Sleepless Doctor

After Wu Mian talked about the entire operation, Zhao Lin was unremarkable, and his lover lay on Zhao Lin's shoulder and cried.

The old leader stared blankly and looked at the door of the operating room.

"Hey, Dean Xue, take a look at this side, I will go in for surgery." Wu Mian said softly.

"Teacher Wu, trouble you."

"fine."

Wu Mian and Chu Zhixi walked back to the operating room, and Chu Zhixi asked in a low voice, "Brother, I look at the video, it seems that there is nothing missing."

"Well, the esophagus is okay, repair it, it is unlikely that there will be a problem."

"Scare me, I thought I was wrong."

"No." Wu Mian said with a smile, "The main reason is that imaging data can't represent everything. In case a problem is discovered during the operation. The family is so used to children, so ugly things must be said to the front."

"Are you afraid that there will be some moths in the future," Chu Zhixi said with a smile.

"Well, it's almost like that." Wu Mian said, "I can understand if you don't have a gastrointestinal endoscopy. After all, that thing is too bad. But you don't even do CT. Isn't that a joke."

Chu Zhixi smiled and did not speak. There are too many parents and elderly people who dote on their children, and it is common in the United States not to vaccinate their children. Sometimes doctors are also helpless, and when faced with stubborn parents, they don't know how to convince them.

The two returned to the operating room.

"Ms. Wu, a slow injection of 0.5% propofol 30mg intravenously, the child fell asleep." Seeing Wu Mian coming in, Ren Haitao reported immediately.

"Okay, position yourself, lying on the right side." Wu Mian and Chu Zhixi worked together to adjust the child's position.

"1% Lidocaine 10mg + 0.5% propofol 30mg intravenously infused with Murphy's pot."

Ren Haitao's report was extremely detailed, Wu Mian did not persuade him, nor said anything else, silently preparing for the operation.

After 5 minutes, the child breathed steadily 18 times/min, and his blood oxygen saturation was 98%.

"Teacher Wu, are you here?" Ren Haitao said.

"Emmm, okay." Considering several unexpected situations, Wu Mian nodded because he still felt safe to come.

Chu Zhixi went to brush her hands and prepared to lay a sterile sheet, while Wu Mian went to the head of the child.

Ren Haitao fixed the head of the child with both hands, while Wu Mian used a 2.8mm soft electronic lens through the left nostril to slowly push it to the pharynx and observe the glottis.

After reconfirming the child’s breathing, he advanced to the glottis and asked Ren Haitao’s assistant to immediately give remifentanil 30ug (3ug/kg) and propofol 30mg intravenously.

About 1 minute after the drug injection, Wu Mian's vocal cord activity was significantly weakened, and the bronchoscope was pushed into the trachea, the tracheal tube was fed into the trachea, and the tracheal tube was simply fixed.

Look up and observe the end-tidal carbon dioxide waveform. The waveform is intact and there are no accidents.

Wu Mian used a bronchoscope to confirm the position of the tracheal tube again, fixed it, connected the ventilator, and adjusted the breathing parameters. The operation process went smoothly. The child had no choking, no bleeding or edema in the nasopharyngeal cavity and trachea.

Preparation before surgery, everything went well.

"Remifentanil and propofol were given intravenous maintenance during the operation." After Wu Mian confessed, she turned around and brushed her hands.

Ren Haitao tried his best to remember all the steps of Wu Mian's operation, and did not dare to neglect.

Each step may have other meanings, just like the aerosol bottle that appears like a flying fairy from the sky. Remember, no matter how hard you go back to study, Ren Haitao planned this way.

After Wu Mian brushed her hands, she put on sterile clothes and gloves.

The gloves are a bit thick, and Wu Mian is not very satisfied. However, when I went out for surgery, I happened to encounter it by chance. There is no good way to make everything feel like at home.

But the current home is the Bajingzi Hospital of Traditional Chinese Medicine, and the situation on that side is even worse. There is no way to perform surgery outside the child.

Just a moment, Wu Mian didn't really care.

"Surgery outside the child, can anyone do it!" Wu Mian's ear moved slightly, and a voice came from the dressing room far away.

"Ms. Wu did it." Xue Chunhe said.

"Dean, Teacher Wu can't do it either, this thing can't be a trifling matter!"

"It's not a child's play." Xue Chunhe said with certainty, "The medical office has been notified of the procedures for inviting experts. You can tell the lower-level doctors. Submit the procedures and the medical office will confirm them immediately."

