The anesthesiologist was stunned.

Looking back on the process of emergency tracheal intubation, I did have certain problems as Mr. Wu said.

But Mr. Wu was smiling, but his words were yin and yang, like an invisible hand, twitching on his face.

It hurts.

"The operation was a success, Mr. Chen. Wu Mian looked at Chen Houkun and asked with a smile.

“......”

If someone else asked, Chen Houkun would definitely say that he had succeeded.

But Wu Mian asked...... There is another patient in the intensive care unit who is more seriously ill and has a better recovery, and Chen Houkun can't say the words "successful operation" no matter what.

"I glanced at the operation record, and the process was fine, and it should have been smooth. Wu Mian's smile was still gentle, "I just said that the problem of the anesthesiologist is not very important, after all, people are lucky and the one-time intubation is successful, so you can't blame the problem on anesthesia." ”

"The successful one-time intubation under the video laryngoscope does not lead to severe laryngeal edema, so what causes the patient to have severe laryngeal edema?" Wu Mian asked.

"Probably...... It may be ......" Chen Houkun also thought about this for a long time, and had certain ideas in his heart.

"The patient was in the prone position, the neck was tilted forward, and the tissues were compressed for a long time, resulting in venous return disorder, and the patient was assessed as having a difficult airway before surgery, and it was a long-term cervical prone operation, so it led to postoperative laryngeal edema. Wu Mian said, "You are considering that the operation went very smoothly, so in order to prove your level, so you extubated in advance?"

Punish the heart, every word and every word is like a knife pierced into Chen Houkun's heart.

Normally, it is prudent to remain intubated for at least 24 hours postoperatively. But the operation went well, Chen Houkun was also a little proud in his heart, and with some careful thinking, he decided to extubate.

Unfortunately, it is easy to extubate, but it is difficult to send it back from the new and undamaged.

"Extubation after surgery is not impossible, but you have to be very careful. It is recommended that the next extubation device or bougie be left to avoid the formation of an emergency airway after extubation. Wu Mian looked at Chen Houkun, his voice was neither high nor low, he just stated one thing, and did not have any subjective thoughts.

"Later, I found that the laryngeal edema, and I tried to re-intubate it repeatedly. After Wu Mian finished speaking, he turned his gaze to Wang Ziliang again.

"Uh...... It's ......"

"You're bolder than they are. Wu Mian said lightly, "The patient has airway obstruction and respiratory depression. Mask ventilation, as a result of which mask ventilation is difficult, oxygen and cannot be maintained. In the case that ventilation cannot be guaranteed, spontaneous breathing is interrupted with vecuronium bromide 8mg. Can you guarantee that mask ventilation will not be difficult after giving muscle relaxants, or will endotracheal intubation be successful enough on the first attempt?"

"But...... No muscle relaxants, more ......"

"I know. Wu Mian nodded, "The British "DAS2015 Edition of the Guidelines for Unanticipated Difficult Endotracheal Intubation for Adults" points out that muscle relaxants can help improve the effect of mask ventilation, improve glottis exposure and endotracheal intubation conditions, and improve laryngeal mask placement and ventilation conditions. ”

"There is nothing wrong with the use of muscle relaxants, but what is the premise of the DAS2015 edition of the Guide to Unanticipated Difficult Endotracheal Intubation for Adults?"

Wu Mian looked at Wang Ziliang and asked in a deep voice.

“......”

"The guidelines clearly state that maximal mask ventilation should be attempted to ensure adequate muscle relaxation, while aggressively preparing for an invasive anterior cervical airway such as cricothyroidotomy. ”

"At this time, it is necessary to explain the condition to the patient's family, and if it is unsuccessful once, you can use cricothyroid membrane puncture to send a wire retrograde. If it doesn't work, why don't you do a tracheotomy?" Wu Mian's voice was a little cold, and his smile was not as gentle as just now.

"The patient's family refused...... Wang Ziliang said curtly.

"It's because that's what the owner of the money meant. Wu Mian shook his head slightly, "The gold lord is not a doctor, they take money, and it is natural for you to see a doctor." However, medical care is not a standard service industry, and in some special cases, it is impossible to adhere to its own professional opinions, make amends for previous mistakes, and blindly listen to the opinions of patients' families, what is the use of asking doctors. ”

"No one can afford not to make mistakes, and what happens to a patient after surgery is not a serious complication. After all, it is normal for the operation to be successful, and occasionally there are some minor complications. But Xiangjiang No. 1, the world's top private hospital, everything is decided by money?" Wu Mian tilted his head slightly, and his eyes swept over all the doctors sitting in the room.

"If money is the final word, why don't you let the patient's family save the life themselves?"

"The Zheng family is a top chaebol in Xiangjiang, but not a top doctor. In your own professional field, can you be a little persistent? ”

"Do you really think you're a waiter?"

"If you can't cook a meal, someone else will change to another one. But if you can't cure the disease, what if you die?"

"Alright, that's all I have to say. Wu Mian swept the people in the room again and smiled slightly, "There should be no problem with the patient, the software and hardware level of the Hong Kong Sanatorium and Hospital are very high, it can be said that it is the top in the world, no problem." ”

After speaking, Wu Mian stood up, bowed slightly, and strode away.

Wei Dabao followed behind Wu Mian and glanced at the many doctors here. He didn't know any of them, but Wei Dabao could feel the aura of a senior doctor emanating from these people.

That's the arrogance that comes naturally with the support of technology.

But these people were trained by Section Chief Wu like dogs, with their heads down, and they didn't dare to say a word.

The old doctor named Wang Ziliang returned the same sentence, but he was directly scolded back by Section Chief Wu. Tsk, when can I be so breezy?

Ren Haitao's face was humble, he was different from Wei Dabao, he knew Wang Ziliang.

As the world's top expert, the academic association also invited Professor Wang Ziliang, a well-known critical care expert in Xiangjiang, to give guidance on the brochure.

At the meeting, Ren Haitao clearly remembered that Wang Ziliang said that he didn't understand technology very well.

But in front of Mr. Wu, Professor Wang Ziliang was like a student, who was pointed out countless mistakes, stupid like an intern.

Really? Ren Haitao knows it in his heart.

What Mr. Wu said is actually correct from some perspectives. But, they can't argue with that.

When the tracheal intubation is not entered, and the family does not agree to do tracheostomy, only Mr. Wu can retrograde send the guidewire up and then implant the tracheal intubation.

People can do it, others can't, so Mr. Wu can point to his nose and train one after another, and others can only listen.

Even if I want to talk back, when I think of the operation just now, I feel empty.

In fact, they are only wrong in one place - they should not listen too much to the opinions of the patient's family.