Chapter 348 The little nurse bowed her head. She was really just a regular trainee.
Zhou Can looked up at the other person, it was the female nurse named Tutu.
The two looked at each other, and the female nurse felt somewhat embarrassed.
Especially when she thought of her ridicule of Zhou Can in the ward not long ago, she felt so ashamed that she couldn't face anyone.
"I'm just a trainee, I can't really help much!"
Zhou Can didn't want to get involved in this mess.
The patient had been sent to the emergency center for more than half an hour. If the situation was ideal, the medical level of the county people's hospital could have saved the patient.
Asking him to come over to help now means that the patient's condition is worsening.
Zhou Can told the family very early on that the prognosis might be very poor.
He has neither prestige nor familiarity with the hospital, so there is really little point in him taking part in the rescue.
Unless all medical staff listen to him and don't want him to be held responsible even if the patient cannot be rescued, perhaps it can be considered.
"Director Wang personally asked me to come here and invite you to have a consultation. Please don't make things difficult for me, okay?" She was just a young nurse. If she messed up what the director asked her to do, she would definitely be scolded.
If things go wrong, work will be affected.
"Your director is sure that your tearful look is extremely lethal. Okay, I'll go over and take a look. But I have to say this first, I can only do my best."
Seeing the mist in the young nurse's eyes, Zhou Can had no choice but to agree.
It would really make the little girl cry, which would have a bad impact.
He couldn't bear it either.
"Thank you! Thank you!"
The female nurse burst into laughter.
"Your mood changes too quickly! Could it be that you graduated from the Imperial Capital Film and Television Academy?" Zhou Can teased her with a smile.
"No way! I'm a serious undergraduate nursing major."
She found that Zhou Can was not as cold as she had imagined, and couldn't help but look at him boldly.
"Are all the doctors in Tuya as good as you?"
"I never thought I was that great. But it is true that there are many highly skilled doctors at Tuya Hospital."
Zhou Can, this is the truth.
Tuya has many top experts, including some heavyweights in certain medical fields.
His level is not low, but after all, his growth period is too short, so he dare not show off.
"I think you're amazing! You knew the patient had heart problems just by taking a few glances. When you said the blood pressure in the two arms was different, I didn't believe it at all. It wasn't until I took the blood and found out you were right that I was shocked. It totally overturned my perception, you know?"
She has a very talkative little mouth.
Fortunately, the county people's hospital is not big, with only a few buildings in total. The two quickly arrived at the emergency center.
Outside the emergency room, the patient's wife was crying.
Judging from the situation, the critical illness notice must have been signed.
The medical staff had serious expressions and hurried in and out of the emergency room. Emergency rescue work should be underway inside.
Zhou Can followed the female nurse named Tutu into the emergency room and saw the patient lying on the emergency bed at a glance.
The person who was fine half an hour ago is now unconscious.
Dr. Luo, Cheng Dazhuang, and several medical staff were all busy at the scene trying to save the patient's life.
"Director Wang, I asked Dr. Zhou to come over."
"Wow, what a young doctor! Hello, Dr. Zhou!" Director Wang is a middle-aged man in his fifties, bald, without glasses, but with very serious bags under his eyes.
Older men and women, especially those who have frequent sex, often have heavy bags under their eyes.
Moreover, unlike the eye bags of young people, the eye bags of middle-aged and elderly people hardly disappear, but only continue to accumulate and get heavier.
Doctors have special jobs and often do not get enough rest.
It is common to be called to the hospital in the middle of the night to rescue patients, so poor sleep quality can easily lead to the appearance of big bags under the eyes.
"Hello!"
Zhou Can shook hands with the other party.
"I have no choice but to invite you here. I heard that it was you who diagnosed this patient. The doctors at Tuya Hospital are indeed well-deserved! The patient's condition is very serious now, and the prognosis is probably very poor. Do you think there is any good solution?"
Director Wang showed Zhou Can the new color ultrasound results.
"Oh, this person's cardiovascular system is so severely blocked. It would have been great if it had been discovered earlier."
After reading it, Zhou Can felt it was a pity.
"When the patient was admitted to the hospital, the main symptom was abdominal cramps. I didn't expect it to be heart disease. We are now using thrombolytic drugs, but the effect is not good." Director Wang admitted his mistake with some shame. "The patient is in his forties and is the main breadwinner of the family. He has elderly parents and young children. If Dr. Zhou has a good solution, I think it is worth trying, even if it is risky."
The level of doctors in the County People's Hospital is just like that. If Zhou Can can't do anything, then they will probably have to continue with routine rescue efforts, and then when the time comes, they will directly announce to the family that the patient has died because the rescue efforts were ineffective.
