I Spent Those Years In the Operating Room Fighting Monsters

"Look at what my child's hand has become now. It was fine when it came. He made it like this."

The child's mother pointed at Lu Cheng and shouted aggressively.

While shouting, he also scolded the people around him: "What are you looking at, do you need to take care of our family's business?"

The premise of paying attention to laws and binding people with morality is that people want face and trees want bark. If they are reasonable, many people are willing to stand on the moral high ground to condemn others, especially to help the weak.

But at this time, when they heard the middle-aged woman scolding, the onlookers just scolded something wrong, and then dispersed.

The atmosphere was a little stalemate at the moment.

But the child raised his head at the moment and said to his mother, "Mom, it hurts just as much when I came here as it does now."

The child can't understand what his mother and father are doing, he only speaks the facts he feels.

This sentence made the faces of the police and the nurses who were watching soften a little.

But the child's mother directly pulled the child behind her back and scolded, "What does the child know, don't talk nonsense."

Then he continued in front of Lu Cheng and said, "I tell you, this matter is not over today. You have made my child like this, and you have to be responsible."

Then he looked at Wang Min and said, "Are you his leader? If you can make the decision, if you can't, call the one who can, and call the director. Now my child's injury is caused by the wicked doctor in your hospital. !I."

Hearing this, Lu Cheng sighed with emotion and said to the two police officers, "Comrade police officer, I really have two emergency surgeries to be done here. She has been so unreasonable, and I don't have that much time here. Delay. There is a patient over there who may die at any time, anyway, you probably understand the whole story now. For the next thing, you should go to the legal process. "

"I'm really going to the operating room." Lu Cheng really didn't have time to quarrel with them here.

"Don't go, you can't go!" As soon as the middle-aged woman heard that Lu Cheng was leaving, of course she couldn't let him go, she had to hold Lu Cheng when she came forward.

"Come here, this unscrupulous doctor will run away when he sees the wrong disease, everyone will come and judge."

She shouted to the people around her, hoping that others could help her stop Lu Cheng.

But everyone is not a fool, and everyone understands the facts of the matter. Who would really help her? Instead, two family members of the patients deliberately walked in the middle of the road and blocked the middle-aged woman. scolded loudly: "run what to run"

"Your home in the hospital, you don't look at your eyes when you walk."

The hospital is a public place, and the emergency department is a place where every patient and family can come.

So there is no need to get used to her at all.

"It's murdered, and the hospital is killing people, there's no reason for it..." The middle-aged woman sat on the ground when she saw Lu Cheng walking away.

Then her son ran up and hugged his mother to comfort him: "Mom, don't cry, don't cry, I don't hurt anymore, I don't hurt at all."

This sound made the hearts of the people around him twitch.

As a result, the middle-aged woman's husband really couldn't bear it, so he ran up and directly pulled his son up, shouting to the surrounding doctors: "Doctor, nurse, I was wrong, it was our fault, you give my son first Take care of it."

Then he yelled at his wife: "What are you doing still, you only know how much money you can get for a little bit of money?"

The middle-aged woman was stunned by her husband's roar.

"Why are you still lying on the ground, get up quickly, that's how you act as a role model for your son." He really regretted it. Before, he thought his son was really fine, and he felt that if the doctor moved, he would have to pay hundreds of dollars. Money is expensive.

But now, seeing such a sensible son watching himself and his wife cheating on their debts in the hospital, and being so sensible, made him feel distressed, and felt like a fool who put his son aside for a few hundred dollars.

The middle-aged woman stood up at once and yelled at the child's father: "What are you yelling at? If it's not that you are incompetent and can't make money, why am I like this? You are incompetent..."

Said to be caught.

His husband grabbed her hand and said, "Get up, is this your own son?"

The middle-aged woman burst into tears on the spot. Today, she didn't plan to ask for her face, and she didn't get any benefits, so it was a big loss. Moreover, her own image in her son's mind is estimated to be ruined in the future.

It's just that there is no way back, her husband is not on her side at this moment, and she has no other way to do it.

The man directly took his child to sign up again, and then the doctor in the emergency clinic called Lu Cheng again.

Although there are a series of things ahead, the patient and the child are innocent, and the hospital cannot refuse the patient to see a doctor, nor does it deprive the patient of the right to see a doctor.

Lu Chengcheng did the manual reset again, and explained the precautions after the reset in detail.

