Chapter 194 Silent Rescue
After the small lesson on unpacking surgery, everyone was still not satisfied and requested that the surgery pictures be shown slower and again.
The chest was split from the middle of the sternum and opened to both sides, and the spine was explored from front to back, all the way to the back. There were no dead ends or omissions. Similarly, the abdomen was also opened longitudinally and fully opened to both sides, fully exposing the injured area. .
In this case, there were two short nails on the wooden stake, and the nails hooked into the abdominal aorta. Looking at the picture, when the aortic injury was revealed, the nails were still hooked into the abdominal aorta.
The picture of the abdominal aorta injury was enlarged, and everyone was horrified and lamented. If the wooden stake was pulled out directly, the nails would continue to tear the aorta. The patient who was still breathing died in an instant due to massive blood loss, and there was no chance for surgery.
"Time is life! With this kind of surgery, one second can determine life or death!" Yang Ping added while standing on the podium.
Hurry up, hurry up, hurry up! It’s the rhythm of this kind of rescue surgery.
There is bleeding in countless places, just like countless faucets are broken and they are all spraying water. It is impossible to turn them all off at the same time. This requires making a judgment on which one to turn off first.
Turn off the one with the fastest water spray first, and then turn off the following ones in sequence. This is the idea. This is the priority of the operation.
After solving the problem of sequence, the next step is how to stop the bleeding. For example, if the spleen ruptures, splenectomy is performed. Before the resection, it will bleed. In order to reduce bleeding and control the risk to a minimum, vascular occlusion has appeared, which solves this problem. contradiction.
Just like there are so many faucets spraying water, I also know which one to turn off first and which one to turn off last. But there is no way, there is water everywhere, I can't see where these faucets are? After finally seeing it clearly, I was so busy that I couldn't finish it.
In this way, first turn off the main gate and stop the water from all the faucets under the jurisdiction of the main gate. In this way, you can see clearly which one is the largest and which one is the smallest. Close these faucets in order and calmly. Repair what should be repaired and what should be repaired. Close directly. Close directly.
The main gate cannot be closed for too long. Others still need to use water. So try to complete the operation within the allowed time. After completion, open the main gate again and the faucet will stop spraying water.
Tan Boyun looked at the screen attentively. He is best at traumatology and has made many achievements in this field. This kind of surgery is indeed difficult and high-risk. The surgeon must not only move very quickly, but also be very familiar with anatomy. In this case, the aorta is blocked at a relatively high position, after the brachiocephalic trunk is separated, and the blocking time is It only lasts about twenty minutes.
According to the introduction, this operation was completed within twenty minutes. This short period of twenty minutes involved complex exploration, repair of the aorta, liver, pancreas, duodenum, diaphragm, and Blood vessels were ligated at multiple locations to stop bleeding.
With such proficiency in dissection, it is impossible to imagine how far it would take to complete this series of operations within twenty minutes. If I were to perform the surgery myself, I would definitely not be able to complete it within twenty minutes.
Temporary blood vessel bridging technology or artificial blood vessel implantation must be used to stop the bleeding in the abdominal aorta so that there is time to slowly perform the following steps.
If it hadn't been for the meeting today and this case was discussed, Director Tan would not have known that Yang Ping was so powerful and that this kind of surgery could be done so easily.
Fatty raised his hand, scratched his head and said: "Dr. Yang, you can be so powerful, but not everyone is so powerful. After you explain this operation, even if I encounter the same case, I still can't do it for you. Is this so? Is there a way to make the surgery for such trauma patients simpler, such as taking pictures? What is the focal length and lighting of a professional camera? It is extremely complicated. A point-and-shoot camera can do it with just one click, although it is not as good as a professional camera. , but it is also a qualified photo.”
Yes, Fatty got to the point and asked a question that everyone was thinking about. Everyone was waiting for Yang Ping to answer. Fatty narrowed his eyes and was also waiting for the answer.
Director Bai next to him said: "Yes, Xiao Yang, the operation must be able to be copied in batches. If it cannot be copied, it cannot be promoted. You must find a way to lower the threshold of this operation so that more people can be saved."
