Of the five patients he managed, three were pending surgery and two were in the postoperative recovery period, which was generally quite easy.

It was rare to be so relaxed, and with a learning and responsible attitude, he began to review the patient's examination report bed by bed to understand the patient's current symptoms. Now he has a wealth of experience in how to communicate with family members or patients.

After all, it's been so long.

When chatting, you can easily open the topic and gain their favor and trust by starting with the concerns of patients or family members.

The 16-bed patient underwent a thoracic catheter ligation two days ago and is now stable and recovering well. There were no complications after the operation.

The 17-bed patient had a cardiac aneurysm.

Judging from the examination report, the diameter of the aneurysm is quite large. There are various surgical options for the treatment of aneurysms, such as aneurysm embolization, stenting, vascular replacement, and clipping.

If it is a ascending aneurysm of the heart, a stent cannot be placed.

The treatment plan set by Director Xue for this patient was to surgically clip the aneurysm, which should be the site of the lesion that was not suitable for interventional surgery.

"I'm afraid the clipping of the aortic aneurysm is not so easy to operate!"

After reading the examination report, Zhou Can thought that the difficulty of this operation was quite high.

He had not had a clipping of a cardiac aneurysm, but he did have clipping of an intracranial aneurysm.

And I have done many units.

For the technical difficulties of clipping hemangioma, he has rich experience in surgery.

Director Xue is the chief physician, who dares to set the operation, and must have made a comprehensive assessment of the risk and difficulty of the operation. It shows that she is sure.

There is no need for Zhou Can to worry about this.

The most powerful surgeon in cardiothoracic surgery should be the 'most stable scalpel' - Director Hu Kan.

Zhou Can is especially looking forward to seeing Director Hu Kan's surgical demeanor.

"Xiao Zhou, the department urgently arranged surgery for 19 beds, and sent the patient to the operating room at 9:50! You follow up! ”

This related household just moved in and had surgery?

It's just a simple pectoral suture, but it's not like that, is it?

Even in the emergency department, it is very prudent to perform general anesthesia surgery on a patient.

"Didn't he just move in? How do I fast 12 hours before surgery? ”

Zhou Can asked.

General anesthesia surgery in adults often requires fasting for 12 hours and abstaining from drinking for 4 hours before surgery. Otherwise, after the implementation of general anesthesia, in case the patient's stomach contents reflux and inhale into the respiratory tract, it is not a joke.

"The attending doctor has asked and the patient has not eaten since 5 pm last night."

Dr. Zhao explained impatiently.

"That's fine!"

Zhou Can began to follow up on the operation of 19 patients.

It is necessary to do preoperative understanding, as well as necessary examinations. Help patients prepare for surgery and prepare for surgery in the best possible condition.

At 9.50, I had to go to the operating room, and the time was quite short.

Zhou Can can only do this first.

Walking directly to the 19th bed, three family members gathered around the bed, waiting for the man on the bed before and after the saddle.

It can be seen that this man must have been spoiled by his parents since he was a child.

The average adult man, even if he is injured and in severe pain, can't scream like a girl.

At this moment, the man took painkillers and lay on the bed with his eyes closed.

His beautiful wife took a small plastic stool and sat at the head of the bed. Constantly playing with the phone.

Zhou Can glanced at it and fainted.

She was actually in Baidu, asking what to do if her chest muscle was injured?

What I am most afraid of is this kind of patient who popularizes science on the Internet on his own. They like to use the popular science knowledge on the Internet to identify whether the doctor's operation is correct and whether there is anything tricky.

"Hello, please show me the patient's examination report!"

The inspection report was in her hand, and Zhou Can could only ask her for it.

The woman looked up at him and asked reluctantly.

"Is it necessary?"

Zhou Can had been making rounds in front of the hospital bed, and they must have noticed him a long time ago.

The family of the average patient will have a lot of respect for the doctor.

But this family of four is not an ordinary person.

They felt that they knew the chief physician of cardiothoracic surgery, and they were a little powerful, so they didn't take a 'miscellaneous' doctor like Zhou Can seriously.

"The patient had surgery at 9.50 and had to prepare for the operation immediately! We need your cooperation. ”

Zhou Can said to her seriously.

