When I arrived at the Department of Cardiothoracic Surgery, I thought about asking the doctors and nurses about which operating room I was in.

He found that all this was superfluous.

No need to ask.

Because there are constantly medical staff trotting in and out of the No. 3 operating room, one by one, with solemn expressions.

Outsiders may not be able to see anything, but insiders know at a glance that something must have happened.

It is only when the patient's life is in danger that the medical staff behaves so nervously.

All kinds of rescue materials were transported in to save people.

Doctors and nurses from multiple departments of the hospital will rush over to participate in the rescue work as soon as they receive a request for help.

Zhou Can followed the two nurses into the operating room.

There were simply not enough clothes in the operating room, and the nurses temporarily placed a large handful of disposable protective suits.

It can be used in an emergency, too.

Uneasy: This kind of protective clothing is not breathable and will be extremely stuffy when worn on the body. If you wear it for surgery, the doctor will definitely be very uncomfortable.

Now it is important to save people, after Zhou Can changed it, he walked quickly into the operating room in the room.

"Director Snow! Director Le! ”

Zhou Can found that many of them were familiar faces, he had spent three months in cardiothoracic surgery, and basically he knew all the formal doctors and nurses in this department.

Ordinary medical staff, he couldn't say hello one by one. I only greeted Director Xueyan and Director Le.

"You're finally here, help see if you can get the patient back!"

Director Xueyan saw that he had arrived, and she had a little hope.

"Okay! Let me first understand the basic situation of the patient. ”

Zhou Can agreed, and at the same time learned about the patient's accident through Director Xueyan's introduction.

The patient, a 41-year-old male, fell down the stairs at home and landed on his left limb first. At that time, after the fall, he got up on his own and did not feel too unwell.

When it was time for dinner, the patient felt tightness in his chest, palpitations, and labored to breathe, as if there was a large invisible hand covering his mouth and nose.

Later, the patient began to cough and coughed up blood.

At this time, the family realized that the situation was not good and took him to the local health center for treatment.

Because it was evening when I went, the doctor on duty asked the patient to be hospitalized first after a simple diagnosis, and was ready to give the patient a chest X-ray after work tomorrow.

The patient was worried about spending money, and felt that it was no big deal, so he refused to be hospitalized, so he insisted on going home.

After returning home, there were no other symptoms except cough and chest tightness.

In the end, I stayed up like this, hoping that my body would get better soon.

This delay was 27 days, and the patient's condition did not improve, but the chest tightness became worse. In severe cases, it is breathless and accompanied by chest pain.

Yesterday, the patient suddenly fainted at home, and the family was taken to the hospital for fear of an accident.

The local health center did not dare to admit the patient and recommended that it be sent to a major hospital for diagnosis and treatment.

After several twists and turns, the family finally brought the patient to Tuya Hospital.

After receiving the emergency treatment, he felt that he could not handle it, so he transferred the patient to the cardiothoracic surgery department for further examination and diagnosis.

Director Hu Kan was reported by the doctor below that the patient's condition was very bad. A chest x-ray was done. Indicates a right-sided fluid pneumothorax with more than 80% compression of the right lung.

Later, a thoracentesis was performed on the patient, and a small amount of non-clotting blood was withdrawn.

The final initial diagnosis was hemopneumothorax.

Because of the urgency of the situation, Director Hu Kan decided to perform thoracotomy on the patient.

Based on his experience, it must have been inferred that the patient had suffered an internal injury. This type of hemopneumothorax is very tricky, especially when the patient has been delayed for so long.

Usually, it is easier to find bleeding spots and injured areas by examination at the time of a fall.

After nearly a month of delay, many of the original lesions disappeared or turned into hidden lesions, which will definitely greatly increase the difficulty of diagnosis and treatment.

Thoracotomy is performed under general anesthesia.

Twenty minutes before anesthesia, Dr. Guan injected the patient with scopolamine, which was injected intramuscularly.