Director Han said with a smile: "This is the topic Xiao Yang is going to talk to you about below, and it is also the improvement we want to make to the entire trauma first aid process. Xiao Yang has spent a lot of effort and made a modular surgical process, which he will get later. Come out and discuss it with everyone. Don’t be impatient. Let’s watch the video of large-scale trauma rescue at the University of Tokyo Hospital first, shall we?”
Yang Ping returned to his seat to rest. Dr. Zhong came on stage and called up the video on the computer: "This is a rescue of a large car accident. The entire video starts from the emergency department and ends with the operation. It is a live video, and the entire process is tracked and filmed. Everyone, watch Just don’t video it, don’t spread it, because it was done privately by friends who were studying there, and they also filmed it in order to regularly improve on the shortcomings and strive for excellence.”
The doctor who had just taken photos and videos with his mobile phone put away his mobile phone, and everyone began to watch the video carefully. This represents the world's top level of trauma rescue.
"First play the video at normal speed, and then play it slowly. When the video is played slowly, Director Tan will explain it to everyone." Director Han instructed Director Tan.
Director Tan said: "Okay, Director! Everyone should read carefully so that I can be on target when I explain later."
The video started to play, and the ambulances carrying the injured were delivered to the lobby of the emergency center one after another. The patients' clothes had been cut off and only covered with special blankets.
The doctors and nurses in the emergency department were divided into groups and were already waiting in the lobby. As soon as the wounded appeared, they immediately took charge of their own injuries. The doctors made a preliminary judgment on the injury and arranged the next step of diagnosis and treatment. The nurses measured the wounded's vital signs and performed blood transfusions and fluids. There is almost no pause, everything seems to be prepared in advance, and it is completed as the flat car moves forward.
The flat cars began to be diverted in the lobby and pushed to different areas. Those who needed emergency surgery were sent to the surgery area; those who did not need emergency surgery were sent to another area.
The screen follows a wounded patient undergoing emergency surgery. He enters the surgical area. The door is opened in advance. When entering the area, the first stop seems to be the CT room, where an emergency CT scan is performed. The height of the flat car and the CT platform are the same. This has been adjusted a long time ago. The flat car and the CT platform are connected, and the injured person is quickly and smoothly pulled to the platform. The stretcher does not need to be dismantled, and it can pass through X-rays and CT.
The injured began to undergo a high-speed CT scan. After the scan was completed, he immediately transferred from the other end of the CT platform to the connected flat car, directly pulled the stretcher, and then arrived on the flat car and was pushed to the next stop - the operating room.
The operating room and the CT room are connected by a corridor in a straight line. The injured come in from one side of the CT room. After the examination, they go out from the other side and are pushed directly into the operating room through the corridor. Doctors and nurses are waiting at the open door of the operating room to receive them. , just push the flat cart to the door and hand it over to them.
The connection between the two stations is completely open and straight, with no obstacles, no twists and turns, and smooth and direct access. The wounded person entered the operating room, and the flat car and the bed were flush with each other. The wounded person was pulled to the operating bed, and the detachable stretcher was disassembled from both sides.
The doctors involved in the operation had already put on surgical gowns and were waiting. The assistants began to disinfect the drapes, and the surgeon read the CT scan reports and images of the wounded.
The efficiency is very high. This place has just been disinfected. The images and reports have been transmitted to the CT room. The CT images and reports of the injured appear on the LCD screen. The control panel of the screen is covered with sterile film.
The surgeon directly controls and accesses emergency medical records and CT data. He reads the report first, quickly obtains information, and then looks at the three-dimensional reconstructed image. At the same time, there is also a reference opinion on the surgical procedure, telling you where the injury is, what to do first, and what to do later. Instructions have been given everywhere, including specific techniques.
This patient suffered from a torn aorta, ruptured spleen, and multiple ruptures in the duodenum. The surgeon first blocked the aorta, then repaired the aorta, then performed splenectomy, loosened the blockage of the aorta, and then performed liver transplantation. Rupture, duodenal rupture, and other injuries were treated. The surgical process was quite scientific, and the operation was successfully completed.
