"Xiao Fang, isn't this a coincidence? I just ordered a late-night snack to eat together. After Fang Ziye came out of the emergency operation room, he met Deng Zhi, a fat man from the Mediterranean.

Deng Zhi is the general inpatient of the surgical clinic of the emergency department, and his chubby figure is fine, but the top of his head is more pure than his master Yuan Weihong, which is enough to see that the emergency department is very polished.

"Brother Zhi, I don't have a small appetite, I won't go and let you starve, right?" It's more than half of the morning, and this place for supper is probably a hospital and similar units.

As we all know, being a doctor is not only mental work, but also physical work.

"Hey, it's just gluttony, just to introduce you to a brother and a sister." Deng Zhi waved generously to Fang Ziye, signaling that you should come.

After Fang Ziye threw the tissue that wiped his hands into the black trash can, he thought for a while and said, "Let me guess, is it Sister Ning Shuang and Sister Piaopiao?" ”

Ning Shuang is the chief inpatient of the EICU, and Guo Piaopiao is the chief inpatient of the emergency internal medicine clinic, both of whom are female!

However, it seems that many people in the emergency department do not regard Sister Ning Shuang as a girl, and regard her as a pure man.

"Hey, I've said I've introduced you to a brother, this frost master drinks beer directly with his feet." Deng Zhi corrected Fang Ziye's wording again.

However, these words happened to be heard by Ning Shuang, who went out to look for Deng Zhi, and she with short and capable hair immediately rolled up her sleeves and came over, speaking in a somewhat rough accent: "Deng Zhi, what do you want to do?" ”

This one is a Northeast accent.

"I was wrong, Master Shuang......" Deng Zhi hurriedly begged for mercy.

Maybe there are outsiders, everyone is a big wrongdoer, so Ning Shuang didn't take it seriously.

Fang Zi took the right to eat himself.

This is the first time Fang Ziye has eaten with colleagues from other departments, although it is a supper, but after Fang Ziye entered the duty lounge of the emergency department, he heard the conversation between Ning Shuang and Guo Piaopiao, which was also quite exciting.

There are teenage girls with ruptured fallopian tubes, women in their forties who come to the emergency room with their teenage 'boyfriends', and those who play too much and dislocate at night.

I want to take a table tennis ball or something......

To sum it up, modern people are really good at playing.

However, after Guo Piaopiao and Ning Shuang chatted for a while, their long hair was shoulder-length, and Guo Piaopiao, who was wearing a long skirt at the moment, glanced at Fang Ziye, and happened to discuss the topic of boyfriend and girlfriend, so he asked, "Does Dr. Fang have a girlfriend?" ”

Although Fang Ziye is the general inpatient of trauma surgery, he has just taken office, so there are not many people who have met with Fang Ziye.

Because the transfer station of the hospitalization is the emergency department, Deng Zhi and the others have more or less impressions of the hospitalization of various departments in the hospital.

Fang Ziye heard Sister Piaopiao's expression at first sight, so he smiled and said: "Yes, otherwise I will definitely let Sister Piaopiao introduce one to me, with the resources that Sister Piaopiao has mastered, I will definitely introduce a good one." ”

The meaning can be expressed accurately, as for the flattery in the back, it actually doesn't matter.

No one would introduce a girlfriend to someone who has a girlfriend in a relationship that only has one side.

Deng Zhi immediately said when he heard this: "Sister Piaopiao, I'm ...... single."

Fang Ziye could hear that this Deng Zhi might be a little interesting to Guo Piaopiao, but Guo Piaopiao was not very interested in Deng Zhi......

"You? Don't hurt my girlfriend. Guo Piaopiao said very disgusted, mainly because Deng Zhi's appearance was indeed a bit miserable.

When Deng Zhi heard this, he turned his grief and anger into appetite and began to eat violently.

Then Ning Shuang and Guo Piaopiao discussed some other topics, such as staying up late and getting wrinkles, what kind of cosmetics are better.

This little salary is all put on maintaining this face......

However, just when a few people were eating happily, a loud shout came from outside: "Emergency emergency, heavy bleeding, hurry up and ask for emergency consultation in vascular surgery and trauma surgery......

Hearing this, the movements of the four of them froze neatly.

Fang Ziye quickly stepped back from the table a few steps and began to put on his work clothes and mask.

Then he said: "Brother Zhi, you eat first, someone outside is called ......"

"Okay!" All three threw pitiful glances.

In fact, the general inpatient staff of the emergency surgery and emergency medical wards are not so busy, and they will only be busy when patients are admitted to the ward.

Fang Ziye didn't talk nonsense, and directly twisted the door of the lounge.

