Back in 2002 as a doctor

They have always believed that Lao Xu from the Department of Radiology is a first-class interventional doctor in China, and he belongs to the same level as Professor Xu Ke from the University of Traditional Chinese Medicine.

But... is it an illusion?

The young doctor who was operating on the operating table seemed to be not at the same level as Old Xu, at least a few levels higher than Old Xu.

Old Xu is a postdoctoral fellow who returned from Germany!

"Huang... Lao, is the operation correct?" Someone stammered and asked in a low voice.

"That's right." Huang Lao said lightly.

"Who is he?"

"A young doctor in a basic hospital, I will accept him as my student, and help me host an academician workstation next year." Mr. Huang watched Zhou Congwen perform the operation through the leaded glass, feeling very proud.

"Are you ready to accept students?!"

"Isn't this a good seedling, who knows it's not a good seedling at all." Huang Lao leaned on the back of the chair, his body hunched into a ball. Although it only took a few minutes to operate just now, dozens of kilograms of lead clothes are not suitable for a nearly eight-year-old man. It is still unbearable for an old man who is ten years old.

"Uh……"

Not a good seedling?So what is a good seedling? !Could it be that Huang Lao meant that if he didn't pay attention, he would not be able to dig up a towering tree.

This evaluation is a bit high.

Huang Lao didn't explain, and watched Zhou Congwen Chaoxuan silently, and the embolism was completed in one go.Three blood vessels were embolized within 11′22″.

Zhou Congwen did not do angiography confirmation, and while talking to the nurse about rescue medication, he completed the embolization operation "simplely".

Interventional hemostasis is successful, the patient should be better.

However, the numbers on the patient's ECG monitoring remained unchanged, and the fragile heart would be in atrial fibrillation and stop beating at any time.

Huang Lao suddenly sat up straight and leaned over to Mike.

"Xiao Zhou……"

"boss……"

Huang Lao and Zhou Congwen spoke almost at the same time.

"You said."

"You say."

"The patient is too fat, and the heart is pressed under direct vision."

"The patient is too fat, it is recommended..."

All the doctors in the operating room were dumbfounded by the simultaneous occurrence of the gods.

Who the hell is in it, who is so synchronized with Huang Lao, saying the same incredible words at the same time.

The patient had amniotic fluid embolism, but even so, the doctors and nurses of 912 were actively rescuing them. They were confident in their technology, and there was at least a 20% probability of "recovering" the patient.

But what the hell is it to cut open and look directly at the heart? !

Is there another way to rescue it?

Hearing what Zhou Congwen said, Mr. Huang heaved a sigh of relief, and sat motionless in the chair as if his whole body had shrunk.

"Old Huang? Cut open? Open chest and press?"

"The patient is too fat. If the incision is not made, it is estimated that cardiac arrest will occur in 10 minutes." Huang Lao explained lightly, but his eyes kept looking at Zhou Congwen over there through the leaded glass.

Zhou Congwen pulled out the guide wire catheter and called a doctor beside him to press it. He didn't take off the lead coat and brush his hands again, but directly began to disinfect the patient's left chest.

Really want to cut!

The doctor who was doing chest compressions was taken aback for a moment, stepped aside, and looked at Huang Lao with a questioning look.

He knew the patient's condition well. After continuous cardiopulmonary resuscitation and multiple electrical defibrillations, the patient could temporarily return to sinus rhythm, which lasted for 1 to 2 minutes and then turned into ventricular fibrillation, which alternated repeatedly.

However, with the deepening of the rescue, the time for the patient to maintain sinus rhythm is getting shorter and shorter, and it is estimated that he will not be able to maintain it soon.

Deng Ming was on ecmo, and the operation was very cumbersome. He concentrated on it and ignored other situations.

"Go!" Huang Lao stood up and said in a deep voice.

Chapter 0362 Rescue Order

After taking a breath, Mr. Huang walked into the operating room with his arms behind his back and a smile appeared in the corner of his eyes above the mask.

"At first, I wanted to risk my life to build an interventional embolism, and try to see if it is possible to save the uterus. I didn't expect this kid to do it. It's not bad, so don't worry." Huang Lao said to himself in a very low voice. .

