The manpower configuration of the operating room here is obviously not as good as the 9 rooms opposite.

There is only one itinerant nurse and only one instrument nurse.

There are only four main knives at this time, Wu Xuanqi, Hong Du, Huang Kai, and Zhong Xuegao of Zhang Mingcan's group.

Originally, at the beginning, Director Wu Guonan arranged for Zhong Xuegao to take Guo Yunlei for this operation.

Liu Linjie's condition looks relatively simple on the surface, just a knife cut on the thigh and arm, and it does not hurt important blood vessels and nerves, and only needs to be simply debrided and sutured.

Find an attending person and do it, and even arrange Fang Ziye to do debridement and suturing, and you can do it.

Unexpectedly, Zhong Xuegao came in and was about to start chest compressions, and the patient was in shock.

This makes everyone realize that there is a high probability of bleeding in the occult space, and then the patient's abdomen becomes more and more swollen, which is most likely considered to be an injury in the pelvis.

Huang Kai, who was called by Fang Ziye to help, found that the result was really the case, and Huang Kai did not hesitate to call the old director of Hongdu.

It's just that the old director of Hongdu didn't have much rescue experience in this regard, so he immediately called Wu Xuanqi, who came over temporarily after stepping down, and arrived at the operating room, but it took more than 20 minutes.

In the previous time, the old director of Hong Du and Huang Kai only did hemostatic suture in the pelvis that can explore blood vessels.

Now, the pelvis is still bloody, and it was only after Wu Xuanqi arrived that he dared to try to open the retroperitoneal hematoma!

Fang Ziye broke in halfway, causing many people to look up at him.

Nie Mingxian sat firmly on the Diaoyutai at the moment, and after controlling his blood pressure, he said: "Dr. Wu, this is Dr. Fang, he did the limb salvage in the operating room next door before, and the technique is still okay." ”

"If you need to, you can call someone to come up to the stage and help."

After Nie Mingxian finished speaking, without waiting for Wu Xuanqi to react, the old director of Hongdu immediately asked: "Do you still have the strength, Xiao Fang?" ”

Fang Ziye is looking for an opportunity to come to power, even as an assistant, he may be able to get a lot of knowledge points, and he has been resting for almost an hour, not to mention fully recovering, but recovering seventy or eighty percent.

"Director Hong, I'll go out and wash my hands right away." Fang Ziye just glanced at Wu Xuanqi, who was skillfully operating, and immediately exited the operating room, not polite at all.

After Fang Ziye washed his hands again and came to the stage, he first squeezed to the most corner position.

The operation is in progress, unless it is a very key person, it is not allowed to set foot in the key position, and can only start step by step from the assistant who does not affect the surgical process.

At this moment, Wu Xuanqi had come to the critical moment of the operation, he took a deep breath, and did not deliberately explain to Fang Ziye, but to everyone.

"There is active retroperitoneal bleeding, that's for sure, but it's unknown how many bleeding points there are, how many blood vessels are damaged."

"Moreover, the retroperitoneal pressure is high, once we break the peritoneal layer, blood may be spurted out in a short period of time, and such a squirting process may lead to secondary damage to the blood vessels that are already damaged."

"Therefore, we must find the bleeding point as soon as possible and do temporary hemostasis."

"At most, I can only catch two bleeding vessels in a short period of time."

"There was no preoperative examination for the patient, so no one could tell how much bleeding there was, so we had to try to stop the bleeding with our bare hands as much as possible, and then hand it over to the assistant to tie up and stop the bleeding."

"Temporary hemostasis is done as quickly as possible."

"However, in this process, if you are not absolutely sure, you must not grab the position and fight, instead of a few hands scurrying around, it is better for you to wait to take over the bundling and knotting at any time." Wu Xuanqi said.

Hearing this, Hong Du nodded: "Xiao Wu, I will try to cooperate with you, and no one else will be able to get started." ”

Wu Xuan nodded when he heard this.

Hong Du did this arrangement, then at least no one would interrupt.

looked at Nie Mingxian: "Doctor Nie, the patient's blood pressure will fluctuate rapidly for a period of time, and the maintenance of vital signs and the control of blood pressure will be handed over to you." ”

"During this time, there may be a large amount of fat backing up or impinging into the bloodstream, which can also cause hemorrhagic shock."

"Okay, I'm always ready here." Nie Mingxian's expression was solemn, and he didn't mean to joke.

