Chapter 184: Old things keep getting stronger - diagnosis is faster than the system
Fang Lao was very disdainful.
“You’re worthy of telling me this if you caught two big fish and couldn’t even find a home.”
Chai Lao was proud and laughed silently.
A few days ago, Chai Lao accidentally caught a large carp weighing more than 20 kilograms. He specially found a 28-bar and carried the fish around the community for 4 hours.
Old Fang's eyes were red when he saw it. Old Chai hit him twice just to say hello, and finally chased him back to his home in Versailles carrying the fish.
"Xiaoluohao is filial to me, but that kid is very attentive. Let me tell you, Lao Fang, you can't avenge private matters publicly, use public weapons for private purposes, pretend to be public for personal gain..."
"What else do you know about public? "Idiom?" Mr. Fang asked unhappily.
"When you review the medical projects of the National Natural Science Foundation of China, you must be dedicated to the public, loyal to the country, self-reliant, and everything must be open and honest."
Fang Lao was gloomy. With a straight face, he strode out of the VIP channel under the guidance of the staff.
"Old stubborn." Mr. Chai sarcastically said from behind.
Facing each other, Mr. Chai saw Luo Hao’s familiar smiling face.
"Mr. Fang, I haven't seen you for a long time." Luo Haoke politely bent down and stretched out his hand.
Fang Lao shook hands with Luo Hao like a dragonfly.
Luo Hao then stepped forward and opened his arms to hug Mr. Chai.
"Boss, haven't you had a good meal recently? You've only been fishing."
"You're so old, what's the point of not fishing?" Mr. Chai scolded, "There's something about the guy in the fishing car who is making food hot." , Don’t look for me when you are hungry.”
The more he spoke, the more proud he became, looking at Mr. Fang’s back with a smile.
Luo Hao sighed inwardly.
The boss is causing trouble for himself.
Usually the boss tells you not to get into trouble. If you get into trouble in the future, just don't say that you are your teacher.
But now, Luo Hao really wants to tell Boss Chai - if you cause trouble in the future, just don't tell me about your apprentice.
But you have to shoulder the blame. If it doesn’t work, Boss Chai will naturally take care of it. Even if he moves to Fang's hometown, he can solve it.
"Lao Fang came here, firstly, to see you, and secondly, because of the need to revitalize Northeast China. He wants to come and see several hospitals here." Mr. Chai said in a low voice, "We are in the provincial capital. The University of Technology is great, but the Medical University is so bad.”
“Boss, the University of Technology has more than 40 academicians from the two academies, and our Medical University only has two, and they are both former presidents and presidents. There is no comparison. .”
"How is your hospital? The one in Donglian is okay, the decoration is grand, but the technical level is too poor."
Chai Lao asked, holding Luo Hao's hand.
"Donglian was built with funds when the mining area still had money. According to the standard of 8,000 per square meter, it is no worse than our Concord International Department. Now that the mining area has no money, no one can do anything. It is the law of nature. ."
Luo Hao replied.
“Where are you in your first year of medical school?”
"It's not bad, I can only say that it's not bad." Luo Hao said, "Last year, the number of surgeries was ranked among the top five in the country. If you remove some water, it will be no problem to rank among the top ten in the country. Boss, you can't be too harsh. I can say that I am in a poor place."
"Is it still not better after China and Russia started talking to each other?"
"I didn't check the previous information. I'm too busy recently. Surgery, teaching..."
"You two, Don't have a small meeting, don't say anything in front of me!" Mr. Fang turned around and scolded the people from the Health Commission and the provincial and municipal offices who came to greet him.
It seems that Mr. Fang is indeed a little unhappy, Luo Hao has nothing to do.
"I caught a big fish a few days ago! It's about to become a sperm!" Mr. Chai glanced at Mr. Fang, mentioned the old story again, and described it again, "I later released the fish. It's not easy to grow so big. Maybe He will really become a sperm in a few decades."
"Boss, do you still believe this?"
"I can't eat it, it's a waste, I just want to piss off these old ghosts. Why bother with such a big fish?"
Chai Lao said with a smile, Luo Hao was very pleased.
As long as the boss is happy, that’s fine.
It is said that the boss is already in his twilight years. No matter how happy he is, he can stay happy for a long time. Every day counts when he is happy.
"Dr. Luo, where are you leading the interventional department in the First Hospital of Medical University now?" Mr. Fang asked.
"Yes, Mr. Fang." Luo Hao replied with a smile.
