The fact that the level of the first orthopedic medicine is so low should be related to the fact that he does not have any foundation in orthopedic surgery.

Dissection and anastomosis are tertiary as soon as they are obtained, and that is because they are advanced medical techniques derived from basic surgical techniques such as incision, suture, and ligation.

Broken bone joint, he did not have any surgical basis.

He was able to succeed in connecting bones for the first time, one is very talented, and the other is the same as all the laws in the world. His four major surgical basic medical skills are already at the attending level, which allows him to touch the bypass.

When it comes to bone grafting, it's definitely much stronger than a true novice.

"Orthopedics is an unavoidable hurdle in surgery, and there are many application scenarios. Now that I've acquired this medical skill, it's not bad to find an opportunity to take it up little by little. ”

Zhou Can has always liked to plan ahead.

Instead of begging people for surgery in the future, it is better to find a way to learn more medical skills.

The field of surgery is very finely divided, and there are few all-round doctors.

In the face of complex surgeries, it is often a multidisciplinary joint operation.

For example, if the rib cage is completely broken and there is a risk of puncturing the heart or other important organs, a thoracotomy may be required.

At this time, cardiothoracic surgery and orthopedic surgeons often work together.

Every time Zhou Can adds a medical skill now, he will have fewer opportunities to ask for help when he has surgery in the future.

Moreover, all kinds of medical skills are inextricably linked, complementing each other, and learning a few more medical skills will also be of great benefit to the improvement of his comprehensive medical skills.

……

"Teacher, can you see that the finger bones are jointed?"

"Well, it's a good pick-up, hurry up and complete the follow-up surgery part!"

Dr. Koh nodded in satisfaction.

It's very good to be able to receive it so well the first time.

In finger replantation surgery, the patient's phalanges are only the first step in the operation.

The next tendon sutures, vascular anastomosis, and nerve anastomosis are all difficult step by step. Failure to do any of these steps may result in the failure of finger replantation surgery.

Fortunately, Zhou Can is already fully capable of doing them well.

Tendon suturing mainly tests the two medical skills of suture and ligation, as well as the knowledge of tendon repair.

A mediocre level of residency is fully qualified for the job.

Zhou Can's two medical skills are all at the main level, which is enough to sew the broken tendon very well.

Nearly 40 minutes later, the tendons and blood vessels were all anastomosed.

In the blood test, in less than 30 seconds, a trace of ruddy appeared on the end of the severed finger.

Perfect.

Dr. Xu was very relieved to see this.

I smiled and went back to work.

Zhou Can continued to complete the follow-up nerve anastomosis and sutures for the patient.

After more than an hour of hard work, the finger replantation was finally successfully completed.

He also earned more points of surgical experience.

I also gained an orthopedic medical skill.

This feeling of steady improvement is exceptional.

The growth of a famous doctor is such a step by step, through countless surgeries, rescue, and diagnosis experience, continuous learning, accumulation.

The surgeries continued one after the other.

Tian Tian still chatted with Dr. Lu and Master Li from time to time.

She wanted to chat with Zhou Can, but unfortunately Zhou Can's serious work didn't take care of it at all.

After a few boring conversations, she shifted the target of the chat.

It was close to three o'clock in the afternoon, and a surgical patient with sutures for trauma came. He had a broken jaw and a crack, and he was very young, only nine and a half years old, and he was a boy.

There were still undried tears on his face.

Children at this age are in the naughty stage of going up to the house to remove the tiles and playing with mud on the ground.

It is not uncommon to play and fight, fall and get injured.

Considering that it is the face that is stitched, and it is a child, the requirements for suture are relatively high.

Dr. Xu handed over the patient to Zhou Can.

Dr. Luk's sutures were too sloppy, and if they left an unsightly scar on the child's chin, it could affect the child for the rest of his life.

Zhou Can learned from Dr. Xu about the seamless suture method very early.

In the past, I couldn't try it because of the low level of sutures.

Since the suture level has been raised to the main level, he has been looking for opportunities to try the seamless suturing method.

After practice, and many consultations with Dr. Koh, he has been able to do quite well.

After Zhou Can took the operation, he first checked the child's examination report.

There was no injury to the bones, just skin trauma.

Not bad.

The amount of bleeding is not large, indicating that the large arteries have not been injured.

This surgery can only be considered a very minor debridement surgery.

Tian Tian and Master Li were chatting happily.

I don't know why she's so happy today?

She said that she will be able to take the intermediate nurse exam this year, and she has great hopes.

