183 Grow old – Diagnosis is faster than the system
Elder Fang was very disdainful.
"Catch two big fish, and you can't even find the master of home, you deserve to tell me this."
Chai Lao was proud and laughed silently.
A few days ago, Chai Lao accidentally caught a big carp of more than 20 catties, and he deliberately found a 28-bar fish to carry around in the community for 4 hours.
Fang Lao's eyes were red, Lao Chai just greeted him twice, and finally chased the fish to Versailles at home.
"The little snail honors me, that kid is attentive. I'll tell you about the old side, you can't declare personal vendettas, public weapons for private use, fake public and private ......"
"What other idioms do you know?" Elder Fang asked unhappily.
"In the past, when you reviewed the medical projects of the National Science and Technology Fund, you must be dedicated to the public, loyal to the country, self-denial and public service, and everything must be open and honest."
Fang Lao had a gloomy face, and strode out of the VIP passage under the guidance of the staff.
"Old stubborn." Chai Lao sneered behind his back.
Facing him, Chai Lao saw Luo Hao's familiar smiling face.
"Elder Fang, I haven't seen your old man for a long time." Luo Hao politely bent down and stretched out his hand.
Fang Lao shook Luo Hao like a little water.
Luo Hao then stepped forward and hugged Chai Lao with open arms.
"Boss, haven't you eaten well lately? Fishing is coming. ”
"At such an old age, why don't you fish?" Chai Lao reprimanded, "There is a hot meal in the fishing car, and you don't want to look for me if you are hungry." ”
The more he spoke, the more proud he became, looking at Fang Lao's back and smiling.
Luo Hao sighed in his heart.
The boss is causing trouble for himself.
Usually the boss says that you don't want to get into trouble, and if you get into trouble in the future, just don't say it as a teacher.
But now, Luo Hao really wants to say to Boss Chai - if you get into trouble in the future, just don't tell me about your apprentice.
But this pot has to be carried by itself, it really can't be done, and Boss Chai will naturally solve it. Even if he moved to live in Fang's house, he could solve it.
"Lao Fang came here, firstly, to see you, and secondly, because of the need to revitalize the Northeast, he wants to come and see several hospitals here." Chai Lao whispered, "You are in the provincial capital, and the university is too bad." ”
"Boss, there are more than 40 academicians of the Chinese Academy of Sciences and the Chinese Academy of Sciences of the People's University of China, and there are only two of us in the medical university, and they are both former presidents and presidents, so there is no comparison."
"How's your hospital? Donglian's side is OK, the decoration is magnificent, but the technical level is too poor. ”
Chai Lao took Luo Hao's hand and asked.
"Donglian was built with funds when the mining area still had money, and according to the standard of 8,000 per square meter, it is not much worse than our association and the international department. Now that there is no money in the mining area, no one can do anything, the law of nature. ”
Luo Hao replied.
"Where's your freshman medical college?"
"It's okay, I can only say it's okay." Luo Hao said, "Last year, the number of surgeries ranked among the top five in the country, and it is no problem to remove some water and rank among the top ten in the country." Boss, you can't be harsh, I can say that I am poor. ”
"Haven't you been okay since China and Russia opened their mouths?"
"I haven't checked the previous information, I've been too busy lately. Surgery, Teaching ......"
"You two, don't have a small meeting, there is nothing you can't say to my face!" After greeting the people from the Health Commission and the provincial and municipal offices who came to greet Fang Lao, he turned around and reprimanded.
It seems that Fang Lao is indeed a little unhappy, Luo Hao has no problem.
"I caught a big fish the other day! It's almost fine! Chai Lao glanced at Fang Lao, brought up the old matter again, and described it again, "I released that fish later, it is not easy to grow so big, maybe it will really become a fine in a few decades." ”
"Boss, do you still believe this?"
"I can't eat it, it's a waste, I'm just angry with these old ghosts, why bother with such a big fish."
Chai Lao said with a smile, Luo Hao was very pleased.
As long as the boss is happy, as long as he is happy.
It is said that the boss is in his twilight years, no matter how happy he is, how long can he be happy, and every day he is happy is a day.
"Dr. Luo, are you now leading the team in the Interventional Department of the First Hospital of the Medical University?" Elder Fang asked.
"Yes, Elder Fang." Luo Hao replied with a smile.
"How many surgeries do you do in a year?"
"I've only been here for less than three months, and I have an average of about 300 surgeries a month."
