Chapter 412: The Real Cause of Gangrene
I don’t know what kind of surgery it is?
There are many major operations in cardiothoracic surgery, and most of them carry extremely high risks.
To be honest, the doctors in the cardiothoracic surgery operating room are very steady in their work, but their hand speed is a big flaw. Even though Director Hu Kan has performed some difficult cardiothoracic surgeries without any problems.
That’s because Director Hu Kan does a lot of calculations before every operation.
It can even be detailed to see what might happen in each part of the operation, so that emergency preparations can be made in advance, or potential risks can be avoided in advance.
Zhou Can learned the true skills from Director Hu Kan and knew very well how Director Hu Kan handled those difficult and major operations.
Director Hu Kan can use this method of avoiding surgical risks well, but that doesn’t mean that Xue Yan, Director Le and others can also use it well.
Because this really tests a doctor's experience, prognosis estimation, and flexible use of various techniques.
After all, Director Xueyan's surgical experience is far inferior to that of Director Hu Kan.
Some of her surgical skills are even only at the deputy director level. She is far from being able to flexibly apply various medical techniques during surgery, especially to flexibly and skillfully apply them when the patient is in an emergency or critical condition.
Under such circumstances, the outcome of taking the risk of challenging a highly difficult level 4 cardiac surgery is almost predictable.
It’s already so late today, Zhou Can plans to find out the details tomorrow.
After all, the patient was dead.
Right now, the priority is to ensure that nothing goes wrong in the emergency department's operating room.
Even the specialist department was afraid to admit the patient who had gangrene. You can imagine how high the risk was.
He made his way to the inpatient ward.
The emergency department is really changing every month now, it is not an exaggeration to say that it is changing with each passing day.
The number of inpatient wards increased from one to two.
Each ward has five beds, and twelve temporary beds have been added in the corridor. If there is an emergency, there is still some space in the observation area and infusion room.
It won’t be a big problem to add five or six temporary beds.
"Hi, Doctor Zhou, you're still not off work so late!" The doctor on duty in the ward tonight was Jiang Shuangshuang again.
"There is a patient with gangrene on his leg wound who just had surgery. I am a little worried, so I came to check on him. Has the patient been transferred to the inpatient ward?"
Zhou Can asked.
"He just arrived and has been placed in bed number 22. I just checked and the patient's vital signs are relatively stable. He still has a slight fever. His wife fed him a bowl of broken noodles."
Jiang Shuangshuang is full of respect for Zhou Can.
Doctors are like this. They respect their colleagues who are virtuous and have excellent medical skills from the bottom of their hearts.
When Zhou Can came to make rounds, he had very brilliant and unique insights on some cases. The medical instructions he wrote were often forward-looking. Jiang Shuangshuang admired him from the bottom of her heart.
Sometimes when she encountered problems she didn’t understand, she would ask Zhou Can for help, and Zhou Can would always patiently give her guidance.
Moreover, some of the explanations she gave were even better than those of her previous teachers.
This point particularly shocked and impressed Jiang Shuangshuang.
Zhou Can went straight to bed number 22.
Along the way, some family members recognized him and greeted him enthusiastically.
Zhou Can was not arrogant and responded in a friendly manner.
The words "everyone is treated equally" and "all are like close relatives" are basically reflected in him.
This is the quality of a great doctor, which is difficult for ordinary doctors to achieve.
"Doctor, thank you for your help. This allowed my husband to have surgery and be hospitalized for treatment." The woman, who was with her several-year-old son, immediately knelt on the ground and was about to kowtow to Zhou Can when she saw him coming.
This scene really scared Zhou Can.
Quickly support the female family member.
"Sister, please don't be polite. I'm very happy to help you without asking for anything in return. Have you had dinner?" Looking at the dry and pale lips of the female family member, it was very likely that she had not had dinner.
“I’m not hungry!”
The female family member said this, but her stomach made a rumbling sound.
"My mother said that food outside is very expensive and she wants to save the money for my father's medical treatment!" The little boy interrupted timidly.
Children are the most innocent and generally they don't lie.
Zhou Can's eyes swept over a bag on the bedside, which contained an opened bag of instant noodles. The little boy was holding a stainless steel rice bowl with some leftover soup in it.
You can still see the residue of instant noodles and the fragrance coming from it, which also proves that instant noodles were soaked in this bowl not long ago.
