Huang Jiacai's brother and sister, don't drop the chain at a critical time, this set of equipment is really the only one in the city, because it is customized by Huang Jiacai, and the connecting rod between the guide and the steel plate is lengthened, which is suitable for particularly obese patients. He also customized some other strange instruments, such as elongated steel plate screws, in case of emergency.

After the fracture was reduced, the plate was successfully inserted, and the locking screw was placed under the guidance of the guide. Long steel plates, high spans, stresses are dispersed, fractures are bridged.

"How come people have equipment, but you don't? Are you trying to tear it down?"

Director Ouyang was disgraced and embarrassed on the stage, and lost his temper at the equipment dealer and the stage.

Just asked him to dig three feet into the ground to get the equipment, but he still didn't get it, and several larger companies have asked, who is okay with a whole set of equipment for 400 pounds of patients, and it is useless to scold people to death. But Yang Ping's equipment dealer has it, and it was delivered, and Director Ouyang has reason to suspect that the equipment dealer is not interested.

If it weren't for Yang Ping's rescue, if it weren't for Yang Ping's instrument dealer's strength, this operation would really not have been able to get off the stage.

"I'm sorry, I'm sorry, I'm sorry, we didn't do our job properly, our manager will be there right away and come over in person to apologize." The equipment dealer who followed the stage did not dare to refute half a sentence.

Director Ouyang is not bad, if you meet Director Bai and the instrument smashes in front of you, you can only nod and smile.

At this time, no matter whether there is a mistake or not, it can only be like this, until Director Ouyang is smooth, and now the instrument dealer is a punching bag, a beaten sandbag, doing this business, without the ability to pretend to be a grandson, this money can't be earned, especially when the main surgery encounters difficulties, the instrument is not easy to use, and it is indispensable to be scolded.

After the screws were played, the C-arm X-ray machine fluoroscopy, there was no problem, Dr. Jin measured the lower limb lines with an electrosurgical wire, the anterior superior iliac spine, the center of the patella, and the middle of the first and second toes, the same as aiming with a gun, three points and one line, normal.

This surgery is an innovative result of fracture treatment technology, called biological fixation, which is suitable for long bone fractures of the limbs, of course, this cannot be done for ulnar and radius fractures, and the ulnar and radius are treated as intra-articular fractures because of their precise rotation function, which requires anatomical reduction and strong fixation.

And this kind of femoral shaft fracture, do not need to be anatomically reduced, do not need to return to the original state, as long as the length and line of force are restored to normal, even if the purpose is achieved, the messy bone blocks in the middle can be ignored, these broken bones seem to be messy, not treated, in fact, the blood vessels are protected, and finally grow into a piece, and the human body will shape it, and the femur will not be different from the normal shape in the future, and there will be no impact on the function.

This is the progress of medicine, the innovation of ideas, the innovation of surgery and equipment, and finally the improvement of treatment results.

"What, don't bring this thing with you in the future." Director Ouyang fiddled with the original guide a few times and threw it directly into the trash, so that the anger could be dissipated a little.

The manager of the instrument manufacturer, who said that he was really coming, hurried to the operating room and kept hunching his waist: "Director Ouyang, we haven't kept up with the service, and we've caused you trouble, you see, give me a chance, get together after work, and let me apologize to my brothers?"

Being scolded like a grandson, letting the director smooth out his anger, and then please eat and drink, this is indispensable, and the grade of this meal cannot be low.

After all, this is not a subjective error, but there is indeed no such equipment, and it has been transferred to the brother company, and there is none.

The manager whispered to the person who followed the stage to understand the situation, only to know that the equipment sent by a small company was urgent, and in response to Director Ouyang's urgency, the manager glanced at Huang Jiahui, a girl who was ignorant of the world.

After a few more glances at the special guide placed on the instrument table, I didn't understand how there could be such a strange guide, I have been immersed in the industry for so many years, and I can be regarded as an instrument expert.

Director Ouyang took off his surgical gown, the manager hurriedly went up to smile, helped untie the tie, moved the stool with the table, adjusted the height, Director Ouyang did not sit, but walked to the reading lamp to watch the film, Yang Ping stood there.

"Lao Jin, explain clearly to the family that these broken bones do not need to be reduced, and they will not affect the function." Director Ouyang explained to Dr. Jin.

The saddest part of this kind of surgery is that the family members don't understand, and when they see the X-rays of the postoperative review, they think that the doctor's level is too poor, the operation is not done well, and the bones are messy.

The doctor explained a lot of medical principles, but the family didn't understand anything, and the last sentence: these bone pieces on the X-ray are similar to those before the operation.

