Back in 2002 as a doctor

"Actually, as long as you know the principle, it's not difficult. I heard from Director Wang that you have to accept 3-5 patients with heart knife stab wounds a year."

"The treatment is the same as that of a heart knife stab wound. As long as you encounter a critical situation, don't panic."

While Zhang You was showing off, his sternum had been separated.

"Sternum saw!" Zhang You said in a deep voice.

The equipment nurse handed the sternum saw to Zhang You, and Zhou Congwen helped to pass it on.Zhang You glanced at Zhou Congwen, who was honest and honest, and the bun folds appeared in the corners of his eyes.

Flick the switch, and the sternum saw hums.

"Open the installation first, and insert the sternum saw after the inspection. Remember, you must lift the saw up hard to avoid most of the damage."

Zhang You said while doing it, and the entire sternum was lifted by at least 0.5cm by the sternum saw.

The incisions under the xiphoid process seem to be not big enough, and they are stretched and deformed, which looks a little pitiful.Zhou Congwen sighed, interventional surgery is better, puncture, stent, end.

Wang Chengfa asked for a sterile gauze to cover above the breastbone.

hum~~~

The sound of the sternum saw sounded, and blood foam and bone fragments splashed everywhere.But Wang Chengfa was prepared, and didn't spray it everywhere.

Whether the operation is done well or not is actually an indication of the experience of the surgeon.

Both Zhang You and Wang Chengfa have rich experience in opening the chest.

When the sternum was sawed to the lower 1/3 of the sternum, there was a sudden freeze. Zhang You's eyebrows twitched slightly, and he stopped temporarily, looking at the ECG monitor.

It's okay, just a false alarm.

But as the humming sounded again, it was accompanied by cardiac monitoring.

The alarm sounded loudly.

Chapter 0171 Crow's Mouth

Zhang You was taken aback suddenly, but he reacted very quickly. Although he didn't know why the ECG monitor called the police at the first time, he still subconsciously stopped the sternum saw.

The buzzing disappeared, and the ECG monitoring alarm became louder, causing blood pressure to soar, and adrenaline and dopamine to be secreted in large quantities.

Zhou Congwen narrowed his eyes, and hooked the footstool under the instrument table with his left foot.

If it is a normal operation, there is no need for a footstool. Zhou Congwen is 1.8 meters seven, and his normal vision is sufficient, but because he is a second aid, he can't see it if he wants to, and he can't do it if he wants to.

But now there is an accident, he needs vision.

No one noticed that Zhou Congwen was "high", and everyone's eyes were on the ECG monitor.

In just a few seconds, the sinus tachycardia on the ECG monitor turned into ventricular fibrillation, and the blood pressure also dropped precipitously, from 128 mm Hg to 85 mm Hg.

Blood gushed out from under Zhang You's hand, like a red spring.

Broken heart... damn it!Zhang You scolded his mother in his heart.

It’s just that I owe it to myself to perform the operation well, and what to do once the heart is sawn through!Since when has my mouth been opened, and I hit it right away!

Okay now!

Zhang You is indeed rich in experience. After all, he is the head of the Department of Cardiothoracic Surgery in a large public hospital in the provincial capital.

Not chaotic in times of crisis is the basic quality, the emergency response that Zhang You said before is not a big talk.

After confirming the situation, he didn't stay in a daze. He immediately took out the sternum saw, and then just like what he said before, he stretched his fingers in to investigate.

He pressed his fingers to the opening of his heart, and hot blood flowed out between his fingers.The blood flow was so fast that Zhang You couldn't hold it down at all.

Fuck it!Zhang You realized that something was wrong, his whole body was cold and his face was pale.

"Epinephrine, 1mg, intravenous injection!" Although Zhang You had a bad premonition, he still presided over the rescue subconsciously.

"Director Wang, cut the sternum."

Cutting the sternum...no one would normally do that.After all, it is a bone. Even if the elderly have osteoporosis, it is difficult to do it without professional equipment.

The surgical instruments in the Third Hospital lacked pliers, so Wang Chengfa could only pick up the blunt scissors in the chest incision bag and start cutting from the position on Zhang You's finger.

The scissors are useless in one click and can no longer be used, but at this moment no one cares.

It is necessary to cut open the sternum exposure field at the first time to see how much the heart is damaged.

