My Medical Skills Give Me Experiences
Chapter 195: 1 is not gentle at all, and it surprises 4 seats
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How can Zhou Can make progress? On the one hand, he learned a little from Dr. Feng;
Of course, it also has a lot to do with the accumulation of time.
Every practice study such as ward rounds, disease management, and surgical participation will make special progress over time.
"Doctor Guan, will you place a nasogastric tube?"
"Of course I let it go! I've done a better job than others, so I'll leave it all to you!"
Doctor Guan was very relieved.
For partial intestinal resection, it is advisable to place a nasogastric tube for gastrointestinal decompression, which is conducive to the exposure of the operation.
In order to prevent accidents such as suffocation due to vomiting due to anesthesia.
Zhou Canneng considers all aspects very thoughtfully, and has many skills and knowledge that only professional anesthesiologists know.
Doctor Guan couldn't help being amazed.
I also know that Dr. Feng has already started teaching Zhou Can about anesthesiology.
Several doctors who were watching from the sidelines, two with a higher level, had already discovered that Zhou Can was not easy.
If there is no real thing in the stomach, there is definitely no way to give some accurate surgical suggestions.
After the patient was connected with the equipment and ready to be given general anesthesia, Director Jia finally rushed to the operating room.
"Hey, how did Zhou Can participate in the anesthesia task?"
Director Jia asked in surprise.
"Junior Brother Zhou knew the anesthesiologist, so he helped him. It seems that he also knows a lot about anesthesiology, and I really admire it." Qiu Hong replied with a smile.
"Although anesthesiology is only a sub-discipline, it involves many aspects of life knowledge and comprehensive application. In the future, when seeing anesthesiologists operating, we should also participate more."
Director Jia said to several doctors.
The words are almost equivalent to praising and affirming Zhou Can's behavior.
"Get ready for the surgery! There are two tough battles today, so we must hurry up."
After all, Director Jia is old, so he can only participate in the core part of the operation, and he can no longer complete a surgery that requires four or five times by himself like a young guy.
Partial bowel resection, even if only the **** is cut, usually takes about four weeks.
The operation went well, and the surgeon's technique was hard, so it could be completed within four hours.
If there is a little accident during the operation, or if the operation encounters difficulties, the operation room will only be longer.
Part of the colon to be removed in one patient.
Surgery will be more difficult.
Coupled with the severe intestinal adhesion of the lesion, the separation is enough to make the brain hurt.
No wonder Director Jia called it a tough battle.
"Doctor officer, is the patient okay?"
"Not bad! Let's start the operation!"
The anesthetist will rate the patient's physical condition on four criteria.
Very good, bad, bad, very bad.
Generally reach a poor level, will choose surgery carefully.
If the anesthetist feels that the patient's condition is poor, the anesthesiologist has the right to terminate the operation directly.
This kind of thing happens less often, but it will.
For example, when a patient is pushed into the operating room, all signs are not bad. As a result, after general anesthesia was implemented, the vital signs dropped off with a crash. At this time, the anesthesiologist will stop the anesthesia immediately, and then decide to continue the operation after observation.
For the safety of the operation, the probability will stop.
It is also a regular hospital, and anesthesia is rarely used.
The main reason why medical and aesthetic institutions frequently explode.
Anesthesiologists in medical aesthetic institutions are only technicians themselves, and lack a highly professional ability to predict the vital signs of patients.
There is no way to mention the danger.
Moreover, ten out of ten medical beauty institutions are all private hospitals, and they are pursuing the interests.
"Plastic doctors" who have only been trained for half a month dare to give patients breast augmentation, nose augmentation, double eyelid cutting, face-lifting liposuction and so on. It's strange.
"The surgical marking lines are drawn, who will perform the laparotomy?"
Director Jia looked at the deputy chief physician and attending physician in his hand. As for the resident doctors, it is very difficult to have the opportunity to practice the knife.
"! With?"
Zhou Can was the first to do it.
The doctors were stunned. The son is like a hungry wolf, it is polite to grab the job.
Just look at what's going on?
Thought it was leather? open belly.
The stakes are extremely high.
Even the average attending doctor dares to say that he is fully sure.
It's a brainstorm to grab a piece of Pearson.
"Opening the stomach requires high-tech work, and Yiqi Pearson has done it. Pay it back!"
The deputy chief physician was about forty years old.
He is a very young deputy chief physician.
When speaking, he is slow and calm, very like a senior.
"Director Jia said, just grasp it, follow it with speech, and follow it with surgical tasks."
Zhou Can argued directly with this, and looked at Director Jia.
"Zhou Can, it's just a joke, are you sure about it? You're talking ugly, and you're doing practical tasks. You only found out that you made a surgical mistake. At least three months of surgical authority will be suspended. If it is serious, it will be directly handed over to the medical department. Therefore, do what you can." Let’s do it, take what you said and use it as a shield to wantonly grab the chance of surgery.”
Director Jia spoke very straightforwardly.
Say it to yourself, and go back on it.
