Chapter 29 How can I say yes, it is quite good
Wang Guohua has experienced many similar rescues.
Like the patient in front of me, there are cases where foreign bodies in the rectum pierce the intestines; there are car accidents where the intestines are ruptured; there are knife stab wounds where the intestines are pierced.
Various situations, all kinds of strange things.
But they all have one thing in common - intra-abdominal pressure is very high.
The first similar patient that Wang Guohua received when he was young was a person who was hit by a heavy object in a mine and injured his abdomen. His organs were ruptured and his intestines were perforated.
Because he was delayed underground for a period of time, the patient was already dying when he was delivered.
Wang Guohua still remembers the moment when the patient's peritoneum was opened. The feces in the abdominal cavity went directly to the roof, as if a detonator was thrown into the dry toilet.
Everyone in the entire operating room was crushed all over their bodies and faces.
That experience turned into a nightmare that Wang Guohua could not forget even after his retirement.
Why is there so much pressure? Wang Guohua knew that it should be related to the fermentation of intestinal contents. But he has not done any research on what kind of patients will be under great stress and how often this situation will occur.
As long as you know there are similar situations, why bother to study them.
Wang Guohua has a little trick: don’t open the patient’s peritoneum first. Reluctantly lift the peritoneum, insert the needle of a 50ml syringe 5mm first and deflate it.
The most correct approach is to open the peritoneum after feeling the peritoneal tension decrease.
Otherwise, the operating room will be full of shit, not to mention how the surgeon, assistant, anesthetist, and nurse should work. Just one infection level will be raised. Can the patient survive the operation? Life is a big problem.
Because there were not many similar patients, Wang Guohua only talked to Wen Youren twice, but Wen Youren never cared.
And in front of you!
Wang Guohua watched in a daze as Luo Hao lifted up the peritoneum with a button with one hand, stretched out the other hand, and asked the nurse for a 50ml syringe needle.
The equipment nurse didn't know why, and she didn't realize the danger, so she asked the patrol to give a syringe.
Luo Hao carefully took the 50ml syringe needle and inserted a few millimeters.
The action is simple, but Wang Guohua knows the meaning behind this action very clearly.
That is the accumulation of countless years of clinical experience and the advice of veteran doctors.
"Luo Hao, what are you doing?" the traveling nurse asked wearing goggles.
Because Luo Hao brought goggles, which reduced the risk of suffering during the operation to a certain extent, her words were also a little gentler.
“Shut up!” Wang Guohua scolded.
His voice sounded like rolling thunder in the operating room.
The circulating nurse and the anesthesiologist were both stunned. It had been several years since they had seen old director Guohua getting angry in the operating room.
Now that the past has returned, they do not feel insulted, but instead feel an inexplicable palpitation.
There is a problem!
Big problem! !
Everyone shut up in unison.
"Didi didi~"
This is the sound that the monitor makes intermittently.
"Huhuhu~"
This is the sound that the ventilator makes intermittently.
Mixed in among these sounds was a slight "hissing" sound.
Huh?
What is this sound? !
It turns out that the reason why the old director Guohua was not allowed to speak was because he was listening to the voice!
They are all experienced clinicians. When they heard the hissing sound, the doctors and nurses immediately thought of the 50ml syringe needle Luo Hao wanted and Wang Guohua's roar just now.
He's deflating!
No explanation was needed, everyone understood what Luo Hao was doing.
But how did Luo Hao know!
The hissing sound gradually weakened. After about 40 seconds, Luo Hao confirmed that there was no gas leaking along the syringe needle, so he pulled out the syringe needle and carefully placed it in the sterile area prepared by the instrument nurse.
Stretching out his hand, the sharp knife was slapped in his hand.
Luo Hao used a sharp knife to carefully make a small incision in the patient's peritoneum.
As the incision appeared, yellow fecal soup appeared in the field of vision.
Luo Hao immediately raised the peritoneum. Seeing that there was no danger of a "volcanic eruption", Wang Guohua calmed down, put aside how Luo Hao knew, and inserted the condom-wearing suction device. go.
Hula~
Hula~~
Hula~~~
The feces was sucked out, and the strong smell began to spread.
