I'm really an intern

Chapter 477

Things were inevitable, and it came to the point of surgery as expected.

The white coats present froze for a moment, and then, their gazes gathered again, and fell on the head of the urology department.

In fact, they have already prepared in their hearts.

After all, it is obvious that the patient is admitted to the emergency department, so why is the multidisciplinary consultation held in the Department of Urology?

"Emergency surgery."

The chief director of the Department of Urology quickly entered the state.

"At present, it is considered that emergency surgical exploration, hemostasis, resection of the left kidney with no normal anatomical structure, and decompression are needed.

However, the patient is currently in a critical condition, and the abdominal cavity decompression and bleeding may lead to a sudden drop in blood pressure after the surgical laparotomy.”

The chief director of urology surgery paused, then turned to look at the chief director of hepatobiliary surgery.

Although the two of them usually look down on each other, sometimes they even want to use their brains when they meet talents.

But at critical moments, they are still partners.

The chief director of hepatobiliary surgery looked back with a serious expression.

"According to the current CT results of the patient, it is considered that there is no definite lesion in hepatobiliary surgery.

The left kidney and effusion pressed and displaced the pancreas and other surrounding organs, the perisplenic area was clean, and no clear bleeding was seen.If treated conservatively, the effusion continues to compress the blood vessels, resulting in a decrease in blood return to the heart and a decrease in perfusion of abdominal viscera.

If the operation is aggressive, hypotensive shock is likely to occur during the operation, and then DIC will occur.At this stage, the huge retroperitoneal space-occupying causes the entire abdominal cavity to be in a high pressure state, and compartment syndrome may occur, and the operation risk is extremely high. "

Unlike the thoracic surgeon who only described his own problems, the chief director of the hepatobiliary surgery also helped the chief director of the urology department check for omissions and pointed out the disadvantages of different options.

The office fell into a brief silence again.

Standing beside a group of big shots, Zhang Tianyang's thoughts changed sharply.

According to the patient's current condition, the choice of treatment options is contradictory.

Whether you choose conservative treatment or emergency surgery, it may cause a sudden deterioration of the patient's condition, and finally usher in the same result-death.

But should we do nothing because of the possible risks?

Isn't their doctor born to turn the tide at such a time?

Zhang Tianyang's eyes gradually became firm.

Nobody wants to talk, so he's the one to talk.

"We can fully prepare, operate as soon as possible, and fully inform the family members of the necessity and risks of surgery."

Zhang Tianyang's tone was very calm, without the slightest tremor.

But this suddenly broke the quiet voice, causing many white coats to cast surprised looks at him.

The chief director of the Urology Department was also looking at Zhang Tianyang, with straight eyes, as if examining him.

The chief director of the hepatobiliary surgery frowned slightly, staring at Zhang Tianyang as well, then nodded slightly as if in a daze.

The other white coats also had different expressions, but most of them were more restrained.

Only Zhao Tianwang and Pan An anesthetized, their expressions slightly exaggerated.

Clear anger appeared on Zhao Tianwang's face again, but it seemed that because the patient's condition was indeed serious, he tried his best to restrain his desire to scold him.

Then make up your mind again.

This brat who likes to make his own way, don't be caught by him!Otherwise, I must curse a hundred times a hundred times!

The expression on Pan's anesthesia face was more complicated.

There are both shock and bewilderment, both excitement and despair, as if there is a palette on the face.

Zhang Tianyang's eyes swept over the faces of a group of bigwigs, but he still persisted.

"The patient's condition is progressing rapidly, and we have to hurry up."

silence.

Silence is urology tonight.

After an unknown amount of time, the director of the Department of Urology suddenly laughed.

He slapped his thigh violently, "Surgery! Fuck it!"

The mouth corners of the chief director of the hepatobiliary surgery also slightly twitched, and he looked at Zhang Tianyang with gentle and admiring eyes, "If problems with the liver, spleen and pancreas are found during the operation, our department can assist."

Saying this sentence means that he also agrees with the decision of the operation.

Zhang Tianyang nodded at the two chief directors, without any intention of relaxing. As soon as he turned his eyes, he looked at Pan Anesthesia.

"Teacher anesthesiologist, please evaluate the patient."

Pan's anesthesia was shaken, the adrenaline soaring excitement and the despair at the thought that he didn't sleep flashed, and then cheered up.

"The patient is currently in critical condition, but now the peritoneal effusion is wrapped and compresses the potential bleeding point, and the patient's blood pressure can still be maintained.

If an emergency laparotomy is performed, the blood vessel pressure drops suddenly, which may lead to shock.

It is recommended that the peripheral venous channel be enlarged to maintain the patient's blood supply. Extreme situations such as unstable circulation and cardiac arrest may occur during the operation.Please cooperate with the blood transfusion department! "

The blood transfusion doctor who was named was also shocked, "Our department will fully cooperate with clinical needs!"

Professor Liu from the Department of Nephrology also said at this time, "According to the CT results of the patient, it is considered that there was chronic renal insufficiency before the onset of the disease. The left kidney has no normal renal tissue structure, and there is no urine after admission. It is considered acute left kidney injury. Consider Mainly prerenal. CRRT can be used if necessary after surgery.”

His eyes were fixed on Zhang Tianyang, his eyes were shining, but he turned his head to look at the director of urology department who was also shining beside him, and rolled his eyes in depression.

Doctors from the Department of Critical Care Medicine immediately expressed their opinion, saying that their department will try their best to cooperate with the patient after surgery.

The medical office also quickly stated that they can coordinate with the patient's family members.

After confirming that the operation was to be performed, the doctors in the relevant departments showed a god-like speed and ended the multidisciplinary consultation with great efficiency.

Zhang Tianyang spoke quickly and made a final summary.

Then, "The meeting is over!"

A group of white coats suddenly dispersed.

Doctors in unrelated departments rushed back to catch up on sleep, or deal with emergencies of patients in their own departments.

The doctors in the relevant departments have already started to perform their duties proficiently.

Zhao Tianwang gave Zhang Tianyang a hard look, then pinched the template of the emergency surgery consent form that Zhang Tianyang had prepared long ago, and pulled the people from the medical office, walking in a hurry, and it seemed that he was going to talk to his family members.

Anesthesia Pan said hello, and he flashed away as if he had oiled his feet, in the direction of the operating room.

The director of the Department of Urology sat in front of the computer displaying the imaging results again, and began to meditate, as if thinking about the surgical steps and route.

The female chief resident doctor of the Department of Urology began to take out her mobile phone to contact and coordinate all parties.

She is the head of the hospital. When everyone is going to the operating room, she still needs to stick to the department.

Commonly known as the housekeeper.

Zhang Tianyang also has his own mission.

He hurriedly greeted the chief director of the urology department, and also chased Pan Anesthesia to the operating room.

For patients with abdominal bleeding and extremely distended abdomen, he will need emergency surgery and may need to prepare more things than usual.

Three minutes later, Zhang Tianyang found the nurse with dark circles under his eyes.

"Where are the protective suits in the operating room? We need at least 5 sets!"

The nurses in the audience woke up instantly from the aftertaste of drowsiness.

"What do you want that thing for?"

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Happy Double Day, cuties~~~

(End of this chapter)