"Even the chief surgeon can't match our boss's speed!"

Yang Zhi said with a smile next to him.

Because the leader of the group also requires at least the level of deputy chief physician, and at the same time, he must also have the title of professor. Zhou Can has the real power of the team leader, but he does not have the title of team leader.

Everyone now habitually calls him the Boss.

This title was first shouted by Luo Shishen.

At that time, the intern Luo Shishen followed Zhou Can and wanted to be Zhou Can's apprentice. It's a pity that Zhou Can thought his talent was too ordinary, so he didn't agree.

So, Luo Shishen began to call Zhou Can the boss.

That kid is currently in regular training, and when the regular training is over, there is a good chance that he will come to beg to join Zhou Can's team.

I heard that it is mixed well, and it has been appreciated by the two chief physicians, and it can be regarded as mixed into the key cultivation sequence.

Even though he was forced to leave Zhou Can's team now because of regular training, he still often asks Zhou Can for medical problems through WeChat. Zhou Can treats him well, and this kid also knows how to be grateful.

During the New Year's holidays, he would call to bless Zhou Can, and often said good things about Zhou Can in front of outsiders.

"It seems that I made a very wise decision to quit my job and join Dr. Chow! Now I hope that Dr. Zhou can let me stay, you all help to say good things, and I will treat you after work. ”

When she talked about the treat, she was very confident.

With an annual salary of at least 300,000 yuan, it is really nothing to invite one or two meals.

"You are so good, Dr. Zhou is afraid that he has already passed it in his heart!" Qiao Yu smiled and helped her speak.

"Sister Qiao Yu is right, I saw the word satisfaction in the boss's eyes!"

Ma Xiaolan is also full of affection for Jiang Wei.

I don't know what ecstasy soup Jiang Wei poured into the two of them yesterday? Let them be so willing to help Jiang Wei speak.

Especially Ma Xiaolan, she is like a bad mother-in-law in the old times, for new people who join the team, whether doctors or nurses, they like to set up a horse first. This time, it's like a change of sex.

"Hurry up and get the surgery! Jiang Wei is indeed very good, but it depends on her next performance. Zhou Can did not let go easily, and the gentleman had no jokes. He is the boss, so he naturally has to be cautious when he speaks.

"Jiang Wei, there are three tertiary surgeries today. I saw that your performance was not bad just now, and I think the third-level surgeon should be able to do it, so you should perform well when the time comes. The affairs of the operating room, I don't count, I have to satisfy Dr. Xu to pass. ”

No matter how demonic Zhou Can is, he is still a junior after all.

Both the second and third level surgeries need to be under the name of Dr. Xu, and he does not have the authority to independently preside over the second and third level surgeries.

According to the surgical hierarchy, a minimum of the attending level is required to be eligible to preside over secondary surgery and begin participating in tertiary surgery. Senior attending physicians can complete tertiary surgery under the guidance of the director or deputy chief physician.

……

Near eleven o'clock in the morning, a male patient in his forties was wheeled into the operating room.

Varicose veins were detected in the patient's right lower limb six years ago and there was some degree of swelling. But because of his busy work and low income, the family's financial burden is almost entirely dependent on him to work alone to make money.

Afraid of spending money, I never had surgery.

It wasn't until not long ago that I couldn't stand the pain and had difficulty walking, so I went to the hospital for treatment.

The local central hospital performed a high saphenous vein ligation and decortication of the patient.

This surgery is also the most commonly used method to deal with superficial varicose veins of the lower limbs, deep vein patency. The vast majority of varicose veins of the lower extremities occur in superficial veins, and in rare patients deep veins follow them.

After examination, as long as the surgical requirements are met, the saphenous vein can be ligated and decorated.

The results of the treatment are usually good, and the swelling and pain of the lower extremities can be greatly improved.

After the patient was operated on at the local downtown hospital, doctors applied an elastic bandage to compress and bandage him from the dorsum of his foot upwards to the groin.

This is also a common method used after surgery.

After all, a superficial vein decoration has been performed, and compression is necessary.

As a result, the patient soon noticed that the toes of the affected limb were swollen and painful.

The family quickly rang the bell and called the nurse to check.

After seeing it, the nurse didn't dare to deal with it without permission, so she invited the attending doctor over.

After examination, the attending physician concluded that the patient's condition was most likely caused by an elastic bandage that was too tightly bandaged.

When doing this compression bandage, Zhou Can still remembered that Director Liu said that the higher you go, the greater the pressure.

The attending physician immediately loosened the elastic bandage and elevated the affected limb.

