mistake, and although he did not witness the end of the simulated patient, he could still imagine his death.

Finally, he stood up again......