Just to prevent the doctor in hand from acting blindly, the punishment conditions prescribed are also extremely severe.
"The first tenet of reverence for life, don't worry, you will never play tricks with a knife." Zhou Can's words were sonorous and loud.
Also shows strong self-confidence.
If you rush for an operation, you will definitely be timid.
Of course, super doctors would simply entrust dangerous surgical tasks to them.
As long as you are sure, you will be brave.
For the vast majority of regular trainees and residents, it is enough to get a chance to have their skin closed.
In actual operation, a novice can close the abdominal cavity by sewing one or two stitches.
In general, the surgeon leaves the field after finishing the key part of the operation. Leave a senior attending to see the situation.
Then Xin took the opportunity to fight for the opportunity to sew the skin.
It's okay to sew slowly.
In order to prevent the senior attending physician who is watching the situation from waiting patiently.
Plus watching from the side, you will feel nervous when sewing.
Let me go first, or please sit next to me and rest.
Wait until you are done sewing, and then please check.
Just put the words beautifully, Ping Duo tried to gain the trust of the top doctor, and worked hard to build a good relationship with him. Most of the remaining attending physicians will let them suture as much as they want.
Very cooperative before leaving the field, or leaving the operating room directly.
Because I am very busy, I have to go all the way again.
Naturally understand its sadness and difficulty.
"Come on! Stop it, you must stop immediately. Also, don't rush the operation process." Director Jia frightened Zhou Can with his words.
I had no choice but to bite the bullet and agree.
Knowing how strong Zhou Can's head is and how courageous he is, he will definitely say that to Zhou Can.
Now it's hard to get overwhelmed, wipe away face.
I had to let Zhou Can try.
"Director Jia, you only train doctors! The risk of laparotomy is high..."
The job of the deputy chief physician was taken away, which seemed a bit resigned.
More worries.
"Let's try it! Watch from the side, risk control."
Director Jia spoke with confidence, but his expression was nervous.
His eyes were fixed on Zhou Can.
Zhou Can was not polite at all, and stood at the chief surgeon's seat, asked the nurse to put on sterile gloves, took the knife, and went straight away.
Laparotomy, the first operation for a long time.
I am now fully capable of doing it alone, and doing it very well.
The operation area has been disinfected and the scalpel position line has been drawn. Just cut it.
The movement I saw was extremely smooth.
With one stroke, the cortex was cut open.
Seeing that it was as casual as cutting pigskin, and at an extremely fast speed, Director Jia covered his heart with his hands and stared at the wound, daring to blink.
After Zhou Can made the first cut, he hurriedly yelled to stop.
I was almost scared to have a heart attack just now.
"The length and depth of the surgical incision are just right. The incision is so fast, so casual, good boy, so confident, the original deep hidden!"
Director Jia breathed a sigh of relief after seeing the surgical incision.
Seeing Zhou Can slashing the knife so casually, I thought, it's over, it must have cut the skin tissue layer and even the muscle layer.
After watching the results, I realized that Zhou Can's abilities were ten times stronger than he imagined.
One knife, it seems to be done casually, but the actual size is just right.
The deputy chief physician almost lost his eyeballs in shock.
Up to now, he still has a **** shocked expression on his face.
Senior sister Qiu Hong's beautiful eyes were also staring.
Several of the doctors, no matter they were attending or inpatient, were all horrified by Zhou Can's knife skills.
"Do you want to continue?"
Zhou Can can't wait to open the sick abdomen to see the condition of the colon.
"continue!"
Director Jia's confidence in the company has increased several times, and his sense of trust has also increased a bit.
Afterwards, Zhou Can opened the abdominal cavity layer by layer like a butcher dissolving an ox.
Cutting through the muscle layer, the knife scratched a section, and obviously felt the same knife feeling, which was extremely subtle.
Also never.
At present, the incision is close to the level of indications, but has not yet been reached.
It stands to reason that such a clear knife feel can only be obtained at the level of the deputy director.
Now you can get a clear sense of the knife once you raise the level, which is often referred to as tactile feedback. Zhou Can was very happy.
Secretly guessing, it can be integrated into the cutting relationship with the quick knife method.
When his brain received the abnormal knife sensation, his hands stopped immediately.
The biggest disadvantage of the quick knife method is that the hand is faster than the brain.
Zhou Can was able to find out the problem and quickly stopped the knife, which is a very good phenomenon. It shows that so far, the tranquility can also restrain the magic of the quick knife technique.
Will be swayed by the extreme pleasure of speed.
"A blood vessel with a relatively thick diameter...well, a vein blood vessel, should it be cut directly?"
After Zhou Can stopped the knife, he raised his head and asked Director Jia.
"have a look!"
Director Jia has rich experience in surgery. Although the assistant drew the knife position, after entering the operating room, he has already checked it secretly.
To be sure there is no problem.
Heavy blood vessels and nerves have been avoided.
"Really! It doesn't matter if you cut off a vein with a diameter of more than two millimeters. Of course, if you can cut it open and find it, the feeling of the knife is already very powerful. The cutting action is so fast, and it is even more powerful if you can stop the knife in the first place." Yes. Surgical endowment, now I have seen it with my own eyes.”