Holding the scissors in his hand, Wang Chengfa cut open the sternum with a 1′21″. An appendix hook was placed on one side of the sternum to pull the sternum apart.

In a flash, no one except Zhou Congwen could see clearly where the heart was damaged in the pool of blood, except Zhou Congwen.He saw two cracks in the patient's right ventricular free wall and the atrioventricular groove, about 6cm and 3cm long, respectively.

How can it be damaged here?

Zhou Congwen didn't even think about this question.

But as a doctor, a surgeon, I know very well in my heart that it doesn't matter if I understand it or not, what matters is how to solve the problem.

"Pull away!" Zhang You roared sharply, and the calmness and calmness just now disappeared in an instant.

Wang Chengfa cut open the patient's sternum, but there was only one appendix hook on the sternum.

At this moment, Zhang You didn't pay attention to who opened the half sternum, and who didn't open the other side. Except for the operation area, the other background was the light of the shadowless lamp in front of him, which was a vast expanse of white.

Liu Di was already dumbfounded by fright, until he heard Zhang You sternly yelling at him, he touched a hook to pull the other side of the sternum apart.

Blood gushed out, and there was no surgical field at all.

"attract……"

As soon as Zhang Yougang spoke, the suction device that had been removed fell into the blood.The negative pressure suction sucked away the blood in the operation area, but the field of vision was still only a moment before the operation area was filled with new blood.

It's over!Zhang You felt a chill in his heart.

Why is there so much blood when my finger is pressing on the wound? !

"Prepare blood, prepare for extracorporeal circulation." A young voice appeared in the operating room.

The extracorporeal circulation technician brought by Zhang You glanced at each other, and they didn't think it would be useful to need extracorporeal circulation now.

Rescue the bleeding first, and use extracorporeal circulation. I don't believe that this operation can continue.

Zhou Congwen saw that no one moved, and Zhang You just pressed his fingers on the opening in a daze. The extracorporeal circulation technician stood behind Wang Chengfa and watched the rescue, and he sighed inwardly.

There can only be one voice in the operating room, but it's 2002... what the fuck!Zhou Congwen cursed in his heart.

"Director Zhang, I saw two cracks in the free wall of the right ventricle and beside the atrioventricular groove, about 6cm and 3cm in length respectively." Zhou Congwen said quickly.

"Ah? Did you see it?" Zhang You asked tremblingly.

"I see." Zhou Congwen said in a deep voice, "The tear in the free wall of the right ventricle is deep to the whole layer, reaching into the cavity of the right ventricle."

"..."

A burst of despair surrounded Zhang You like a tide.

If this is the case, even if there is blood around, giving blood with a pressurized blood transfusion device will definitely not be able to match the bleeding speed.

As for finger pressing on the wound...

This deep and full-thickness heart trauma, the wound is so big, and there are two, it is impossible to suppress it!

The patient did not seem to be in hemorrhagic shock and should go into cardiac arrest immediately.

Sure enough, just like Zhang You imagined, before his thoughts dissipated, the heart beat that was pressed by his fingers began to slow down and weakly.

"Heart stop! Anesthetist, give epinephrine; tour! Need blood, a lot!" Zhang You hissed.

"Participate in rescue by extracorporeal circulation, have you ever done it?" Zhou Congwen asked condescendingly, looking at the two extracorporeal circulation technicians in the Second Hospital.

"Ah? Is extracorporeal circulation necessary now?" asked the male extracorporeal circulator.

"The bleeding speed is slowed down under low temperature, followed by the autologous blood recovery system and extracorporeal circulation assistance.

The most important thing is to recover blood loss from the operative field to reduce the loss of the patient's own blood. On the other hand, artificial pumps can be used to quickly transfuse blood to maintain blood volume and arterial pressure. "

Zhou Congwen quickly explained the theory and convinced the extracorporeal circulator.

"Doctor Zhou, have you rescued him?" Zhang You asked tremblingly.

"Try it." Zhou Congwen said calmly.

"Get ready!" Zhang You had no choice but to just watch the patient die like this.And the time left for him is very short, as long as he hesitates for a moment, the patient will die after a few tens of seconds.

Zhang You heard Zhou Congwen's explanation just now. There is indeed a similar statement in the academic circles, but it is very high-end, and Zhang You has never come into contact with it.

