My medical skills are a billion points

"Thank you doctor!"

"Doctor, you have worked hard."

When the two finally returned to the office, they breathed a sigh of relief.

It has been several hours from the time he received the car accident patient to the end of the operation, Xiao Chu can't even take care of his saliva.

Now all the car accident patients have been dealt with.

Those who should transfer have already transferred.

Those who need emergency surgery have already been on the operating table.

Those who need to be hospitalized for observation have already lived in the general ward or the intensive care unit.

In short, after several hours passed, Xiao Chu finally had some free time.

But he still dare not take it lightly.

After all, several patients were also very serious before, but they could not meet the conditions for emergency surgery.

He still needs to visit these patients now to see how the situation is?

Has the condition progressed?

Are vital signs stable?

These are the key points that Xiao Chu needs to pay attention to.

Xiao Chu drank half a bottle of water in one breath, rested for a while, and was about to get up and go to the ward.

Unexpectedly, nurse Wang Jing hurried in and said quickly: "Director Xiao, the patient with head injury is now in a coma, and the pupils on both sides are not equal in size. Go and have a look."

coma? !

Bilateral pupils are not equal in size!

This is a sign of brain herniation!

Xiao Chu quickly rushed to the ward where the craniocerebral injury patient was.

At this time, an intern doctor and a nurse were surrounding the patient bed, checking on the patient.

Several family members are anxiously shouting to the patient!

"Sanba, what's wrong with you?"

"Sanba, talk, Sanba, open your eyes!"

"Sanba, I'm your mother, take a look at me."

Seeing that the patient was unconscious, several family members rushed to call him.

mess up.

As soon as Xiao Chu entered the hospital bed, a middle-aged woman in her fifties hurriedly grabbed his arm and asked in a crying voice:

"Doctor, hurry up and see what's wrong with my son. He was fine just now, why didn't he talk all of a sudden?"

Immediately afterwards, a young woman in her thirties also came up and said anxiously: "Doctor, my husband was still talking to me before, why did he suddenly stop talking, and he didn't wake up no matter how much he shouted, what's wrong with him? Is it right?" Is it getting worse?"

Xiao Chu didn't answer the family members, but went forward to check the man's situation.

This man was in his thirties, and he was the patient with subdural hemorrhage that Xiao Chu paid attention to before the operation.

Xiao Chu first checked the patient's pupils.

It was found that his left pupil had reached [-] millimeters and had no reflection to light.

On the other hand, the pupil on the right side is [-] millimeters in size and has a slow response to light.

The patient suddenly fell into a coma, and the bilateral pupils were unequal.

Clearly, the patient had increased subdural hemorrhage.

Brain herniation has now formed, and craniotomy must be performed as soon as possible.

Otherwise, the patient would die.

Patients like this are conscious when they are admitted to the hospital, the diagnosis is clear, and the bleeding is not much, so they cannot meet the surgical standards.

But within 24 hours, must be closely observed.

Because the possibility of continued bleeding is high.

If the observation is not careful, the patient is considered to be asleep.

That would be a big mistake, even a medical malpractice!

Chapter 251 A Twistful Rescue

Xiao Chu gave a detailed explanation to the family members as to why the patient suddenly fell into a coma.

And made it clear that the patient must be surgically treated immediately, otherwise life is in danger.

Now the patient only has unilateral mydriasis. If the operation is not done in time, there will be no need for surgery after the bilateral mydriasis is dilated.

By that time, he would be brain-dead, and there would be no point in rescuing him.

The patient was at a critical moment, and the family immediately signed the consent form for the operation.

Then the patient was pushed into the operating room by the intern.

Xiao Chu and Gao Yingjun walked back into the operating room in less than half an hour after getting off the operating table.

Gao Yingjun smiled wryly and said: "Xiao Chu, today's car accident is really busy for us, the whole rescue is really full of twists and turns!"

Xiao Chu was also helpless.

It's now two o'clock in the afternoon, and it's already past the time to get off work.

All the medical staff on duty can't even take care of food.

A patient like this one must be operated on immediately.

Xiao Chu and Gao Yingjun didn't care about eating at all.

After the two washed their hands and disinfected, they stood on the operating table again.

Xiao Chu has already done a few craniocerebral injury surgeries.

For this type of surgery, only two people are needed.

After all, it's an operation on the head. There are too many people not only can't sit down, but also can't be used.