The people next to him didn't hear what Huang Lao was saying, and followed him with their ears pricked up.

When they walked into the operating room, someone brought Huang Lao a footstool, and Huang Lao stood directly behind Zhou Congwen and looked over his shoulder.

"Old Huang, is it necessary to open the chest and press directly?" the obstetrician asked.

If she hadn't heard Mr. Huang say to cut open and press directly, even if Director Deng Mingdeng suggested, she would have denied this "extreme" approach.

In her opinion, the way of incision and direct pressure is not very suitable.

"Chest compression is not effective." Mr. Huang said calmly as he stood behind Zhou Congwen with his hands behind his back and watched him operate.

"But……"

"The patient repeatedly suffered from alternating sinus rhythm and ventricular fibrillation, and the resuscitation effect is hard to describe. We should decisively adopt intrathoracic heart compression, ice cap to protect the brain, and appropriate hormone therapy. This is the key to the successful treatment of amniotic fluid embolism..." Zhou Congwen quickly opened his chest, While explaining for his boss.

"Xiao Zhou, guess what your heart is like now?" Elder Huang asked.

"The right heart expands, and the beating is weak." Zhou Congwen said, "Open the chest... Hurry up and open the chest bag!"

His voice was raised 15 degrees, slightly harsher.

The itinerant nurse was startled, and immediately turned around and ran out of the operating room to remove the chest pack.

Zhou Congwen was a little helpless. After all, he was an unfamiliar team, and he didn't have any prestige. Some details still lacked continuity.

Opening the ribs with their fists, Zhou Congwen and Mr. Huang behind him saw the patient's heart enlargement at the same time, especially the right heart part was exaggerated, as if all the cardiomyocytes were congested and edematous by at least three times.

Zhou Congwen reached in and started chest compressions.

It wasn't until this step that Huang Lao relaxed slightly, and his eyes looked at Deng Ming.

"Deng Ming, how long will it take?"

"Boss, start the machine now." Deng Ming replied immediately.

He was a little ashamed, the boss and Zhou Congwen... No, mainly because Zhou Congwen had already performed an interventional embolization of the uterine artery, and performed cardiac compressions under open chest.

And I haven't started to turn around yet, so I can't justify it.

The little guy Zhou Congwen is a bit interesting. Not everyone knows how to perform interventional surgery. How did he become so proficient?

Although he had doubts in his heart, Deng Ming didn't ask directly. Instead, he concentrated on establishing the ECMO cycle in VA mode, and used the machine to reduce the patient's cardiopulmonary load.

After 5 minutes, the waveform on the ECG monitoring became sinusoidal, and the patient's enlarged heart gradually "reduced swelling" under direct vision and pressure. So shocking.

At the same time, ecmo began to turn around.

Huang Lao nodded, turned around and walked off the footstool, "The obstetrics department should go to suture, by the way, remember to increase the level of antibiotics, and give some Tylenol after the operation."

"Yes, Mr. Huang."

"Zhou Congwen, tell me about the first aid steps in the emergency room just now." Mr. Huang didn't leave the operating room, but found a stool and sat in the corner of the operating room.

"912 has strong technical force and good hardware conditions. If the patient is in our place, he must have died." Zhou Congwen answered irrelevantly.

But this is the biggest emotion in his heart.

If it wasn't for 912, the third hospital of Jianghai City would have been unable to save the patient even if he was present.

Interventional surgery and chest opening and cardiac compression are trivial matters for Zhou Congwen, but it seems that ecmo is still not available in the Third Hospital of Jianghai City after 20 years.

The other doctors were taken aback for a moment, thinking that Zhou Congwen was flattering Mr. Huang, or taking the initiative to curry favor with the 912 clinical departments.

They smiled, this little doctor is quite interesting.

"Tell me, don't you think it's putting the cart before the horse that I need to solve the womb first?" Mr. Huang asked many people's thoughts.

"For amniotic fluid embolism with a definite diagnosis, it is necessary to make a timely decision on whether to remove the uterus to avoid further deterioration of blood coagulation function." Zhou Congwen said lightly, "Director Deng is doing ecmo, and there are only two remaining questions-whether to remove the uterus and open the heart Press."

Huang Lao's mask moved slightly.

