Yang Ping saw the patients lying on the operating table, counted, there are more than two steel bars on the body, there should be two longer strokes, and the rest of the strokes are relatively short, and there are three, most of which are in the waist and back, and out of the chest and abdomen.

Everyone gathered firewood and the flame was high, Director Long did not hesitate to join the team of brushing hands, and Director Wen immediately followed.

At this time, in addition to this rescue operation, there are other ongoing surgeries in the operating room, so the lights are bright and lively.

There are many people inside and outside the emergency surgery room, especially when there are many people standing outside, in order not to create obstacles to the rescue, everyone did not block the door, nor near the sink, but took the initiative to evacuate in a staggered manner.

The anesthesiologist had already administered general anesthesia to the patient, the young doctors moved quickly, put on a good position, completed the disinfection sheet, Director Xu put on a surgical gown and put on gloves, and then several doctors had completed brushing their hands and began to quickly dress and wear gloves.

This kind of rescue surgery is not like ordinary elective surgery, many things are also informal, even brushing hands is to try to shorten the time, sometimes do not brush hands directly wear gloves to dry.

All kinds of instruments have also been deployed, the instrument nurse has been sitting on the table and waiting, Director Xu is standing on the right side of the patient's abdomen, and the other doctors are quickly in place, and the operation is quickly launched.

"Anesthesiologist, we're having an open stomach."

Even the preoperative check-in is exempt, such an obvious trauma rescue, the pre-check-in will only waste time.

There are many doctors standing on the stage at the same time, and there are doctors from the four departments of thoracic surgery, cardiac surgery, basic surgery, and orthopedics, so everyone should try to move as little as possible so as not to disturb each other.

On the cephalic side, the neurosurgeons are already preparing to open the craniotomy and carry out the quadripartite operation at the same time, which requires extremely high organizational and coordination skills, otherwise the stage will be chaotic and "fighting" with each other.

"Did the firefighters come in?"

Director Xu asked as he scratched the skin on his abdomen.

"Arrived, waited outside." A doctor replied.

Just now, a doctor followed this incident, accompanying the firefighters to carry tools, wear a school coat, and wear a mask and a hat into the operating room.

In the emergency department, firefighters have helped to cut the exposed parts of the steel bars as much as possible, so that they can be easily transported and reduce the interference of surgery.

During the operation, it is not possible to pull out these steel bars in one piece, but to fully separate them from the surrounding tissues, and take them out in sections after fully stopping the bleeding, so that it is safe.

The rebar cutting during the operation requires the help of firefighters, who have tools and experience in cutting.

Director Xu's movements were very fast, and the bow-holding knife opened the abdomen with a bold sword, the abdominal cavity was opened, and the suction device sucked out a large amount of blood from it, some of which were already dark red, indicating that it was not a recent bleeding.

"Speed up blood transfusions!"

The operation is a bit difficult, several steel bars are staggered in the abdominal cavity, which will form a barrier to many operations, and Director Xu's hand understands the sinister situation after probing inside.

There are many injured parts, and the steel bar is an obstacle to surgery, and a variety of factors are intertwined, so it is certain that the operation time is long, and during the operation, only blood transfusion can maintain the patient's life and strive for the most time window for rescue.

"Tissue scissors!"

Director Xu figured out the general situation in the abdominal cavity, and began to separate with tissue scissors, stop bleeding from various bleeding blood vessels, and separate the steel bars.

"Chest opener!"

Thoracic and cardiac surgeons have also opened their chests.

To stop the bleeding, there must be a race against time, so everyone is squeezed together for surgery at the same time, which is also a last resort.

The longest two bars now run through the perineum, through the pelvis, abdomen, diaphragm, and thoracic cavity, into the neck, through the neck into the head, and then through the top of the head, and this bar has the longest path.

The other is not much better, penetrating from the anal area, going in a forward-to-backward direction, diagonally from the lower back to the front and upward, passing through the pelvis, abdomen, through the diaphragm, into the chest, and then through the pericardium, and out of the anterior chest.

The other three have short paths, and they are also intricate in the thoracic and abdominal cavities, some of which pass through the liver and some through the gastrointestinal tract, none of which are worry-free, and the situation is very dangerous and complicated.

This is an injury caused by several dangerous steel bars, as well as comminuted fractures of the pelvis caused by falls from heights, fractures of the femoral shaft, central dislocations and acetabular fractures of one hip joint, comminuted fractures of the spine, intracranial hemorrhage, multiple rib fractures, hemopneumothorax, and many more, all of which are fatal.

At the time of the emergency department, the thoracic surgeon has already given thoracostomy drainage; The orthopedic department installed an external fixator for the pelvis.

These can be operated under local anesthesia, and they are easy to operate for a skilled doctor and can be solved in a few minutes, so as soon as you enter the emergency department, the doctor will deal with it immediately.

