Receiving patients to the emergency ward, preparing for the operation, and explaining before the operation are very tedious.

Even if the emergency department was simplified, but when the patient's state allowed, it was at least half an hour before Su Yun pushed the patient to the operating room.

By the time the patient was pushed on stage, the patient's high pressure had dropped to 90 mm Hg.

The continuous decline in blood pressure indicates that the patient's condition does not seem to be as simple as it appears.

Under anesthesia, Su Yun placed the patient in a position, laid the first layer of sterile sheets, and then brushed his hands again. At this time, Zheng Ren put on a sterile gown and began to lay the second layer of sheets.

The operation officially began.

Zheng Ren stretched out his hand, a pair of hemostatic forceps, and was slapped into his hand with iodophor gauze.

Sterilize, put the forceps on the side of the patient's leg, reach out again, and the scalpel slaps up.

The skin was opened, with a large 20cm incision, followed by layer by layer incision, blunt separation, and electrocautery to stop bleeding.

Cao Guozhen had already come to the operating room, and he was standing behind Zheng Ren at the moment, looking at the operation from the perspective of an operator.

The thoracotomy process is almost perfect with minimal bleeding.

Although Cao Guozhen was still not convinced, he scolded himself for opening his chest, and he would not have much blood.

Open chest and open abdomen are two very different ways of opening.

Many years ago, when electrocautery was not widely used in clinical practice, 500ml of blood was necessary to open the chest.

However, Zheng Ren and Su Yun's surgery did not have visible bleeding at all, and some large blood vessels were directly picked out of the tissue with hemostatic forceps and stitched on.

Only after the muscle is broken, the blood in the muscle is burned with electric cautery.

The operation was done cleanly and neatly, and the more Cao Guozhen looked at it, the more scared he became.

How can this demon in the emergency ward do such awesome thoracic surgery? If you want to grab the emergency department of the chest department, it's really not just a casual talk.

Zheng Ren and Su Yun had a tacit understanding that they did not go for internal fixation of rib fractures, but opened their chests first.

Because there is no strong evidence that thoracotomy can be performed, it can only be said that internal fixation of rib fractures should be done.

this

It's already stepping on the line.

Even if the postoperative recovery is not good, the patient's family is hypocritical, Zheng Ren and Su Yun may be in trouble.

Of course

They found the trouble themselves.

Cao Guozhen's sneer under the mask is getting stronger and stronger, these two guys in the emergency department are really presumptuous.

Don't they know that the procedures are irregular?

The patient's surname is not Zheng, nor is it Su?

It's still inflated, and I don't know anything about my surname.

Although I didn't see any problems after thoracotomy, I could do internal fixation of rib fractures directly, but the patient's family didn't know about it, and I wouldn't instigate it.

However, there is no reason not to get your shoes wet when you walk by the river.

Let them continue to be so arrogant, it's not far from an accident.

Cao Guozhen watched intently as the two opened their chests, and as soon as Zheng Ren raised his hand, a heavy automatic retractor appeared on his hand.

Open the ribcage and use the automatic retractor to open the surgical field of about 8 cm.

Under normal circumstances, the field is definitely not that big. However, the patient has a rib fracture, and the rib cage is not so elastic and tough, and the surgical field is wider than before.

"I first wanted to do chest surgery because of this kind of surgery. Su Yun disliked that the operating room was too quiet, and began to nag, "It's so bright, you don't have to dig out feces from your intestines." Boss, you said yes. ”

As the buckle of the automatic retractor was unscrewed one by one, the lungs appeared in front of him.

The middle and lower lobes of the right lung each have a huge incision with dark red edges, which appear in the field.

Zheng Ren and Su Yun let out a sigh of relief.

If there is a problem, there is nothing wrong with intuition!

Zheng Ren was a little afraid, and secretly scolded the big pig's trotters in his heart, only saying that the lungs were ruptured, and he didn't mark how big it was.

Can a 0.5cm abrasion lung rupture be the same as a 10 cm long and 10 cm deep lung rupture?

Zheng Ren probed with hemostatic forceps, and all the hemostatic forceps went in before he explored to the end.

The middle lobe of the right lung was almost not penetrated.

Cao Guozhen stood behind Zheng Ren and was stunned.

How does this work?

With such a large lung rupture, why is there no hemopneumothorax? Impossible!

No, you can't!

He was confused.

Cao Guozhen has also been a doctor for ten years and has seen countless traumatic injuries, but this is the first time he has encountered this situation.

What's going on?

Zheng Ren probed, and Su Yun was verbose, "Boss, I guess the force of the steel bar is too strong, and the broken end of the rib fracture is like a dagger, causing trauma in the middle and lower lobe of the right lung, and then because of the elasticity of the rib itself, it retracts again."

Because the force is too great, the trauma is too severe, and it is still similar to a sharp wound. At the moment of injury, the bronchial arteries were damaged in multiple places, and a large amount of blood gushed out, filling the lungs directly. ”

The process that Zheng Ren recalled in his heart was similar to what Su Yun said, and there was not much difference.

"So on the video, it's similar to traumatic wet lung. Because the blood is poured into the bronchial and bronchiolic tubes of the right lung, there is no pneumothorax. The lungs themselves are not compressed, the pressure is huge, and the blood cannot come out, so there is no hemothorax. ”

"This case is simply too misleading. Su Yun was very happy after exploring the patient's lungs, and the words in his mouth were not broken.

Compared with the previous caution, it is like a different person.

Cao Guozhen stood behind Zheng Ren, already in a petrified state.

What Su Yun said makes sense. But if you change it to yourself, you have such a guess, dare to open your mind?

He pondered for a long time, and he definitely didn't dare.

If there is no indication for surgery, if you open your chest at will, you may be sued by the family members of those patients who have malicious intentions to the medical commission.

These two people...... The guts are simply too big.

But if he continued to think about it, Cao Guozhen came out in a cold sweat in an instant.

If Zheng Ren and Su Yun hadn't insisted on opening the chest for exploration, the patient would have been observed for a few more hours, and I am afraid that the blood would not come out of the chest cavity, but would have passed through the upper respiratory tract little by little.

Similar to the process of drowning, only this time it was his own blood that affected the patient's breathing.

It's more of a headache than drowning, where the blood clots into a scab and the airway is blocked......

The patient had to die in thoracic surgery.

Thinking that the patient was fine when he was hospitalized, he died in the thoracic surgery department without staying up all night...... Cao Guozhen is stupid.

Even just thinking about it is as creepy and chilling as watching the scariest horror movie.

His blood all over his body was coagulated, and he recalled that there had been a rib fracture in the ward that caused an aortic dissection, and when he did a CT scan, the dissection was not serious, and he was not found. A few hours later, the dissection ruptured and the patient died suddenly.

After the death of the patient, dozens of people came to the house, dressed in linen and filial piety, put the patient's body at the door of the thoracic surgery, burned paper and mourned.

In that kind of scene, Cao Guozhen just thought about it, and his legs were already weak.

It's not that the doctor doesn't care, or that the patient's family wants to make trouble. Good people, who can stand it if they say that there is no salvation?

But do 10 CT scans 8 times a night to prevent and avoid?

The chest department has to accept hundreds of fractures a year, and I am afraid that the patient's family will have to die.

It's so terrible, thinking about it, Cao Guozhen's palms are full of sweat.

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