Chapter 438: With the style of a coach, sixth-level medical skills
The operation officially began, and the patient lay supinely on the operating table, already in a coma.
Director Xueyan held the knife and made an incision through the front midline of the patient's chest.
She was originally a chief physician, and after a year of devilish training, she became more skilled in performing thoracotomy, and it was no problem for her to perfectly avoid large blood vessels and important nerves when making the incision.
We are now able to deal with any emergencies encountered during the thoracotomy process with relative ease.
Zhou Can stood beside her to support her, and the atmosphere in the operating room was not tense at all.
After working together to perform many level 3 and 4 open-chest surgeries, everyone's psychological quality has been greatly improved.
"The patient's left thymus gland is a bit of a hindrance!"
Xueyan said to herself.
"No, this thymus is too annoying. It always blocks my surgical vision."
She complained again.
The one who made the pinky promise was Dr. Long, who was in his forties and had just been awarded the title of associate senior physician. He did not get carried away by this, but became more humble and eager to learn, and took the initiative to serve as the third assistant to Director Xueyan as an associate chief physician.
"If it's really in the way, it can be removed. Losing a thymus is not a big problem. If it gets in the way and the operation fails, the patient will lose his life. Compared with the huge potential risks, removing it in exchange for better exposure is worth it, I think."
Zhou Can gave some advice from the side.
Most people would not dare to instruct the surgeon to remove an organ or tissue.
One reason is that the level is not high enough, and the other reason is that there is a difference between the upper and lower levels. It is easy to be scolded if you make irresponsible remarks or interfere with the surgeon's operation.
"I have performed a similar operation with Director Hu before, and the left thymus was also removed. I did not see any adverse reactions from the patient afterwards."
Director Le spoke promptly to support Zhou Can's suggestion.
"Well, I'll cut it off then."
Director Xueyan did not hesitate and decisively removed the left thymus.
Not long after the operation, the anesthesiologist cried out, "Oh no, the patient's vital signs are dropping." She hurried to check what went wrong.
I searched for a long time but couldn't find where the problem was.
“Could it be caused by the removal of the left thymus?”
The anesthesiologist wasn't too sure.
Director Xueyan was relatively calm at first , and repeatedly checked the surgical incision and the surrounding area to see if any important nerves were cut.
The beating of the heart is driven by electrocardiogram signals.
There are still many important nerves around it.
If you accidentally cut off an important nerve, it will be a big trouble.
The monitoring equipment soon sounded an alarm.
This time, Director Xueyan and the anesthesiologist were both anxious, and Director Xueyan even had a panicked expression on her face. This is human instinct, and it is impossible to hide it in an emergency.
"It should be caused by brain hypoxia!"
After careful study, Zhou Can gave his judgment.
As he spoke, he had already tried to flex the child's lower limbs and change him to a knee-chest position.
"Morphine, subcutaneous injection at 0.05mg/kg!"
In this case, the child may die in a very short time, and Zhou Can must quickly come up with a corresponding rescue plan.
People didn't invite him here to just roll up his sleeves and watch the show.
The circulating nurse, anesthesiologist, and surgeon-in-chief should all know the patient's weight. Even the interns who are in charge of the patient's bed can grasp the patient's key data if they pay more attention.
After injecting morphine subcutaneously, a hint of joy appeared on the anesthesiologist's face.
"It's getting better, it's getting better!"
It's not easy to make an anesthesiologist who usually has a stern face and is serious, excited like a little girl.
Many people say that circulating nurses are extremely aggressive and swear at people at every turn.
In fact, the circulating nurses smile a lot.
In most cases, they are only aggressive towards doctors of lower ranks, such as interns, trainees, and junior residents. If these people litter in the operating room or perform some irregular operations, the circulating nurses will scold them.
Under normal circumstances, they are still quite gentle.
"If there is improvement, inject sodium bicarbonate intravenously to correct the acidosis."
At this moment, Zhou Can is more like the late Director Hu Kan. He became the real backbone of this surgical team at the critical moment.
"How is the patient's blood pressure? Is it rising?"
He continued to question the anesthesiologist.
"The blood pressure is still very low and is recovering slowly," she replied.
"Miss Patrol, get a bottle of phenylephrine for intravenous drip."
Zhou Can calmly issued the third rescue order.
Finally, after everyone's concerted efforts, the child's vital signs gradually stabilized.