Fortunately, I am wearing goggles. Although it has been produced for several years, the sealing strip still blocks the penetration of irritating gases. At least my eyes are much more comfortable.
After extracting part of the feces, Wang Guohua assisted Luo Hao in peritoneal protection.
Admittedly, peritoneal protection is not very useful in this situation, and postoperative infection can be said to be 100%.
But it’s better to do it than never do it.
"Prepare warm salt water." Luo Hao said softly.
"Dr. Xiao Luo, I have prepared 10 bottles of 500 salt, is that enough?" the circulating nurse looked at the patient's abdominal cavity and asked worriedly.
“That’s not enough, give me another 20 bottles.” Luo Hao said.
The circulating nurse did not question it. She looked at the patient's abdominal cavity and felt that 30 bottles of warm saline might not be able to clean it, so it would be better to prepare more.
Don't be scolded by the old director of Guohua when the time comes.
Start flushing.
The large pieces of feces are removed by hand, and the rest is washed with saline and sucked out with a suction device.
“This is for saline water,” the anesthesiologist said. “I remember an incident happened in my second year of medical school in 2005. The patient’s family sued the hospital, saying that more than 10,000 ml of infusion was given at one time. I was scared at that time. I'm so stupid. I wonder if a second-year medical student is crazy. Why would he do such a thing? "
"I remember this too. Later I heard it was for dialysis," the circulating nurse chatted while busy.
"It was all confusing at that time." Wang Guohua said solemnly, "I was very confused when writing medical records, and I didn't record them in detail. Ten thousand ml of normal saline was just entered into the account so casually, and someone found a problem. So I will tell you about every item. We must do it perfectly to avoid big trouble in the future."
"Old Director Guohua, I have been trained by you many times. I always remember to be careful and be careful again," the anesthesiologist said with a smile. .
Wang Guohua lowered his head to perform the operation and said casually, "Being a doctor requires you to know how to read faces. You guys don't even know how to just let others be lazy."
"Old Director Guohua, we are materialistic. Doctrine, you can’t believe this.”
“If I don’t talk about anything else, let’s talk about the dispute in 2005. The patient’s family is also a well-known person in the provincial capital. They are hypocritical and can cause huge waves. They are the people behind it. Awesome.
It is said that the patient was initially hospitalized in the provincial hospital. The director of the provincial hospital felt something was wrong and kept mobilizing the patient to go to a higher-level hospital. ”
When Wang Guohua started gossiping, it became old and everyone listened attentively.
Everyone has the heart to gossip.
Although doing this kind of surgery to remove feces Even breathing is wrong, but in such an environment, it’s good to distract yourself.
Yaoshou.
"Ah? Is there such a thing?!" the anesthetist's eyes lit up.
It can be said that the old directors are treasures of gossip. Unlike nurses, they do not gossip about who is running out to check out a room with whom, but they tell some secrets in the industry.
The anesthetist was very interested in what the old director Guohua mentioned inadvertently.
"Of course, doctors must be able to meet each other. This is not an empty talk." Wang Guohua said while picking up feces with Luo Hao, "The director of the provincial hospital is my classmate. One time he drank too much. He I said it myself.”
“Let’s talk, Director Guohua.”
"At that time, he expected that there must be something wrong with the patient, so he went to talk to the patient's family, but it was of no use at all. They just refused to leave the hospital. Later, the situation became desperate and my classmate almost didn't live in the dean's office."
"!!!"
"!!!"
The doctors and nurses present really didn't know what kind of patient they had encountered that could make a department director make such a determination.
Living in the dean’s office means a lot.
But no matter what it means, even if it is mentioned again 20 years later, the people in the operating room can still feel that kind of determination.
“The dean was also tortured. He pointed at his nose and scolded him for three days. Just like that, my classmate insisted on standing up. Later, the dean came forward to talk to the patient’s family. They are all members of the society, and the dean I still have to give him some face, but..."
Wu Guohua's long tail voice left him in suspense.
"Nothing, Director Guohua."
"The patient was mobilized and discharged, but he left with a ventilator from the provincial hospital. The ventilator is from the provincial hospital. As long as he is willing to be discharged, A ventilator for free.”
"Holy shit!!" the anesthesiologist was shocked.
