Surgeons dressed as poor people in the Republic of China

In the operating room, Ye Yibai had already got off the operating bed, his body was covered in blood, and he was panting against the wall.

The two hands naturally hang down on the sides of the body, and the blue veins on the hands are still throbbing because of the sudden relaxation after a long period of hard work, "I'm going to brush my hands."

Ye Yibai walked towards the operating preparation room as he spoke.

"Doctor! There is a blood donor with a matching blood type!" Lily flew in from the operating room like a happy bird.

Followed by Laura and a 34-year-old Chinese woman.

Ye Yibai paused, with a puzzled expression on his face.

"Doctor Ye." Lili entered the door, saw Ye Yibai, immediately restrained her extroverted emotions, and said hello obediently.

Ye Yibai nodded, glanced at Aunt Shanghai behind Lily, and a trace of surprise flashed in his eyes, "Are you a blood donor?" He asked.

Auntie nodded and saw Ye Yibai, who was covered in blood and tired, with a hint of distress flashing in her eyes, "You kid, you just graduated, and these foreigner hospitals don't have older doctors anymore, it's really frustrating."

Ye Yibai was taken aback. It had been a long time since anyone had said such words to him. Unlike Zhang Su'e's doting on his son, from this aunt, he seemed to feel a kind of care from the elders for the younger ones.

Dr. Ye showed a gentle smile, "Thank you, and also, you are amazing."

Because time was tight and every second counted, Ye Yibai didn't delay here too much. On the way to the preparation room, he could vaguely hear the conversation between his aunt and the two nurses.

"Oh, it's not good for you. That doctor is still so young. Don't all foreigners say that everyone is equal. You can't bully him just because he is from China."

Lily and Laura had to go through the aunt's Hua Guowen with a Shanghai accent twice in their heads before they were sure what the aunt wanted to express, and they couldn't help crying and laughing: "Auntie, that is the head of the surgical team of our ambulance center, we did not bully He, we can't bully him."

Maybe Lili's Chinese is too substandard, or maybe the information contained in Lili's words is too incredible. Auntie didn't understand, and walked towards the operating room while babbling, making Ji He feel sorry for Ye Yi. Bai such a "good boy".

The preparation room and the operating room are next to each other. Dr. Ye laughed involuntarily while brushing his hands and doing disinfection work. This feeling of being cared for was very good.

When Ye Yibai put on the surgical gown and surgical cap and mask, and Aunt Shanghai was lying on another surgical bed, Lily yelled loudly.

"Auntie! Dr. Ye is our leader! The director will be the biggest! Only he bullies us, we don't bully him!" This time, Lily's Chinese was unexpectedly standard.

"Leader?" Auntie was full of doubts, obviously she couldn't connect that tender-faced little doctor with the leader of this group of foreigners.

"Is he your leader?" the aunt turned to ask Wang Mao, there were only two Hua people in the operating room.

At this time, Wang Mao and Richard had already taken out the metal sheet, and at the same time cleaned up the superficial foreign objects near the abdominal wound, and covered them with gauze. Bringing out more bowel, Richard didn't force it.

Hearing his aunt's question, Wang Mao turned his head and said with a simple smile, "Yes, Dr. Ye is the head of our surgical team."

After getting the affirmative answer from her compatriots, the aunt finally stopped worrying about Ye Yibai being bullied. However, she glanced at Wang Mao, who was clearly in his thirties, and then thought about the tender-faced little doctor she saw just now. It can't help but become weird.

She muttered in Shanghai dialect in a very low voice: "Such a big person is not as good as a young man..."

Wang Mao: ...he can understand

Ye Yibai walked in from the door with his hands raised.

As soon as he came in, the entire operating room immediately fell silent, and Richard took two steps back to give up the position of the chief surgeon.

"The metal plate was inserted into the abdomen and caused the liver to rupture. Her mother protected her very well, and other organs should not be damaged." Richard said softly.

Ye Yibai nodded, "Let's deal with the ruptured liver first, and check it later."

"Jonna, stop the veins of the lower extremities, Richard, subclavian puncture." Liver trauma may be accompanied by inferior vena cava injury, and a large amount of fluid cannot be infused, so a subclavian puncture catheter is needed for rapid infusion, blood supplementation, and central venous pressure testing.

"Ok."

"blood pressure."

"Blood pressure 90/58."

"Richard?"

"Clavicle puncture and intubation completed."

"Lily?"

"300ML, the blood collection is complete."

"Subclavian access blood transfusion for rapid blood transfusion."

"Okay, Doctor Ye."

Ye Yibai observed the abdominal cavity while talking. In the abdominal cavity, Richard clamped the hepatoduodenal ligament with sponge forceps, and the amount of bleeding in the abdominal cavity was significantly reduced, which indicated that hepatic parenchyma was bleeding rather than hepatic veins.