“How many operations are performed in a year?”
“I have been here less than three months, and the average is about 300 operations per month.”
Although the volume of 300 operations a month is not shocking, it is still enough to meet the standard.
Of course, this is to be compared with the "monsters" who appear under certain special circumstances.
Mr. Fang was quite satisfied with Luo Hao's surgical volume, "How is the patient's recovery?"
"The time is relatively short, and the follow-up records, secondary admissions, and long-term treatment effects are still limited for the time being. There is no rigor..."
Luo Hao changed his tone and answered Fang Lao's questions with professional sentences, attitudes, and vocabulary.
Regarding the other party's old question, Luo Hao did not talk rhetorically, but just explained the problem realistically.
The scope involved is only in the interventional field, and he keeps silent about other rescues and surgeries he has completed.
Mr. Fang is very satisfied with this.
“Let’s visit the First Hospital of your Medical University and see the medical construction here.” Mr. Fang waited for Luo Hao to finish and then said, “You have a lot of surgeries every year. Dr. Luo, you Are you still used to it? "
"It's pretty good." Luo Hao said, "Although the research on rare diseases is not as good as that of the Imperial City, the level of diagnosis and treatment of common diseases has not fallen behind. , always keeping up with the times.”
Dean Zhuang and Dean Jin let out a sigh of relief.
Luo Hao is not a bad guy. He can help and say something when something happens. Not much, just one sentence is enough.
Arrived at the First Hospital of Medical University, the group started from the emergency room.
The emergency department is in good order.
Although he knew that Mr. Fang was coming to visit today and was prepared, it seemed to Luo Hao that it was the same.
The diagnosis and treatment in the emergency department of the First Medical University Hospital are also very standardized.
For example, the patient with ruptured abdominal aortic dissection had already been diagnosed in the emergency department.
The prerequisite for successful self-treatment is a clear diagnosis from the first doctor.
At that time, the patient was even given a micro-pump to reduce blood pressure in the emergency department, was also given subcutaneous injection of morphine for pain relief, and consulted with relevant departments. The whole process was flawless.
If emergency care across the country were at this level, at least many fewer people would die every year.
As for the mezzanine rupture, it was an extremely rare accident and cannot be blamed harshly.
Luo Hao introduced as he walked, including the case of aortic dissection rupture he encountered last time.
He was not vague about his rescue, nor was he exaggerating. While affirming the emergency first aid level of the First Hospital of the Medical University, he told Fang Lao the entire process of his first aid.
Mr. Fang listened with great interest.
Abdominal aortic dissection ruptures. Anyone who knows much about medical care knows that the patient will definitely die, and there is almost no accident.
But if nothing else, the accident still happened, and it happened to Luo Hao.
So Mr. Fang raised many questions about this, and Luo Hao answered them one by one.
A doctor who can save a ruptured aortic dissection will definitely gain enough respect. Even though Mr. Fang thought in his heart that Luo Hao was a flatterer, he didn't say much about it.
It's unreasonable to say too much. If you want to find fault, you can't catch Luo Hao's proud rescue.
"Dr. Luo, that's good, awesome!" Mr. Fang finally praised Luo Hao.
Luo Hao was not modest either. This kind of rescue was very impressive in itself and could be boasted even in Concorde.
If you are modest, it is hypocritical, but not beautiful.
The emergency department is ready and Mr. Fang is very satisfied.
Then I went to the interventional department and interventional operating room to look around.
Chen Yong, Shen Zizai, Yuan Xiaoli and other leading professors were operating. Mr. Fang came in and walked around without commenting.
The amount of surgeries performed by Luo Hao's medical team can be said to be the backbone of any hospital, and it is not bad even at Union Medical College.
"Not bad. Dr. Luo was able to open up the situation within three months of coming to the First Hospital of the Medical University. He is worthy of being Boss Chai's disciple." Mr. Fang sarcastically said.
As expected, Boss Chai’s face looked a little ugly, and Luo Hao was even more embarrassed.
But what can Luo Hao say? I just slandered in my heart - the bad old man is very bad.
"Go and take a look at the operating room of your hospital, and then take a look at each of the critical care units." Mr. Fang suggested.
Dean Zhuang has obtained information from various channels in recent days. Fang Lao came here not just for Luo Hao, but also to take a look at the current medical situation in Beijiang Province and get a feel for it.
For what purpose, a dean at the level of Dean Zhuang did not know.