The use of this drug can effectively slow down the patient's intestinal peristalsis and reduce the secretion of mucus in the respiratory tract.

As soon as the patient was connected to the life monitoring device, and before he had time to perform the general anesthesia operation, the patient suddenly began to have symptoms such as irritability, clammy limbs, and cyanosis of the lips.

In the face of such an emergency, Director Hu Kan was not alarmed, and immediately administered local anesthesia to the patient, and then performed thoracostomy drainage from the midaxillary line of the sixth intercostal space on the right side.

In the end, nearly 1000ml of blood was drained out of the drainage bottle.

Director Hu Kan then administered intramuscular injection of 12ml of 2.5% sodium thiopental and 100mg of succinylcholine to the patient.

Immediately afterward, an endotracheal tube is inserted into the patient.

After about two minutes, the patient regained spontaneous breathing.

After discussing with the anesthesiologist and physician, Director Hu Kan administered intravenous fentanyl to the patient and let the patient inhale anflurane.

But the situation is not getting any better.

After a while, it was found that there were no blisters boiling in the drainage bottle, and the water column of the glass tube did not fluctuate.

Director Hu Kan squeezed the drainage tube with his hands, but there were still no blisters overflowing.

At this moment, the patient's heart stops beating.

Director Hu Kan decisively ordered the patient to be rescued by cardiac compression.

Thoracotomy is probed between the ribs, and when the pleura is incised, air bubbles and blood gush outward from the incision.

Seeing this situation, Director Hu Kan said in a sad voice, "Heart compressions continue, intravenous and intracardiac injections ......" Before he finished speaking, he fainted directly to the ground.

Director Hu Kan is known as the most stable scalpel and has never missed it before.

Only the last time I ventured to operate on that thymoma patient, I almost had an accident. At that time, Director Hu directly had a heart attack. It was Zhou Can who carried him around to find a way to rescue him, which saved him back.

It is precisely because of this relationship that Director Hu Kan still has a very close relationship with Zhou Can.

Unexpectedly, less than a year has passed, and Director Hu Kan has an accident again.

And this accident is a bit unjust.

The person with the greatest responsibility should be the anesthesiologist and the official physician, and Director Hu Kan just happened to be involved in this matter. He would pass out in the operating room, knowing that it would be difficult for the patient to be resuscitated.

He worked hard to retain the title of the most stable scalpel for the rest of his life, and it was ruined.

The stimulation was too great, and then I passed out.

After Director Hu Kan fainted, he was rushed to the hospital without mentioning it. Director Xue Yan took over the position of director Hu Kan's chief surgeon, and continued to rescue the patient together with Dr. Guan.

Under her command, the patient was given intravenous and intracardiac injections of epinephrine and lidocaine.

With the help of these drugs, which make the heart beat hard, the patient gets back to beating again.

Unfortunately, it lasted less than a minute, and the patient's heartbeat stopped again.

Since then, they have been working to continue to resuscitate the patient.

After Zhou Can quickly understood what happened, he had a general understanding of the patient's cause and condition.

When I reached out, the patient's pulse was gone, the body was cold, and the skin was sticky.

There is no body temperature that a normal person should have.

"What could have gone wrong?"

Zhou Can forced himself to calm down, the patient is currently not spontaneous heartbeat and breathing, and relies on manual cardiopulmonary resuscitation to maintain the most basic blood oxygen exchange. At this time, every second counts.

Most of the patient's body has entered the ghost gate.

A number of chief physicians and deputy chief physicians of the Department of Cardiothoracic Surgery participated in the rescue at the scene. He also invited Liu Xiangqing, director of the intensive care medicine department.

However, in the face of the fact that the patients almost died, they were helpless one by one.

At this moment, Zhou Can's first-aid intelligent medical skills have played a huge role.

His mind is extraordinarily calm, and his thoughts on diagnosis and treatment have become stronger and clearer than ever.

"Amputate the patient's three ribs and enlarge the chest cavity! The problem is likely to be that there is a blood clot in the chest cavity itself, and the closed chest drain is very likely to be blocked by the blood clot. ”

Zhou Can spoke out loud about his diagnosis.