In order to save money, I might only soak half a pack.
Seeing this scene, Zhou Can understood everything. He just felt very upset.
The world is never fair. People who live well can spend thousands of dollars on a single meal, while poor people are reluctant to buy a box lunch outside.
Even a packet of instant noodles needs to be soaked twice.
Zhou Can is a rich man and cannot understand how difficult it is for this family.
All I know is that the three of them went to the city to work, and the husband was injured in a motorcycle accident and has been receiving treatment ever since. It must have cost a lot of money.
She had to take care of her children and her injured husband, so she couldn't go out to work.
The daily rent, utilities, food and drink expenses for a family of three, as well as the husband’s medical expenses, are enough to quickly deplete the family’s small savings.
"Little boy, are you hungry?"
Zhou Can squatted down and touched the little boy's head.
Perhaps due to malnutrition, the little boy's hair is thin, sparse and yellow.
"I... am a little hungry!"
The little boy peeked at his mother and answered quietly.
"How cute! Uncle will bring you food tomorrow."
Zhou Can smiled friendly at the little boy.
"Our hospital has a charity project that specifically provides assistance to some out-of-town patients and their families. I'll ask about it tomorrow. If you meet the requirements, you can eat in the cafeteria for free."
This sentence was obviously directed at the female family member.
"Thank you! Thank you!"
The man on the hospital bed sounded very weak when he spoke.
People are all made of flesh and blood.
There are unruly and difficult family members, as well as heartbreaking family members and patients. Zhou Can has encountered quite a few of them.
But he always maintains the kindness and warmth in his heart.
When he sees a patient in need of help, he will do his best to provide appropriate help.
"You're welcome, big brother. How do you feel now? Are you feeling uncomfortable?"
Zhou Can asked the patient.
"I feel much better, but I still feel a little cold," the patient replied.
Chills are one of the more common symptoms of severe infection and large-scale gangrene.
Sepsis can literally kill people.
And it can easily take a life.
"I'll ask the nurse to bring another blanket. Someone will come to give you an IV later. Let's wait and see tomorrow. I hope we can save your leg."
Zhou Can did not blame the patient and his family for their previous actions, causing a wound that could be healed by sutures to become infected, festered, and even gangrene.
Because it no longer makes sense.
I believe that if they could do it again, the patient and his family would definitely go to a regular hospital to treat the wound without hesitation.
Instead of going to a small clinic for hasty treatment just to save money.
Such tragedies of saving money but ultimately suffering greater losses occur almost every day in hospitals. Sometimes, even lives are lost.
For example, a 41-year-old male patient felt that he always had irregular abdominal pains, but he was worried that it would be too expensive to go to the hospital for examination, so he didn't take it seriously. Until one day, he fainted from the pain on the construction site.
He was sent to the hospital for examination by his coworkers and was diagnosed with advanced colon cancer.
If you can go to the hospital for examination earlier, perhaps you can nip cancer in the bud.
Another patient squeezed a rash on the bridge of his nose and later found that his nose was swollen and painful, and the swelling continued. Less than three days later, he was sent directly to the hospital ICU.
Think about it, the cost of staying in the ICU for one day starts at at least several thousand yuan.
It's common for someone like him who just moved in to spend tens of thousands a day.
Zhou Can noticed a trace of pain on the man's face.
This is by no means a sign of coldness.
"Are you in pain somewhere?"
"The leg that had the surgery is a little swollen and painful. It should be nothing serious. It has been a long time. Since the accident, it has been swollen and painful from time to time."
The patient replied nonchalantly.
“Do you often experience leg pain after the injury?”
Zhou Can asked.
As professionals, we are able to keenly discover hidden dangers that patients cannot discover.
"Well, it seems that this phenomenon has been happening since the operation." The patient nodded in confirmation.
"Is the pain migratory or fixed in one place?"
Zhou Can asked again.
"It seems to be a migratory type! The swelling and pain are in this large area, and sometimes it feels like there is a drill bit drilling around inside."
The man thought about it carefully before answering.
Zhou Can felt relieved.
"Okay, you rest first! You can drink water and eat food, but don't move your leg. It's best to go to the toilet in bed." Zhou Can made a request to the patient.
Walking or squatting may cause the wound to further crack, bleed, and exude.