When he arrived at the dressing room of the operating room of the University of Foreign Medicine, Mr. Fang looked at the no-smoking sign and asked, "Dr. Luo, do you often sit here and smoke?"
"Fang "Old man, I rarely smoke." Luo Hao took out his cigarette and showed it to Mr. Fang, "I usually hold it in my mouth to think about something, and then put it back when I'm done thinking about it."
"That's right!" Mr. Fang glanced at Boss Chai, "Learn something good, don't always follow them. It's as if you can't see such a big brand. Astigmatism and presbyopia are all problems that need to be treated. "
"I'm used to smoking, and it won't be fun if I don't do surgery."
"It sounds like you can still have surgery. Your last surgery was probably done when you were 72 years old. Lao Chai, This guy needs to be convinced." Mr. Fang said with a smile.
Chai Lao sighed, his originally triumphant expression looked a little lonely.
Beauties grow old, heroes die, life is mostly like this.
Mr. Fang is a pharmacologist, and he is the type who becomes more valuable as he gets older.
Luo Hao knows the thoughts of the elderly. They may be generous, kind and kind to the younger generation, but their attitude towards the "old immortals" of their generation will be much different.
They were fighting and scolding each other, as if they had retained the shadow of their youth.
But!
Luo Hao couldn't listen to anyone saying that his boss was old, not even Mr. Fang. He turned around and looked at Mr. Fang.
"Boss, you will get stronger as time goes by." Luo Hao said to Mr. Fang calmly but seriously.
It seemed to be telling a fact, and like a little beast baring its teeth at the king of the tribe, issuing a challenge.
Chai Lao raised his eyebrows and raised his hand to reach Luo Hao's shoulders.
Luo Hao knelt down, bowed, and with a smile on his face, handed his shoulders to his boss.
“Old, that is, old.” Chai Lao said, “Being old makes you stronger. I haven’t dared to perform surgery since I was 72. When my hands are itchy, I just work as an assistant for a small amount of money to enjoy myself.”
"His level is much better than when I was young. I think back then it took me 3 or 4 hours to perform a combined pancreaticoduodenectomy. I had to worry about various complications after the operation and was sent to the ICU...Now I can buy Dafen for a small amount of money. Qi robot, two points for one, after surgery... tsk tsk.”
Boss Chai spoke with a smile, unknowingly suppressing the little spark of Luo Hao's "offense" just now.
Mr. Fang looked at the old and the young with a smile.
That’s great.
"Two old men, our operating room in the first year of the medical school has a total operating room..." Dean Zhuang began to introduce, everything was detailed, and he was quite well prepared.
Chai Lao nodded slightly as he listened and walked in the corridor of the operating room.
"This is the emergency room, where an appendectomy is performed."
"This is the emergency room, where a caesarean section is being performed."
"This is the emergency room, where an acute cholecystitis is performed. ""This is the slow diagnosis in the underworld, doing..."
"This is the slow diagnosis in the yang world, doing..."
The director of the anesthesiology department introduced Mr. Fang and Mr. Chai in each operating room.
Chai Lao looked at it with a smile, and Luo Hao followed the boss quietly.
He did not continue to provoke Mr. Fang. Although Luo Hao felt uncomfortable hearing those words and replied, Boss Chai suppressed the matter and pretended that it had not happened.
Luo Hao is not afraid of Mr. Fang taking revenge on him.
If you are afraid of academic struggle, it would be better to stay in the first hospital of a medical university and become a department director or dean.
Academic struggle is not about treating guests to dinner, it involves bloodshed!
Luo Hao knew it very well and had witnessed several bloody academic struggles.
After introducing more than twenty techniques one by one, everyone has reached the end of the corridor.
Mr. Chai saw that the traveling nurse was clinging to the wall when she came out to get things, so he smiled and said, "Let's go back, don't delay others' work here."
Mr. Fang also said nodded.
The doctors and nurses in the First Hospital of the Medical University are well-trained and orderly. They are indeed worthy of being ranked among the top ten large tertiary hospitals in the country in terms of surgical volume.
"Xiao Luo, let's go check out your circulating CCU." Mr. Chai said.
“Okay!”
More than twenty people were crowded in the corridor of the operating room. Chai Lao knew that he and Lao Fang had caused trouble for others.
It’s not a serious inspection, just take a look. I know that the working environment of Xiaoluohao is reliable, and I feel reassured.
"Didi dididi~~~"
The monitor's alarm sounded.