From the time the emergency flat car appeared in the emergency department, the entire process was like a precision gear. It was as if it had been rehearsed over and over again. No matter how you looked at it, you couldn't tell where it was unreasonable, where the connections were improper, or where time was wasted.
The whole process takes a little more than an hour, and most of the time is spent on the operating table, and the time is concentrated after the aorta is blocked. Therefore, most of the time, the patient is in a controllable state, that is, in the hands of the doctor. Finally, the patient became stable.
From the emergency room to the operating table, including the CT scan in between, it took less than ten minutes, that is, just a few minutes, to get to the operating table. An examination was performed, the extent of the injury was clarified, and a mature surgical plan was specified.
This is just a rescue operation for a wounded person. Several other rescue scenes are also switched out one by one. The rescue of each wounded person is almost as fast as possible without any delay. It is simply shot deliberately. The whole process, The whole picture was smooth and neat, without any clutter. Even after the operation, even the garbage in the operating room was put into its own bucket, without any clutter.
One injured patient was treated with balloon interventional aortic occlusion to temporarily stop bleeding as soon as he entered the emergency department; another patient had multiple rib fractures, tension pneumothorax, and cardiac arrest, and his chest was opened directly in the ambulance. Perform chest compressions.
After the scene was played, everyone took a deep breath and the entire venue fell silent. The doctor who was joking just now said impatiently privately: "Watch a Japanese video -" and stopped talking.
Some people suspect that this is fake, and was it deliberately photographed for everyone to see? How could it be so fast and with such perfect coordination? The rescue would be a bit messy and a waste of time.
"This is a video of one of their daily trauma emergency surgeries!"
Director Tan's words broke the silence and dispelled everyone's suspicion.
"Only their ordinary doctors participated in the operation. There was a scene just now of rescuing a patient with a ruptured liver and spleen. The surgeon was just a lecturer, who is equivalent to our attending physician. His operation took twelve minutes. The surgeon who performed the surgery just now had a ruptured aorta. , liver and spleen rupture, and duodenum rupture, the operation took one hour and was performed by a lecturer. ”
"Each of their doctors of this level has this level of expertise. Professor Fujiwara Masao has not yet performed this kind of surgery. He only repairs the aorta and it never takes more than two minutes!"
"Without comparison, there is no gap. There is nothing to be afraid of if there is a gap. What is scary is hiding one's ears and not acknowledging the gap. Just now I heard someone say that they are very busy doing surgery. How can they watch Japanese surgery videos? How are they better than us? ? See it now? Do you know where the awesomeness is? ”
Director Han stood up and spoke word by word.
"To surpass others, to be strong, you have to do it with your hands, not your mouth, you know?"
Thanks to the leader of Wolf Sled for the reward! I’m under pressure and can’t keep up with the updates, but I’ll still work hard. I’ll take my time adding updates to the leader. I hope for your understanding. Really, I haven’t saved the manuscript!
Thank you George for your many random 5,000 coin rewards!
Thanks to Chenxi Muyan and -ooooo for the reward (I can’t type your name, I don’t know where to copy it, so it’s a bit similar, sorry)!
Thank you Nuclear Explosion Infantry for your valuable comments. Indeed, those details were too rough and have been revised. I hope you can provide more comments to help improve the work.
The previous chapter about the two-person steel bar penetrating injury appeared in "Grey's Anatomy", not "House". I watched it for too long and got confused. It has been corrected.
The penetrating injury caused by the wooden stake performed by Yang Ping was restored from a real case. It was the masterpiece of a teacher and senior. The operation time was shortened and the operation process was restored almost according to the original surgical records. In order to restore the details, the senior helped to read the records of more than 20 years ago. medical records. The wooden stake is still preserved in their hospital. At that time, the methods were very limited, and it was not easy to succeed in this kind of surgery. Even now, rescuing such cases is extremely challenging, requiring rich experience and superb surgical skills. Pay tribute to this respected teacher!
(End of chapter)