super anesthesiologist

Chapter 32 This Patient Has Coronary Heart Disease (Please bookmark, please recommend, thank you!)

Lin Xiaobei didn't have a car himself.It was already late at night, and the taxi driver was hesitant and very reluctant when he heard that it was such a remote location.

"Is it 100 free?" These people are nothing more than wanting to give more money, blackmailing in disguise.

Money can make ghosts turn the millstone, the driver took the money and never said a word again.

Wang Xuguang's work unit is not very far away, but the traffic is not so convenient. Under Lin Xiaobei's anxious urging, the driver finally arrived at the destination after 30 minutes.

The hospital is very small, and the entire inpatient department has only one five-story building surrounding a yard the size of a basketball court.

Lin Xiaobei called Wang Xuguang at the entrance of the hospital, and a nurse came out to greet him a few minutes later.

In the middle of the night, there was no one else at the entrance of the hospital. The nurse saw Lin Xiaobei and walked over to say hello, "Excuse me, are you Dr. Lin?"

"Yes."

"Doctor Wang is busy inside, come with me."

The operating room of their hospital is on the second floor, and there is only one operating room in the entire anesthesiology department.

Lin Xiaobei took an isolation gown from the nurse, put on shoe covers and went in.Rural hospitals have less strict requirements on asepsis, and there are no special workers guarding the passages of the operating room.

This is completely inconsistent with the norms in regular large tertiary hospitals.

"Mr. Lin, thank you in advance." Wang Xuguang greeted Lin Xiaobei in a leisurely way.

There is only one operating bed in the operating room, and an old-fashioned three-hole shadowless lamp (now there are at least nine holes, and Lin Xiaobei and his operating room use 27 holes).

Lin Xiaobei walked to the operating table. There was a man in his fifties lying on the operating bed. He had a messy beard, sallow skin, and no flesh on his face. He looked like a man who had suffered a lot.

He still has a tracheal tube inserted into his mouth, and the data on the monitor are stable and normal: BP 135/76mmHg, HR 82 beats/min, SPO2 99%.

After Wang Xuguang said hello, he took a deep breath, held it, then bent down, and blew down hard on the patient's endotracheal tube on the bed.

He blew vigorously, and the patient's chest rose and fell significantly.

Lin Xiaobei couldn't help laughing. He told Wang Xuguang that mouth-to-mouth ventilation is a last resort, but there are many ways to ventilate patients in the operating room. Connect the head to the tube, and then pinch the ball with your hands, which is equivalent to manually giving oxygen to the anesthesia machine.There are also simple respirators.

There are so many methods, but Wang Xuguang chose the most clumsy and helpless one. The phrase "Yugong Yishan" could not be more appropriate for him.

Fortunately, the patient is safe and sound.

Lin Xiaobei stood beside Wang Xuguang, carefully inspecting the anesthesia machine.

The anesthesia machine in their hospital was actually a domestic product in the 90s: Wu*xi Zhongyuan.

This kind of anesthesia machine has long been eliminated due to incomplete system parameter setting, large tidal volume error, and loose airtight circuit. Now this brand is no longer seen in the market.

However, almost [-]% of the anesthesia machines in front of them are new, which shows how long they have not been used, and they are probably collected like antiques.

The procedures for using this old-fashioned anesthesia machine are relatively cumbersome, just like driving a manual transmission for a driver accustomed to automatic transmission, which is particularly uncomfortable.Lin Xiaobei debugged it for a long time before starting it. No wonder Wang Xuguang didn't know how to use it.

"This kind of anesthesia machine needs to be warmed up first. Its gas supply valve is bidirectional, but you have no choice. It uses the default unidirectional system, so oxygen cannot be supplied."

Wang Xuguang couldn't believe it. Under Lin Xiaobei's guidance, he finally figured out how to use it, "Damn it, I couldn't find the reason after working on it for a long time. You don't know how anxious you were at that moment."

Who told you not to grope often?Lin Xiaobei blamed in his heart.

"Actually, it doesn't matter if you can't breathe. You can remove the air bag and connect it to the endotracheal tube. Isn't that all right?"

He talks and demonstrates.

Wang Xuguang's face turned green, and he said, "I didn't know anything when I panicked, and my mind went blank. The only thing I remember is that I followed you to rescue a few times, so I thought of calling you."

"What surgery do you do?"

"Colon cancer."

No wonder the patient looked so thin, and no wonder he hadn't woken up for so long.Wang Xuguang was only given a muscle relaxant during the induction period. According to the time, he should have recovered to breathe spontaneously.

Lin Xiaobei frowned secretly.

Colon cancer is a serious medical treatment, and the hospital for treatment must have the corresponding qualifications, at least a second-class or above.

The hospital where Wang Xuguang works is at best a first-class hospital, and they don't even have the qualifications for diagnosis. It's obvious that they are overstepping.

Lin Xiaobei didn't say much. This kind of situation is common in the medical system, and the legendary Putian system is the most common.As long as a patient comes to see a doctor, no matter whether he can be cured or not, he will try to stay first.After a lot of tossing, if it is cured (the possibility is very small), it is a superb technique. If the patient fails, he will be transferred to a higher-level hospital as soon as possible.

At this time, the surgery room was opened again, and two doctors came in.

"Doctor Wang, how are you doing now?" one of them asked Wang Xuguang, who was about 40 years old.

