Chapter 518: I was instructed, it's not unfair
According to his clinical experience, the most common cause of venous thrombosis is the failure to completely expel the air during puncture, which is also a mistake that many novice doctors tend to make.
Some experienced doctors are also likely to overlook this problem when they are in a hurry to save lives.
After listening to Zhou Can's analysis, Director Xiang didn't show much expression on his face.
The other doctors who were not good enough thought Zhou Can was talking nonsense. Especially the two young doctors under Director Xiang, each of them thought they were very good and had high expectations.
Learning from famous doctors is the greatest source of superiority.
Besides, it is not easy to become Director Xiang's student. You need to fight against thousands of competitors and defeat many competitors to stand out and be selected by Director Xiang.
The chief physician of almost any hospital has very high requirements when choosing apprentices.
Talent, understanding, and strength are all in place, but it still depends on fate.
"Director Xiang, the patient's blood pressure and blood oxygen are still dropping! The blood oxygen level has dropped below 60."
The nurse reminded.
Director Xiang's expression changed and his brows were tightly furrowed.
Obviously still hesitating.
As a chief physician, he had to consider not only the issue of rescuing the patient, but also the image of the hospital and the negative impact it would have on the hospital if the news got out.
"May I ask your name?"
"Your surname is Zhou."
"Mr. Zhou, thank you for your valuable advice. We will seriously consider it. Your visiting time has expired. Please leave first! Thank you!"
Director Xiang finally considered the hospital's reputation and asked someone to ask Zhou Can to leave.
This is going to be handled behind closed doors.
Zhou Can didn't say anything else.
Under the current circumstances, he really has no right to make any comments.
Even if what Zhou Can said was right, he still couldn't direct Director Xiang and others to carry out the rescue.
After Zhou Can left, Director Xiang said directly, "Give the patient a color Doppler ultrasound right away."
"Professor Xiang, do you really believe what that young man said?" Director Xiang's male apprentice asked in surprise.
"Medicine is a process of continuous verification. Any suspected cause of disease is worth investigating. Please quickly push the color Doppler ultrasound equipment over and check the patient's color Doppler ultrasound."
Director Xiang naturally refused to admit that what Zhou Can said was correct in front of so many doctors and students.
Otherwise, wouldn't it mean that he, the chief physician of the Provincial People's Hospital, was being led by a young doctor of unknown origin?
Face is more important than anything else, and this is absolutely not an empty statement.
Especially some high-ranking scholars and professors, they attach great importance to reputation. Just look at the news reports of individual professors abusing their power and deliberately forcing female students.
Even if they are doing things like theft and prostitution, they still have to talk about morality and justice, stand on the teacher's commanding heights, and use all kinds of verbal inducements or soft threats.
For example, the thesis will not be passed, you cannot graduate, you are not allowed to participate in important projects, etc.
They have countless ways to force female students to obey.
What if they don’t submit?
In the end, some female students with strong personalities exposed the incident directly online.
But after all, failures are still rare.
After checking the patient's superficial and deep veins, especially the central veins, the most important thing is to check.
Because Zhou Can clearly said that there was most likely a blood clot in the central vein.
"Director Xiang, Director Zhao, it seems that there really is a dark mass, and there is an obvious blockage in the blood flow." The doctor who performed the color ultrasound on the patient was very good at speaking and never mentioned that a blood clot had been discovered.
It is an indirect description.
"It seems that the blood vessel is really blocked. Just take the thrombolytic drug and administer it directly through this intravenous catheter."
Director Xiang was already feeling a little embarrassed at this time.
That young man only stood by and took a few glances, and he was able to find out the real cause of the patient's illness. This level is really high!
So many people tried to rescue him for a long time, but they didn't consider this aspect.
Thinking of this, not only Director Xiang, but even Director Zhao and several older doctors felt a flush on their faces.
Fortunately, I was wearing a mask, so it couldn’t be seen unless I looked carefully.
The two young doctors under Director Xiang felt as if they had been slapped in the face. In addition to being shocked, they also felt a little ashamed and a little bit unwilling to accept it.
Especially the young female doctor, she never expected that the young doctor whom she looked down upon would be so powerful.
She was secretly curious, which hospital was the young doctor from?
In the province, there are only a few hospitals with good strength. Tuya, Provincial Children's Hospital, Provincial People's Hospital, and a digital hospital are four general hospitals that are recognized as strong.