This is not difficult for Lu Cheng. Before, the child's mother left immediately after being reset. He was caught and dislocated again before he could even say the precautions. Can you blame Lu Cheng?

However, Lu Cheng didn't really pursue the legal responsibility of the child's mother for injustice and damage to his reputation.

He really doesn't have that much time.

After finishing the reset and writing the medical records, I went straight to the operating room.

No matter how much time a few idiots have delayed, they are still innocent to the other patients who need him to deal with.

...

Only this time, Lu Cheng really understood why many seniors would say a word in private, that is, no matter how pitiful the patients and their family members are, they must strictly follow the medical procedures and norms, and can't leapfrog and mess around. kindness.

Otherwise, it's you who suffers.

The human heart is originally hot, but after being watered with more ice and snow, it will gradually become colder.

In addition to professional knowledge and professional skills, there is a lot of accumulation in clinical practice, as well as the style and skills of doing things, all of which clinicians need to learn.

If you fail to study, you may have to pay tuition. Fortunately, today Lu Cheng kept his mind and knew that he would collect the medical records in advance. Otherwise, he really didn't know what to say.

Before Lu Cheng left, Liu Xuan also found Lu Cheng and said, "Brother Lu, I'm sorry about this today. I'm the one who caused you trouble."

In fact, the most fundamental reason was that he called too early. Lu Cheng was only a consulting doctor, and Liu Xuan was the first doctor. In the first consultation system, Lu Cheng is only responsible for helping him cure the patient. The follow-up explanations and urging fees should be the responsibility of the first consultation doctor. Unless the patient is transferred to the orthopaedic ward, then it will be the responsibility of Lu Cheng.

Lu Cheng said, "It's okay, Dr. Liu, we are all colleagues, and there will be many places where we need help in the future."

"It's also my fault for being so impatient. The main reason is that I encountered too many emergency patients today. I wanted to be in a hurry, and the child was poor, so I did the reset in advance. It will definitely not be like this in the future."

"Doctor Liu, don't mind."

Liu Xuan shook his head and said, "Doctor Lu, you are joking."

...

The patient who was debridement and exploration started first. When Lu Cheng walked in, people from the Department of Thoracic Surgery and the outside world were already there.

When the anesthesiologist saw Lu Cheng, he quickly said, "The patient's blood pressure is very unstable now, and it is already under the shock blood pressure. Even after blood transfusion, it still cannot be stabilized. It may be considered that there is still active bleeding."

"Orthopedics, you must stop the blood as soon as possible, otherwise it doesn't matter how many bags of blood you lose, and the patient may say it's gone."

However, Lu Cheng didn't look nervous. Such a patient can't rely entirely on the orthopedics department, so he said, "Teacher anesthesiology, this patient's blood pressure is unstable, but it has little to do with our orthopaedic department. If the patient is fractured It's in the pelvis, so we can still be found."

"However, if there is an injury near the knee joint, even if the tibial artery or the popliteal artery is injured, a tourniquet is the big deal."

Then I took a look and said, "Whether this patient's leg can be saved, and whether it will function after it is saved, is another matter. My investigation is very fast. As long as there is a problem with the blood vessels, I will sew it up. Vascular problems can be solved by simply sticking a vac."

As Lu Cheng said, he turned his hand and pressed the patient's popliteal artery for about a while. Then he checked the vascular signs at the distal end, and found that there was a problem with the vascular filling.

This just represents the position of Lu Cheng's pressing hemostasis, which is extremely accurate.

General Shenwai was hospitalized: "..."

General hospitalization outside the chest: "..."

The anesthesiologist was speechless. Seeing this, he could only press the button to measure the patient's blood pressure again, and at the same time began to check blood gas and electrolytes.

Patients who lose a lot of blood cannot be rescued by a large amount of blood transfusion.

It is also necessary to detect whether blood oxygen saturation and electrolytes are disturbed, especially hyperkalemia, which leads to cardiac arrhythmia, and then cardiac arrest, and the person is gone.

This condition can come and go without a trace, so blood gas and electrolytes must be checked at regular intervals.

Even so, the anesthesiologist still thought that the patient had active bleeding, although he heard Lu Cheng say it was easy, the blood vessels were anastomosed and it was over.

But the essence of the treatment of all diseases in this world is actually very simple.

It's just harder to do.

