My medical skills add experience

Chapter 518 I Was Instructed, It's Not Injustice
According to his clinical experience, the most likely cause of venous thrombosis is that the air is not exhausted during puncture.This is also a mistake that many novice doctors tend to make.

Some experienced doctors are also prone to ignore this problem when they are in a hurry and eager to save lives.

Director Xiang didn't have much expression on his face after listening to Zhou Can's analysis.

If the other doctors are not good enough, they think Zhou Can is farting.Especially the two young doctors under Director Xiang, each of them thinks that they are superior, and their eyes are above the top.

Learning from famous doctors is the biggest source of superiority.

Besides, it is not easy to become a student of the project director.You need to stand out from the thousands of troops and defeat many competitors before you can stand out and be selected by Director Xiang.

The chief physician of almost any hospital has very high requirements when choosing apprentices.

Talent, savvy, and strength are all available, and it depends on fate.

"Director Xiang, the patient's blood pressure and blood oxygen are still dropping! The blood oxygen has dropped below 60."

The nurse reminded.

Director Xiang's eyes changed a little, and his brows were tightly frowned.

Obviously still hesitating.

As a chief physician, you have to consider more than just rescue.The image of the hospital should also be considered, as well as the negative impact on the hospital if this matter gets out.

"May I ask your surname?"

"Your surname is Zhou."

"Mr. Zhou, thank you for your valuable advice, we will seriously consider it. Your visiting time is up, please go out first! Thank you!"

In the end, Director Xiang still thought about the reputation of the hospital and asked Zhou Can to be invited out.

This is ready to be dealt with behind closed doors.

Zhou Can didn't say anything more.

In the current situation, he really has no right to dictate.

Even if what Zhou Can said is correct, he still cannot direct Director Xiang and others to rescue him.

After Zhou Can left, Director Xiang said directly, "Immediately give the patient a color Doppler ultrasound."

"Professor Xiang, do you really believe what that young man said?" Director Xiang's male apprentice asked in surprise.

"Medical medicine is a process of continuous verification. Any suspicious cause is worth investigating. Hurry up and push the color ultrasound equipment over to check the color ultrasound for the patient."

In front of so many doctors and students, Director Xiang naturally refused to admit that what Zhou Can said must be correct.

Otherwise, wouldn't it mean that he, the chief physician of the Provincial People's Hospital, was led by the nose by an unknown young doctor?
It is definitely not a lie to save face.

Especially some high-status scholars and professors, they value face very much.Just look at the news about individual professors using their powers to deliberately force female students.

Even if what they are doing is male robbers and female prostitutes, they still have to be full of benevolence and morality, stand on the commanding heights of the teacher, and use all kinds of verbal temptations or soft threats.

For example, the dissertation is not given, the coursework cannot be completed, the important topics are not allowed to participate, and so on.

They have countless ways to force female students to obey.

What should I do if I don't give in?
In the end, some female students with strong personalities were directly exposed on the Internet.

It's just that the things that roll over are still a minority after all.

After checking the superficial and deep veins of the patient, especially the central vein, the most important thing is.

Because Zhou Can clearly stated that it is likely that there is a thrombus in the central vein.

"Director Xiang and Director Zhao, it seems that there is a shadow block, and the blood is also obviously blocked." The doctor who gave the patient a color Doppler ultrasound was very eloquent, and never said that he found a blood clot.

It's a side-by-side description.

"It seems that the blood vessel is really blocked. Immediately take the thrombolytic drug and administer it directly through this intravenous catheter."

At this moment, Director Xiang couldn't hold back anymore.

The young man was able to discover the real cause of the patient just by standing aside and taking a look.This level is not generally high!

They have been saving so many people for a long time, so they didn't think about it.

Thinking of this, not to mention Director Xiang, even Director Zhao and several older doctors had a fever on their faces.

Fortunately, wearing a mask, you can't tell if you don't look carefully.

The two young doctors under Director Xiang seemed to have been slapped by an invisible slap.In addition to being shocked, they also felt a little bit ashamed, and a little bit unconvinced.

Especially the young female doctor, who never thought that the young doctor she looked down upon would be so powerful.

She secretly wondered, which hospital did the young doctor belong to?

In the province, there are only a few hospitals with good strength.Tuya, Provincial Children's Hospital, Provincial People's Hospital, and a certain digital hospital, these four general hospitals are recognized as powerful.