"From the results of the color Doppler ultrasound, there must be an arterial embolism in this area. The best way is to do a cardiac artery angiography, then insert a guidewire into the femoral artery, remove the blood clot, insert a stent, and clear the blood vessel."
Zhou Can gave a treatment plan.
It would definitely be too late to do a traditional thoracotomy. If it could be discovered earlier, there might still be a chance.
After listening to this, Director Wang sighed and said, "Alas! I also know that interventional treatment is the best way, but our hospital's technical level is limited. Whether it is arterial angiography or thrombus removal and stent placement, it cannot be completed in a very short time."
Cardiac angiography seems to be a very common operation in a large hospital like Tuya, but it is a very difficult operation in the County People's Hospital.
Especially in this emergency situation, the time left for doctors to operate is very short.
Both anesthesia and cardiac catheter puncture involve certain technical difficulties.
To put it bluntly, even for routine operations such as lumbar puncture, most county people's hospitals have immature and inaccurate technology, and puncture failure is common.
The technical barriers between county hospitals and provincial tertiary hospitals are invisible and intangible, but they do exist.
It is really not true that the provincial tertiary hospitals have blocked the technology and prevented it from being passed on to others.
It is certain that many core medical skills are kept secret from outsiders.
Everyone needs to make a living, and if the most core technologies are passed on, patients can receive treatment directly in their local counties. How can large hospitals survive?
In addition, many difficult surgeries and treatments require a complete and strong team.
Anesthesiologists, instrument nurses, assisting scrub nurses, round nurses, nutrition nurses, rehabilitation nurses, nursing nurses who provide postoperative care, and first, second, third, and fourth assistants who help the surgeon perform the operation. Some operations require two surgeons to perform the operation at the same time.
It is difficult for the County People's Hospital to gather these top-notch talents.
Even if a talented doctor or nurse occasionally appears in a county hospital, due to the bad environment, they either quit or become mediocre and become one of the mediocre masses.
Even with an excellent team, hardware and software facilities are still a hurdle.
Even provincial-level tertiary hospitals have to be extremely cautious when purchasing medical equipment and inspection equipment that costs tens of millions of yuan each, and they have to hold multiple meetings before making a decision. This is even more true for county-level hospitals with limited scale and number of patients.
Hospital leaders must consider whether they can make their investment back.
In addition to the above-mentioned strong team, hardware and software facilities that do not meet the requirements, the biochemical laboratory sometimes also does not meet the requirements. It can only perform some routine biochemical tests, and more advanced ones can only be sent to large hospitals for testing.
It is understandable that Director Wang sighed as he looked at the dying patient, seeming helpless.
"So it has both imaging equipment and interventional treatment equipment, right?"
Zhou Can asked.
"Of course! We are a Grade 3A hospital after all!" Director Wang straightened his back. He would not weaken the reputation of the hospital in any way.
“Are there any nurses who can assist skillfully?”
Zhou Can nodded and asked again.
"I can assist!"
A female nurse in her forties raised her hand.
"This is Liu Bin, the head nurse of the cardiothoracic surgery department of our hospital. She has studied at Tuya Hospital and is very good at various auxiliary operations." Director Wang added, introducing the identity and strength of the female nurse.
He had a vague expectation that this young doctor from Tuya might take over the task of rescuing this patient.
With the technical level of our hospital, it is difficult to save this patient's life.
All we can do is wait and see whether this young doctor from Tuya can perform a miracle.
Zhou Can was able to easily diagnose the cause of the patient's illness, which made Director Wang look at him with a new eye and trust him more.
"Hello, Head Nurse Liu!"
Zhou Can nodded to her.
Zhou Can felt quite familiar with this head nurse when he heard that she had studied at Tuya.
It feels a bit like meeting a fellow countryman in a foreign country.
"It's an honor to meet Dr. Zhou! It's not easy to be a doctor in Tuya Hospital! Dr. Zhou is young and promising, and we admire him!" She smiled and extended .
Zhou Can shook hands with her like a gentleman.
"You're too kind! I'm just an ordinary doctor in Tuya." Zhou Can said modestly, looking at Director Wang. "If Director Wang and Head Nurse Liu can trust me, I can try angiography, interventional thrombectomy, and stent placement."
Interventional surgery and endoscopic surgery are Zhou Can's strengths.
Not to mention puncture.
His injection skills are even better than those of the head nurse who has been working for decades.
"It is of course very good that Dr. Zhou took the initiative to help save the patient's life. However, as you know, the current medical environment is not very good. I would like to ask, can Dr. Zhou be more than 30% sure?"
Generally speaking, whether it is surgery or other treatments, doctors will divide them into several levels.