After going through it twice in his head, he thought there was only one possibility.

If the patient has a major heart problem, he would have died when he fell and would not have survived at all.

Since a large amount of blood is drawn from the patient's chest, although it is uncoagulated, it does not mean that no blood clots have developed.

After intramuscular injection of scopolamine, the patient experienced irritability, cyanosis of the lips, etc., which is likely to be related to the blood clot seriously affecting the lungs. Because the patient's right lung was already compressed by nearly 80%.

After straightening out the ideas, Zhou Can was more sure of his guess.

[Pathological diagnosis experience value +1, first aid life intelligence experience value +1.]

[You can clear your mind as quickly as possible in the rescue, find out the cause, and reach a new level of application of medical knowledge and clinical experience. Reward Pathology Diagnosis XP +100, Reward First Aid Wisdom XP +100. 】

After Zhou Can was rewarded with experience points, he was even more sure that his diagnosis was correct.

The rescuers did not listen to him, but looked at Director Xueyan, who was in charge of the command at the scene.

"Immediately do as Dr. Zhou Can said, and enlarge the opening of the chest cavity."

Director Xueyan did not hesitate, this is the absolute trust in Zhou Can.

The patient's condition at this time also does not allow for any indecision.

Death has loomed over the patient.

The situation is dangerous, and these chief doctors are rare in their lives.

At present, the rescue of patients is actually more of a rescue obligation of medical staff, and the symbolic meaning is greater than the actual rescue significance.

At this critical moment, Zhou Can put forward a rescue idea that everyone did not expect, perhaps thought of but did not dare to implement, which can be regarded as a dead horse as a live horse doctor. Fight for the last handful.

The patient's chest cavity is enlarged, which means that cardiac compressions need to be interrupted for a few moments.

This is also the reason why the doctors involved, including Director Liu of the Intensive Care Medicine Department, did not dare to obey Zhou Can's command.

Director Liu of the Department of Intensive Care Medicine has a deep understanding of Zhou Can's skills, and he has also taken Zhou Can for nearly three months. The personal relationship between the two is also excellent.

But when it comes to rescuing patients, personal relationships are nothing at all, and everything is about the patient's life.

Director Xueyan trusted Zhou Can so much and decisively followed Zhou Can's advice to further open his mind, which surprised Director Liu.

In fact, the conditions do not allow it, and the time is too urgent.

Otherwise, according to Zhou Can's idea, it is best to sawn the sternum from the middle and then expand it.

This is the most common frontal thoracotomy.

It's just that the patient has no heartbeat and no breathing, and if you really do this, the daylily will be cold.

"I'm coming!"

Zhou Can found that the surgical speed of these doctors in the cardiothoracic surgery inherited the stability of Director Hu Kan, and the so-called slow work made meticulous work. They're just too slow.

In desperation, Zhou Can could only get started in person.

Many doctors in cardiothoracic surgery know about his surgical ability.

No one objected.

After he came for the operation, the speed immediately changed from walking to flying an airplane.

Brush Brush Brush!

The operation was as fierce as a tiger, and Zhou Can's doctors and nurses were dumbfounded.

Watching Dr. Chow do the surgery was really scary.

Many people secretly say in their hearts, even if the patient's heart has stopped, it can't be treated like a wild animal, right?

After the death of a patient, whenever the family asks questions, there will definitely be forensic intervention.

When the time comes for the forensic autopsy, if you see that the surgical wound is caused by rough operation, there will definitely be a bad evaluation.

It was only when Zhou Can really completed the expansion of the chest window that everyone found that although his operation speed was fast, the surgical incision was not rough. Even more neat than the wounds carefully cut by cardiothoracic surgeons.

"A straw drains the blood in the chest."

There is still some blood in it.

Immediately after it was removed, a blood clot was found, and there was more than one.

It is clear that the intrathoracic drain has been blocked by a blood clot.