In fact, this is faster and better than cutting open and putting the bone pieces together, and the fracture will heal faster and better.

Joint fractures cannot be operated on in this way, and joint fractures must be put together piece by piece, honestly, so that the mirror can be broken and reunited.

Director Ouyang came over and planned to ask Yang Ping how to pry and reset it once, but the instrument manager was next to him, so it was difficult to speak for the sake of face.

Yang Ping doesn't have the impulse to lecture, naturally he won't take the initiative to explain, some people like to learn, some people don't like to learn, everyone is casual, if you want to know more, ask him directly, he will explain, don't ask, he won't take the initiative to tell you, except for Song Zimo.

At the end of the operation, it is also challenging for the patient to get out of bed.

When I entered the operating room, the width of the flat car was not enough, and the bed was directly propelled in. Now that the bed has passed, the horizontal width of the bed sheets is not enough, and the nurse has figured out a way to spread it horizontally with several sheets, so that it can work.

Six people, three on one side, pulled one side, and sent on the other side, pulling until the lumbar disc herniated and the patient moved a little.

I had to add two more young men, and the five of them pulled together to pull the patient to the bed.

The manager of the equipment manufacturer and the followers also participated, working very hard, and at this time they wanted to confirm their efforts to Director Ouyang.

The patient is under general anesthesia with endotracheal intubation, and the commonly used anesthesia for this surgery is sciatic nerve and femoral nerve block, or combined spinal-epidural anesthesia, but in either case, it is extremely difficult to locate because the fat is too thick.

Combined spinal-epidural anesthesia requires the injection of anesthetic into the spinal canal, and the anesthesiologist's conventional lumbar puncture needle is estimated to be unable to reach the spinal canal at all, the puncture path is too thick, and the conventional puncture needle is relatively too short.

"Wei Danian, wake up!" The anesthesiologist slapped the patient's face, hoping to wake him up with stimulation and prepare for extubation.

Dr. Jin reminded the anesthesiologist: "In another way, not long ago, in the emergency department of a hospital, an old lady suffered cardiorespiratory arrest, and the doctor used a fist hammer to make cardioversion, and smashed it down with a punch, and the old lady's son was slapped twice. ”

Frightened, the anesthesiologist stopped, this habit was not good, he still didn't move his mouth, he pulled his throat and shouted at the patient: "Wei Danian, wake up, the operation is done." ”

The patient is dazed, opening his eyes is a response, and then closing his eyes again, opening his eyes, spontaneous breathing, can be extubated, the anesthesiologist uses a suction device to clear the secretions of the respiratory tract again, and successfully pulls out the tracheal intubation.

"Blood pressure is down!"

Dr. Kim kept staring at the monitor, and his blood pressure actually dropped to 7635mmHg, and his breathing became deeper, and the patient inhaled and exhaled sharply.

"Ketoacidosis?"

The patient has diabetes, breathes deeply, blood pressure drops, the anesthesiologist immediately thinks of ketoacidosis, sniffs the nose, pulls the mask slightly, exposes the gap, and breathes without the smell of rotten apples.

"Re-intubation!" The anesthesiologist quickly reinserts the endotracheal tube.

"Blood glucose meter to check fingerstick blood glucose, blood draw to check blood routine, biochemistry, liver and kidney function, blood gas analysis, ---" the anesthesiologist reported a series of verbal medical instructions.

He is experienced, breathing deeply, this is acidosis, the patient has diabetes, blood sugar 38mmoll when he was admitted to the hospital, and he dared to operate only when he was satisfied with insulin, it was not the stimulation of the operation, and the blood sugar came up.

In the operating room, the anesthesiologist is responsible for the safety of the patient's life, so the anesthesiologist is naturally nervous.

"Blood sugar 6.2mmoll" The nurse looked at the data on the blood glucose meter.

"Not tall, huh? What's going on? The anesthesiologist wondered.

Director Ouyang and Dr. Jin were also nervous, they suspected that fat embolism caused pulmonary embolism, but the blood oxygen was not low.

"Check the blood lactate!" Yang Ping suggested.

"Well, check the blood lactate." The anesthesiologist instructs the nurse.

The hospital has a special automated logistics system, as long as the nurse labels the specimen, scans it into the computer, and then loads it into the logistics cylinder, it will automatically be sent to the laboratory through the transportation pipeline.

The results came out quickly, with a bicarbonate ion of 8 mmoll, a pH of 7.21, and a blood lactate concentration of 2.8 mmoll.

"Acidosis is right, it's lactic acidosis, not ketoacidosis!"

The prognosis of lactic acidosis is critical, and the mortality rate is high.