Will a ventilator be given away for free after discharge? ! There is such a thing! !
“The patient left the Provincial Hospital and went directly to the Second Hospital of the Medical University, and you guys saw it too. That incident made a big fuss, and the newly appointed president of the Second Hospital was really unlucky.”
"Tsk, tsk."
Wang Guohua narrowed his eyes behind his goggles and seemed to be smiling.
"Speaking of the Dean of the Second Hospital, there is one more piece of gossip."
"Director Guohua, tell me, tell me." The anesthesiologist asked happily.
It’s good to have an operation with the old director, because you can hear so much gossip at the wine table.
“This man, even if he has all kinds of abilities and abilities, he still has to look at his fate in the end. The world and the earth are all working together, and it’s not for nothing that heroes of luck are not free.”
“ ?”
"???"
Hearing what Wang Guohua said, Luo Hao took a look at his lucky value and felt very comforted.
“Not long before this medical accident, there was a reelection in the Second Hospital of the Medical University, and the two candidates had their bayonets red, and they were arguing fiercely. Later, the one everyone was optimistic about failed and went to another hospital. It didn’t take long for the Third Hospital of Medical University to be established, which is now the Cancer Hospital.”
“Ah!” the anesthesiologist was surprised.
The famous Third Hospital of Medical University in the province specializes in cancer treatment. Unexpectedly, no one wanted to go there before 2005.
"The one who stayed has lost face in front of the whole country. So, this is probably where good fortune and misfortune depend."
Wang Guohua said, frowning slightly, "Have you turned on your ventilation? "
"It's on," the circulating nurse immediately replied, "Director Guohua, the sound of the ventilation fan is so loud that it's deafening."
Wang Guohua shook his head and wanted to. I'm holding my breath, but I can't stop breathing.
“There is a joke on the Internet about a fortune teller when he was a child, and the fortune teller said that the boy would be destined to pick out feces. Later, in order to get rid of the fetters of fate, the boy studied hard, got into a good school, and studied medicine.”
When the anesthesiologist said this, regardless of the fact that the story was not finished, he and Wang Guohua took a leave of absence and ran out to take a breath.
The anesthesiologist and circulating nurse can go out to take a breath intermittently, but the few people on the operating table cannot. After a few gossips, Wang Guohua couldn't bear the fuss, so he shut up and tried hard to make the operation a little faster.
But Luo Hao’s surgery was impeccable for Wang Guohua.
He even felt that if he were the surgeon, not only would the operation not be faster than Luo Hao's, but it would be a bit slower.
What the hell!
Wang Guohua had not thought of this beforehand.
Before the operation, Wang Guohua also wanted to show his superb surgical skills during the operation, so that Luo Hao, a new generation of doctors who mastered new technologies, would have enough respect for him.
What he never expected was that Luo Hao not only mastered new technologies like ercp, but he even performed as well as traditional laparotomy surgery.
After 12′21″.
"Director Guohua, this is a foreign body in the intestine." Luo Hao had already "removed" all the feces in the patient's abdominal cavity, exposing a "hard" intestine.
"Open 5cm first to see the situation."
"Okay." Luo Hao "accepted the order."
Wang Guohua looked at the operation area intently. He didn't notice that Luo Hao's attitude made him feel much better.
Luo Hao cut open the intestines along the rupture point under the diaphragm, and an eggplant appeared in front of him.
"Eggplant?!" the anesthesiologist was surprised.
Wang Guohua and Luo Hao are okay, the images have already been judged.
"Director Guohua, the patient's habit is also a bit harsh." Luo Hao said.
"No." Wang Guohua denied Luo Hao's view, "stuffing eggplants to treat constipation is a folk remedy."
The useless knowledge has increased a little bit.
Luo Hao said "Ah". This kind of knowledge point has never been taught by Xiehe's teacher, and it is not described in the system library. Luo Hao doesn't know about it at all.
"Director Guohua, there is such a folk remedy, isn't it a scam?" Luo Hao said.
“There are many folk remedies, which are particularly unreliable.” Wang Guohua said, “I have received two similar patients, but they were not as serious as this patient. I guess he stuffed eggplant into his intestines, because He used too much force, so the hard stool pushed out a hole in the splenic flexure of the colon."