"How can I have surgery on my husband? Who is the surgeon? Even if it's a preoperative conversation, shouldn't the surgeon come and talk to us personally? We know each other very well! ”

After she asked a series of questions, she even moved out of her relationship with Director Xue.

The doctors and nurses have a lot of headaches when they encounter such patients.

Because it's not easy to deal with.

He thinks he is familiar with the processes and routines of the hospital, and shows his IQ and superiority everywhere.

Of course, their original intention was to obtain better medical resources.

"When the surgical plan comes, the surgeon will talk to you, and I am the doctor in charge of the bed, responsible for following up the operation and helping the patient to make the necessary preparations before the operation." Zhou Can was a little brain-sore by this woman's question.

The patient's parents stood by and remained silent, leaving their daughter-in-law to do her bidding.

It is estimated that this woman also wants to show her knowledge and ability in front of her parents-in-law.

That's why it's so difficult.

"Okay, okay, you know that you don't know anything as a bed-doctor doctor! When your chief knife comes, I'll ask him for more information. The woman reluctantly gave the inspection report to Zhou Can.

In his eyes and tone, his contempt for Zhou Can was really undisguised.

Zhou Can made a conclusion to this woman, being beautiful does not necessarily have quality.

It could be a good-looking skin.

I reviewed the inspection report carefully. At the very least, it is necessary to see if the patient has done the necessary tests such as a complete blood count before the operation.

There is also whether the patient has infectious diseases, inflammation, etc.

It seems simple to follow up on an operation, but there are actually many things to do.

If there is a major omission, he will be scolded by the senior doctor and scolded by the chief surgeon.

When he first started his internship, he was scolded many times.

That's how almost every doctor grows up.

The patient's condition is okay and there are no contraindications to surgery.

"You don't have any symptoms like a cold or fever now, do you?" Zhou Can began to ask the patient some basic information.

Some patients may be annoyed, but these must be asked.

Before surgery, patients should avoid respiratory illnesses such as colds and inflammation.

"No, no!"

She replied very crisply.

"Do you have a cough?"

"There must be a normal cough, and there must be no cold cough you said."

"Do you have underlying medical conditions such as high blood pressure and diabetes?"

"My husband is so young, do you think there may be a disease that only these old people get? Why don't you wait for the surgeon to come? My husband needs a good rest now. ”

She was annoyed by Zhou Can's question.

"Don't eat or drink before surgery! If you need to go to the toilet, you can go to the toilet in advance! ”

Zhou Can didn't bother to ask any more.

If the family members do not cooperate, there is a high probability that they will be scolded if they continue to ask.

If something really happens, it must be the patient himself who suffers.

Doctors sometimes don't really care that much.

"I know all this common sense."

The woman was already visibly impatient.

"Don't make a noise here, okay? Let me sleep for a while. "The patient's mood is also not very good.

The patient's parents saw that their son's rest was affected, and their faces became unsightly.

Zhou Can didn't say anything more, and went directly to other beds to do his own thing.

Not long after, the surgeon came.

is a thirty-five or sixteen-year-old short man, about the same age as Jin Mingxi.

Chest muscle suture is also a second-level operation, and it is difficult to say whether this male doctor is a resident or a attending doctor.

"I am Duan Shangqing, the attending physician of the Department of Cardiothoracic Surgery, and I am also his chief surgeon. How's it going, it's not that painful with painkillers, is it? Dr. Duan walked straight to bed 19 and gently inquired about the patient's condition.

There was concern in the tone.

When the patient's beautiful wife heard that it was the chief surgeon who came, she immediately stood up and greeted her with a smile on her face, "Thank you Dr. Duan for the painkillers prescribed, my husband is much better." Do I have to have surgery? ”

The patient's parents were also smiling and polite to Dr. Duan.

"If you look at his film, there's a clear laceration here. Theoretically, without surgery, there is a possibility of self-healing, but it may cause symptoms such as difficulty in moving his left arm in the future, chest tightness and chest pain. If you don't pay attention, the tear will expand again, and it may even affect the esophagus, heart and lungs and other functions. In addition, we cannot see the internal bleeding, and it is most beneficial for the patient to repair the wound, stop the bleeding, and suture in time. ”

"It's just a simple suture operation that sits between primary and secondary and has a very low risk. Unlike thoracotomy, which is risky. ”

Dr. Tuan worked hard to reassure the family and put them at ease.