Director Xueyan's face was slightly pale, and she was obviously very frightened.
Not to mention her, even the anesthesiologist was scared to death. Only the circulating nurse was relatively calm.
"That was so scary just now. Fortunately, the patient was saved. Can the operation continue?"
"Don't worry too much, it should be fine for now. The child will still not survive without surgery. It's better to go down one path at a time, maybe he will be able to survive." Zhou Can also let out a breath of relief.
"Doctor Zhou, you were the calmest just now. I think you are the anchor of our surgical team. Just now, you were calmly directing the rescue. I vaguely felt from you... the stability that only Director Hu Kan can bring to us."
He didn't dare to accept the offer even though Zhou Can was promoted to such a high position.
"I'd be very lucky if I could have even one-tenth of what the teacher has, but facing the critical condition of the sick child, there is nothing I can do but go ahead!"
To say I'm not panicking would be a lie.
Zhou Can is also a human being, and he may not have experienced as many dangerous situations as Director Le and the others.
In times of crisis, someone has to step up and take charge of the situation.
"By the way, in the patient's condition just now, it's best not to use Rehmannia drugs when rescuing him. Otherwise, it's very likely that the patient will die."
Zhou Can reminded everyone.
In the operating room, people generally don't say the word death.
This is quite taboo.
Some ignorant interns, when entering the operating room for the first time, asked their teachers what to do if the patient dies on the operating table?
At this time, you can see that the teaching teacher has a dark face, and he wishes he could slap this talkative intern to death.
If something really goes wrong during this operation, I guarantee that this intern will never be able to enter the operating room again.
Also, when people talk in front of patients, they usually use some code words.
For example, if the patient has cancer, Ca will usually be used instead. If the patient is undergoing a second surgery, then the term "second visit" will be used instead.
"Zhou Can, can you be the lead surgeon?"
Xueyan looked at him for help.
"Didn't you want to try to challenge Tetralogy of Fallot? Why are you giving up so soon?" Zhou Can asked as he walked towards the operating position.
"This operation is far more dangerous than I imagined, and I'm worried about something going wrong. If I want to practice, I'll find an opportunity next time. There's no need to take risks on this particular patient." Xueyan analyzed calmly.
"Okay, leave it to me."
Zhou Can has always been very enthusiastic about this type of level 4 major surgery.
He had only performed Tetralogy of Fallot surgery following Director Hu Kan, and this was the first time he performed the surgery alone.
"Sister Yan, after reaching this step, the next step is to free the mediastinal pleura on both sides. Be careful not to destroy it."
After Zhou Can took over, the operation speed was significantly increased many times.
"Next, insert a blood vessel into the ascending aorta, insert drainage tubes into the superior and inferior vena cava, and establish extracorporeal circulation..."
Nearly three hours later, Zhou Can looked at the surgical masterpiece with satisfaction.
The operation encountered many minor setbacks, but thanks to his efforts, it was finally completed safely and successfully.
"Who will close the chest?"
"Why don't you do it? The patient's tolerance is already poor, and if the thoracotomy takes too long, I'm worried that it will be detrimental to the prognosis. This is the first time our cardiothoracic surgery department has performed a similar operation in a year. So I want to play it safe."
Director Xueyan’s feelings are understandable.
If you don’t manage the household, you don’t know how expensive firewood and rice are.
After she became the director of this department, she was responsible for the future and fate of the entire department, so she had to consider things far beyond those of ordinary people.
The two residents were eager to try and really wanted to take advantage of this opportunity to close the chest.
But after Director Xueyan said the word "play it safe", they took the initiative to give up the idea of taking action.
"Dr. Zhou's surgery speed is first-rate, and he closed the chest very quickly and well. It's already very late, so I think it's good that he can finish the work early."
Director Le said with a smile beside him.
"That makes sense. You young people may be able to handle it, but to be honest, I'm old and I really can't stand it." Deputy Director Han is in his fifties, about the same age as Director He.
Men are born to be hardworking. Whether at home or outside, they are the main force in heavy labor and technical work.
Sometimes when I get home from get off work, no matter how tired I am, I still have to pay my dues to my wife.
Just two words: hard life.
Many women always complain about how hard it is to do housework, give birth to children, and have their periods every month... If they saw how hard men work outside, they might not say that.