If it weren't for the fire breathing from the ancestral grave, this fate would have been confessed to the scene of the injury.

Director Xu had never seen such a complex trauma, and he was under a lot of pressure, and he had to rely on his usual experience in emergency surgery to fully direct the operation.

Although Director Long and Director Wen have also brushed their hands and put on surgical gowns, they are standing next to them, as substitutes, and they specialize in surgery, and they may not be as good as the doctors standing on the stage now.

Director Long estimates that he has not been exposed to this kind of abdominal trauma for many years, and usually does pancreatic cancer surgery the most, and Director Wen also does a lot of coronary artery bypass, and he has rarely participated in this kind of chest trauma, and several doctors on the stage are experienced and in excellent condition every day, and they are the backbone of Xiehe Emergency Surgery.

Therefore, the two directors are very self-aware, and in this case, let alone participating in the stage, even blind command will bring them obstacles.

Professor Liang did not speak beside him, did not find any mistakes or deficiencies in principle, and he would not interfere with everyone's rescue.

Other doctors, graduate students and advanced doctors, except for those who participate in the rescue and have substantive positions, the rest of them act when they see the opportunity, and the general principle is to help as much as possible, but not to help indiscriminately, and not to add to the chaos.

For example, when I just went to pick up the firefighters, several doctors took the initiative to go out to help, get tools together, plan the position of the firefighters on standby and the placement of tools together, accompany them and explain some simple rules in the operating room to prevent contamination of the operation.

Otolaryngologists, dentists and ophthalmologists also rushed to the scene, as the steel bars piercing through the head could damage the mouth, ear, nose and throat and eyes, and they needed to assist the neurosurgeons in dealing with their own specialties.

Yang Ping, Song Yun, and Kong Weiquan all stood on the side of the reading light to watch the film, and at this time, everyone consciously stood on both sides of the film, and the front was vacant for the doctors on the stage, who sometimes came to watch the film at any time to guide the next step of their surgery.

Qiu Nuo, the instrument nurse in the orthopedic department, also caught everyone in the middle, she was also eating with her before, and now she came with her.

Yang Ping watched the film very quickly, as long as he glanced at it, he had already mastered the information on the film, these two long steel bars were indeed difficult to deal with, the longest one just passed through the side of the abdominal aortic artery, it seemed that it had just passed through the side, and it did not hurt the aorta, but it was actually injured.

Whether it's harassing it when it's separating or when it's time to sawn the rebar, it can lead to ruptured aortic bleeding.

This patient was lucky to be able to make it to Concord alive.

Professor Liang also looked at the CT pictures with Yang Ping, and he paid more attention to the spine, the thoracolumbar burst fracture, the severe fracture involved chest 12 upward, and waist 1 and waist 2 downward, and the most serious part of the burst corresponded to the conus medullaris, which is difficult to recover from the injury.

If it is a single such injury, it must be emergency surgical decompression fixation, but this is not a single injury, but multiple injuries, spinal fracture as a part of multiple injuries, relative to other injuries, has retreated to a secondary position, because the spinal fracture does not affect life for the time being, but affects the function of urine and urine and the sexual function of men in the future.

In the case of saving lives as the first principle, these can only be sidelined.

"The weather is not very hot, and the third watch is wrapped in a blanket in the middle of the night on the balcony to cool off, and the adults really have no sense of safety."

Professor Leung sighed.

"The price of this patient's cooling is too great, everyone must pay attention, we must have a sense of safety, do not lean on the balcony railing at night, and do not sit on the railing, how dangerous!"

Professor Leung admonished everyone as an elder.

It seems that the old professor's thinking still can't keep up with the times, and the young doctor next to him can't help but think so.

Seeing that everyone was indifferent to his admonition, Professor Liang turned his head and said, "You don't have such a habit, do you?" Chill out on the balcony at night and lie on the railing. ”

Everyone quickly shook their heads: "No, no, how can there be such a habit." ”

"It's good if you don't have it!" Professor Liang was relieved.

The general duty did not know when he appeared in the crowd, and the family had not yet arrived, and he had already signed the operation information form.

Since the patient entered the emergency department and the emergency physician reported to him, he has been involved in coordinating the rescue and has just been coordinating the blood supply to the blood transfusion department.

This kind of rescue surgery, whether it is the blood transfusion department or the blood bank, will try their best to supply blood, unlike elective surgery, which is careful to calculate, this kind of rescue surgery is the priority of blood supply.

Moreover, this kind of rescue surgery takes the green channel, even if there is no family member, the operation will be carried out as usual, the informed consent form for surgery is signed by the hospital leader, and the largest on-duty leader of the hospital at night is the general duty, and the general duty is served by the hospital administrative leaders in turn every day to ensure the normal handling of major emergencies at night.