For craniotomy, doctors do it while sitting on a stool.

Xiao Chu looked at the operation sheet.

Diagnosis: severe closed craniocerebral injury

Anesthesia: endotracheal intubation general anesthesia

Surgical method: decompressive left craniectomy + subdural hematoma evacuation + intracerebral hematoma evacuation + inactivated brain tissue evacuation

Chief Surgeon: Xiao Chu

First Assistant: Gao Yingjun

The head has been prepared and the surgical site has been determined by drawing a line.

After general anesthesia with endotracheal intubation took effect, the patient was placed in a supine position with his head turned to the right.

Gao Yingjun sterilized his entire head three times with iodophor, and then spread a towel.

Xiao Chu was sitting on the right side of the patient's head, Gao Yingjun was holding a bipolar coagulator on the left side.

Gao Yingjun also followed Xiao Chu once when he was undergoing craniocerebral injury surgery.

Under Xiao Chu's command, he played the role of the first assistant very well.

Even if sometimes he can't keep up with his movements occasionally, Xiao Chu will make up for it in time.

On the right occipital of this patient, a 4x4cm scalp abrasion with exudate surface was seen.

Local scalp swelling, extended to the right parietal, right temporal, the scalp swelling area is about 15X15cm.

The operation begins.

Xiao Chu made a skin incision from the left large bone flap, cut the scalp, turned the muscle skin flap to the face, and removed the bone flap about 8X9 cm with a milling cutter.

The dura mater is exposed and is purple-blue.

Normally, the dura mater is white.

And now it is purple-blue, which means that it is caused by subdural hemorrhage.

Xiao Chu said to Gao Yingjun who was staring intently: "Poke the dura mater with your finger and see how it feels."

Hearing this, Gao Yingjun immediately poked it with his finger.

"This membrane is so hard! It's almost like a ball."

Xiao Chu nodded and said: "It's because the pressure on the brain is too high, the tension is high, let's open the meninges to decompress him now."

As Xiao Chu said, the scalpel made a small cut in the dura mater.

Immediately see the dark red blood clot gushing out of the subdural.

Gao Yingjun had quick eyes and quick hands, and hurriedly used the suction device to suck up the gushing blood clots.

In fact, the role of Gao Yingjun is mainly electrocoagulation to stop bleeding and blood sucking and ligation.

He doesn't know the main technical moves, all of them are done by Xiao Chu.

When the blood clot was almost removed, Xiao Chu cut the dura mater with a "C"-shaped knife, and removed about 50ml of hematoma.

The dura mater was suspended around, and the brain tissue was slightly bulged, and the frontal lobe and temporal lobe could be seen with flaky contusion and inactivated brain tissue.

The brain at this time is like a tofu brain wrapped in intestines.

It's topped with shreds of bright red chilli and pulsates in sync with your heartbeat.

One drum and one drum!

Deactivated brain tissue, like a smashed milkshake, has no effect and must be removed.

Xiao Chu instructed Gao Yingjun to use bipolar coagulation and aspirator to remove the inactivated brain tissue.

But more bleeding.

For a while, Gao Yingjun couldn't completely stop the bleeding with electrocoagulation, and from time to time, blood still came out on the surface of the brain.

"You're not good at this speed!"

As Xiao Chu said, he took the bipolar electrocoagulation from Gao Yingjun's hand, and quickly coagulated several bleeding points completely.

This completely stopped the bleeding.

Gao Yingjun smiled mischievously: "I'm not learning for you. If you take me a few more times in the future, won't I be a teacher?"

Xiao Chu didn't answer.

Instead, check carefully to see if there are other bleeding points.

Surgery for craniocerebral injury sounds grand and bluffing.

In fact, such an operation is not difficult.

Just uncover the cranium, open the dura mater, remove the bleeding inside, remove the necrotic brain tissue, and completely stop the bleeding, the operation is considered complete.

It's that simple!

Because the brain injury caused by this kind of trauma, the bleeding is basically on the surface of the brain, so the operation is not difficult.

It's just that people who don't know how to do it or their family members will be terrified when they hear that there is an operation on the head.

After all, the human brain is the most important organ in the body.

Once an operation is performed on the head, it is no small matter!

Xiao Chu checked the surface of the brain in detail again, and there was no bleeding point.

After being rinsed and clarified with normal saline, gelatin sponge was applied to the brain tissue wound.

This thing has a hemostatic effect.