In hospitals, medical staff must have two major advantages: geographical advantage and people.

If you want to persuade patients to leave, there are many ways.

And everyone is the same interest group, and they don't even need anyone to mention it. When you encounter this situation, you basically know what to do.

"You can't go wrong by listening to the doctor. The reputation of Tuya Hospital is so great, and the medical ethics must not be bad. Let's hurry up and send Xie Chao to the Provincial People's Hospital. ”

"I also think that people should be sent to the Provincial People's Hospital, after all, it is a large public hospital, and it is more secure in all aspects."

"Take advantage of the fact that the ambulance you asked has not left, and contact us quickly."

The family members said a word to me, and the matter was quickly settled.

The patient was pulled away by the doctor and nurse in the ambulance.

Renting an ambulance to transport patients is usually only possible by renting a private ambulance, also known as an out-of-hospital ambulance. The hospital's own ambulance generally does not take this kind of work.

At this time, the ambulance driver will contact and hire a doctor and a nurse to follow the car.

The fare is usually included in the fare, but the family members need to seal an additional red envelope for the doctors and nurses.

If the family members are ignorant and the red envelopes are not in place, the doctors and nurses who follow the car will be passive and slack off.

Seeing the patient being pulled away, Zhou Can and Director Lou were secretly relieved.

There are always a few patients who need to be persuaded to leave in a day.

Clearly refusing to treat patients, few major hospitals do this. They all use some soft methods to persuade patients to leave.

"Xiao Zhou, how low was the survival rate of that patient just now?"

Director Lou asked in an indifferent tone.

"Without a miracle, there is no certainty of death."

Zhou Can answered categorically.

"So sure?"

Director Lou's level is not low, but in terms of diagnosis, he is no longer as good as Zhou Can.

"It's a very conservative statement. I'm sure that even if the urine excreted by the patient is still only a dark yellow color, it will turn soy sauce color in two days at most. He had developed acute renal failure. The upper lobe of the right lung was resected, and respiratory failure was also induced. Don't look at this patient is not particularly serious now, but there is no way to save it. ”

If it had been placed in the past, Zhou Can would definitely not have dared to give a diagnosis so surely.

Even if you are facing your own people, you are not so sure.

Now, his pathological diagnosis has been promoted to the level of director, and in order to treat Su Qianqian's kidney disease in the past, he has worked hard to learn the diagnosis and treatment of kidney disease. I even studied urology.

So now he can diagnose such patients, and he can basically get nine out of ten.

"Cutting the upper lobe of the right lung, why did it still damage the patient's kidney? This third hospital is really thundering now! "Director Lou has also heard about some things in the Third Hospital.

It's mostly negative news.

Especially in recent times, there has been a problem with the funding chain of the Third Hospital, and there is no spare money to deal with negative news.

As a result, all kinds of shady scenes are constantly posted on the Internet by victims.

It's almost the end of the road, and the wall is down and everyone pushes it.

"It should not be directly related to the resection of the upper lobe of the right lung, which I suspect is most likely due to anesthesia. In the past, I thought that the Third Hospital must be very strong because it invited a Japanese extracardiologist. Now it seems that the strength of a hospital is simply not something that one or two doctors can hold. The third hospital lacks a foundation and has many shortcomings. This medical malpractice is likely to be the fault of anesthesia. It's time to see what the family will do. ”

Zhou Can's eyes flashed.

I used to really look up to the Third Hospital.

After the death of this patient, it is difficult to say whether the family will make trouble.

Some family members are more honest and feel that the doctor has done his best to die after the operation. Often, they don't bother with hospitals.

It is not easy for family members to get into trouble with the hospital.

For individuals, hospitals are behemoths.

Both the family and the patient are relatively vulnerable.

"The problem with anesthesia? Analyze it and listen to it. ”

Director Lou is not experienced, and his level is not low, but he is very weak in the face of some incurable diseases. This is determined by talent, specialization, and diagnostic thinking.

Whether he admits it or not, although Zhou Can is very young, because of the teaching of famous teachers in many departments, coupled with his excellent talent, he has accumulated more than Director Lou in his ability to diagnose a variety of difficult cases.

"I think the patient had intrathoracic surgery, usually in the lateral decubitus position. This can lead to a crush injury to the patient's limb on the side of the operating table due to gravity. The patient's left shoulder, arm, hip, and thigh all had obvious soft tissue crush, swelling and blackness, which was probably due to the operation of general anesthesia, and the lower branch pad was too hard, resulting in severe squeezing of the left limb and avascular necrosis and fragmentation of the muscles. ”

"Capillary rupture, blockage, permeability changes. At the end of the operation, the patient was switched back to the supine position and the pressure on the lateral limb was relieved. At this time, local bleeding occurs, and a large amount of plasma fluid rapidly extravases into the interstitial space, which causes muscle swelling. Because it is not treated in time, the increased intermuscular pressure further aggravates the local blood obstruction and ischemia, and eventually leads to swelling, hardness, and coldness of the left crush site. ”

Zhou Can carefully analyzed the entire injury process of the patient.