There are other strong hospitals, but most of them are specialized hospitals.
For example, Fangxin Cancer Hospital, Jiang's Orthopedics, and the former Xinxiang Women's and Children's Hospital are all well-known specialized hospitals. Each hospital has made great achievements in its own field.
The doctor was very young and seemed to be very skilled. When facing Director Xiang, he was calm and composed.
This means it must have come from a large compound.
Although she was curious about Zhou Can's identity, she was currently saving the patient's life and focused her attention on the rescue.
“Who did the IV cannulation?”
After Director Xiang confirmed through color ultrasound that the patient might indeed have venous thrombosis, his face looked somewhat grim.
Anyone who performs intravenous puncture on a patient will definitely be scolded.
"Xiao Chen did the venipuncture and he's off work now."
When air enters a blood vessel, blood clots do not form immediately, but take time to form. It may take longer to cause a significant impact on the body.
Central vein thrombosis is an extremely terrible thing.
If the disease is not discovered in time and not handled properly, it can directly lead to the patient's death.
In fact, even if venous thrombosis forms in the limbs, it is also very harmful. Especially some free thrombi in the blood vessels are simply invisible killers.
"You must learn from this and be careful not to be careless when inserting a venous catheter. Remember to talk to Xiao Chen about this tomorrow."
"OK."
The person who responded was Dr. He, who was an attending physician.
Because of the intravenous catheterization, drug administration is very convenient, and the thrombolytic drugs can directly and quickly act on the site of thrombus formation.
"It seems to have little effect. The patient's current condition may not last long enough for thrombolysis to succeed. Moreover, the blood clot is very large. I am worried that it may become free after thrombolysis and cause further harm."
Director Zhao has been carefully observing the patient's blood circulation, especially the blocked area.
Color Doppler ultrasound or CT scan are good methods of diagnosis for venous thrombosis, but they are not as good as angiography, which is the only gold standard recognized in medicine.
Auxiliary diagnostic methods such as checking plasma D2 aggregates have certain reference value, but cannot directly confirm the diagnosis.
Only one diagnostic direction can be provided.
If it is a superficial venous thrombosis, a preliminary diagnosis can even be made directly by palpation.
When you press it, it will feel hard and even cause swelling of the limbs.
The lower limbs are particularly prone to this disease.
In addition, older people are most likely to develop varicose veins in the lower limbs.
This is directly related to the formation of venous thrombosis.
When you touch your lower limbs, especially the calves, you can feel lumps, which is likely to be varicose veins.
"The thrombosis may have occurred for a long time, and the thrombus is tightly attached to the blood vessel wall. If drug thrombolysis does not work, I am afraid that interventional surgery is the only option."
Director Xiang also knows that time is life now.
Even though it is just a small blood clot, if it cannot be removed or melted in time, it will be fatal to the patient.
With the continuous development and progress of human medical technology, there are now many ways to deal with deep vein thrombosis.
Interventional thrombectomy is recognized as one of the most direct and effective methods of thrombectomy.
However, this operation has high requirements on the surgeon's technical level and the patient's physical tolerance.
In the early years, removing blood clots was the most difficult thing, and it was even necessary to cut the blood vessels, remove the blood clots, and then perform vascular anastomosis.
Interventional surgery is much less traumatic to the patient.
It is efficient, fast and safe.
If they had not been overly wary of Zhou Can and had allowed him to stay at the scene, Zhou Can might have requested interventional thrombectomy long ago.
And as long as they are willing to give Zhou Can a chance, Zhou Can can do it directly.
His interventional skills are not the best, but they are probably ranked among the best in the province.
After all, his advanced medical skills are now all level six, including injection and implantation. These are also the two most commonly used skills in interventional surgery.
There are not so many assumptions in the world. The doctors at the Provincial People's Hospital would never ask a doctor they don't know to perform interventional surgery for them.
…
Half an hour later, the doctors from the Provincial People's Hospital finally removed the blood clot after great effort, and the patient's blocked venous passage was restored.
Here comes the problem. The drug just given was a thrombolytic drug.
It has no effect on the blood clot, but once it enters the blood circulation, it can easily cause bleeding again in the patient's body where the bleeding has already stopped.
They still have a lot of difficult things to face.
"Indicators such as blood pressure and blood oxygen have all risen, and the patient's previous condition has rapidly deteriorated, which is likely caused by this blood clot."