Because the blood circulation in the lower limbs is farthest from the heart, it is also the most difficult to revasculate. In cases like this, when the swelling of the lower limbs is severe, elevating the lower limbs is beneficial for blood to return to the heart, considering that blood circulation is caused by blood vascularization.

This reduces swelling and also provides quick relief from foot pain.

After the bandage was released, the patient still complained of unbearable pain in the affected limb, and the attending doctor prescribed analgesics to the patient for pain relief.

The patient was also informed to observe for 48 hours before formulating the next treatment plan.

It's all part of the normal process.

At least in terms of the way of diagnosis and treatment.

After more than 30 hours of observation, the skin of the patient's right leg turned dark purple, the dorsalis pedis artery fluctuations also disappeared, and the skin temperature was extremely low. To put it bluntly, it's like when a person dies, the corpse quickly becomes cold.

And the patient's right leg is already more swollen.

At this point, the family members were both griefed and angry, shouting that they would kill the doctor in charge of the treatment.

The doctor was so scared that he didn't dare to show his face at all.

The hospital leaders tried their best to persuade the family to pull the patient to a big hospital in the provincial capital city first. Now it's definitely life-saving.

The family is also worried that if the time drags on, they will not even be able to save their lives.

At this time, he could only endure his grief, and the ambulance of the central hospital pulled the person to the top three compound in the provincial capital.

In fact, the central hospital is also a tertiary hospital.

However, in terms of strength, there must be a big gap with provincial top three hospitals such as Tuya and Provincial People's Hospital.

The family's son heard that the level of Tuya Hospital was very high, and strongly requested that the patient be brought to Tuya Hospital for treatment. The doctors and nurses who followed the car were afraid of being beaten, so they naturally complied.

After the person pulled over, I heard that the doctor and nurse who were following the car slipped away on the spot.

Everyone works for the hospital, looking at more than a dozen family members, one by one, full of righteous indignation, fierce and vicious, who is not afraid?

I'd rather go back and be scolded by the leader than be broken by my family.

So after dropping off the patient, they quickly slipped away.

After Tuya received the consultation, the patient was examined and found that the patient had gone into shock and wet gangrene of the lower limbs.

On the spot, he told his family that he had to have an amputation to save his life.

The family was devastated when they heard that the limb was to be amputated. A person who is only in his forties is the pillar of the family, and he has amputated his right leg, how will he live in the future?

They tried to settle accounts with the doctors and nurses at the central hospital, but after searching, they found that the doctors and nurses who came with the car were long gone.

Fortunately, the doctors and nurses who followed the car slipped quickly, otherwise they would have become a punching bag for these angry family members.

In the event of a doctor-patient dispute, especially if the patient dies or suffers a major injury, the family is extremely at risk. It's easy for them to make some crazy moves that go too far.

Some doctors are crippled, almost always in this case.

There is also a situation that is also terrifying, and that is revenge after the fact.

If there is a doctor-patient dispute in person, doctors and nurses can at least be prepared. Some family members and patients withheld it in front of them, and afterwards carried murder weapons, mostly sharp knives, and went to the hospital to find the doctor concerned and stabbed them frantically.

In such cases, doctors and nurses can easily be seriously injured or even killed because they are defenseless.

Why do doctors and nurses get nervous when they see family members holding long strips?

Because no one knows whether the family will pull out a sharp knife after opening the package.

The patient's family members had no choice but to tearfully sign the amputation after searching for the medical staff at the central hospital. It's all about saving your life.

In the end, this amputation fell to Zhou Can.

Patients with disputes like this tend to be especially cautious when they are treated by a second hospital.

Now letting Zhou Can do amputation surgery on this patient is also a trust in Zhou Can. Optimistic about his surgical ability.

Dr. Xu personally swept the scene at the scene.

It can be seen that with the presence of Dr. Xu, Jiang Wei seems a little nervous.

It shows that Dr. Xu's aura is very powerful.

At least she was in front of Zhou Can, and Zhou Can's aura couldn't suppress her.

The whole amputation process was simple, brutal and bloody.

Jiang Wei's performance is as good as ever.

"Xiao Zhou, do you know what caused the amputation of the patient?"

Dr. Xu asked lightly.

"Jiang Wei, tell me your opinion first." Zhou Can did not answer Dr. Xu, but asked Jiang Wei.

He wanted to see how strong this female nurse really was.

At present, he feels that this nurse is unfathomable, and the strength she has shown is likely to be just the tip of the iceberg.

"Judging from his postoperative condition, it is likely that it was caused by venous thrombosis."

She replied crisply.

I didn't even think about it at all, which means that I had this diagnosis in my head a long time ago.

"Qiao Yu, what is your opinion?"

"I ...... Not very clear. Qiao Yu blushed.