Moreover, the wound is now in an open drainage state and the first surgical debridement has just been completed, so we must prevent the wound from being contaminated again.
"When he goes to the toilet, or when you help him wash his body, in order to prevent the gauze on the leg wound from being contaminated, you can use plastic wrap, plastic bags or something like that to protect it. You must not remove the water."
This water includes the patient's urine and feces.
After finishing his instructions, Zhou Can got up and left.
His brows were slightly furrowed, obviously thinking about the patient's condition.
I had migratory swelling and pain in my legs, which occurred from time to time and still exists today.
Is there any connection with the patient's gangrene?
Zhou Can has extensive surgical experience and has encountered local gangrene caused by arterial embolism.
At this moment, he highly suspected that the patient had suffered a local arterial embolism in his leg.
If this is true, then the patient must be helped to remove the blood clot or fat clot in the artery. Only after blood circulation is restored can the patient's leg wound heal.
Zhou Can ran to the night market stall outside the hospital, bought three servings of hot dumplings, and returned to the emergency room.
"Hey, why is Dr. Zhou back again?" Jiang Shuangshuang was still treating the patient diligently.
Giving intravenous drips and changing dressings are basically the responsibilities of nurses.
But it's like a husband and wife. If they are too clearly separated, it will be meaningless. Doctors and nurses should work together with the same goal, which is to find ways to help patients recover.
In this regard, Jiang Shuangshuang and Lin Ping are both competent.
"I saw someone selling dumplings outside the hospital, so I bought some for the patient in bed 22 and his family. The child was too young, and it must be pitiful that he was hungry!"
Zhou Can replied with a smile.
"It's really pitiful. And I've never heard of any charity program in our hospital that provides three meals a day for patients and their families. Dr. Zhou is really special!"
There was a beautiful curve at the corner of her mouth.
"Haha, seeing the truth but not speaking it out is the rule for us adults! If you can help, help. Everyone gets into trouble sometimes!"
Zhou Can smiled and winked at her.
Jiang Shuangshuang was left looking at his back with a nice smile on her face.
Warmth can illuminate everyone's heart.
It can better influence others and serve as a role model.
A person with great virtue can carry all things.
Needless to say, Zhou Can must have become even more prominent in Jiang Shuangshuang's heart. Even this good impression will last a lifetime in her heart and will always affect her medical career.
When Zhou Can brought the dumplings over, the nurse had already given the patient an IV.
"I went out for a midnight snack and bought some for you. I don't know if it suits your taste."
"Thank you! Thank you so much! I'll pay you whatever you want!"
The female family member was so moved that tears welled up in her eyes.
Only after experiencing helplessness, despair, and the coldness of human nature, can you know how warm and precious the care from strangers is.
When she called to borrow money for her husband's medical treatment, she was turned down everywhere.
When she took her husband to see a doctor, the big hospital heard that she insisted on saving her husband's leg and passed the buck to others, and refused to admit him.
Until they met Zhou Can, who gave their family a lot of help.
"No need to pay, I'll treat you guys to a meal!"
Zhou Can refused to take the money.
"I was thinking carefully about the cause of his illness on the way. Logically speaking, he is so young and strong, and the wound was treated in time, so gangrene should not have occurred. Considering the migratory pain in his legs he mentioned just now, I suggest a color ultrasound to see if there is any blood vessel embolism."
He made some new examination recommendations to the family.
"You must be aware of how serious your husband's condition is. Every second counts if we want to save his leg. My personal opinion is that if you agree to do this examination, I will ask my senior doctor to order an expedited color Doppler ultrasound. There are people on duty in the ultrasound room at night in our emergency department. If it is really a blood clot, there can be no delay and the thrombus must be removed immediately..."
Zhou Can explained the reason in detail to the family members.
"Doctor Zhou, we trust you very much. Since you said so, let's do the examination!"
The female family member has extremely high trust in Zhou Can.
This is also the most ideal doctor-patient relationship for doctors. Patients can highly trust doctors. Only in this way can doctors let go and try every possible way to treat patients.
"Okay, I'll go ask the senior doctor first. I'll write a checkup order and arrange for someone to do a color Doppler ultrasound for your husband."
After Zhou Can came out, he called Dr. Xu directly.
This matter must be reported to Dr. Xu.