Emergency patients with massive bleeding will generally ask for an emergency consultation from a specialist to stop the bleeding urgently, so there is no need for Deng Zhi and others to make any more noise.

After Fang Ziye stepped out quickly, he immediately saw that there were blood stains on the ground at the registration desk of the emergency department, and the blood stains went all the way in the direction of the emergency room.

At the same time, Fang Ziye's consultation phone rang.

Fang Ziye immediately connected and changed to running: "I'm in the emergency department, I'll be there soon." ”

After speaking, Fang Ziye hung up the phone.

Then take out the disposable examination gloves from the right pocket of the white coat and prepare to put them on your hands.

But when he arrived at the door of the emergency room, Fang Ziye found that there were several white coats inside, and it seemed that blood was still gushing out.

"Can't hold it back, are the people from the vascular surgery department here?"

"Do you want to send it to the operating room right away?" The doctor's white coat was stained with blood from the patient's outlet.

Seeing this, Fang Ziye put a layer of gloves on his right hand at the fastest speed in his life!

After walking quickly to the rescue bed, I glanced at the patient's current situation and knew that the situation was very bad.

I don't know what caused the sharp injury, but at this moment, the patient's left lower abdomen still has a sharp deformed steel sheet, and after cutting the superficial layer of skin fat, it also cuts into the blood vessels.

At first glance, it looks like an injury to the left femoral artery.

But in fact, the patient's bleeding is much more than that, "hemostat, open the debridement bag!" ”

"It's not just a femoral artery injury, and compression to stop the bleeding doesn't work." Fang Ziye quickly commanded the nurse.

Fang Ziye was wearing a white coat and hanging the general badge of the hospitalization that had been handled, and the exit was particularly crisp and neat.

With this layer of identity, the nurse assisting next to her did not hesitate to tear open the debridement bag and the tracheotomy bag, and sent the hemostat that Fang Ziye wanted.

There was also a nurse on duty who made an emergency consultation call and finished the call at this moment and ran over quickly.

After Chen Jiameng from the surgical clinic saw Fang Ziye, he said, "Xiao Fang, what should I do?" If the bleeding can't be stopped, the person will be gone, this is an acute blood vessel damage and blood loss......"

Fang Ziye didn't reply, Fang Ziye didn't have any energy to be distracted at this time.

Looking at the general direction and shape of the steel sheet, he analyzed the anatomical location of the possible injury and the damage to the blood vessels inside.

The blood vessels in the lower abdomen are very complex, and the aorta divides into the left and right common iliac arteries, which in turn divide into the internal and external iliac arteries.

There are also many branches of the medial and medial iliac arteries, and the femoral artery is only one of the branches, and the arterial injury in this patient is definitely not a simple femoral artery injury.

Manual pressure to stop bleeding is only suitable for simple single blood vessel injury, and multiple blood vessel injuries cannot be used to stop bleeding by manual pressure hemostasis.

Fang Ziye's current proficiency in hemostasis is level 4, and in addition to the operation, there will also be some ideas for hemostasis.

Perhaps these concepts are not as good as Wu Xuanqi, who is better at vascular surgery, but Fang Ziye still relied on his own understanding and made a relatively bold attempt.

The femoral artery is a branch of the external iliac artery and is one of the largest.

The position of the internal iliac artery will be closer to the midline of the abdomen, and according to the angle of the current patient's steel plate, it should not cause damage to the internal iliac artery!

However, this is also just speculation.

However, even if it was just a guess, Fang Ziye could only take guessing as the right condition.

Temporary clamping and hemostasis directly from the source, that is, through the access caused by this steel plate, it is directly blindly penetrated into the body and the external iliac artery is found for clamping.

Artificial clamping of the external iliac artery, as long as the time is controlled in a very short time, the impact is almost negligible, and this can complete the hemostasis as quickly as possible.

There were a lot of thoughts, but in reality, only five seconds had passed.

Fang Ziye moved: "According to the patient's current steel plate embedding angle, considering the probability of external iliac artery injury, I recommend directly clamping the external iliac artery." ”

Fang Ziye said as he directly pierced it with a hemostat.

Similar to blunt puncture, the blunt-tipped vascular forceps, in Fang Ziye's hands, were like sharp weapons, and they quickly cone into the patient's body.

When Chen Jiameng next to him heard this, he said: "Doctor Fang, you are a professional, you can do it!" ~”

"I'll go explain to the family later!"

"Does this external iliac artery injury belong to your orthopedic subspecialty or vascular surgery?" Chen Jiameng asked.

Specialization, this must now be clarified.