This is an important reason why the patient's breathing and heartbeat all stop. It is also the culprit who caused Director Hu Kan's rescue measures to stop beating again as soon as they took effect, and they only lasted less than a minute.

"The patient appears to have a severe tumor in his right upper lung, and there has been ruptured hemorrhage."

Zhou Can said.

"It should be the luminal breathing after anesthesia intubation that causes the lobes to swell, the blood clot moves and blocks the drain, and eventually tension hemopneumothorax causes cardiac arrest."

opened his chest to find out the root of the problem, and no one thought that Zhou Can was messing around.

On the contrary, they admired Zhou Can's diagnostic ability and rescue ideas from the bottom of their hearts.

Under such circumstances, it takes a great deal of courage and determination to resolutely insist on further open-mindedness. It is necessary to have an in-depth and comprehensive understanding of the patient's etiology and condition before daring to make such a decision.

"Perform pericardial compressions immediately! Blood transfusion rescue. ”

Zhou Can gave the order again.

In this kind of emergency rescue moment, every second is extraordinarily precious, and he really can't ask Director Xueyan first, and then give orders through her mouth.

If you do that, the face project will be done enough, but it will be too delayed.

It is also extremely detrimental to rescue.

Medically, cardiac arrest has a saying that it is a golden three minutes to be saved.

At this moment, it has actually been more than three minutes.

Zhou Can quickly cleaned the blood clot in the drainage tube.

"After surgical thoracostomy drainage, it is more secure to use double-lumen endobronchial intubation."

The patient's accident was both accidental and inevitable.

Dr. Hu Kan may have considered the urgency of the situation at that time and only used a single-lumen tube to intubate.

Eventually, the blood clot blocked the single-lumen tube, causing the patient's breathing and heartbeat to stop again, making the first rescue fail.

Another thing that really caused the patient to die was the rupture of a lung tumor causing massive bleeding.

The bleeding can still be seen continuing.

As soon as the pleural effusion was removed, a lot more was soon produced.

Zhou Can's all-round advantage is completely evident at this moment.

He quickly determined the location of the patient's pulmonary bleeding, and then implemented a combination of clamping, ligation, and electrocoagulation to successfully stop the bleeding.

Originally, if possible, the patient's lung tumor should have been removed. It may even be necessary to remove the entire right lung.

Who would dare to do that now?

I didn't dare to do this if I borrowed his three fat guts.

Otherwise, you'll only get yourself in trouble.

And it could be a big problem.

After a series of effective rescue measures, the patient's heartbeat was restored again, and after a large amount of blood transfusion, the blood pressure slowly rose.

Because the bleeding stopped, the blood transfused no longer had to worry about running away, and the rescue effect was almost immediate.

"It's so dangerous, it's almost a human life!"

Doctor Guan is usually a very calm person, but when the accident happened just now, his face was extremely pale, and he didn't say a word.

It is estimated that he was also scared half to death.

"The patient's life was saved by us. However, he has a tumor in his right lung, and the possibility of being malignant is high. How to solve this? ”

Zhou Can asked Director Xue and the others for their opinions.

In the operating room, the atmosphere is not as tense as the patient's vital signs gradually stabilized.

Zhou Can, a small standard pearson, has become the core existence of the operating room without dispute.

In the operating room, it is like this, whoever can save the patient's life, who has strong surgical ability, and who has good diagnostic ideas, is the boss.

Even if you are just an intern, you will be the main surgeon, and other senior doctors will naturally be put to a considerable height.

"What do you mean?"

Director Xueyan asked him.

When she looked at Zhou Can, her eyes flashed with a special light. This younger brother is really powerful, and when he arrived, he was stunned to turn the tide and save the patient from death.

Just now, her heart was already desperate.

I thought that the patient would definitely not be saved.

Unexpectedly, a medical miracle happened, and after Zhou Can boldly proposed to expand the chest wound, he was able to successfully find out the cause and successfully save the patient.

(End of chapter)