"After the operation, my husband's hands and esophagus will no longer be affected, right?"

She was still somewhat worried.

"As long as the operation is successful and he recovers ideally, he can fully return to his preoperative state."

After listening to Dr. Duan's reply, the woman glanced at her in-laws and exchanged glances.

"Okay, then we'll do the surgery, and please bother more."

The patient's father took out a red envelope from his pocket and quietly stuffed it to Dr. Duan.

"Doctor Duan, I'm such a son, I must ask you to bother more. With a little care, you should be treated to a cup of tea. ”

He stuffed the red envelope like this, which frightened Dr. Duan.

The hospital has repeatedly ordered that it is not allowed to eat kickbacks, and it is not allowed to accept gifts and red envelopes.

In front of so many people, if he accepted this red envelope, he might not have to wait until tomorrow, and the medical department would invite him to talk.

"Don't do this, don't do this, I will definitely do a good job of operating on him. If you stuff red envelopes again, it will hurt me. ”

Dr. Duan is small, and he is really a little unstoppable.

After hearing this, the patient's father took back the red envelope in a mocking manner.

"You're such a good doctor. Another day, when my son recovers and is discharged from the hospital, please eat, and please enjoy the light! ”

"Let's talk about it then! If you have no other questions, please sign the Surgery Information Form and pay the treatment fee in advance. ”

After the family members had signed, Dr. Duan looked at the patient.

"Didn't you notify the doctor in charge of the bed to follow up on the operation? Why hasn't anything been prepared yet? ”

Dr. Duan was visibly displeased.

"I just followed up on the surgery and helped the patient prepare for the surgery. The family said that they would wait for the main knife to come. ”

Zhou Can won't suffer this dumb loss.

Doctors and nurses help patients prepare for surgery, and if the patient does not cooperate, there is really no way to do it.

Healing is the patient's own business.

The emperor is not in a hurry, and it is useless for the eunuch to be in a hurry.

"Hmm...... I just asked this young doctor, but I didn't know anything. I'm sure I'll wait until you get there! After the woman finished speaking, she raised her beautiful melon seed face and looked at Zhou Can arrogantly. You see, after Dr. Duan came, the conversation ended quickly. Like you, asking questions is useless. I think you have to study harder, it's not professional at all. ”

Instead, she taught Zhou Can a lesson.

Zhou Can's face was blackened by her.

Arguing with family members is a stupid act, and Zhou Can did not argue with her.

It's about doing what needs to be done.

It is really tiring to do preoperative preparation for such a patient.

The nurse came over with a plate to disinfect the patient before the operation and clean the skin. The knife position is drawn by the main knife.

Stumbling, the patient was finally sent to the operating room.

Dr. Duan, the chief surgeon, Dr. Zhao, the resident doctor, and a surgical nurse, anesthesiologist, are all ready in place.

Considering the cost, the medical equipment for primary and secondary surgeries is often not too much.

"Xiao Zhou, the family members reported to me that you are very unprofessional. In the future, you should pay attention and study more. Dr. Zhao reprimanded him.

"Okay!"

Zhou Can is so depressed, don't mention it.

This kind of grievance can only be considered unlucky, and cannot be too concerned with the family.

The operation began soon and the patient was under general anesthesia with stable vital signs.

I saw Dr. Duan holding a scalpel and carefully making a longitudinal incision from the middle of the sternum. Then cut the skin, subcutaneous tissue, muscles.

In addition to the longitudinal incision from the middle of the sternum, the incision can also be made from the level of the fourth rib between the breasts and the inframammary fold. It mainly depends on the part that needs to be sutured, as well as the gender, etc.

If you are a female patient, you need to pay attention to the perfection of the incision and try not to damage their body shape.

When doctors operate on female patients, they take into account their post-operative lives.

For example, after giving birth to a child, if there is a tear underneath, the doctor will deliberately stitch a little more when he stitches it up. In order to ensure the harmony of the married life of the mother in the future.

The same is true for the protection of women's bodies.

"Stop the bleeding!"

Dr. Duan was reminding Dr. Zhao of this.

I saw that Dr. Zhao gave the patient electrocoagulation to stop the bleeding, and the operation was okay. The level of hemostasis should be at the level of excellent residency.