Intraoperative bruises are easily overlooked by doctors.

This actually requires a high degree of vigilance.

"When I examined the patient just now, I pressed on his left swollen area, and it was hard and erect, like a stone, and his limbs were cold. This indicates that the limb muscles have undergone necrosis, and the best treatment period has long been missed. ”

When examining the patient, it seemed that he just pressed it at random, but Zhou Can directly judged the patient's state with his rich diagnosis and treatment experience.

"Yes, very well analyzed. You think kidney failure is related to lateral limb crushes, right? ”

After listening to this, Director Lou nodded in agreement.

The young doctors next to them quietly took notes and recorded Zhou Can's analysis. for later learning and learning.

"Because the left muscle is necrotic, swollen and stiff, this can cause a large amount of local oozing or bleeding, which eventually leads to a decrease in blood volume throughout the body. The patient's blood pressure is so low, which is the best proof of this. When systemic blood volume decreases, blood perfusion to the kidneys decreases, resulting in ischemia. At the same time, the release of large amounts of toxic substances into the circulation by the necrotic muscles of the crushed injury can further aggravate the kidney toxicity. At this time, myoglobin is deposited, which directly blocks the renal tubules, which leads to acute renal failure. ”

Zhou Can analyzed the complete occurrence process of the entire kidney failure one by one, and listened to Director Lou's great appreciation.

The other doctors and nurses looked at Zhou Can with admiration or admiration.

"It's a pity that the patient is still so young, and a life has been delayed. If there is a problem after surgery, it can be treated in time, and there may be hope for recovery. Now it has entered the irreversible stage of acute renal failure and exhalation failure, and it is already a lack of surgery and terminally ill. ”

Zhou Can did not explicitly say that the Third Hospital delayed the patient's life.

However, from his analysis, it can be clearly seen that the Third Hospital has dereliction of duty and mistakes in the treatment process.

This is a classic case of serious medical malpractice.

……

After the operation in the emergency department in the evening, after checking the room, and eating the delicious meal sent by Su Qianqian, Zhou Can hurried to the cardiothoracic surgery.

There's a whole bunch of things to take care of for him.

The old cadre has already agreed to the operation, how to convince the family, the specifics are not clear.

The hospital is like this, and it can only adapt the family and patients to the hospital's diagnosis and treatment mode, but it is impossible to act according to the wishes of the family and the patient.

This veteran cadre's treatment expenses can basically be reimbursed 100 percent, and his family is not short of money. His daughter-in-law was bent on using the safest 'best' surgical method and placing a vascular stent.

The doctor couldn't do what she thought.

How many brackets do I have to put in this?

And it doesn't work well.

Directly use an artificial blood vessel to complete the bypass, and everything is solved.

The cost is much lower, and it saves worry and effort, and there is basically no need to worry about problems with this blood vessel in the future. The only problem with artificial blood vessels is aging, and there is also leakage caused by poor anastomosis.

Let's start with aging.

The service life of artificial blood vessels is at least more than 10 years, and the better ones are more than 20 years.

In fact, there are not necessarily any problems in 30 years.

Because it is sealed inside the human body.

In addition to the corrosion of blood and body fluids, there is basically no problem of contact with outside air. This will undoubtedly extend its service life considerably.

That old cadre is already sixty-five years old, and even if he lives to be one hundred years old, he will only have thirty-five years left.

The replacement of artificial blood vessels should be fine by that time.

Even if something really goes wrong, you can always come back to the hospital to get a new one.

Patients with arteriosclerosis and systemic lesions generally find it difficult to live to be 100 years old.

Often, living to the age of about 80 is considered a long life.

Because the patient's abdominal artery, even including the cardiovascular, cerebral artery, etc., will continue to deteriorate. When the time comes, maybe a cerebral hemorrhage or a heart attack will send the person away.

In the cardiothoracic surgery room, Zhou Can personally operated on this old cadre.

The patient's family waits outside the operating room.

How Director Xueyan talked to them specifically, Zhou Can didn't know. I only know that the old cadre offered to ask Zhou Can to help him operate.

The more distinguished the patient, the more he pursues the treatment of famous doctors.

AFTER ZHOU CAN'S INTRAOPERATIVE INVESTIGATION, AN ARTIFICIAL BLOOD VESSEL WITH A LENGTH OF 38CM AND A DIAMETER OF ABOUT 8 MM WAS FINALLY SELECTED, AND THE PATIENT WAS GIVEN A BYPASS BYPASS FROM THE RIGHT COMMON FEMORAL ARTERY TO THE POPLITEAL ARTERY.