“Wow~~~”
The door of the operating room opened, and the circulating nurse went out to announce the good news. There was a nurse holding a big fat boy inside.
Chai Lao followed the cry and looked over.
Luo Hao's eyes also turned to follow the boss.
Next second!
The diagnostic assistant AI starts to spin crazily, giving a diagnosis at the snap of a finger.
Luo Hao noticed that the background board turned white, pale and pale, with red blood dripping from time to time, like a poster for a ghost movie.
This is...
At the same time, the location of the system task kept flashing, and it looked like it should be an emergency task.
Is it a newborn?
As soon as Luo Hao's thoughts changed, Mr. Chai suddenly straightened up, as if he had become twenty years younger in an instant, and walked into the surgery room with flying strides.
When he passed by the surgeon, he glanced along the surgeon's shoulder, and then came to the patient's head.
“What’s your name?”
"I..." The patient's voice was a little soft and he barely opened his eyes.
Chai Lao glanced at the monitor and then raised the patient's eyelids.
A moment.
Chai Lao’s aura has changed!
“Amniotic fluid embolism!”
Before Mr. Chai finished speaking, the words "Emergency Mission" appeared on the system panel in the upper right corner of Luo Hao's field of vision, and the diagnostic assistant AI also gave a diagnosis - amniotic fluid embolism.
Luo Hao's heart felt cold and his heels felt cold.
Chai Lao has arrived at the left chest area of the patient and walks in the standard external chest heart compression posture.
Others haven’t reacted yet.
Not to mention human beings, even the ECG monitor has just responded. The patient's heart rate has rapidly increased from 120 beats/min to 160 beats/min.
The ECG oscilloscope began to tremble, and the blood oxygen saturation dropped from 99% to 67%.
Just as Chai Lao's hand was about to fall, the electrocardiogram had changed again from brief ventricular fibrillation to a straight line.
As soon as Zhizhi walked 1/4 of the screen, Mr. Chai’s chest heart compressions had already started.
"Epinephrine 1 mg intravenously." Chai Lao's doctor's order came out immediately.
There was only the alarm sound of the monitor in the operating room, and no one except Luo Hao realized what was happening.
"Pa~~~"
Luo Hao immediately cut open the body with one hand, extracted 1mg of epinephrine from the syringe in his right hand and pushed it in along the three-way.
"Professor Luo, you..."
"Amniotic fluid embolism! It's not a machine failure, hurry up and rescue!" Luo Hao said.
He immediately handed the syringe to the anesthesiologist, "Boss, I'll do it."
"Go and cut the uterus!" Mr. Chai said seriously.
The voice was not loud, but the voice was cold and sharp, as sharp as a knife.
It took a few seconds for everyone to realize that something was wrong with Mr. Chai’s standard for chest cardiac compressions.
The patient had a large amount of bleeding in his abdominal cavity.
The operation was very clean. It was just a caesarean section. There was no reason why it was not clean. But the sight of a pool of blood instantly frightened the surgeon, wondering what had happened.
It’s really amniotic fluid embolism!
The surgeon’s mind went blank.
For obstetrics and gynecology, amniotic fluid embolism has special significance.
Seeing that his boss's chest cardiac compressions temporarily stabilized the patient's circulation, Luo Hao poured a handful of red soup on his hands, wiped his hands randomly with iodophor gauze, and then put on clothes and gloves.
After fastening the belt of the sterile suit, Luo Hao pushed his shoulder and pushed the surgeon aside.
The patient's body was moving violently, firstly due to Chai Lao's chest cardiac compressions, and secondly due to the dying twitching of the muscles themselves.
It was just continuous epidural anesthesia, no muscle relaxants were given.
"Intubation, general anesthesia!" Luo Hao shouted.
Director Xu of the Anesthesia Department saw the blood oozing in the abdominal cavity and the blood oxygen saturation could no longer be measured. He just changed the fingers of the blood oxygen saturation clamp and still could not measure it. He was already convinced. Chai Lao’s diagnosis.
What the hell, I encountered amniotic fluid embolism!
Director Xu began to instruct the anesthetist to intubate and change the continuous epidural anesthesia to general anesthesia.
"Push the new triple combination once."
"Push the second combination of breathing once."
"Epinephrine, 2mg, give it intravenously right away!"
Mr. Chai was performing chest heart compressions while giving medical instructions.
"Mr. Chai... is this?" Dean Zhuang came over tremblingly, "Is it a machine failure?"