The abdominal cavity has been cleaned up, so there is no need for suction. Ye Yibai directly stretched his left hand into the abdominal cavity, and began to carefully inspect the diaphragmatic and visceral surfaces of the right lobe of the liver. and inferior vena cava.

"Multiple superficial lacerations, contusion and laceration on the right anterior part of the liver, liver laceration suture and partial liver resection are required. Do the liver laceration suture first. Richard, how many minutes has it been since the sponge clamp?"

Clamping the hepatoduodenal ligament with sponge forceps can control blood flow into the liver, but if the clamping time is too long, prolonged liver ischemia will cause irreversible damage. Therefore, under normal temperature conditions, the blocking time should not exceed 15 minutes, preferably within 10 minutes.

But turning it on and off like this will not only greatly interfere with the operation process, but also the wound where the blood enters the liver has not been sutured, and the blood will still be lost as usual, and if it is not replenished, it will be life-threatening.

"Go get some ice, preferably ice chips." Ye Yibai said.

No one knows what Ye Yibai suddenly asked for ice, but everyone is used to everything in the operating room being based on the surgeon, and no one objected to Ye Yibai's request. Laura nodded quickly and walked quickly to the operating room. go.

"Needle holder."

While taking over the needle holder, Ye Yibai glanced over the curious eyes of Richard, Henry, and Wang Mao, and explained while moving: "Removing the sponge forceps once every 10 minutes will have a great impact on the operation process and will greatly prolong the operation. Time, if ice chips are used for partial cooling of the liver, the portal of the liver can be blocked, and the tolerance time of liver ischemia can be extended to 30 minutes. If there are many superficial liver lacerations and need to be treated for a long time, this method can be used. "

The white coats in the operating room nodded at the same time, with serious expressions on their faces. If it was not the time of life-and-death surgery, they would have just taken out a pen and paper to write it down.

If we talk about how to choose the incision and how to suture it, this is a standard surgical technique. In the last craniotomy, a syringe was used to cut the craniotomy to reduce the injury of the cranium. This time, ice chips were used to cool the liver to prolong liver ischemia. The tolerance time is an extremely personal skill.

This kind of skill can only be obtained by the surgeon after the accumulation of countless cases, in the long-term exploration, coupled with such a flash of inspiration and countless attempts. These extremely personalized and useful skills.

"If the bleeding has stopped, there is no need to deal with it. Line 1."

Ye Yibai's expression was serious. The pressing for more than an hour just now had an impact on his hand. He could use interrupted sutures to stitch the slightly uneven wound to perfection, but now, Ye Yibai is meeting someone Some irregular lacerations were sutured by omentum packing.

"I'm a bit conservative here. In fact, these slightly shallower wounds can be sutured directly. There is no need for omentum filling. If you encounter them in the future, you don't have to be so conservative when you feel confident."

Two superficial wounds were stitched, the sponge forceps were opened once, and after completing a hepatic circulation, blood leaked out of the abdominal cavity again.

"Suck."

The right lobe of Thomas's liver was severely contused and lacerated, and a lot of blood flowed out once the blood flowed into the liver. If the blood type O was used as a supplementary blood transfusion, the little girl might not be able to persist until the end of the operation.

There were still two superficial lacerations. Ye Yibai frowned. Qiao Na immediately turned her head and gave Lily a wink. Lily immediately understood and was about to turn around to urge Laura. Already came in with a basin.

Rao was in the 30s. As the top hospital in the public concession, Jihe had used refrigerators and freezers early on. After all, many precious medicines need to be stored at low temperatures, so Laura went straight to the pharmacy as soon as she went out. Holding the washbasin, under the disbelieving gaze of the pharmacist, he just shaved half a plate of ice chips and came back.

"Is it enough? I'll get it if it's not enough." Laura said loudly. She was afraid that it would be unsustainable to plan it all, so she left a freezer there.

Ye Yibai glanced past the ice flakes that used the washbasin as a unit of measurement, and his facial nerves twitched unconsciously, "Enough, Richard."

Richard nodded, and stuffed his rubber-gloved hand into the ice, and then left it there for a while, then stretched his hand with a little bit of ice into the abdominal cavity, and gently touched the little girl's liver, repeating this several times, making the ice chips Distribute evenly over the liver before stopping.

Henry noted down the cooling time, and made an OK gesture to the two.

The operation is still going on.

With the liver cooling down, there is no need to open the sponge forceps every 10 minutes, which makes the subsequent operation smoother. The white suture dances on the liver on the chocolate, and the broken organs are pieced back together little by little.

Two to 10 minutes later, the superficial laceration was sutured.

Next came a partial liver resection.

"Jonah, prepare the hot salt water, it will be used later."

"Okay, Doctor Ye."

"A blood injection, and another liver cooling."

When Richard heard this, he quickly removed the sponge clip, and the blood flowed into the liver along the vein, circulated inside, then flowed out from the hepatic vein and injected into the inferior vena cava.