There are other powerful hospitals, but most of them are specialized hospitals.

For example, Fangxin Tumor Hospital, Jiang's Orthopedics, and the former Xinxiang Women's and Children's Hospital are all well-known specialized hospitals.Each hospital has worked intensively in its field of expertise and achieved good results.

The doctor was very young, and his level seemed to be extremely high. When facing Director Xiang, he was even more calm and calm.

The description must have come from a compound somewhere.

Although she was curious about Zhou Can's identity, she was currently saving the lives of patients, so she focused on the rescue.

"Who put the IV in place?"

After Director Xiang confirmed through color Doppler ultrasound that the patient might really have venous thrombosis, his complexion was somewhat ugly.

Whoever performs a venipuncture on a patient is sure to get scolded.

"Xiao Chen did the venipuncture, and he is off work now."

After the blood vessel enters the air, the thrombus will not form immediately, but it will take time.Significant effects on the body may take longer.

Central vein thrombosis is an extremely scary thing.

Untimely discovery and improper treatment can directly lead to the death of patients.

In fact, even the formation of venous thrombosis in the limbs is also extremely harmful.Especially some free thrombi in blood vessels are simply invisible killers.

"We must take this as a warning. When the venous catheter is operated, you must not be careless. Remember to talk to Xiao Chen about this matter tomorrow."

"Ok."

It was Dr. He, who was at the attending level, who answered the call.

Because of the intravenous catheter, the administration is very convenient.Thrombolytic drugs act directly and quickly on the thrombus formation site.

"It seems that the effect is very small. The current situation of the patient may not be able to support the successful thrombus ablation. And the thrombus is very large. I am worried that the thrombus will dissociate after ablation, causing further harm."

Director Zhao has been carefully observing the patient's blood supply, especially the blocked position.

If you want to diagnose venous thrombosis, color Doppler ultrasound or CT are good examination methods.But they are not as good as angiography, and the gold standard recognized in medicine is only angiography.

Auxiliary diagnosis methods such as checking plasma D2 polymers have certain reference value, but they cannot be directly diagnosed.

Only one diagnostic direction can be provided.

If it is a superficial venous thrombosis, even a preliminary diagnosis can be made directly by palpation.

When you press it down, you will feel hard, and even your limbs will swell.

Especially the lower extremities, most likely to appear.

In addition, older people are also the most prone to varicose veins in their lower limbs.

This is directly related to the formation of venous thrombosis.

That is, when you touch the lower limbs with your hands, especially the calf, you can feel bumps one by one.This is most likely varicose veins.

"It may have been a long time since the thrombus occurred, and the thrombus is tightly adhered to the blood vessel wall. If drug ablation fails, the only option is to remove the thrombus through interventional surgery."

Director Xiang also knows that time is life now.

Although it is just a small thrombus, if it cannot be removed in time or melted away, it will be fatal to the patient.

With the continuous development and progress of human medical technology, there are many ways to deal with deep vein thrombosis.

Interventional thrombectomy is recognized as one of the most direct and effective thrombectomy methods.

However, this operation has high requirements on the technical level of the surgeon, and also requires the patient's physical endurance.

In the early years, the thrombus was most likely to be removed, and it was even necessary to cut the blood vessel, drain the thrombus, and then perform vascular anastomosis.

Interventional procedures are much less invasive to the patient.

Efficient, fast, and greatly improved security.

If they hadn't been too wary of Zhou Can and let Zhou Can stay at the scene, maybe Zhou Can would have already proposed to intervene to remove the thrombus.

And as long as they are willing to give Zhou Can a chance, Zhou Can can directly operate it.

Not to mention his interventional technique is top notch, he should be ranked first in the province now.

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 hypotheses in the world, and it is absolutely impossible for the doctors of the Provincial People's Hospital to ask an ignorant doctor to do interventional surgery for them.

……

Half an hour later, the group of doctors from the Provincial People's Hospital finally took out the thrombus with great effort.The blocked venous channel of the patient also recovered unimpeded.

Here comes the problem, the thrombolytic drug was given just now.

It has no effect on the thrombus, but after entering the blood circulation, it is easy to cause bleeding again in the part of the patient's body that has already stopped bleeding.

There are still a lot of difficult things facing them.

"Blood pressure, blood oxygen and other indicators have all risen, and the patient's previous condition has deteriorated rapidly, which is likely to be caused by this thrombus."