Wu Xuanqi said again: "The two negative pressure suction devices are ready to clear the field of vision and blood accumulation at any time, and I am going to open the peritoneum." ”

"A large number of silk threads have been prepared in place, each of you has one, after I temporarily stop the bleeding, you will immediately cooperate to complete the temporary binding of blood vessels."

"You know, it's possible that there are two bleeding spots in a blood vessel."

Wu Xuanqi quickly finished speaking, and immediately took the sharp knife in his hand and broke a small opening.

As soon as the peritoneum burst open, the hematoma that had accumulated inside instantly gushed out like a spring, like a new spring.

But Wu Xuanqi's right hand turned the sharp knife against the assistant position, and at the same time, his left hand quickly stretched into the pool of blood without hesitation in the opening between Zhong Xuegao and Huang Kai.

With a slight rotation of the palm of his hand, he condensed a vein head that was writhing like a yellow eel and took it out.

At the same time, one of the old director Hongdu's hands also reached in and caught an unnamed artery.

Seeing this, Wu Xuanqi threw the knife away, landed in the tray, and immediately squeezed his right hand into the blood pool again.

"Silk thread! ~" Wu Xuanqi shouted in a low voice.

Huang Kai pressed one end of the S hook with his stomach, and then immediately went up with both hands, first took the head of the blood vessel grabbed by the old director of Hongdu, and began to tie it.

And Zhong Xuegao, because of Huang Kai's movements, there was no position, his left hand continued to pull the S hook hard, and the other hand took over Huang Kai's original hook position: "Master Kai, you let go first." ”

In this way, there is not a lot of room left for Fang Ziye to operate.

But even so, Fang Ziye was still holding the silk thread with both hands, and after bypassing one of Wu Xuanqi's hands, his hands were quickly knotted and a blood vessel was temporarily tied.

After directly and quickly dealing with the dead knot, Fang Ziye quickly pulled out a silk thread and bundled it on Wu Xuanqi's other hand, and after tying out a slippery knot, it slid down like a sleeve.

When he arrived at the blood vessels, he pulled hard, and before Wu Xuanqi could react, Fang Ziye completed the tying of another knot.

This is a flexible application of knotting.

Fang Ziye came here to check and fill in the gaps, so what kind of work he did if he lacked a functional position.

Wu Xuanqi glanced at Fang Ziye, and before he could instruct, Fang Ziye had already completed the knotting and bundling in two places, and then decisively withdrew his hand, picked up the suction device that was currently unmanned, and stuffed it directly into it, leaning on the side and giving up the position.

At the same time, his body was deviated, giving up more positions to Wu Xuanqi.

This is called giving way.

Although Fang Ziye felt that he could also complete the operation of freehand hemostasis, on the operating table, the division of labor had been clear, and he could no longer occupy someone else's position!

Don't say that you are squeezing out the main knife, even if you pollute yourself, you have to give up the position to the main knife.

One mountain cannot tolerate two tigers, one country cannot tolerate two masters, on an operating table, there can only be one chief surgeon, and everyone else is an assistant, this is an iron law!

Fang Ziye had skillfully tied up the oblique horse step, and his ass was sideways.

looked at Wu Xuanqi.

Wu Xuanqi was only stunned for about two seconds, and then continued to operate.

When Wu Xuanqi caught a vascular stump again through the turbulence of the body-sensing blood flow, Fang Ziye immediately gave his suction device to Wu Xuanqi's other palm.

His eyelids blinked quickly, and he was about to speak a reminder, but Wu Xuanqi seemed to understand what he meant and took the suction device.

Fang Ziye immediately retracted his half-step backward step, pulled out a silk thread with his left hand, and then sent it to the index finger of Wu Xuanqi's right hand at this moment.

His hands quickly surrounded, and in just two seconds, Fang Ziye completed two knots again!

Immediately afterwards, Fang Ziye removed both hands without any nonsense and nonsense, skillfully moved the knot of the two lines to the direction of his left abdomen with his left hand, and then took over the suction device in Wu Xuanqi's hand again with his right hand.

He turned his head: "Teacher instrument, help me straighten the knot with blood vessels." ”

The previous knots were too late to sort out because of the urgency, but now the knots must be cleaned up because the situation is no longer so urgent.