Whether it is Dr. Duan, the attending doctor, or Dr. Zhao, the resident doctor, the surgical ability of both of them is in line with their professional titles.

It seems that although the doctors in cardiothoracic surgery are arrogant, they are quite strong overall.

It does have the capital of pride.

After Dr. Zhao had stopped the bleeding, Dr. Duan proceeded with the operation.

Begin to free the flap and pectoral flap.

Zhou Can looked very seriously, and this was a good learning opportunity.

He saw Dr. Duan's scalpel, a little bit of free pectoral flap from the sternum to the outside.

Whether it is his scalpel wandering away, or Dr. Zhao's hemostasis, it is quite steady.

The incision shown by Dr. Duan is okay, and the level of the attending is inferior. However, his free level was much worse, because it required a powerful separation technique to support it.

Optimistically, Dr. Duan's dissociation barely reached the excellent level of a resident doctor if he survived.

Dissociation is very difficult to practice.

Even Zhou Can has only reached the level of the attending doctor at present.

At the time of separation, Dr. Duan may have made his hand a little heavier, and small blood arrows spurted out.

Zhou Can looked closely, and it turned out that a thicker arterial vessel was broken during the separation process.

Dr. Zhao immediately cooperated with tacit electrocoagulation to stop the bleeding.

Zizizizi!

The electrocoagulation knife burns the blood vessels and surrounding tissues.

The level of hemostasis is not at the level of the indication, which is basically what it is. The hemostatic operation is as fierce as a tiger and appears rough.

Only when the main level is reached, can we achieve both precision and dexterity.

Dr. Zhao's hemostasis at the moment is more like a drastic move. If Zhou Can is allowed to stop the bleeding, it will be a dragonfly dotting water, a butterfly wearing flowers, and dexterity and precision are taken into account.

Any medical skill that reaches the level of treatment above the level of treatment already has a very high level.

Further up, if you want to reach the director level, it will be a qualitative leap forward.

For example, Zhou Can is now suturing and ligating, and now all of them are at the level of deputy director, which is really different from the level of the main director.

Zhou Can looked at Dr. Zhao's ferocious hemostatic operation, and stopped talking.

If the electrocoagulation stops bleeding for too long and too violently, it will seriously damage the surrounding tissues.

Doctor Duan didn't speak, he really didn't have a lot of mouths.

The status itself is low, and it is a new entry into this department, and it is almost crazy to accuse the senior doctor of being a junior doctor.

Electrocoagulation continued to stop the bleeding, and eventually, the bleeding finally stopped.

Zhou Can subconsciously fixed his eyes and carefully checked the situation of the bleeding point. I saw that the tissue in that part had changed color slightly.

Maybe it was because Zhou Can's hemostasis had reached the middle level of the main treatment, and he had a very bad feeling in his heart.

Dr. Duan proceeded with the operation.

"Here, here! Finally found the tear site! The hole was torn quite widely. ”

Dr. Duan was delighted to have successfully found the torn muscle layer.

Don't look at Zhou Can, he is helping Director Wen with third- and fourth-level major surgery outside the god at every turn. In fact, for many attending doctors, it is quite a matter of pride to preside over a second-level surgery alone.

"The absorbable line, it should be thicker, the tension here is relatively large."

The invention of absorbable threads is a boon for surgical patients.

Today, the technology is very mature.

And it's not that expensive.

In the past, when internal sutures were not invented, subcutaneous tissues needed to be sutured, and ordinary sutures could only be used.

When the wound on the inside is almost long, cut the outer epidermal incision again and remove the thread on the inside. Then sew the skin.

One can imagine how sinful the patient is.

This procedure is also particularly susceptible to scarring.

After the torn pectoral muscle was sutured, Dr. Duan handed over the rest of the stitching work to Dr. Zhao.

Zhou Can's gaze was once again staring at the electrocoagulation site that had changed color slightly.

To see better, he leaned closer.

"That's right, it's a serious injury. If not, it will definitely die. ”

After he confirmed it again, he already had a judgment in his heart.

Dr. Duan's failure to detect this problem indicates that he is either not adequate, or he is insensitive.

Most likely, the level is not enough.

Otherwise, Dr. Zhao should have spoken out to stop it when he was electrocoagulation.

(End of chapter)