The medical staff were very happy to rescue the patient from Hades.

However, Director Xiang always felt that his face was dull, because the cause of the disease was pointed out by the young doctor surnamed Zhou.

They are just operating with the baton of others.

The real hero is that young man.

"Director Zhao, do you know the young doctor who came in to visit the patient just now?"

Director Xiang asked Director Zhao, who was less than fifty years old.

An intensive care unit is not like an outpatient or inpatient ward.The work here is not only technical work, but also physical work.

Older doctors can't bear it at all.

Therefore, the doctors here are mainly aged 27 to 50 years old.

The young doctors who have just graduated are also not suitable to work here because of their lack of rescue experience and limited level. People in their 30s are considered an important labor force in the ICU, and those in their 40s are the backbone and elite.

Those around 50 years old are basically the big shots here.

The group of people holding the baton.

"I don't know it. It just looks familiar, but I can't remember where I saw it."

Director Zhao shook his head.

"I also think it looks familiar!"

A young doctor answered.

"It does look like deja vu, could it be a doctor from our hospital?"

Another nurse followed suit.

"No, it shouldn't be the doctor of this hospital. I basically have the impression of a young doctor in our hospital who is better. This young doctor neither checked the patient's examination report, nor did he understand the patient's condition and injury in detail. After looking at the monitoring equipment and the patient's body, he can accurately tell that the real cause of the patient's critical illness is a blood clot. This kind of ability is really amazing."

Director Xiang was full of doubts. He felt that the young doctor's strength was unfathomable.

And he is very measured in speaking and doing things.

To put it more exaggeratedly, the whole body exudes the demeanor of a king.

"Ah... I know who he is!"

The nurse who seemed to have known Zhou Can exclaimed.

"Teacher Hu, please control the volume, this is the ICU."

"SOORY! Blame me for being too emotional and unable to control it." She quickly apologized. "That young doctor calls himself Zhou. Do you think he is similar to Dr. Zhou who performed a heart surgery on the Internet a while ago?"

After being reminded by the nurse, several people remembered.

"That's right! It's him, it's Dr. Zhou Can, no wonder he looks so familiar!"

Director Zhao affirmed it.

"It turned out to be an excellent young doctor from Tuya Hospital. It seems that we are not wronged at all by being mentored by others today!" Director Xiang still feels bitter about being mentored by Zhou Can.

For a person of his level, the most difficult thing to let go of is this face.

Famous people!
But now that he knew Zhou Can's true identity, Director Xiang felt somewhat relieved.

Today can be regarded as an increase in knowledge.

I have personally experienced how good the young doctors in Tuya Hospital are.

"Ru Yaji, Pang Houzhong, the two of you should learn from others. Normally, you two always keep your eyes high above your head. Now do you know how far you are from a really good young doctor?"

Responsibility is deep, love is deep.

It can be seen that Director Xiang loves the two young doctors under his command very much.

We want them to grow quickly and become the pillars of the department as soon as possible.

"He's really strong."

Ru Yaji admits that Zhou Can is very strong, but she is extremely unconvinced in her heart.

She didn't have any scheming, basically it showed on her face.

"If I have the chance, I really want to have a good conversation with him." Pang Houzhong also refused to admit defeat, no one would admit that he was weaker than others.

"It's not unreasonable that Tuya Hospital has been able to gain momentum and continue to rise in recent years! The quality of the young doctors alone is already frighteningly strong. The director-level doctors behind them are probably even more extraordinary."

Director Zhao expressed deep emotion about this.

"Director Zhao, Director Xiang, there is one thing that I don't know if I should talk about it or not?"

Doctor He at the attending level said weakly.

In front of ordinary doctors, he is a veritable superior doctor.But in front of these directors and deputy chief physicians, they immediately fell short.

"Just tell me what's going on! There are no outsiders in this duty room."

Director Xiang spoke.

"When Dr. Zhou Can brought up venous thrombosis just now, he seemed hesitant to speak before leaving. I was wondering if he had other medical opinions that he wanted to provide us, but he was worried about misunderstanding, so he didn't say it in the end? "

Everyone observes things differently.

Dr. He inadvertently observed some subtle expressions of Zhou Can.

"What do you mean?"

Director Zhao's eyes narrowed slightly.

(End of this chapter)