With the stumps of the four blood vessels being tied one by one, the bleeding speed in the pool of blood has been reduced by more than three-quarters, and the bleeding speed can no longer catch up with the suction speed of the negative pressure suction device.

Pools of blood are visibly descending to the naked eye.

At this time, Hong Du and Huang Kai completed the suturing of a blood vessel head.

Are they slow?

Not really, the current time is only fifteen seconds since Wu Xuanqi's incision.

The old director of Hongdu was able to find the blood vessels, and Huang Kai cooperated with him to prick the blood vessels, and it only took fifteen seconds, which was already not slow.

After all, in critical cases, it is not the knot that is sutured, but the opportunity to create the knot, and then the knot is completed, which requires a process.

Not everyone can have a level 4 knot tying operation to perform rapid knotting and ligation of blood vessels like Fang Ziye.

Seeing this, Hong Du and Huang Kai knew that the cooperation between the two of them just now had completely slowed down the rhythm of the operation, and their faces turned slightly dark, and they each gave way to their positions.

At the same time, he took over the negative pressure suction device in Fang Ziye's hand and the S hook in Zhong Xue's hand.

Wu Xuanqi was not idle at the moment, and glanced at Fang Ziye: "Follow-up bleeding points, use vascular clamps." ”

Wu Xuanqi gave Fang Ziye a secret point, if Fang Ziye understands, then Fang Ziye can also operate, if Fang Ziye doesn't understand, then Fang Ziye can hand him vascular forceps.

In the light of electricity, he would not waste even one more word of time.

"Good! ~"In the curved plate, there are a large number of vascular clamps, at least the vascular clamps in the three instrument bags, all of which have been put in.

After Fang Ziye got the vascular forceps, he took a little half a step back, and only after Wu Xuanqi's left and right hands reached in at the same time did Fang Ziye send the vascular forceps in his left hand to the bleeding point of his sharp field of vision.

At the same time, the vascular forceps on his right hand sent the bleeding point where both he and Fang Ziye had a good field of vision.

There was no fight, and the time was staggered before and after, but at the same time, the bleeding point was temporarily punctured in the form of vascular clamping to stop the bleeding.

This is also a common use of hemostasis.

There are many manifestations of hemostasis, as long as all operations that can stop bleeding can be classified as hemostasis, stopping bleeding with bare hands, which is just one of the manifestations.

Among them, the hemostasis of temporary clamping of vascular clamp to stop bleeding is actually the content of the freehand hemostasis method, which is one of the most simple and simple hemostatic surgeries.

Fang Ziye is naturally able to operate freely when it is visible to the naked eye.

And the position where everyone stands, there are blind spots and sharp vision positions, whether it is the main knife or the assistant.

"You go to the other side! ~" After Wu Xuanqi saw Fang Ziye's operation proficiency, his eyes lit up at that time, he had already seen Fang Ziye's operation level, in the basic skill of hemostasis, Fang Ziye's level was quite sophisticated.

And this sentence is not that Wu Xuanqi drove Fang Ziye away, but let Fang Ziye become his first assistant to complete the bleeding point hemostasis operation and follow-up operation in the blind area of his vision.

The chief knife and assistant stand in a bilateral position, which is to complement each other.

But obviously, the old director of Hongdu, for various reasons, could not achieve such a complementary position, so he could only go to the opposite side of Fang Ziye.

Fang Ziye nodded without hesitation, took two steps back, turned around and left the operating table with Wu Xuanqi back to back, and then turned around again, facing the direction of the operating table, and began to walk around the operating table.

On the operating table, when crossing positions with people, it needs to be back to back to ensure the principle of sterility.

When going around the operating table, with your back to the operating table, it is taboo because if you don't look at it directly, you don't know if you will pollute the operating table.

Hong Du moved a position, and Huang Kai was very sensible from another direction, facing the operating table, and walked to the position of Fang Ziye's assistant in front of him.

Although I don't know why Fang Ziye is so powerful, but on the operating table, it is never the time to ask questions, and now, Fang Ziye can cooperate more perfectly with Wu Xuanqi, which is the most important.

When Fang Ziye just changed his position, Wu Xuanqi clicked and closed the three bleeding points again.

Active retroperitoneal hemorrhage is already visibly controlled.

At this time, Nie Mingxian in front of the anesthesia table said: "The blood pressure is currently temporarily stable. Tour, call four more plasma, 400 suspension red over. ”

"The blood bank is in a hurry." The itinerant nurse said.