As far as the popliteal fossa is concerned, there are extremely important structures such as the popliteal artery, the anterior tibial artery, the posterior tibial artery, the medial saphenous vein, and the popliteal nerve...

The anesthesiologist could only smirk; "Well, when I didn't say anything."

"The patient's current blood pressure is still extremely unstable. Now it is only 75/65mmhg. Although norepinephrine has been used, it cannot rise back. Immediate craniotomy and thoracotomy are needed."

Whether it is supernatural high intracranial pressure or hemopneumothorax, it can cause shock to the patient.

Hearing this, the total hospitalization and disinfection rate of neurosurgery and thoracic surgery has been accelerated by a full three points.

Emergency consultation is actually a game and competition between various departments. As long as others can prove that there is no problem with others, you have to quickly deal with the problems of your own departments.

After pressing to stop bleeding, the blood pressure fluctuation still exists, which proves that it has nothing or little to do with the active bleeding of the lower extremities. Lu Chengda can think that there is no active bleeding in the lower extremities, or that the active bleeding will not affect the patient's vital signs.

That is equivalent to just oozing blood. Basically, he has already dealt with it, and he only needs to deal with this open wound. And put a tourniquet to ensure that the bleeding volume of the lower extremities is limited to a certain range. You can deal with your own problems first in other departments. Our orthopedics department can completely delay the time.

Lu Cheng pressed it for a while, then released it, and then called the anesthesiologist to take another blood pressure measurement. The final result was not much different from the one before the pressing.

Lu Chengcheng smiled, it seemed that the patient's luck was good this time, there was no active bleeding, only oozing blood.

The student who followed the anesthesiologist immediately said: "Teacher, the patient's blood pressure is dying. Now the high pressure is only 60. The heart rate is only 70+."

Anesthesiologist Jiang Yuan just threw the phone he was about to pick up:

"Epinephrine 1mg, static push!"

"The pumping speed of demethylation jumped to 40, and the oxygen flow was adjusted to 430."

"Shout two more bags of blood!"

Looking at Jiang Yuan's calm and busy figure, Lu Cheng became calm and revered in his heart.

In the operating room, in fact, many people have misunderstood that the surgeon is the soul stone.

But not really,

At the time of death, seven points of anesthesia and three points of surgery were a bit exaggerated, but the level of anesthesiologists definitely occupied 80% of the active position in terms of patient safety.

With a good anesthesiologist, the surgeon's heart will become extra calm and reassuring.

Because in addition to the responsibilities of anesthesia, the anesthesiologist also has to undertake the responsibilities of correcting the patient's various vital signs during the operation, and to monitor the changes in the patient's condition during the operation.

Anyone who understands it knows that the chance of death of a patient directly caused by surgery is almost zero.

Complications are more of a cause of death.

Including myocardial infarction, pulmonary infarction and cerebral infarction caused by embolism;

Respiratory depression secondary to cerebral infarction;

Shock caused by bleeding, cerebral infarction caused by insufficient circulating blood;

Arrhythmias caused by electrolyte disturbances;

Even for aortic dissections, which have a mortality rate of nearly 50%, most of the deaths are due to insufficient blood perfusion secondary to the rupture of the dissection, followed by brain death and myocardial infarction.

Surgeons are not afraid of how complicated and difficult the operation is, they are just afraid of these complications.

The person who prevents and monitors these complications is the anesthesiologist.

This is also the reason why many people basically call an anesthesiologist an anesthesiologist. Having a good anesthesiologist **** is a guarantee for surgeons to improve their operations, and it is also a guarantee for new doctors to have enough time to accumulate their own clinical experience.

Professor Jiang Yuan has never known how many patients he has anesthetized and how many operations he has participated in.

Compared with his ability and decisiveness in rescuing patients during surgery, Lu Cheng felt that even if he had external help, he would need at least five years of experience in anesthesia.

So now, he just needs to wait quietly for the hand-washing nurse to get the surgical instruments ready, after he debridement and exploration and vac cover, the orthopaedic surgery can be declared over.

Under Jiang Yuan's calm command, the patient's vital signs stabilized at a high pressure of 70, a low pressure of 40, and a heart rate of 65.

Although the blood oxygen saturation is not high, it is still eighty-eight.

Although long-term low oxygen saturation can lead to irreversible complications, at such a critical moment, a short-term drop in blood oxygen saturation will at least not cause cerebral ischemia, and there is a full guarantee.