Director Jia was amazed at Zhou Can's ability to detect blood vessels with root diameters that were considered thick.
A decent old surgeon, immersed in surgery for over forty years. It is strange to be able to find heavy tissue such as blood vessels or nerves with a keen sense of knife.
After all, the level of cutting at the director level is there.
If Zhou Can, a novice Gui Peisheng, could do something, it would be quite abnormal.
In the end, Director Jia attributed it to Fu.
To be honest, Zhou Can's talent in traditional surgery is not good.
At most, it is equal to the level.
On the contrary, there are many nerve anastomoses and advanced surgical endowments.
It is now able to show super strong traditional surgical strength, which is completely based on the comprehensive results of the quick knife method and the experience value system to help raise the basic surgical medical skills to a higher level.
"Can it be ligated first and then cut open?"
Zhou Can wanted to take this opportunity to show off his medical skills so that he could gain more opportunities for surgery after the abdominal cavity was opened.
Grabbing the training opportunity, Director Jia's assistant is very gentle and polite.
During Zhou Can's foreign internship, those who rushed to practice surgery were all like hungry wolves.
That's called fear.
"Yes, of course!"
Director Jia readily agreed.
This is something that should have been a helper's job. However, the deputy chief physician stood there indifferently relying on his status. I made it clear that I wanted to be Zhou Can's assistant.
Because it will make you feel cheap.
Zhou Can quickly placed the scalpel, took the needle holder, crochet needle, and thread from the nurse, and then ligated the root vessel.
The whole ligation action is fast and handsome, and the ligation is very good.
"Tsk tsk, the level of ligation is conservatively estimated, and it has reached the level of the deputy director. It is scientific."
Director Jia let out a series of exclamations.
To save face, the deputy chief physician who offered to be Zhou Can's assistant looked at Zhou Can, and his eyes changed.
There has been a rare trace of respect.
Zhou Can is so young, but he can have such a high level of incision and ligation, which is enough for people to re-examine and quickly adjust their impression of Zhou Can.
Qiu Hong was even more amazing. She looked at Zhou Can with her beautiful eyes, showing bits and pieces of admiration.
Although he is already an attending physician, compared with Junior Brother Zhou who is still a regular trainee, his surgical skills are far behind.
The specific academic qualifications that are not yet known. At least all postgraduate masters.
All doctoral students, including some excellent postgraduate masters, are academically well-equipped.
In terms of practical operation, it is easy to say.
After all, it takes a lot of practice to achieve results.
The seemingly simple ligation involves many surgical skills.
It must be explained here that a ligation is equal to a knot.
Knot only part of the ligature.
It's like men belong to, but equal to all categories.
Classes include male, female, children, and the elderly.
Ligation often requires the skillful use of crochet needles to pierce part of the tissue. In case of injury to heavy tissue and blood vessels, the blood vessels should be bound as perfectly as possible. Then tie a knot to secure.
The process avoids involving the surrounding tissues, and ensures that the degree of tightness and firmness of the ligation meets the requirements.
Therefore, ligation is equal to knotting.
Medicine has also called knotting as the four basic medical skills of surgery.
After Zhou Can knotted the root vessel, he decisively cut it off.
Feel the tactile feedback of cutting the vascular belt carefully again.
Especially wonderful.
Provide safety protection for future operations. As long as the knife touches a blood vessel, you can get a signal feedback imprinted deep in the brain. Then stop immediately.
With the current ability, it should only be able to obtain vascular feedback of about 2 mm.
With the continuous improvement of surgical capabilities, we may be able to capture more sensitive vascular signal feedback in the future.
Because the root vessel was lifted and ligated, there was not much blood.
The abdominal opening process is quick and efficient.
After Zhou Can opened the peritoneum, the organs in the abdominal cavity were exposed.
After seeing Zhou Can's surgical prowess, the deputy chief physician's attitude changed completely.
Began to actively help stop the bleeding.
For those blood spots, electrocoagulation was performed.
"Open the abdominal wound to fully expose the surgical field of vision."
Director Jia said to the resident doctor who helped one of the three.
Sansuke Qiuhong~www.readwn.com~ The purpose of surgery is only to be in the position.
The operating room, perhaps the only place to look at academic qualifications.
Whoever is more powerful in surgery will be old.
Academic theory, surgical practice ability.
"Oh, my colonic disease is quite serious! If I can be treated in the hospital earlier, I will need to remove part of my intestines. Many diseases are delayed until they are very serious, so I don't want to treat them. Fortunately, only intestinal obstruction and intestinal polyps , if it is delayed until it is dealt with, it will become malignant."
Director Jia sighed while observing the diseased intestinal segment in the patient's abdominal cavity.
"In the future, you must remember to go to the clinic. After discovering the patient's intestinal lesions, if you need to deal with it, you must explain it clearly to the patient's family members. You can think that nothing is wrong, and then wait until it is done."
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