"If the blood bank is in an emergency, you will say that there is also an emergency in the operating room, and you have to find a way to balance it out!" Nie Mingxian's command is beyond doubt.

"Okay, I'll call right away." She didn't dare to refute.

On the operating table, Fang Ziye, Wu Xuanqi and the others were not affected by the conversation at all, Fang Ziye stood on the opposite side of Wu Xuanqi, and then used hemostats to clip a few bleeding points that Wu Xuanqi could not see.

After this, I looked at the inside of the retroperitoneal hematoma, and I regained a peaceful atmosphere, and there was no active bleeding.

Even if there is some faint bleeding, this is not the bleeding that can be handled by hemostats, and it must rely on subsequent hemostatic materials such as gel sponges to complete hemostasis.

The mood of the crowd was relieved at this point.

Wu Xuanqi exhaled: "It takes more than forty seconds to complete the cleaning and hemostasis of a hematoma, and this speed is timely." ”

"Director Nie, is the situation okay over there?"

"Director, your uncle." Nie Mingxian had already stood up and started to draw blood to check electrolytes, scolding.

Obviously, he couldn't hear Wu Xuanqi call him Director Nie.

The old director of Hongdu narrowed his eyes at this moment and asked back: "Doctor Wu, or will Dr. Fang cooperate with you, will make you feel more comfortable?" ”

The reason why Wu Xuanqi said that this is the speed of time is to imply that his cooperation with Huang Kai is a bit of a dish, and he belongs to the category of being brought.

And only Fang Ziye's technology can cooperate with him, although it may also be with Fang Ziye, but at least the distance between them will not be very far.

The higher the level of the assistant, the more comfortable the operation of the main knife will be.

This is also the main reason why many surgical teachings are performed by high-level people as assistants, and low-level people will become extra relaxed.

"Director Hong, I didn't mean that, but Xiao Fang's level is really good." After Wu Xuanqi finished speaking, he bowed down again and began to clean up the mess.

When the operation came to this point, it was just that the vital signs could be temporarily stabilized, and the next hemostatic operation was also careless.

If the bleeding is not stopped, the subsequent hematoma or the rupture of the stump of the blood vessel is higher than the risk of initial hematoma and blood loss.

After all, people are flesh and can't afford to be hurt many times.

Fang Ziye took the initiative to help, cleaning up the blood masses, blood lumps, and black blood clots, without saying a word.

is not proud, but he does not pretend to be a dead man, waiting for Wu Xuanqi's orders.

Wu Xuanqi is the main knife, he does not occupy Wu Xuanqi's position, he does not rob his operation, and other small operations can be played freely.

Wu Xuanqi was also silently cleaning up the remains after the hematoma, and said in his mouth: "Ziye, if the blood vessels are sutured later, you and I will sew them together." ”

"If it should be sutured, it will be sutured, and if it can't be sutured, it will be pierced directly, and don't force it to be sutured."

"Okay, Senior Brother Wu." Fang Ziye nodded, not daring to make other suggestions without authorization.

Wu Xuanqi's level is higher than his own, what he said is better advice, and he should not use his own level to guide Wu Xuanqi.

Moreover, Fang Ziye also knew that if he had to experience such a hematoma rescue in the future, the level of hematoma incision and hemostasis must be high enough to be able to stabilize the incision, cleaning and hemostasis of such an active hematoma.

The two worked together in an orderly manner, and finally slowly advanced the operation to the final stage of vascular suturing.

Huang Kai and Hong Du have completely become assistants, helping Fang Ziye and Wu Xuanqi cut threads.

Then he joked occasionally: "Huang Kai, look at them, this is really fast!" ~”

Huang Kai insisted that he was older: "After all, it is a craft, but it may hurt a little." ”

When Huang Kai and Hong were joking like this, Fang Ziye found that this Senior Brother Wu Xuanqi was also silently immersed in the operation, and he didn't dare to refute more, as if he knew that a young man like himself had congenital deficiencies compared to these 'directors'.

"Damn, it's good that hypokalemia was found."

"These can rest assured, they shouldn't be able to die." When Nie Mingxian approached again, he said the most fierce words in a scolding tone.

Everyone smiled and calmed down.

The anesthesiologist is the patron saint of the patient's life in the operating room, and since Nie Mingxian said that he can't die, then they can open and close the operation.

(End of chapter)