300 surgeries a month, although the number of surgeries is not appalling, but it is enough to meet the standard.
Of course, this is compared with the "demons" that appear in some special circumstances.
Fang Lao was satisfied with Luo Hao's surgical volume, "How is the patient's recovery?" ”
"The time is relatively short, and there is no rigorous ...... on the follow-up records, second admissions, and long-term treatment effects."
Luo Hao changed his tone and answered Fang Lao's questions with professional sentences, attitudes, and vocabulary.
Luo Hao didn't talk about the other party's old question, but just explained the problem realistically.
The scope of involvement is only in the field of intervention, and he does not talk about other rescues and surgeries that he has completed.
Elder Fang was very satisfied with this.
"Let's visit the first hospital of your medical university and see the medical construction here." Fang Lao waited for Luo Hao to finish speaking, and then said, "You guys have a lot of surgeries every year, Dr. Luo, are you still used to it?" ”
"It's good." Luo Hao said, "Although the research on rare diseases is not as good as that of the imperial capital, the diagnosis and treatment of common diseases are very high. The development of new technologies has not been left behind, and it has always kept up with the times. ”
Dean Zhuang and Dean Jin breathed a sigh of relief.
Luo Hao, this kid is okay, he can help say something when something happens. Not much, just one sentence is enough.
When they came to the First Hospital of the Medical University, the group started from the emergency department.
The emergency department is well organized.
Although he knew that Elder Fang was going to visit today and was prepared, in Luo Hao's opinion, it was almost the same.
The diagnosis and treatment of the emergency department of the first hospital of the medical university are also very standardized.
For example, the patient with a ruptured abdominal aortic dissection already had a definitive diagnosis in the emergency department.
A prerequisite for successful self-treatment is a clear diagnosis from the first doctor.
Moreover, at that time, the patient was in the emergency department and even had a micropump to lower blood pressure, and also injected subcutaneous morphine for analgesia, and consulted with relevant departments, and the whole process can be said to be flawless.
If the level of emergency departments in the whole country is at this level, at least many people die every year.
As for the dissection rupture, it was an extremely rare accident and cannot be blamed.
Luo Hao introduced as he walked, including the case of aortic dissection rupture that he encountered last time.
He was not vague about his rescue, nor did he exaggerate, while affirming the level of emergency first aid in the First Hospital of the Medical University, he told Fang Lao the entire process of his first aid.
Fang Lao listened with relish.
Abdominal aortic dissection ruptures, and anyone who knows much about medical care knows that the patient is definitely gone, and there are almost no accidents.
But if nothing else, the accident still happened, and it happened to Luo Hao.
So Fang Lao raised a lot of questions about this, and Luo Hao answered them one by one.
The doctor who can save the ruptured aortic dissection will definitely gain enough respect, even if Fang Lao said in his heart that Luo Hao was a sycophant, but he didn't talk much about this matter.
It's unreasonable to talk too much, and if you want to pick a thorn, you can't catch Luo Hao's proud rescue thorn.
"Dr. Luo, yes, amazing!" Elder Fang finally gave Luo Hao a compliment.
Luo Hao is also not modest, this kind of rescue itself is very awesome, and it belongs to the kind that can be blown in Concord.
If you are modest, you are hypocritical, and you are not beautiful.
The emergency department was on standby, and Fang Lao was very satisfied.
Then I went to the interventional department and the interventional operating room.
Chen Yong, Shen Zizai, Yuan Xiaoli and other professors with the group were operating, and Fang Lao came in and took a turn, noncommittal.
The number of surgeries in Luo Hao's medical team can be said to be the backbone of the hospital no matter which hospital it is in, and it is not bad even if it is placed in Xiehe.
"It's not bad, Dr. Luo has been able to open up the situation in less than three months since he came to the First Hospital of the Medical University, and he is worthy of being Boss Chai's apprentice." Fang Lao secretly sneered.
Sure enough, Boss Chai's face was a little ugly, and Luo Hao was even more embarrassed.
But what can Luo Hao say? I just slandered in my heart - bad old man is very bad.
"Take a look at your big operating room, and then go to the various critical cases." Fang Lao proposed.
Dean Zhuang has received information from various channels in recent days, and Fang Laolai is not just for Luo Hao, but also to take a look at the current medical situation in Bac Giang Province and find out the bottom.
What exactly it is for, the dean of Dean Zhuang's level is unknown.