"Dean, I don't believe in Teacher Wu, but has he performed surgery outside of children? It is more difficult than other surgeries!" The person continued to insist.

Wu Mian smiled slightly, listening to the words, he should be the director of the second pediatric surgery of the medical college.

Surgery outside the child? It seems a bit difficult, but it's not a problem, Wu Mian said solemnly, "Girl, let's go."

"Yeah." Chu Zhixi turned around to brush her hands.

"The Dean..."

"You follow along. If it doesn't work, just say it, no problem." Xue Chunhe's voice increased a little and said, "Director Liu, cooperate well. Teacher Wu is a top surgeon."

"He wrote the tenth edition of "Diagnostics", I know about it, but pediatric surgery is really difficult!"

"I know, get ready for surgery."

The voice of the speech was getting closer and closer, and it seemed that Xue Chunhe had left the locker room and walked towards the surgery room.

Wu Mian smiled. Director Liu's worries were right, but he performed pediatric surgery by himself, hoping that Director Liu's glasses would not break.

Brush your hands and put on clothes. Wu Mian asked Ren Haitao to adjust the angle of the shadowless lamp, stood at the position of the surgeon, and began to disinfect, then the knife fell and cut a 12cm surgical incision.

Director Liu of the Pediatric Surgery Department came in very docile and did not directly question Wu Mian. She stood in the second assistant's position and asked, "Ms. Wu, can you do it with a cavity mirror?"

"It can be done, but there are more complications after surgery, so it is safer." Wu Mian said, "After all, it is the esophagus, not the stomach."

"This kid...you said this is a trouble." Director Liu sighed.

"If it's found early, wouldn't it be okay?"

"Using an esophagoscope to take out the button battery, there are many details, such as the chemical leakage in the battery, the area of ​​the burn is too large, and the esophagus is stuck." Wu Mian said, "I saw one in Mayo. It is recorded that there are 23 cases of accidental ingestion of button batteries. The older the patient, the worse the postoperative recovery. The largest patient is 43 years old."

"Uh, 43-year-old adults still eat this stuff?" Director Liu was taken aback.

"Hehe, I don't understand the thinking of foreigners." Wu Mian said, without stopping for a second, he cut cleanly, stopped the bleeding, and separated layer by layer.

"It was reported in "New England" magazine that a person swallowed a five-pound iron nail. I don't understand how the nail would not damage the esophagus when the nail was eaten." Chu Zhixi said from the position of Yisuke.

"..." Director Liu was taken aback. The five-pound iron nail, can't his stomach be pierced and punctured?

"Maybe the person who eats the button battery just wants to try a small battery stimulation, who knows." Wu Mian said, "Children's chest opener."

Open the chest cavity, start one-lung ventilation, gradually free the mediastinum and separate the esophagus.

Director Liu's heart was raised.

Don't miss it. If this is missed, a 4-year-old child undergoes an operation for esophageal cancer and removes a part of the esophagus, which will seriously affect the quality of life in the future.

Wu Mian was holding the smallest hemostatic forceps and doing blunt separation with patience. Wu Mian is tall and has a big frame. Although relatively well-proportioned, the fingers look slender, like the hands of a pianist.

But on the operating table, everything changed with the reference.

The surgical instruments outside the child were small, and Wu Mian used the smallest hemostatic forceps to perform blunt separation, and his fingers could not be inserted at all.

His finger "touched" the ring buckle under the hemostatic forceps, UU reading www.uukanshu.com, but the strange thing was that even if it was "touched", the hemostatic forceps were firmly attached to the fingers, no matter how they moved, they did not fall off. fall.

But Director Liu's eyes were not on this little trick. She was feeling that it was indeed a pleasure to watch the top surgeons perform operations.

Wu Mian's surgery is not fast, simple and clear step by step. It is exactly as written in the textbook. After opening the mediastinum, the attractor attracts and then moves away layer by layer.

A not-so-difficult operation seemed to be easier under Wu Mian's hands. At least every step seems to be without difficulty, there is no dazzling skills, nor deliberately increasing the speed of the operation, just go on steadily.

The anatomical structure is so clear that Director Liu feels like he's taking a local anatomy class, and it's just that Wu Mian will test what his anatomical structure is called every step of the way.

Even because it is not like the general teacher is fixed by formalin, the anatomical structure is clearer and more vivid than the general teacher.

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