Luo Hao hummed and memorized the knowledge points Wang Guohua told me honestly.
Taking out the eggplant, Luo Hao hesitated.
"I'll show it to the patient's family later." Wang Guohua knew what Luo Hao was thinking, and he said lightly, "If you don't want to see it, I'll go."
"Okay, Director Guohua . ”
Luo Hao was worried that if someone found out about the patient stuffing eggplant into his intestines, he would not be able to hold his head up in the future. But if you keep confidentiality for patients, there will be great hidden dangers.
While making a choice, as soon as I hesitated, Wang Guohua saw the clues, and Wang Guohua directly took over all the responsibilities.
It seems that what the uncle said is wrong. The old director of Guohua and Wen Youren are not the same people.
With this style of doing things, Wen Youren can't even win over him.
The anesthesiologists and nurses did not notice the conversation between Luo Hao and Wang Guohua. They marveled at the eggplant and took pictures.
Wang Guohua repeatedly told him to wait until he had spoken with the patient and the patient’s family before saving the photos. Even if they were saved, they could only be used as pictures in the paper.
His attitude towards doing things made Luo Hao even more recognized, and his good impression doubled.
Taking out the eggplant, Luo Hao rinsed the abdominal cavity again and carefully flushed it with hydrogen peroxide.
When Luo Hao started to use hydrogen peroxide, Wang Guohua fell silent. His eyes were as wide as copper bells, staring at Luo Hao's every move.
Hydrogen peroxide rinse looks like just a rinse, but it is full of dangers. Wang Guohua knew that he was ready to point out Luo Hao's mistakes anytime and anywhere.
However, Luo Hao "easily" overcome all the pitfalls, leaving Wang Guohua with no idea who to tell about the clinical experience he had been holding back.
After flushing, Luo Hao took the trouble to explore the abdominal cavity three times, looking for any missed wounds.
Looking at Luo Hao's method of stroking his intestines, Wang Guohua stopped what he wanted to say again.
Before the operation, Wang Guohua was well prepared. The clinical experience accumulated over countless years always gave Luo Hao more insights and made him realize how powerful the old doctor was.
However!
The operation was almost finished, but Luo Hao didn't make any mistakes. He didn't do anything "serious" except gossiping.
Wang Guohua was a little depressed.
What the hell!
Did that bitch Lin Yuming embarrass himself? !
"Director Guohua, I don't see any other holes. What do you think?" Luo Hao asked.
“No, just sew it up.” Wang Guohua said in a deep voice.
Luo Hao used absorbable thread to sew the cut intestinal part, covered it with warm saline gauze against the irritating gas in the room, and then observed it carefully for five minutes.
The anastomotic site was locally red with no signs of ischemia, and the main body of the surgery was declared to be successfully completed.
Place sterile towels again, re-sterilize, and rinse for the last time.
"Brother Guan, do you have gentamicin?" Luo Hao asked.
"Qingda Flush?" The anesthesiologist glanced at the circulating nurse.
Before the circulating nurse could speak, Wang Guohua said, "I brought it, and it's on the table under the reader."
It's so frustrating! Wang Guohua thought to himself.
It doesn’t matter if the surgery is done well. How can young doctors today still have the awareness to use gentamicin for irrigation.
For young doctors, gentamicin is an old thing, and they may have never seen it used clinically.
The last "knowledge point" to be taught to Luo Hao was gone, and Wang Guohua sighed deeply in his heart.
Nowadays, due to veterinary drug residues, antibiotic abuse and other reasons, the human body is highly resistant to antibiotics. High-end antibiotics may not be easy to use, but drugs such as gentamicin in the past are very effective.
This is what Wang Guohua summed up after decades of surgery, but he didn’t expect Luo Hao to know about it.
If Wen Youren had half...one-third of the spirituality of Luo Hao, why would he bother to go on stage in his sixties?
Wang Guohua never expected that he would give birth to someone else’s child on the operating table.
Rinse with gentamicin and start closing the abdomen. Luo Hao finally moves the omentum to cover the position where the intestine is sutured.
He even knew this little thing, Wang Guohua was speechless.
What else doesn’t Luo Hao know? !