"It should be no problem." He introduced to Lin Xiaobei: "This is our President Li and surgeon Ye Guchen."

"This is Mr. Lin Xiaobei, my teacher when I was studying at S University."

That Dean Li immediately came forward with a smile on his face and shook hands: "Hello, hello!"

"Hello there!"

After exchanging pleasantries, Dean Li asked Wang Xuguang: "Then we can start the operation?"

But Wang Xuguang cast his eyes on Lin Xiaobei for help, "Mr. Lin, since you are here, please guide me once."

"I have to go to work tomorrow." Lin Xiaobei thought I was here to help you in an emergency, not to give you anesthesia.

"Ms. Lin, this patient is a bit special. I'm afraid I can't handle it alone." Wang Xuguang said in embarrassment, he is now a bird of fright.

"What's special?" Lin Xiaobei couldn't help being curious.

"This patient, this patient---" Wang Xuguang glanced at Dean Li, hesitating.

He must have some scruples in his heart.

"Speak directly. You have studied in our hospital for more than half a year, and you should know that all operations have contraindications." Lin Xiaobei encouraged.

"This patient has coronary heart disease, which happened only half a month ago."

"This? Do you dare to do it too?"

Coronary heart disease is a heart disease caused by atherosclerosis (vascular wall lesions gradually lose contractile elasticity) in the large blood vessels (coronary arteries) that supply the heart, resulting in narrowing or blockage of the vessel lumen, resulting in myocardial ischemia, hypoxia or necrosis.

The most common clinical ones are what doctors often refer to as "angina pectoris" and "myocardial infarction". The former is caused by myocardial spasm due to insufficient blood supply, which causes chest tightness and pain in patients; Thrombus blockage) and partial necrosis occur, which is much more dangerous.

The former is usually relieved slowly by taking nitroglycerin sustained-release tablets in the mouth (to reduce the oxygen consumption of the heart); while the latter requires emergency thrombolysis with drugs or interventional surgery (thrombosis is removed through a guide wire under fluoroscopy).

According to anesthesiology guidelines, patients with coronary heart disease attack within six months are prohibited from surgery, and now some hospitals can relax the period to three months if conditions permit.

But Wang Xuguang's hospital doesn't say three months, even if it occurs within half a year but has a definite diagnosis, it can't do it.

Lin Xiaobei's questioning was not unreasonable, and Wang Xuguang could of course hear the meaning behind his words.But he is also helpless, their hospital is no more worrying about patients than the S University Affiliated Hospital.

Nowadays, due to the high diagnosis and treatment technology of large hospitals, patients with a little financial ability are willing to spend more to enjoy better medical services.Small hospitals of their level are sparsely populated, and appendicitis, hernia, and even circumcision, which used to be a constant stream, are becoming rare day by day due to the development of minimally invasive surgery in large hospitals.

Although the hospital is a state-owned enterprise, it is responsible for its own profits and losses, and its income comes from serving and treating patients.Without patients, they can only drink Mistral.

Therefore, knowing that this kind of risky patient is extremely high, Dean Li and the others have to try their best to intercept it.On the one hand, in order to survive, on the other hand, it can also improve the reputation of the hospital.

As long as the patient is fine, it will be a good promotional material in the future: Look, their hospital can do such a difficult operation, and it will save a lot of money for the patient!

Wang Xuguang looked at Dean Li, his eyes were firm, and there was no doubt that he was ready to give it a go.

"Mr. Lin, you can stay and guide me."

Even the dean dared to take such a risk, and Wang Xuguang had almost no reason to back down.There happens to be an expert here to check, and of course he will not miss such a good opportunity.

"Mr. Lin, since you are here, please give some guidance to our Dr. Wang. He has just returned from your department and will be tested to see if he has learned your true skills." Dean Li lost no time in complimenting him.

Lin Xiaobei could justly refuse at this time, but as a doctor, he either didn't see it, or if he saw it, he couldn't ignore it.It is the nature of the profession.

"Okay, let me get ready first," he said.

　The popularity has been very low in the past two days, which means that the writing is not good. Dugua Zuoan deeply blames himself and is reflecting on himself.No matter what, you can't be sorry for your book friends.

　　I was on duty 24 hours from last night to today.

　　Two operations were performed last night, and one was replanted for 6 hours during the day. The surgeon praised the left bank brachial plexus well (generally this type of operation is under general anesthesia), which saved the patient a lot of money.

　　There is no handsome Lin Xiaobei, no young Lin Xiaobei, and no supernatural operation like Lin Xiaobei, but as a senior anesthesiologist in a tertiary hospital, his basic skills are still good. . . . .

　　Oops, stop blowing. ^_^^_^^_^
　　Thanks to book friends 2020***6170, 2018***5034, Xiaoyao Dixuan, Orange Born Huainan Grape Boy, Sakura, Discrete Chapters Circling Straight Up, and other book friends for their recommendation tickets.

　　Thank you for your book friends.

　　thanks for your support.

　　Dumb Zuo An came back from get off work and lay on the bed, not wanting to move, but saw that compared with yesterday, his favorites had increased by 6, and his recommendation votes had increased by 20, so he immediately became excited.Every book friend is my God, and I will cherish your support.

　　Please don't be stingy and throw the recommendation tickets in your hands over to the left bank of the idiot, thank you!
　　


(End of this chapter)