Coming to the locker room of the operating room, Elder Fang looked at the sign prohibiting smoking and asked, "Dr. Luo, do you often sit down here and smoke?" ”
"Elder Fang, I rarely smoke." Luo Hao took out his cigarette and showed it to Fang Lao, "I usually think about things, and when I finish thinking about it, I put the cigarette back." ”
"That's right!" Elder Fang glanced at Boss Chai, "Learn something good, don't always learn from them." Such a big brand, as if it is invisible, astigmatism, presbyopia, these are all problems, and they must be treated. ”
"I'm used to smoking, and if I don't have a one, I'm bored."
"It's like you can still have surgery. Your last surgery, when you were 72 years old, must have had it. Lao Chai, this person, you have to obey the old. Fang Lao said with a smile.
Chai Lao sighed, his originally triumphant expression was a little lonely.
Beauty is twilight, heroes are at the end, and life is probably nothing more than that.
Fang Lao is pharmacological, and he belongs to the kind that the older he gets, the more valuable he is.
Luo Hao knows the thoughts of the elderly, they may be magnanimous, kind, and kind to the younger generations, but their attitude towards the "old immortals" of their peers will be much worse.
Fighting and scolding each other, as if they kept the shadow of their youth.
But!
Luo Hao couldn't hear anyone say that his boss was old, even if it was Fang Lao, he turned around and looked at Fang Lao.
"The boss is always strong." Luo Hao said to Elder Fang plainly but seriously.
As if telling a fact, it was like a small beast baring its teeth at the king of the tribe and issuing a challenge.
Chai Lao raised his eyebrows and raised his hand to Luo Hao's shoulder.
Luo Hao bent his knees, bowed, smiled all over his face, and sent his shoulders under his boss.
"Old, that's old." Chai Lao said, "What is old and strong, I didn't dare to go to the stage after 72 years to be the main knife, and when my hands are itchy, I will give Xiaoqian an assistant to enjoy it." ”
"His level is much higher than when I was younger, and I thought that it would take me 3 or 4 hours to have a pancreaticoduodenectomy back then, and I had to worry about various complications after the operation, so I was sent to the ICU...... Now I have a small amount of money to open a da Vinci robot, order one for two, and ...... after surgery Gee. ”
Boss Chai said with a smile, and unconsciously suppressed the little flame that Luo Hao was "offended" just now.
Elder Fang looked at the old and the young, and showed a smile.
That's nice.
"Two old people, there are a total of ...... operating rooms in the operating room of our first medical university," Dean Zhuang began to introduce, no matter how big or small, the preparation was quite sufficient.
Chai Lao listened with a slight bow and strolled through the corridor of the operating room.
"This is the emergency room, and it's an appendectomy."
"This is an emergency room, a C-section."
"This is an emergency room, and I'm doing acute cholecystitis."
"This is a slow diagnosis of the underworld, doing ......"
"This is a slow diagnosis of the yang, doing ......"
The director of the anesthesiology department introduced Mr. Fang and Mr. Chai to Mr. Fang one by one.
Chai Lao looked at it with a smile, and Luo Hao quietly followed the boss.
He didn't continue to provoke Fang Lao, although Luo Hao was very uncomfortable listening to that sentence and replied, but Boss Chai suppressed the matter, and he treated it as if it didn't happen.
Luo Hao was not afraid of Fang Lao's revenge on him.
If you are afraid of academic struggles, it is better to stay in the first hospital of the medical university as a department head or dean.
Academic struggle is not a dinner party, it is about blood!
Luo Hao is well aware and has witnessed several bloody academic battles.
After introducing more than 20 operating rooms one by one, everyone had already reached the end of the corridor.
Chai Lao saw that the itinerant nurses were clinging to the wall when they came out to get things, so he said with a smile, "Let's go back, don't delay people's work here." ”
Elder Fang also nodded.
The doctors and nurses of the First Hospital of the Medical University are well-trained and orderly, and they are indeed worthy of the top 10 large-scale tertiary hospitals in the country in terms of surgical volume.
"Little Snail, go to your circulatory CCU and have a look." Chai Lao Dao.
"Great!"
More than 20 people were in the corridor of the operating room, and Chai Lao knew that he and Lao Fang were causing trouble.
It's not a serious inspection, just take a look, know that Xiaoluo's usual working environment is reliable, and I also have a bottom in my heart.