Zhou Can quickly closed the chest.
[Chest closure successful, Suturing Skills experience points +100 awarded. Congratulations on reaching level 6 in Suturing Skills.]
While performing the chest repair just now, Zhou Can earned a lot of medical experience points as rewards.
I really didn't expect that at this juncture, suture technique had been upgraded to level six and became his first director-level medical skill.
It is really not easy to accumulate a full 100,000 experience points.
He could clearly feel that his understanding and comprehension of suturing was completely different from any previous advancement in medical skills.
Even if his medical skills were upgraded to level five, reaching the level of deputy director, he only felt like he could glimpse some deeper medical mysteries. But that feeling was very uncomfortable, like looking at a beautiful woman through frosted glass.
You don't know whether she is pretty or not, you can only vaguely see her graceful and slender figure.
"Is this the sixth-level medical skill?"
Zhou Can was immersed in the brand new director-level suturing skills.
If the fifth-level suturing technique gave him the ability to suturing just right, then the sixth-level suturing technique gave him something even more mysterious.
It was as if he could peek into the mystery of life directly through a small wound.
For example, when he takes a look at a chest wall wound that has just been sutured, he does not see whether the stitches are neat or whether the wound layers are tightly fitted, but he can truly feel that the life on the operating table has been repaired and is quietly recovering its vitality.
As for the speed of the recovery process, he couldn't feel it clearly.
Maybe his realm has not reached that level yet.
Or maybe only one medical skill has been promoted to level six.
After all, the entire composition of life is very complex, and the human body is thousands or even hundreds of thousands times more complex than the most sophisticated and complex computer in the world.
So far, even the United States, the most developed country in the world, has not been able to thoroughly study the mysteries of the human body.
Just a neuron simulation has made countless scientists, biologists, doctors, and scholars return empty-handed. A large amount of research and development funds have been invested, but the artificial intelligence simulation has never been successful.
This is just the study of the human brain neurons. If it is the entire body, it may not be fully studied even in five hundred years.
The genes of the human body, the DNA genetic code of the blood... There are too many unsolved mysteries of mankind waiting to be solved by future scientists and doctors.
"Level 6 medical skills are truly amazing. I wonder if other doctors can also see the secrets of life directly when examining the patient's wounds like I do?"
At this moment, Zhou Can was looking forward to the day when his other medical skills could be promoted to level six.
Perhaps then, his glimpse into the mysteries of life will be clearer and deeper.
"Doctor Zhou, Doctor Zhou...it's time to call it a day!"
The instrument nurse waved in front of Zhou Can, waking him from his thoughts.
"Oh, sorry, I was distracted! Is the patient's vital signs stable?"
Zhou Can asked the anesthesiologist who was packing up his tools.
"The operation went very smoothly, and the child's physical signs are all quite good. But he will definitely need to stay in the ICU for a while. It depends on the situation, maybe three to five days at the shortest, or longer... I'm not sure."
The anesthesiologist is optimistic about the child's prognosis.
"Since you, the protector of life, have spoken, I have nothing to worry about. Let's have a midnight snack before we go!"
Zhou Can greeted the anesthesiologist.
"There are children at home waiting for me to go home, so you can let me take some back for them to eat."
The anesthesiologist is at least thirty-seven or thirty-eight years old.
She is considered a very outstanding young and middle-aged .
"I knew that some of you are family-oriented, so I ordered them to be packaged. There's one for everyone, including the interns. Take it home and eat it!" Director Xueyan continued with a smile.
After overtime, a generous director will usually order some midnight snacks for everyone or invite everyone to have a meal together.
Considering our financial ability, we only have dinner parties once or twice.
It’s impossible to have dinner together every day.
Because this money is not paid by the department, but by the director himself.
"Thank you, Director Xue!" After hearing this, the anesthesiologist smiled and thanked her, which was rare.
"How many children do you have?"
Zhou Can helped her pack up her tools while chatting with her.
"How many children are there? We doctors are so busy all day long. It's good enough that the hospital allows me to take maternity leave. Of course, if I insist on having a baby, my boss probably won't be able to do anything about it because the anesthesiology department is always short of staff."
When she was working, she had a stern face and was very serious.
After the operation, he talked more or less like a normal person.
"What about you? Are you married?"
The anesthesiologist may have considered that Zhou Can was particularly young, so he added another sentence.