In general, the promotion of a nurse is different from that of a physician. After graduation, you can take the junior nurse exam after working for one year, and after getting the junior nurse certificate, you can take the intermediate nurse exam after working for four years.

She said that she will be able to take the intermediate nurse exam next year, indicating that she has worked for at least five years.

No wonder Qiao Yu was bullied to death by her.

"Local anesthetic!"

Zhou Can had to remind her.

"Okay!"

Tian Tian agreed with a smile, quickly dispensed the anesthetic, and then handed it to Zhou Can, who was carefully examining the child's wound.

Because there was a lot of blood in the wound, some of which were clotted, there was no way to see the specific condition of the wound.

Only after anesthesia and cleaning and disinfection of the wound can the best suturing plan be formulated.

Zhou Can casually took the prepared anesthetic and injected it around the wound on the child's chin.

With his attending level injection technique, he is afraid that the local anesthetic is better than most of the attending doctors.

Not long after the fight, the amount of bleeding from the child's wound suddenly increased.

The child complained of a headache, chest discomfort, and shortness of breath.

This frightened Zhou Can.

Jin Mingxi had an accident last time, and he is still being punished.

"Teacher, this child behaved abnormally in many places after playing anesthesia. Could it be an anesthetic allergy? ”

Zhou Can encountered this situation for the first time and was a little panicked.

Hurry up and ask Dr. Xu over there for help.

"What is the dosage of medication?"

"About 20mg!"

Zhou Can injected the child with a superficial anesthetic, and the dosage was at least halved.

"What anesthetic is used?"

Doctor Xu looked at Tian Tian.

At this moment, Tian Tian behaved calmly. When something happens, the nurse generally doesn't have to take much responsibility, and the doctor stands in the way.

Unless it is found to be a nurse's negligence or error, it is the nurse who is responsible.

The biggest risk of instrument nurses is that when they participate in major surgery, they do not count the consumables, resulting in gauze, vascular clips and other things left in the patient's body.

With this kind of minor surgery, the probability of a nurse making a mistake is very small.

So Tian Tian showed that he had nothing to do with himself and was quite calm.

"Tetracaine! Dilute with normal saline in strict proportions. ”

She replied.

As he spoke, the child's condition took a turn for the worse.

There are risks associated with any surgery.

When danger occurs, sometimes doctors and nurses don't even have time to react.

The situation is extremely dangerous at this moment.

"It is almost impossible for tetracaine to cause a severe allergic reaction, and procaine only needs to be tested for allergies before use." Dr. Xu's brow furrowed into Sichuan characters.

Delegating authority to let Zhou Can operate independently is actually against the hospital's regulations.

But as long as he, as a teacher, is willing to take this risk, he can be justified in terms of procedure. At least there is no legal risk.

If nothing happens, nothing happens.

If the people don't raise it, the officials won't hold it accountable.

But now the child's condition is so dangerous that even the experienced Dr. Xu doesn't know what the problem is for a while.

Then there is no way to rescue accurately.

Time is of the essence.

For every second of delay, the risk of death for this surgical patient multiplies.

Fine sweat came out of Dr. Xu's forehead, and his eyes were extremely sharp, staring at the child tightly, observing some of his symptoms.

"Sudden increase in bleeding from the wound? This indicates that the patient's heart contractions are increased and blood pressure may be elevated. Check his blood pressure immediately. ”

After measurement, 190/110mmHg, the systolic blood pressure is frighteningly high.

Suddenly such a high systolic blood pressure indicates that the heart is contracting sharply and its ability to pump blood is far beyond normal levels.

"Teacher, did you think there was a problem with the anesthetic?"

Zhou Can had quickly calmed down from his panic.

The most important thing at the moment is not to think about being suspended or even sentenced after an accident.

It's about finding a way to find out the reason and rescue the child.

Zhou Can's diagnostic ability is extremely strong, and after testing his blood pressure, he thinks of the cause and effect. It is an abnormality that occurs after the anesthetic is injected.

That's definitely a problem with anesthetics.

"Show me the bottle of anesthetic."

Not only did Dr. Xu have the strength to speak, but he also realized that it might be a problem with anesthetics.

Tian Tian immediately squatted down to look for the bottle of anesthetic.

I saw that her face changed slightly.

Then take out a medicine bottle from inside.

"Well, this is the medicine bottle."

Her eyes were a little evasive, and her face was a little unusual.

Zhou Can has been dealing with her for so long, and knows that this woman is a scheming.

I don't believe her words.

Walk directly around the operating table and walk to the small trash can and crouch down.

There are already quite a few medicine bottles thrown in it.

Almost all of them are vials of local anesthetics.