"Didi Didi~~~"
The alarm of the monitor sounds.
"Wow~~~"
The door of the operating room opened, and the itinerant nurse went out to report the good news, and there was a nurse holding a big fat boy inside.
Chai Lao looked over along with the cry.
Luo Hao's gaze also turned with the boss.
Next second!
The diagnostic assistance AI began to spin wildly, giving a diagnosis at the snap of a finger.
Luo Hao noticed that the background board turned white, miserable white, and occasionally red blood dripped, like a poster of a ghost movie.
This is......
At the same time, the position of the system task is constantly flashing, and it seems that it should be an emergency mission.
Is it a newborn?
As soon as Luo Hao's thoughts turned, Chai Lao suddenly straightened his waist, as if he was twenty years younger in an instant, and walked into the operation room like a fly.
He glanced over the surgeon's shoulder as he passed by, then over to the patient's head.
"What's your name?"
"I ......" The patient's voice was a little small, barely opening his eyes.
Chai Lao glanced at the monitor and rolled the patient's eyelids again.
Moment.
The momentum on Chai Lao's body has changed!
"Amniotic fluid embolism!"
Before Chai Lao's voice fell, the words "Emergency Mission" appeared on the system panel in the upper right corner of Luo Hao's field of vision, and the diagnostic auxiliary AI also gave a diagnosis - amniotic fluid embolism.
Luo Hao's heart was cold, and his heels were cold.
Chai Lao has come to the patient's left chest area, and walks up in a standard chest compression position.
The others haven't reacted yet.
Not to mention people, even the ECG monitoring has just responded, and the patient's heart rate has risen rapidly from 120 beats per minute to 160 beats per minute.
The ECG oscilloscope began to vibrate, and the oxygen saturation changed from 99% to 67%.
Chai Lao's hand was just about to fall, and the electrocardiogram had changed again from a brief ventricular fibrillation, pulling out a straight line.
As soon as the straight line walked 1/4 of the screen, Chai Lao's chest heart compressions had already begun.
"Epinephrine 1 mg intravenously." Chai Lao's medical order came out immediately.
There was only the alarm sound of the monitor in the operating room, and no one except Luo Hao realized what was happening.
"Smack~~~"
Luo Hao immediately broke the section with one hand, and the syringe in his right hand extracted 1mg of epinephrine and pushed it into the tee.
"Professor Luo, you ......"
"Amniotic fluid embolism! It's not a machine failure, hurry up and rescue! Luo Hao said.
He then handed the syringe to the anesthesiologist, "Boss, I'll do it." ”
"You go cut the uterus!" Chai Lao said solemnly.
The voice was not loud, but the voice was cold and cold like a knife.
Chai Lao's chest heart compression standard, a few seconds later, everyone realized that something was wrong.
The patient has a large amount of oozing blood in the abdominal cavity.
The surgery was clean, it was just a caesarean section, and there was no reason why it wasn't clean. But the scene of a pool of blood in an instant frightened the magician, what happened.
It's really an amniotic fluid embolism!
The surgeon's mind went blank.
For obstetrics and gynecology, amniotic fluid embolism has a special significance.
Luo Hao saw that the boss's chest heart compression temporarily stabilized the patient's circulation, poured a handful of red soup on his hands, wiped his hands with iodophor gauze, and then put on clothes and gloves.
Tying the straps of the sterile gown, Luo Hao pushed his shoulders and squeezed the surgeon aside.
The patient's body was moving violently, one was caused by Chai Lao's chest compressions, and the other was the dying convulsions of the muscles themselves.
It was only a continuous epidural anesthetic, and no muscle relaxants were given.
"Intubation, general anesthesia!" Luo Hao roared.
Director Xu of the anesthesiology department saw the oozing blood in the abdominal cavity, and the blood oxygen saturation was no longer measurable, he just changed his finger to the oxygen saturation clip, but it still couldn't be measured, and he already believed Chai Lao's diagnosis in his heart.
Fuck it, have an amniotic fluid embolism!
Director Xu began to instruct the anesthesiologist to intubate, and the continuous epidural anesthesia was changed to general anesthesia.
"The new triptych pushes once."
"Woo two push once."
"Epinephrine, 2mg, given intravenously right away!"
Chai Lao was doing chest heart compressions while giving medical orders.
"Chai Lao...... This is? Dean Zhuang walked over tremblingly, "Is it a machine failure?" ”
"Get out of the way! Rescue it! ”
Chai Lao's temper was ignited, and he scolded in a deep voice.