The medical staff were very happy that they successfully rescued the patient from the clutches of the devil.
Director Xiang felt ashamed because the cause of the disease was pointed out by the young doctor named Zhou.
They are just following other people's instructions.
The real hero is that young man.
"Director Zhao, do you know the young doctor who came in to visit ?"
Director Xiang asked Director Zhao, who was less than fifty years old.
The intensive care unit is not like an outpatient clinic or an inpatient ward. The work done here is not only technical but also physically demanding.
Older doctors simply can’t handle this.
Therefore, the doctors here are mainly between 27 and 50 years old.
Young doctors who have just graduated are also not suitable to work here because they lack rescue experience and have limited skills. People in their thirties are considered the important labor force of the ICU, and those around forty are the backbone and elite.
Those who are around fifty years old are basically the big guys here.
The group of people holding the baton.
"I don't know him. He just looks familiar, but I can't remember where I've seen him before."
Director Zhao shook his head.
"It looks familiar to me, too!"
A young doctor answered.
"He does look familiar, could he be a doctor from our hospital?"
Another nurse followed suit.
"No, it shouldn't be a doctor from our hospital. I have a basic impression of all the young doctors in our hospital who are more capable. This young doctor didn't check the patient's medical report, nor did he learn about the patient's condition and injuries in detail. He just stood by and looked at the monitoring equipment and the patient's body, and he was able to accurately tell that the real reason for the patient's critical illness was a blood clot. This skill is truly amazing."
Director Xiang was full of doubts. He felt that the ability of this young doctor was unfathomable.
He is also very tactful in what he says and does.
To put it in an exaggerated way, his whole body exudes the demeanor of a king.
"Ah... I know who he is!"
The nurse who looked familiar to Zhou Can exclaimed.
"Teacher Hu, please control the volume. This is the ICU."
"SOORY! It's my fault for being too emotional and losing control." She quickly apologized. "That young doctor said his last name was Zhou. Do you think he looks very similar to the doctor Zhou who performed a cardiac surgery live online a while ago?"
After the nurse reminded them, everyone remembered.
"Yes, yes, yes! It's him, Doctor Zhou Can. No wonder he looks so familiar!"
Director Zhao affirmed this.
"It turns out that he is an outstanding young doctor from Tuya Hospital. It seems that it is not unfair at all that we are being mentored by him today!" Director Xiang is still feeling aggrieved about being mentored by Zhou Can.
For a person of his level, the hardest thing to let go of is his face.
Fame and fortune are harmful to people!
However, now that he knew Zhou Can's true identity, Director Xiang felt somewhat relieved.
I have learned a lot today.
I personally experienced how amazing the young doctors at Tuya Hospital are.
"Ru Yaji, Pang Houzhong, you two should learn from others. Normally, you two always look up to others. Now do you know how big the gap is between you and the truly great young doctors?"
The more you criticize, the deeper your love.
It can be seen that Director Xiang is very fond of his two young doctors.
I want them to grow quickly and become the backbone of the department as soon as possible.
“He is indeed very strong.”
Ru Yaji admitted that Zhou Can was very strong, but she was extremely unconvinced in her heart.
She doesn't have any scheming intentions, and it's basically reflected on her face.
"If I have the chance, I really want to have a good talk with him." Pang Houzhong is also unwilling to admit defeat. No one will admit that he is weaker than others.
"There is a reason why Tuya Hospital has been able to maintain strong momentum and continue to grow in recent years! The quality of the young doctors alone is already frighteningly high. The director-level doctors behind them are probably even more extraordinary."
Director Zhao expressed deep emotion about this.
"Director Zhao, Director Xiang, there is something I want to tell you. Should I tell you?"
Dr. He, an attending physician, said weakly.
In front of ordinary doctors, the attending physician is truly a superior doctor. But in front of these chief and deputy chief physicians, he is immediately inferior.
"Just tell me what you want to say! There are no outsiders in this duty room."
Director Xiang has spoken.
"Just now, Dr. Zhou Can mentioned venous thrombosis, and before he left, he seemed to be hesitant to speak. I wonder if he had other diagnostic and treatment opinions to provide us, but was worried about causing misunderstandings, so he didn't say it in the end?"
Everyone observes something different.
Dr. He inadvertently observed some subtle expressions of Zhou Can at that time.
"What's the meaning?"
Director Zhao's eyes narrowed slightly.