One of the bottles was buried underneath the others, but it was still slightly different from the other narcotic vials.

Zhou Can felt that something was wrong and was about to turn it out.

Tian Tian said with a concerned face, "Doctor Zhou, those glass bottles are broken, be careful to prick your hands." ”

Zhou Can didn't speak, but used a bottle to pick open the bottle on top, and then turned out the medicine bottle that was pressed underneath.

At this moment, Tian Tian's face became a little pale.

But still pretending to be calm.

"Isoproterenol!"

Zhou Can saw the name of the medicine on the bottle, and suddenly realized in his heart, he couldn't wait to greet Tian Tian's ancestors for the eighteenth generation.

What is a femme fatale called?

Tian Tian is.

"I didn't use isoproterenol for today's surgery, where did this bottle come from?"

Zhou Can coldly questioned Tian Tian.

Dr. Xu has rich experience, and has seen all kinds of tricks, ghost tricks, cows, ghosts, snakes, and gods.

His gaze was also extremely cold, staring at Tian Tian.

"This, I don't know! Maybe it was left by the doctor who worked the night shift yesterday! ”

Tian Tian was still trying his best to quibble.

If Zhou Can hadn't seen that she was a woman, he really wanted to slap her to death.

It's all this time, and I'm still lying here.

She only fears that if she admits her mistake, she will be punished. But they ignore the danger of the patient, and ignore the fact that the patient may die at any time.

I can't imagine that there is such a vicious, stupid woman in the world.

That beautiful face is disgusting to look at at at the moment.

"Isoproterenol enhances myocardial contractility, increases heart rate, and dilates peripheral blood vessels and smooth muscle. Clinically, it is used to treat bronchial asthma, cardiac arrest and shock. It is a common rescue drug in the operating room. ”

Zhou Can gave her a cold face about the use of this drug.

In fact, there is no need to popularize science, she is also a professional, and she must know the purpose of this medicine.

Otherwise, when she squatted down in the trash just now to find the medicine bottle, she would not have deliberately buried the medicine bottle under the many bottles.

Dr. Koh almost understood the cause of the accident.

There are many things that cannot be said in front of the patient.

He hurriedly took Zhou Can and Tian Tian into the dressing room outside.

"Tian Tian, human life is at stake, are you treating this medicine as an anesthetic drug?"

Dr. Xu's face is so cloudy that it can drip water.

The eyes are also extremely terrifying.

"I, I don't know, it's possible."

It's all come to this point, and she's still hiding it.

This woman is so stupid and bad.

If a person who studies medicine has a problem with his morality, it will be a disaster for the patient and the hospital.

They are like a ticking time bomb that could explode at any moment.

"I'll ask you one last time, is it really?"

Dr. Koh rarely barks at female nurses like this.

At this moment, I was really angry.

This stupid woman, she didn't know how serious the consequences of this incident would be. It is likely that Dr. Xu and Zhou Canquan were harmed.

I have to take this child's life.

Of course, the child may not die, but how can the parents explain it?

Sew up a superficial wound, you made the child like this for me.

I'm afraid no parent will say yes.

Tian Tian couldn't be sure if he had taken the wrong medicine, so they could only draw blood for a test before determining the rescue plan.

By then, the daylilies will be cold.

"Yes! I made a mistake, I was chatting with Master Li and them just now, and Dr. Zhou suddenly urged me, and I was negligent, so I took it wrong. In the face of Dr. Xu's fierce eyes, she finally didn't dare to avoid the important anymore.

"You, let me tell you what's good?"

Emergency rescue medication and anesthetics are stored separately.

I really don't know where her mind drifted to make such a serious low-level mistake.

"Use 100 mg of α blockers to reduce the damage immediately!"

After identifying the cause of the child's danger, Dr. Xu immediately tried to save him.

α blockers have a specific effect on isoproterenol. Some patients are born with this blocker and will not respond to isoproterenol.

After a series of rescue measures, the child's condition finally improved.

Dr. Xu also breathed a long sigh of relief.

This matter must not be concealed, and it must be reported to the higher authorities in accordance with regulations.

"Xiao Zhou, you continue to stitch up his wounds, and I'll report."

Dr. Xu is only an attending patient, and this matter needs to be reported to Director Lou first, and then Director Lou will report to the relevant departments of the hospital.

Fortunately, there were no serious consequences, and it should be stabbed at the level of the medical department, and the fire will be extinguished.

Naturally, there will be an experienced doctor to explain the child's parents.

Sometimes, it is also a good thing that family members and patients do not understand medicine.