Luo Hao ignored the surprise and surprise of Dean Zhuang and the others, Boss Chai was experienced and sophisticated, and the diagnosis of amniotic fluid embolism was even a little earlier than the systematic diagnosis.
There is a boss's diagnosis, a systematic diagnosis, and I also saw a large amount of non-clotting blood gushing out along the surgical incision, not amniotic fluid embolism or something!
Luo Hao picked up the arc scissors, cut the uterus, bladder, peritoneum, and folded back, reached the round ligament on both sides, and suddenly pushed down to the uterine opening.
Immediately, the left broad ligament was perforated in a vascular-free position, and three hemostats clamped the isthmus of the fallopian tube, the propria ligament of the fallopian tube, and the round ligament in turn.
Although Boss Chai's action of chest heart compressions seriously affected the operation, Luo Hao followed his boss's movements to complete the operation and didn't seem to notice it at all.
Line 10 is single-tied, Luo Hao has no time to sew, and the opposite side is the same operation.
Then Luo Hao copied it with his left hand, held up the uterus, and began to tie and suture the blood vessels.
The instrument nurse was dumbfounded, and she realized that something was wrong.
It's not just the ECG monitoring that is alarming, but there are more and more non-coagulating blood in the abdominal cavity, and Yizhu subconsciously sucks blood with a suction device, but he can't finish sucking it.
Like Kubrick's Shining, the instrument nurse subconsciously felt that she didn't know when the invisible door would disappear and blood gushed out.
She almost subconsciously handed Luo Hao the instruments, but she did not delay the operation.
3′12", the uterus is cut off and thrown on the instrument table.
Luo Hao carefully inspected the place where the stitches should be stitched, and then said to the surgeon, "Go and tell the patient's family that the uterus must be cut!" ”
The sorcerer cried.
Big brother, you cut it first! I even explained a yarn to the patient's family.
"Pure oxygen, pure oxygen for his mother!!" Director Xu only reacted at this time and began to yell.
The total mind of the obstetric hospitalization is still blank.
"Meng Liangren!"
"Professor Luo, I'm here."
"Go and tell the patient's family that the amniotic fluid embolism must be cut to the uterus, and they will say."
"Yes, I'll go." Meng Liangren kicked open the airtight door of the operating room and walked out.
Elder Fang, the leaders of the provincial and municipal health commissions, and the deans of the First Hospital of the Medical University were all dumbfounded.
"I'll go." Feng Zixuan stopped Meng Liangren and said with a sad face.
"Director Feng, inform the ICU that the patient will go down immediately. Prepare blood, at least 10,000 ml!! Today!!! I don't know how much I will need tomorrow, but prepare at least 50,000 ml of blood. ”
"You, shut up!" Luo Hao handed the instrument to the general manager of the obstetrics hospital, took off his gloves and came to Chai Lao's side.
Although it was only less than 5 minutes, Chai Lao was already tired and sweaty.
"Boss, I'll come." Luo Hao said respectfully in his busy schedule.
Chai Lao nodded, turned around and stepped down.
"Roar~~~" Chai Lao's breathing has already begun to pull the wind box.
Strenuous exercise caused tracheal spasm, and the sound of breathing changed, old man, indeed old man, Boss Chai sighed in his heart.
But no one notices this, and everyone's attention is on the number of signs on the ventilator, on the monitor.
After chest compressions, hysterectomy, and endotracheal intubation, the patient's condition is gradually clear - amniotic fluid embolism!
"Epinephrine 1 mg intravenously, von ...... Dean Zhuang, you go to the leader of the blood bank in the city center and ask for a large amount of blood, and how much blood is in the bank. Luo Hao said coldly while doing chest compressions.
Luo Hao lost his usual gentleness, and his whole body exuded a cold aura.
Dean Zhuang was startled, but realized that it was an amniotic fluid embolism, so he immediately took out his mobile phone, kicked open the airtight door of the operating room, and walked out.
"I, Zhuang Yongqiang, a medical university! There was a patient with amniotic fluid embolism who needed 30,000 blood. ”
"None? What the are you eating! I don't care, there must be! ”
Dean Zhuang was anxious.
Maternal, amniotic fluid embolism.
Others don't know what these two words mean, but Dean Zhuang understands.
The salvage is over temporarily, but that's only temporary.
(End of chapter)