In a trance, the image of the French IV and the video of the thoracoscopic demonstration operation overlapped. Zhang You felt that the figure opposite him was getting taller and more majestic, as if it was his teacher.

No time to hesitate, no time to think about other things, Zhang You saw that the cardiopulmonary bypass technician was still in a daze, he shouted sharply, "Prepare for cardiopulmonary bypass!"

Chapter 0172

"Is there a chance to salvage blood?" Zhou Congwen suddenly asked in a cold voice.

"Will... what model?" The extracorporeal circulator was startled.

Zhou Congwen remembered that the Third Hospital had bought a blood recovery machine, but because no one knew how to use it, it kept rusting.

"I'll push it." The itinerant nurse was already busy with smoke, but she was experienced after all, and after Zhou Congwen's reminder, she suddenly realized that the most important thing now was hemorrhagic shock.

Autologous blood is completely different from blood stored in a blood bank.

It is easy to dic if there are too many banked blood transfusions. I don’t know if autologous blood will cause dic, but just thinking about it can tell that the problem is not big.

"Autologous-3000P blood recycling machine."

The extracorporeal circulator did not speak, and Zhou Congwen exuded a powerful aura during the emergency rescue, which made them terrified.

After seeing the blood recovery machine, the extracorporeal circulation teacher breathed a sigh of relief, but fortunately it was the same machine as the Medical University.

Add 500U heparin to 25000ml normal saline to make anticoagulant.Connect the negative pressure suction to the blood storage tank, and pre-fill the recovery system with 50ml of heparin saline.

"Pay attention to the ratio of the amount of anticoagulant instilled to the amount of inhaled blood." Zhou Congwen saw that the extracorporeal circulator is very skilled in operation, so he told him not to worry about it later.

"Epinephrine 1 mg."

"Isoproterenol 1 mg."

"Lidocaine 10mg."

Zhou Congwen lowered his head to observe the damaged heart, while explaining the rescue doctor's order, he stretched out his hand and pressed the damaged point together with Zhang You.

However, the patient's heart beat more and more weakly, and stopped beating after pushing 2 rounds of medicine.

"Prepare the defibrillator, go on tour, stimulate blood. Director Wang, look directly at the pericardial cavity and press."

A series of doctor's orders came out of Zhou Congwen's mouth, and he paused slightly at the end.

Zhou Congwen turned his head to look at Zhang You, "Director Zhang, shall I take charge of the rescue?"

Zhang You felt bitter in his mouth, but his understanding of Zhou Congwen suddenly became much clearer.Chen Houkun's level is clear to him, why every time he finds this little doctor to perform surgery, it goes so smoothly?

The problem lies with Zhou Congwen!

Coupled with Zhou Congwen's responsibility when he encountered a problem that he couldn't solve, Zhang You understood everything in an instant.

"Come here, if I preside over the rescue of patients, I will definitely die. Don't worry, it's my operation's fault that caused the accident." Zhang You said in a deep voice.

Zhou Congwen glanced at Zhang You, but said nothing.

Wang Chengfa was shocked, Director Zhang is planning to turn against him?Isn't this a joke!

Zhang You was very single in the critical moment, not to mention giving up the work of presiding over the rescue, the accident was still his fault, first paved the way for Zhou Congwen, and let him carry out the rescue with all his heart.

But Wang Chengfa's confusion lasted only a moment. He raised his eyes and saw Zhou Congwen turned away from the operating table, with his hands flat on his chest, and walked quickly in a circle to his side.

"Liu Di, go to the blood bank to get a lot of blood!" Zhou Congwen explained in a deep voice.

Liu Di was stunned for a moment, glanced at Wang Chengfa and then at Zhang You. Seeing that the two directors focused on the rescue without saying a word and did not deny Zhou Congwen's words, he turned around and stepped off the stage, and trotted to the blood bank.

Zhou Congwen stood beside Wang Chengfa and pushed Wang Chengfa to the side of the patient's head.

"Ice cap!"

"Adrenaline, isoproterenol, another round of lidocaine."

"The preparation for the extracorporeal group is the Stockert III heart-lung machine and the Medtronic-541 membrane lung."

The extracorporeal circulator was taken aback for a moment, and gave an affirmative answer.

The young doctor opened his mouth and asked the model of the machine. The question had a different meaning in the ears of the extracorporeal circulator.