In an emergency like this child, as long as the explanation is reasonable and the child is fine, parents can generally accept it.

Of course, when explaining, you will definitely not be stupid to say that the drug is wrong.

Tian Tian was directly stopped from the operation.

Temporarily called Master Li over to Zhou Can as a nurse, while Dr. Lu stopped the independent operation.

……

The child's wound was well healed after the stitches.

After being rescued with the wrong medicine, it is no longer a major problem.

The end result is okay.

This is the only place to be thankful and rejoicing.

It's not over.

A special person came forward to explain and communicate with the family, and the family accepted the hospital's explanation. Came home with the child.

In the office of the emergency department, Director Lou's face sank like water, and Dr. Xu's face was also ugly.

Zhou Can was cautious.

Tian Tian lowered his head and fiddled with the corners of his clothes.

Soon, the nurse in charge of Tian Tian and the head nurse of the nurse station in the emergency department also walked in.

"Today's medical accident is very undeserved. Due to the negligence of the instrument nurse Tian Tian, he was paralyzed and careless, and almost caused irreparable serious consequences. Our emergency department operating room was supposed to be competing for excellence this month. Now that this incident has happened, let alone the evaluation, it will definitely attract criticism and punishment from the superiors. ”

Director Lou's temperament was originally a little anxious.

Something so big happened, he slapped the table angrily.

"Director Lou, you are discouraged. Tian Tian has such a serious mistake, it is really undeserved, and I will definitely strengthen her education. "Nurse in charge

It's still very protective of the nurses under him.

Doctors are actually pretty much the same.

Protecting cubs, many people have this kind of behavior.

Doctors and nurses have a high chance of making mistakes.

If there is no care from senior doctors and nurses, I am afraid that less than one in ten can survive.

Whether it is Director Lou, Director Tan of the Department of Internal Medicine, or Dr. Xu...... The bigwigs of these hospital departments have made mistakes. How many mistakes were made, no one remembers exactly.

Because there are too many.

It is also a good thing that interns and regular doctors are sometimes scolded.

Only when you are scolded can you remember it for a long time.

"This incident deserves the vigilance of every nurse in our country, and I will hold a nurse safety meeting as soon as possible. List this incident as a typical example, and educate all nurses to strictly abide by the relevant regulations and put safety first in the operation. ”

The head nurse was seated when she spoke.

From this, it can also be seen that her status is quite high.

Basically, you can be a head nurse, and you are at the level of a chief nurse. In terms of nursing profession and management, there is a high level.

Director Lou's face softened slightly.

"Niu Lan, what do you think of this Tian Tian?" Director Lou is giving face to the head nurse and a kind of respect for her.

"Deduct the bonus of the month, cancel the qualification for the annual evaluation, and write a deep reflection review. Do you think it's okay? ”

The name of the head nurse cow is really unique.

Ordinary parents would never come up with such a name. After all, it is homophonic with the bullpen, and it is easy to misunderstand it.

She speaks very steadily, not in a hurry, calmly, modestly but independently.

"Well, I think these punishments are enough for her to remember deeply."

Director Lou affirmed her decision.

When it comes to this matter, it is basically over, and it can be over.

The responsible person has been put in place, and Tian Tian is responsible for it.

"Nothing else, go get busy!" Director Lou said to everyone.

Zhou Can deeply felt the art of being a leader.

Not long ago, it was thunderous, and he slapped the table in anger. Now it is picked up high, gently put down, and the clouds and rain stop.

Maybe it's just a knock on the emergency department.

Don't poke out the basket next time.

"Please head nurse Niu stay, there is one thing I want to discuss with you in front of Director Lou and Dr. Xu."

Zhou Can has waited for so long, and the opportunity has finally come.

Originally, he thought that it might take two or three months before he had a chance to mention this matter after he had learned most of the first and second level surgeries.

I didn't expect Tian Tian to die by himself and cause such a big disaster.

really responded to that sentence, if the sky wants you to die, it will make you crazy.

Tian Tian may be very happy because he cleaned up Qiao Yu yesterday and established his status. In a good mood, I chatted with Master Li, Dr. Lu and others.

happened to talk about the fact that she could take the intermediate nurse exam this year, and she felt that the future was bright, and all aspects were extremely smooth.

Get carried away.

Eventually make a low-level mistake that can be easily overlooked.

Zhou Can is still a little worried that she will return to the operating room, and when the time comes, she will have to suffer a lot when she is an assistant again.

It's better to seize this opportunity and help Qiao Yu up.

Despite the suspicion of falling into the well, he didn't care.

(End of chapter)