At the same time as Lu Cheng was rapidly debriding, a thoracotomy had already found the bleeding point. After a lobectomy was performed on a part of the completely necrotic lung tissue, a closed thoracic drainage tube was placed. Youzhi also completed the fenestration and drainage of the subdural hematoma of the head.

Although debridement and suture is only a type of operation at the surgical level, the complexity varies depending on the injury situation, and its operation time is not shorter than that of craniotomy and thoracotomy.

And because craniotomy decompression and thoracotomy exploration are life-saving operations, and there are extremely standardized operating procedures and experience to learn.

Debridement and suture time is longer than both.

It seems that the most dangerous craniotomy decompression, but it is the first to complete it. After reading the film again, it can be seen that the hematoma in the brain has been completely removed.

Huang Youzhi said: "I've finished here, only the hematoma is cleaned up. I just saw that the hematoma here is fine."

"You're probably going to be looking at the chest injury."

The two procedures of craniotomy are decompressive craniectomy and hematoma removal, which are life-saving operations. Generally, after the decompression is completed, the remaining hematoma removal is not risky.

Unless there is concurrent cerebral hemorrhage or subarachnoid hemorrhage, it is extremely life-threatening and affects vital signs.

After Huang Youzhi finished this step, he breathed a sigh of relief, and the subsequent hematoma removal can be done in no hurry, and then take it slowly.

And he did not see obvious cerebral hemorrhage and subarachnoid hemorrhage in the patient's preoperative CT.

As a result, the pressure on Chu Lin, who had not ruled out the life risk of his related departments, suddenly became very high.

Although he had opened his chest cavity and saw a hemopneumothorax, the situation was still not optimistic for the time being. There were still some lung contusions, and some lung lobes were completely crushed.

At this time, removal of part of the lung lobe must be performed.

Chu Lin didn't say a word, and after seeing the bleeding through the open chest again, he immediately started to stop the bleeding.

There is no harm in having a quicker or slower operation. The most important thing is the effect of the operation.

On this basis, the pursuit of surgical speed is the business.

However, that was when Chu Lin began to assess lung lobe and segmental damage.

Chu Lin glanced at Lu Cheng, and immediately said, "Fuck, you're all finished."

Is Lu Cheng tearing nerves and muscles directly with his hands to pull them out instead of using instruments?

Hearing Chu Lin's words, Huang Youzhi also looked at Lu Cheng.

With a confused look on his face, is this a debridement and exploration that started surgery later than us?

how did it get done so soon

Could it be that the trauma is such a coincidence that some dead muscles are ripped open, and blood vessels and nerves lie underneath, and they are not damaged.

You must know that the debridement and exploration must expose the anatomical alignment very clearly before proceeding to the next step of the separation operation.

Otherwise, if there is partial damage to the blood vessel, in the case of blunt dissection, it will lead to the fracture of the corresponding structure.

Lu Cheng simply can't be a man, he shouldn't be a man!

How can people be so fast and play like this.

Lu Chengcheng smiled and said: "I still have an emergency patient who needs to be reset. So it's a little faster, and the debridement here is also simple."

Lu Cheng said that before the joint capsule was partially closed but not completely closed, he covered the vac dressing, sutured it to the skin again, and sealed it with the film.

After connecting to the negative pressure suction, he got off the stage, and then said to the nurse who was washing his hands: "The patient does not have any fractures on the X-ray when looking directly at it~www.wuxiaspot.com~ but the ligament is damaged. I will tell the ward in charge of it when I go back. Remember to contact the knee brace for fixation.”

"Okay." Lu Cheng completed the debridement and suture in such a short period of time. He is like the relatives of all the surgical nurses and anesthesiologists on duty in the emergency class.

After all, they may encounter any trouble in the future, and they have to set up a stage with Lu Cheng. Such speed and proficiency will allow them to take an extra day off.

After the operation here, Lu Chengcheng stepped down and walked to another operating room. Of course, before leaving, he greeted Chu Lin and the others.

Lu Cheng still had emergency surgery, so they didn't say a word of nonsense and went on with their work.

After all, Lu Cheng had already completed the surgery in his department, even if he avoided his own risk. And now they still have to be careful about the patient's, where is there any extra thought to keep Lu Cheng?

Watch them perform

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