If he hadn't known Luo Hao's age, Wang Guohua would have thought that the person performing the surgery in the surgeon's position was an old man.
There is nothing much to say about the remaining steps. Luo Hao finished the last stitch, and Wang Guohua used the thread scissors hooked with the little finger of his right hand to cut the knot. Without saying a word, he walked out of the surgery room with the eggplant.
The door to the surgery room was always closed. When he walked into the corridor, Wang Guohua took a deep breath and felt much more comfortable.
Fortunately, Luo Hao had prepared goggles in advance, otherwise his life would have been shortened by at least half a month due to an operation.
Wang Guohua was holding a specimen basin in his hand. There was an eggplant in the basin. The further he walked toward the door, the more strange he felt.
He suppressed his strange mood, hid the eggplant first, and called the patient's family members waiting outside the door.
Wang Guohua was not in a hurry to talk about the eggplant. He watched his words and made sure that the patient's family members knew about it. It was not because the patient had any special hobbies, but because the patient's family members heard it from a dance partner when they were dancing in the square.
At this time, Wang Guohua took out the eggplant and gave the patient’s family a good lesson.
The old director has the majesty of the old director, even though he almost cursed his mother and almost stuffed the eggplant into his mouth.
But the patient's family members did this. They were not angry, but more ashamed and grateful.
"Don't do such stupid things in the future." Wang Guohua said in a solemn voice, "If you do it again, you won't even know how you died."
As they spoke, Luo Hao and Chen Yong pushed the patient out.
Wang Guohua took advantage of the situation and turned back.
Looking back, Wang Guohua saw Lin Yuming.
After handing the specimen to the equipment nurse, Wang Guohua and Lin Yuming went to change clothes.
"Old Director Guohua, I'm really lucky that you are here, otherwise it would be difficult to perform this kind of surgery so quickly." Lin Yuming said with a smile.
His smile looked so hateful to Wang Guohua. For a moment, Wang Guohua wanted to use the specimen to block the old man's mouth.
"Director Guohua, the operation went well."
"Of course it went well!" Wang Guohua glanced sideways at Lin Yuming, his displeasure in his words no longer concealed.
Lin Yuming was stunned, "Director Guohua, I see you are unhappy. Is there something wrong with the surgery? Or did some kid offend you? Just tell me, whoever offends you, I will look good on him!"
"You told me to see how Luo Hao's surgery went." Wang Guohua said unhappily.
"???" Lin Yuming had a question mark.
“Have you never seen Luo Hao perform surgery?” Wang Guohua said contemptuously.
"No." Lin Yuming replied blankly.
“???” This time it was Wang Guohua’s turn to raise a question mark.
"He did not stay in the imperial capital after graduating from his 8-year doctorate program. When he came back, he asked me to get intermediate certificates in various disciplines without doing his job."
"What?" Wang Guohua suspected that there was something wrong with his ears and that he heard Lin wrong. Yu Ming's words.
Lin Yuming could only suppress his doubts first and told Wang Guohua about Luo Hao's previous request for an intermediate certificate to solve the problem of scope of practice.
In the past two years, Luo Hao has been working in the medical office. He has never seen Luo Hao perform surgery. And Luo Hao didn't show off how well he did the surgery, he just did his job in the medical department honestly.
After hearing what Lin Yuming said, Wang Guohua fell into deep thought.
After a long while, Lin Yuming asked tentatively, "Director Guohua, did Luo Hao do well in the operation?"
"Good?" Wang Guohua raised his head and glanced sideways at Lin Yuming, his tone full of displeasure.
“…”
“Can that be said to be good! It’s quite good!!”
Fuck!
Lin Yuming never dreamed that Wang Guohua would give such a high evaluation.
Is it a scam?
There must be a scam!
Lin Yuming carefully observed Wang Guohua's expression, trying to see some clues.
“You don’t understand surgery, so it’s useless to tell you.” Wang Guohua said solemnly.
"Director Guohua, please tell me. I don't know how to perform surgery, but I have never eaten pork and I have seen pigs running away." Lin Yuming begged.
“Tch, let me ask you a simple question, what are the complications of hydrogen peroxide flushing the abdominal cavity.”
(End of this chapter)