"If it weren't for the hybrid operation room, hysterectomy would definitely be the only option. But our 912 emergency room is all hybrid, and it's okay to try it in 15 minutes. Boss, you are quite confident that you can tie it in 15 minutes."

Hearing what Zhou Congwen said, Mr. Huang smiled slightly, "How can you be confident? Just look at the feel of the hand. If you're lucky, you won't have to have a hysterectomy. If you're not lucky, there's nothing you can do about it. It's you, keep talking."

"Cardiopulmonary circulatory failure caused by amniotic fluid embolism is one of the best indications for the use of ECMO. There have been reports of successful treatment in foreign literature. Although it is not necessary to open the chest and look directly at the heart, the better the effect of the chest can be seen just now. It's getting worse, so choose to press under direct vision."

"There is nothing questionable about all the rescue steps. The only question that needs to be discussed is whether the patient's uterus can be preserved as much as possible during the rescue. It seems that there should be no problem now."

Zhou Congwen explained, pressed, and looked at the ECG waveform on the monitor.

The heart rate has returned to sinus rhythm, and the ecmo has successfully turned around. Depending on the situation, the patient's life has been saved.

"Take a breath."

After a few minutes, the blood gas analysis returns.

The speed was so fast that Zhou Congwen, who was used to the speed of the Third Academy, was a little stunned.

pH7.28, Hb67g/L, BE-9.4mmol/L, Lac26mmol/L.

"Continue to correct the acidosis, give red blood cells 8u, and fresh frozen plasma 600ml. Xiao Zhou, do you have anything to add?" Huang Lao asked again.

Others are awe-inspiring.

The rescue that Mr. Huang participated in personally required this young doctor to speak up?And it was Huang Lao who took the initiative to ask.

"Do we have cryoprecipitate here?" Zhou Congwen asked.

Huang Lao smiled, "Yes."

"Give it all, what do you say?"

"Prepare 10U cryoprecipitate, 6-10g fibrinogen, hurry up." Huang Lao said.

"Doctor Zhou, take a break, I'll come." Director Deng Mingdeng said.

"Oh, good." Zhou Congwen was not polite, waited for Deng Ming to brush his hands and put on his clothes, turned around and stepped off the stage, picked up the medical records and began to look through them.

Huang Lao nodded invisibly.

Zhou Congwen is a careful child. Although the rescue can be said to be over, he still needs to re-read the past history that he has not read to avoid missing some rare complications.

"Doctor Zhou, where is your home?" The obstetrician asked after the skin was sewn up, seeing that the patient's ECG monitoring values ​​were all within the acceptable range, and he was a little relaxed.

She is also very interested in Zhou Congwen and intends to get closer.

Chapter 0363

"Jianghai City, I work in the Third Hospital." Zhou Congwen looked up and smiled at the obstetrician.

An old acquaintance, but she doesn't know herself yet.

This is a wonderful feeling, Zhou Congwen noticed it for the first time.

The people in the room all know each other, but they don't know themselves, which is very strange.This feeling was not strong when he was just reborn. After all, the people in the Third Court knew him, but he didn't know he was reborn.

"How old are you this year? I don't think you are very old. Are you thirty? Have you had any children?" the obstetrician asked.

"I'm not married."

"Is it okay to be exposed to interventional surgery so early?" the obstetrician asked after cutting off the last knot.

"I just got a girlfriend, and it's still too early to get married. Just avoid the line half a year before I want to have a baby, so there's no delay." Zhou Congwen replied with a smile.

"Has your hospital carried out interventional surgery?" The obstetrician asked suspiciously, "The level is really high, I think it is much stronger than old Xu."

"Occasionally I do a case, but only the X-ray machine, and an aortic stent was placed under the X-ray machine a few days ago." Zhou Congwen put down the medical records and said with a relaxed smile.

The patient's past history was fine, and the occurrence of amniotic fluid embolism was just a coincidence.Looking through the medical records, Zhou Congwen felt relieved.

"Xiao Zhou, when you come to our 912 to work in the future, your girlfriend will also be transferred. Mr. Huang has to be responsible, otherwise it will be easy to break up if you are in a different place." nerve.

"ED, I don't have this problem."

"..."

"..."