Considering that the fourth toe of the right foot has been necrotic and blackened, there is no way to preserve it.

Before the operation, with the consent of the patient and his family, the amputation surgery was performed.

This is already a minimization of damage.

Other hospitals asked him to have his right leg amputated to save his life.

In Zhou Can's place, only cutting off one toe is indeed the best result.

After the operation, the blood vessels of the right foot, popliteal artery, and dorsalis pedis artery were all recovered. At a speed that can be seen by the naked eye, the skin surface of the patient's right foot is gradually becoming a little ruddy.

Compared with the previous pale and cold, now there is a hint of blood.

It means that the blood circulation of the right foot has been restored.

With the nourishment and nourishment of qi and blood, necrosis should no longer occur in the right foot.

"Pay attention to anti-infection treatment for him after surgery, closely observe the condition of the right foot, and if ischemia occurs and necrosis continues, it must be treated in time."

Zhou Can admonished the itinerant nurse.

"Understood."

The itinerant nurse has great respect for Zhou Can.

The operating room of cardiothoracic surgery is basically Zhou Can's world. The nurses and doctors here all highly recognize Zhou Can's strength and trust him very much.

After this operation is completed, there are still two major surgeries waiting for Zhou Can.

One was operated on in a provincial tertiary hospital outside the province, but the postoperative effect was not satisfactory and the second uterine surgery patient needed to be reworked. The other is mitral valve and tricuspid valve insufficiency surgery.

This is all major surgery, Zhou Can sighed in his heart, and fought properly until the rhythm of dawn.

Now, more and more, he feels that the power of one person is very limited. Even if he is desperate for surgery, how many can he save from morning to night?

This also made him pay more attention to the cultivation of successors.

Whenever he has the opportunity, he will selflessly share his surgical experience, mentor newcomers, and even other attending physicians. As for the deputy director, the director level, he did not dare to use the word "pointing", but "communication".

……

I was busy until one o'clock in the morning, and finally called it a day.

A total of three surgeries were performed, all of which were successfully completed. The last mitral valve and tricuspid valve were incomplete, and Xue Yan was the main knife, assisted by Zhou Can.

It can also be thought of as two people operating at the same time.

It's a completely new endeavor.

It means that two people operate on the patient at the same time, each doing a part. As long as it is properly coordinated, it can indeed greatly shorten the operation time.

For major thoracotomy surgery, the shorter the duration of the surgery, the more advantageous it is.

If it weren't for the two of them performing this operation on the patient at the same time, I am afraid that I would not be able to leave work at 3 o'clock in the morning.

At ten o'clock in the morning of the next day, Zhou Can was busy in the emergency operating room, and Dean Zhu called Dr. Xu.

Because Zhou Can's surgery was not answered at all.

"Xiao Zhou, after this operation, you use your mobile phone to call Dean Zhu back. Said he was looking for you. ”

Dr. Koh came in to inform him.

"Okay."

Zhou Can had already guessed a few points.

It is estimated that the matter of medical exchanges with the Provincial People's Hospital has been trusted.

In the operating room, all the doctors and nurses couldn't help but feel envious when they heard Dean Zhu call Zhou Can in person, and they were also a little more in awe of Zhou Can.

This elevation of status is intangible.

Just like a certain relation, colleagues in the department know that his uncle is the vice president, and everyone will consciously let him score three points.

After Zhou Can finished the operation in his hand, he handed over the suturing task to the two doctors under him, and he went to the changing room to take his mobile phone and call Dean Zhu back.

Dean Zhu called him twice, but no one answered.

Hurry back to the past.

Ring twice and you're done.

"Zhu Dean, I'm sorry I didn't answer your call in time, I was having surgery just now, and I stored my phone in the changing room."

As soon as Zhou Can came up, he hurriedly explained.

The top leader of the hospital called him but did not answer, which will definitely make the leader a little unhappy.

"Understood! You don't bring your mobile phone into the operating room to concentrate on the patient's surgery, and this kind of work attitude is commendable. Xiao Zhou, regarding the matter of medical exchanges with the Provincial People's Hospital, the hospital has already held a meeting to approve it. Can you contact the Provincial People's Hospital and see if they can send a leader to discuss this matter? ”

Zhu Dean didn't mean to be angry.

Instead, he praised Zhou Can.

"Okay, I'll have surgery at noon, and I'm going to visit Director Lu in the hospital, and I'll ask them when the time comes."

Zhou Can deliberately mentioned Director Lu.

Whether those people can return to Tuya Hospital or not, they still need to nod and agree to the dean.

Director Xueyan didn't mention this matter to him, which means that there has been no progress yet.

The hospital leaders didn't nod their heads, and no one could do anything.

(End of chapter)