Fang Ziye can take the rescue procedure of emergency avoidance, and for the purpose of rescue, he will be temporarily disposed of across specialties, but after the temporary disposal is completed, he still has to return to the specialty.

Fang Ziye didn't reply, but used a hemostat to stir in the patient's body for a while, and after squeezing a few muscle gaps again, the distal end of the hemostat stretched out.

After flipping up and down, feeling that the wall of the tube he touched was the anatomical tissue of the blood vessels, Fang Ziye opened the hemostat, and then clamped it without hesitation.

This kind of technique is actually a flexible application of more advanced physical examination.

After the physical examination has reached a relatively proficient level, even the subtle pulsations of blood vessels can be felt, and it is relatively simple to find out whether it is a blood vessel material.

After the clip was closed, Fang Ziye immediately let go of his right hand, and then said, "Doctor Chen, you let go of the compressions first, if this patient has an external iliac artery injury, the hemostasis should be slowed down immediately." ”

"A small amount of oozing blood is a small amount of residual in the lumen of the vessel, which is harmless."

"Oh. Good! Chen Jiameng let go of his hand.

He is the chief of geriatric surgery, which is rarely emergency and is only a separate subspecialty. Because the emergency department of geriatric surgery is also classified as a common specialized emergency department.

After all, just because he's old and has an aortic dissection, you can't put him in geriatric surgery instead of heart surgery......

After Chen Jiameng retreated a little distance, he found that the blood had disappeared, and only a small amount of oozing blood remained.

"It should be guessed that there is no mistake in guessing that this kind of hemorrhagic shock, after the location of the bleeding is treated, the patient's blood pressure fluctuations will level off."

"But the blood transfusion is still necessary, and according to the amount of bleeding at the scene, the patient's blood loss has reached above the shock standard."

Fang Ziye explained that his operation was effective, and at the same time continued to warn the others not to let their guard down.

Everyone observed for a while, and finally saw that the patient's blood pressure was maintained at a high pressure of about 85!

I didn't go any further, thank goodness.

Chen Jiameng immediately said: "Contact the blood bank immediately and apply for emergency blood matching, red blood cells and good plasma are all needed, the more the merrier!" ”

"Tell them that the patient's blood loss is at least 3000ml or more!"

"Establish venous access ...... right away"

When Chen Jiameng said this, the doctor in his own department in the emergency department immediately nodded in thanks. And said: "Dr. Chen, Dr. Fang, thank you for your hard work, except for the surgery, we will make proper arrangements for the rest." ”

In fact, the emergency rescue task of the emergency department belongs to the emergency department.

But it was really the rescue of this patient, there was no other way than to stop the bleeding, and even temporary compression to stop the bleeding was useless, so the doctor on duty in the emergency department could only turn to Chen Jiameng for help.

Chen Jiameng didn't reply, although he didn't help much, he could be regarded as completing his task.

With a sigh of relief, Chen Jiameng glanced at his white coat that had been contaminated, smiled bitterly, and said to one of the people in the emergency department: "Brother Liang, I have to borrow your white coat again, I can't use it again." ”

"It's okay, we have a lot of white coats in the emergency department, and there are various models." The person named Brother Liang has very kind eyes.

It's just that when he was talking, he consciously or unintentionally glanced at the ears of the hemostats inserted into the patient's body at the moment, and always felt that such an operation would come from the hands of such a young doctor, which was still too unbelievable.

Only then did Fang Ziye answer the question of the attribution of the disease raised by Chen Jiameng before: "Doctor Chen, the follow-up surgical treatment of this patient should be taken over by vascular surgery, and I have never seen our department deal with the iliac artery system. If it is simply below the femoral artery, it is under our management. ”

"Well, good! ~”

"Thank you. Dr. Fang. "Chen Jiameng didn't call Fang Ziye Xiaofang today.

"Yes, Brother Mong......"

Chen Jiameng and Fang Ziye went to the emergency surgery clinic for the time being!

The situation here is not particularly clear, and Fang Ziye is not a god.

Nor can it be determined visually that the patient's subsequent surgery does not require the involvement of trauma surgery.

And when Dr. Mitch from the Department of Vascular Surgery rushed from the break room to the emergency room as quickly as possible, it was less than a minute before the call ended, which was very timely.

But even so, Mitch seemed to find himself a little late.

A general glance at the hemostat in the patient's lower abdomen showed both ears on the outside and the tip on the inside.

Mitch's back tightened and asked, "Who is here?" ”

This kind of operation cannot be completed by ordinary people in vascular surgery, and he has seen several professors who have operated at special points in time.

(End of chapter)