If you tell the family that the chance of curing the disease is less than 10%, then it is basically a matter of life and death. If the chance is higher than 30%, then it is worth a try. If the doctor says the chance is 50-50, then congratulations, the success rate of treatment is at least 90%.
The last type is when the doctor tells the family that they have had so many successful cases of this type of surgery and are very confident that it will work. This basically means a 99.9% success rate.
If the operation unfortunately fails, we can only say that it is fate.
"30% sure, it should be fine."
Zhou Can said lightly.
"Then I'll have to trouble Doctor Zhou! Talk to the family immediately and ask them to sign. We will send the patient to the interventional room for further rescue."
Director Wang was not fussy. When he heard Zhou Can say that he was more than 30% sure, he thought it was worth a try.
Doctor Luo Jian pulled Director Wang aside and whispered, "This Doctor Zhou is just a resident intern. Isn't it too risky to let him operate?"
"Any surgery has risks. We don't have a better solution right now. Interventional therapy is the only way to save the patient's life in a very short time. Be prepared to assist with all your efforts!"
After Director Wang made up his mind, he was extremely decisive.
Not swayed by Dr. Luo's persuasion.
In the interventional operating room, Zhou Can was already standing at the operating position wearing a lead suit.
Other medical staff took him as their center and were ready to provide all kinds of assistance at any time. Even Director Wang lowered himself to be his assistant, just to save the patient's life.
The vast majority of medical staff are able to respect life.
After all, there are only a few doctors and nurses who play with patients' lives for their own selfish interests.
"2ml of lidocaine!"
Zhou Can seemed unusually calm.
Cardiac angiography is usually performed under local anesthesia and the patient is awake.
Lidocaine is usually injected subcutaneously.
"Head Nurse Liu did a great job in skin preparation and trocar placement!"
Zhou Can seemed very relaxed, as if he was completely at ease.
"Thank you! I do this a lot, so I'm already very skilled at it."
A smile appeared on her face.
"I feel relieved that you have adequate assistance. Start piercing!"
Zhou Can began to puncture the patient.
The right radial artery is usually punctured.
Zhou Can completed the puncture easily and successfully recovered blood. Head Nurse Liu and Director Wang, who were watching from the side, felt relieved when they saw his skillful and precise operation.
This young man is really capable.
Cheng Dazhuang looked at his childhood friend with envy as he skillfully completed operations that he had never dared to even think of.
Doctor Luo Jian's expression changed slightly, and he watched quietly.
"Prepare to implant guides, catheters, and guidewires!"
Zhou Can actually didn't need to be reminded, as Head Nurse Liu had already prepared everything for him.
After he took it, he manipulated the catheter along the descending aorta to the root of the ascending aorta, and then inserted it into the left and right coronary arteries. The whole operation was not only smooth but also extremely fast.
It was all completed in less than ten seconds.
This miraculous operation stunned Director Wang, Head Nurse Liu and others.
"Is this...really a cardiac artery angiography? Why does it feel like Doctor Zhou is just playing with it?"
"With such a high level of operation, is he really a trainee? I won't believe it even if you kill me."
If Director Wang hadn't been worried about interfering with Zhou Can's operation, he would have wanted to ask immediately, what level Zhou Can is? With such a high level, it is impossible for him to be a regular trainee.
"Head Nurse Liu, don't just stand there, it's the contrast agent!"
Zhou Can turned his head and found that Head Nurse Liu was in a state of extreme shock and stunned, so he had to remind her.
"Oh... OK, OK!"
She quickly agreed and handed over the prepared contrast agent.
After contrast agent was injected into three blood vessels, the image began to appear on the screen.
It is easy to find out which blood vessels are narrowed or blocked.
"So there's a problem here. Is the thrombectomy equipment ready?"
After Zhou Can read it, he already had an idea in his mind.
If we speed up the process, this patient's life might be saved.
However, after all, the blood vessel blockage has occurred for such a long time, it will definitely have an impact on the patient. Necrotic myocardium is irreversible. This part of the myocardium loses its vitality, which will affect the patient's heart function.
Director Wang and others were completely convinced by the subsequent thrombectomy and stent insertion operations.
I was simply astounded by Zhou Can.
If the previous angiography was only a little difficult, then thrombectomy and stent placement are definitely extremely difficult.
But in Zhou Can's hands, without exception, the operation is always so simple and clear.
Completed with uncompromising ease.
It’s really fast and good.
This is the level.
"Tuya Hospital is so famous, it really deserves its reputation! In this life, if I can have the opportunity to study in Tuya, even if it's just for one or two months, I will die with no regrets."
Director Wang is in his fifties, and the hospital rarely considers him for further training opportunities.