"Get out of the way! The rescue is on!"
Mr. Chai's His temper was aroused, and he shouted in a deep voice.
Luo Hao ignored the surprise and astonishment of Dean Zhuang and others. Boss Chai was experienced and seasoned, and the diagnosis of amniotic fluid embolism was made a little earlier than the system diagnosis.
With the boss’s diagnosis and systematic diagnosis, I also saw a large amount of non-coagulated blood pouring out along the surgical incision. It was not amniotic fluid embolism or something!
Luo Hao picked up the curved scissors, cut the uterine bladder peritoneal reflection, reached the round ligament on both sides, and suddenly pushed it down to the cervix.
Immediately, a hole was made in the avascular part of the left broad ligament, and three hemostatic forceps clamped the isthmus of the fallopian tube, the proper ligament of the fallopian tube, and the round ligament in sequence.
Although Boss Chai’s chest compressions seriously affected the operation, Luo Hao followed his boss’s movements and completed the operation without seeming to notice it.
Line 10 was tied alone, and Luo Hao had no time to suture it, so he performed the same operation on the opposite side.
Then Luo Hao inserted his left hand, held up the uterus, and began to ligate and suture the blood vessels.
The equipment nurse was stunned, and she also realized that something was wrong.
Not only was the ECG monitoring alarming, but there was more and more non-coagulated blood in the abdominal cavity. Issuke subconsciously used an aspirator to suck blood, but he couldn't suck it all out.
Just like the scene in Kubrick's The Shining, the equipment nurse subconsciously felt that the invisible door would disappear at some point and blood would pour out.
She handed the instruments to Luo Hao almost subconsciously, but did not delay the operation.
3′12″, the uterus was removed and thrown on the instrument table.
Luo Hao carefully checked and sutured where the sutures should be, and then said to the surgeon, "Go and tell the patient's family that the uterus must be removed!"
The surgeon cried.
Brother, you cut it first! Why don't I even tell the patient's family about this?
"Pure oxygen, give me fucking pure oxygen!!" Only then did Director Xu react and began to yell.
The obstetric resident’s mind is still blank.
"Meng Liang!"
"Professor Luo, I'm here."
"Go tell the patient's family that the amniotic fluid embolism requires a uterine incision. Can you tell me?"
"Yes, I'll go right away." Meng Liangren kicked open the airtight door of the operating room and walked out.
Mr. Fang, the leaders of the provincial and municipal health commissions, and the deans of the First Hospital of the Medical University were all dumbfounded.
"I'll go." Feng Zixuan stopped Meng Liangren and said with a sad face.
"Director Feng, notify the ICU and the patient will go down immediately. Prepare blood, at least 10,000 ml!! Today!!! I don’t know how much will be needed tomorrow, prepare at least 50,000 ml of blood."
"You, close your abdomen!" Luo Hao handed the instrument to the obstetrics resident, took off his gloves and came to Mr. Chai's side.
Although he only had less than 5 minutes, Mr. Chai was already so tired that his armor was soaked with sweat.
"Boss, I'll come." Luo Hao said respectfully despite his busy schedule.
Mr. Chai nodded, turned around and stepped off the stage.
"Roar~~~" Chai Lao's breathing has begun to pull the wind box.
The strenuous exercise caused tracheal spasm, and the sound of breathing changed. I am old, I am indeed old. Boss Chai sighed inwardly.
But no one noticed this. Everyone’s attention was on the physical signs of the ventilator and monitor.
After the chest compressions were completed, the hysterectomy was completed, and the endotracheal intubation was completed, the patient's condition gradually became clear - amniotic fluid embolism!
"Adrenaline 1 mg intravenously, Director Feng...Zhuang, you go to the leader of the central blood bank and ask for a large amount of blood, as much as the blood bank has." Luo Hao said coldly while doing chest heart compression.
Luo Hao lost his usual gentleness, and his whole body exuded a cold and harsh aura.
Dean Zhuang was startled, but realized it was amniotic fluid embolism. He immediately took out his mobile phone, kicked open the air-tight door of the operating room and walked out.
"I, Zhuang Yongqiang of the Medical University! There is a patient with amniotic fluid embolism and I need 30,000 blood."
"No? What the hell are you doing for food! I don't care, there must be!"
Dean Zhuang was anxious.
Mother, amniotic fluid embolism.
No one else knows what these two words mean, but Dean Zhuang understands.
The rescue is temporarily over, but that is only temporary.
(End of this chapter)