In terms of pathological diagnosis, her experience and level need to be improved. There is far no way to compare with a super talent like Jiang Wei.

"Jiang Wei, do you think the patient's thrombus was caused before or after surgery?"

Zhou Can asked again.

"I don't really know. I think it was caused after surgery! ”

Jiang Wei was able to know the general cause, but she couldn't diagnose it in more detail. This is because nurses are studying in different directions.

It would be rebellious if a nurse could diagnose a specific cause like a doctor.

It's like Zhou Can already has a high level in the fields of pathological diagnosis and surgery, but he only knows a little about nursing. There is no way to compare with Qiao Yu and Jiang Wei.

"Teacher, I think the patient was not meticulous in the preoperative examination and did not find a blood clot, which caused the situation that needs to be amputated now."

Zhou Can looked at Dr. Xu.

Just now, he finally figured out some of Jiang Wei's bottoms.

"It's a possibility. And even if the preoperative examination is not meticulous and there is a problem after the operation, there is still a chance of rescue. The attending doctor was paralyzed, believing that it was caused by the elastic bandage being tied too tightly, which caused the tragedy. When you practice medicine, you must be careful and careful, and you must take the lives of your patients to heart. ”

Dr. Xu admonished everyone with a serious face.

After amputation, blood clots were found in both the iliac vein and the femoral vein.

At this point, the truth is revealed.

This is a typical medical malpractice, which deserves to be thought about and vigilant.

After the amputation, the patient underwent a series of anti-shock, anti-infection and other treatments. After Zhou Can got off the operation at noon, when he went to check on the patient, the patient had already woken up.

It's just that the mental state is not very good.

His face was even paler.

I'm afraid this big brother doesn't know that he has already fought in the Ghost Gate.

Now his right leg is gone, but his life has been saved.

At noon, when a few people were eating in the cafeteria, Yang Zhi couldn't help but ask, "Boss, if I meet a patient with a similar amputation of my right limb in the future, how can I avoid an accident?" ”

The two doctors under him, Yang Zhi's personality is more cheerful, and Pu Dingdong is honest and Muna's kind.

He rarely asks questions, but silently takes notes.

Only when you encounter someone who can't understand the information, will you ask Zhou Can for advice.

There is another phenomenon that is particularly interesting.

Every time he asked Zhou Can for advice, he would keep his head down, like a shy elementary school student.

"When encountering such patients, problems can be found by preoperative color ultrasound, deep venous patency test, and deep venous angiography. The surgeon in the central hospital failed to find deep vein thrombosis in place before the operation, but peeled off the saphenous vein, which caused the venous return disorder of the lower limbs. The attending doctor mistakenly believed that the patient's toes were swollen and severely painful because of the bandage being too tight, so he missed another chance to remedy, and eventually caused gangrene of the lower limbs, and he had to amputate his leg to save his life. ”

Zhou Can analyzed the pathological mechanism for the two subordinate doctors.

Since his level of pathological diagnosis has been raised to level six, various pathological analyses have fully reached the level of the director. Yang Zhi and Pu Dingdong only nodded in admiration.

Of course, Qiao Yu and Ma Xiaolan can sometimes learn a lot of knowledge by the side.

There is one more person today, and that is Jiang Wei.

Although Dr. Xu has not finally nodded and agreed to let her stay, Zhou Can has already passed. Director Lou's hurdle has already passed. The probability that she will stay is almost 100%.

While quickly destroying the food, she listened carefully to Zhou Can's pathological analysis.

It can be seen that her face also shows an expression of admiration.

Zhou Can is so young and only a resident, but he can have such a high level, which is indeed very good.

"Boss, if it is found to be caused by deep vein thrombosis after surgery, how can I remedy it?"

Pu Dingdong asked a little shyly.

It is only when he encounters this kind of question that he is very interested in and eager to know the answer to, he will ask it on the spot.

"In fact, it is quite simple, as with other deep vein thrombosis of the lower limbs, first do a bypass surgery of the descending blood vessels to ensure that the blood vessels of the lower limbs are restored. Then find a way to do venous thrombectomy. Interventional imaging is the preferred option for thrombectomy. On the one hand, interventional thrombectomy is minimally invasive and has little harm to patients. On the other hand, it can also ensure that the blood clot is removed. For this type of venous thrombosis, interventional thrombectomy is a very good first choice. ”

Zhou Can glanced at Pu Dingdong appreciatively, and then patiently gave a solution.

The oldest thrombectomy is to cut the blood vessels, which is a large project, difficult and extremely traumatic. Nowadays, with the continuous advancement of technology, interventional thrombectomy has gradually become the mainstream.

(End of chapter)