"Professor Liang!"

The chief duty saw Professor Liang next to the reading lamp and immediately came over.

"How did you alarm your old man?"

The chief duty felt that the scale of today's rescue was a bit beyond imagination, and the academicians of the Department of Orthopedics were dispatched in the middle of the night, and looking at this formation, there were many people here.

"I heard that the spinal injury is also serious, so I came over to take a look." Professor Liang said calmly.

There are many orthopedic talents, what spinal injury can make Professor Liang come over for consultation in the middle of the night, and the general duty is not clear about the situation, how can today's rescue be so big.

''You always rest early, let these young people toss.'' ”

The chief duty exchanged a few words with Professor Liang, and hurriedly went to work on his own, in the event of this kind of big rescue, the chief duty must have run up and down all night, and the phone calls had to be hot.

Director Long and Director Wen were wearing gloves in the operating room, and it was not a taste to sit on a cold bench, so the two simply put down their hands and came to the reading lamp.

"Professor Yang has done this kind of case before?"

Director Long asked.

Yang Ping nodded: "I have rescued similar cases when I worked in the trauma emergency center of our hospital before. ”

"Xiao Yang, tell me what you think." Professor Liang asked.

"Be very careful here, the aorta should be rubbed over and then back in place, and be careful when separating, otherwise it will be easy to burst blood." Yang Ping pointed out the images of the aorta on several films.

"If you want to complete the surgery as quickly as possible, these are the key points of bleeding, and you need to be ligated to stop the bleeding, and these need to be separated, and then you can pull them out."

"It's best to take out these short ones first."

Yang Ping's fingers quickly pointed out dozens of well-known blood vessels on the two relatively long steel paths, which ones to deal with first and which ones to deal with later, and said clearly.

And he divides the numerous blood vessels into different priorities, so that the bleeding can be minimized.

Director Xu is struggling to stop the bleeding, and now the main task is to stop the bleeding, but where can he be busy, there is bleeding everywhere, Director Xu calmly responds, ligating blood vessels one by one.

The chest side is not much better, it is full of bleeding spots.

The main reason is that there are too many of these steel bars, which are criss-crossed inside, and the surgical operation is very inconvenient.

The neurosurgeon has opened the skull and is cleaning up the subdural hematoma, but this steel bar is poked out like this, and it is also very tricky to deal with it, and it is necessary to separate the steel bar little by little, completely separate the steel bar from the surrounding tissues, and all the blood vessels along the way must be treated to stop bleeding.

Intracranial hemostasis is very strict, it needs to be operated under the microscope, and if you are not careful, there are untreated bleeding points, and the postoperative bleeding is intracranial hemorrhage, which seriously causes brain herniation.

"Gauze! Hurry up, stuff and press. ”

"Vascular clamp!"

"Suction device, here, see clearly!"

"No, the bleeding here can't be stopped, and I'm going to have a lobectomy."

"This side of the pelvis is also bleeding, orthopedics, can we deal with it together."

The orthopedic department has installed an external fixator, but the hemostatic effect is still not good, and the treatment measures must be upgraded.

"Do you want to call the interventional department to prepare for embolization?" The next doctor in the audience advised.

But once the intervention department is required to embolize, all other surgeries have to be suspended, how is this possible?

"No, temporary gauze packing, lots of gauze, quick, temporary pelvic packing."

The emergency temporary reduction of pelvic fractures and external fixator fixation is to control the volume of the pelvis, so that the retroperitoneal bleeding will naturally stop to a certain extent, but now it seems that this trick is not effective.

The orthopedic surgeon extended the incision of Director Xu's abdomen a little lower, exposed the pelvis as thoroughly as possible, and then continuously filled the retroperitoneal space with large pieces of gauze.

Tamponade to stop bleeding, this is the fastest, safest and safest method, but also the last trick, if there is any other way will not use this original method, gauze tamponade, wait for many days, the human body self-coagulation function seals a part of the damaged blood vessels, and then the second operation to remove the gauze.

At this time, because most of the injured blood vessels are closed, the injured area is much cleaner, and it is much easier to stop bleeding, and the gauze can be taken out.

These gauze cannot be left in the body for a long time and can easily cause infection, so they must also be removed after surgery.

A large amount of gauze was used to control the bleeding in the pelvis, and the operation of the abdominal cavity and chest cavity was still continuing.

With the support of a large number of blood transfusions, the precarious blood pressure goes up and down, as if it is a little difficult to support, and it may fall rapidly at any time.

"Active blocking! I'm going to block the aorta temporarily! ”

Director Xu shouted, because there were too many bleeding points, which were far beyond his control, and the aorta had to be temporarily blocked to obtain a certain time buffer.

This is a major battle of emergency surgery, where almost all trauma emergency surgery techniques are put into play.