Back in 2002 as a doctor

"Master Shi, wait a moment." Zhou Congwen bent over and said to Master Shi.

Master Shi was very silent, like a stone, and nodded without saying a word of nonsense.

Zhou Congwen didn't get into the car either. He squinted his eyes and looked at the blue sky, thinking about the one-day neonatal surgery precautions in his mind.

The surgery for congenital esophageal atresia and intestinal atresia is extremely difficult. In 2002, it is estimated that the boss did not have the certainty to win it.

Moreover, this operation requires not only the strength of the surgeon and the tacit cooperation of the assistants, but also a team!

team!

Zhou Congwen felt a headache when he thought of these two words.

Surgery is not done by one person, this sentence is right or wrong.

When he was aiding Xinjiang in his last life, Zhou Congwen was an anesthetist and a surgeon by himself, and it was not too difficult to cut appendicitis or anything.

But in front of the 1-day newborn, without a mature team, everything is nonsense.

Even if I and my boss can make the operation work out, the child will not survive.

How difficult is this operation?

Not to mention that the surgeon needs the top in the country, but just the anesthesia - in the era before Zhou Congwen's rebirth in the future, not only an anesthetist but also an anesthesia nurse are required to perform this kind of operation.

As the name suggests, anesthesia nurses are nurses who have obtained a nurse practice certificate and are engaged in nursing work in the anesthesia department.

This is an interdisciplinary subject combining anesthesiology and nursing. It is a subject that studies how to care for patients in the perioperative period, especially during the perianesthesia period, so that they can be in the best condition.

Now there is no dedicated anesthetist nurse in China, so Zhou Congwen can only temporarily bring an anesthetist from the Third Hospital—Liu Wei, and explain to him carefully what needs to be done during the operation on the way.

Alas, in 2002, even 912 was powerless. Zhou Congwen felt helpless when he thought about everything he had to face ahead.

However, even in later generations, there are many diseases that cannot be overcome, and Zhou Congwen is quite open about this.

Soon, a familiar figure appeared in the field of vision.

Liu Wei was tall and thin, and ran all the way here, like a bamboo pole fluttering in the wind.

Zhou Congwen waved, opened the car door, and sat in by himself.

"Congwen, where are we going?" Liu Wei asked hurriedly after getting into the car without breathing well.

Although Zhou Congwen said on the phone that he would go to 912 for surgery, Liu Wei felt that he must have heard it wrong along the way.

How much time difference is there between the Third Hospital of Jianghai City and 912?Liu Wei knew it in his heart.

In Jianghai City, both the Third Hospital and himself are second-rate goods, let alone going to places like 912.Does 912 need me?What a joke.

There are plenty of big-handed anesthesiologists over there. Do you want to kneel down to wipe flip flops?

"Take a breath, we may be very busy along the way." Zhou Congwen said indifferently.

"Congwen, really go to 912?" Liu Wei asked nervously.

"Well, there was a 1-day-old newborn with congenital esophageal atresia, intestinal atresia that required emergency surgery."

"..." Liu Wei was taken aback.

With such a serious illness, why do you have to do it yourself? What can you do by yourself?

"The operation is huge, and the boss and I went on stage in person."

Zhou Congwen recalled the surgical plan of congenital esophageal atresia and intestinal atresia under thoracoscopic surgery, and inadvertently used the word "personally".

Liu Wei was dumbfounded and went on stage in person, taking what Zhou Congwen said as a matter of course.

"I want you to go with me this time, not to be an anesthetist, but to be an anesthetist."

"..."

Liu Wei froze for a moment, looking at Zhou Congwen speechlessly.

Anesthesia and nurses?Are you sure Zhou Congwen is not joking? He wanted to reach out and touch Zhou Congwen's head to see if he had a fever.

"That's right, old Liu." Zhou Congwen looked at Liu Wei and said, "Do you know the requirements for one-day anesthesia and intubation for newborns?"

Liu Wei shook his head, who knows what the hell!

1 day, and there are congenital diseases, the child's condition must be particularly poor.

Not to mention the third hospital, Liu Wei had never encountered this kind of surgery when he was studying in the provincial capital.

"The key to anesthesia for congenital esophageal atresia with tracheoesophageal fistula under thoracoscopic surgery is left lung ventilation, which can easily lead to hypoxemia, and requires the close cooperation of itinerant nurses, anesthetists and anesthesiologists."

"The anesthetist, that is, you, should prepare B-ultrasound, foot pedal, bronchoscope, sterile paraffin oil, sterile gauze, etc. before the operation." Zhou Congwen said, looking sideways at Liu Wei.

"Is there still time for me to get out of the car?" Liu Wei felt that he was on a thief's boat.

"I'm going to the Second Hospital of Medical University in the next year, and I'm in charge of the boss's academician workstation. There is a shortage of an anesthesiologist. Maybe I will return to 1 in a year..." Zhou Congwen said leisurely.

"Hmm!" Liu Wei suddenly raised his voice, "I'm an anesthetist! I can do everything a nurse does, so just tell me what position you want."

"Don't make trouble." Zhou Congwen said seriously, "There are a lot of things you need to do. Originally, there are many people with a higher level of 912 than you, who are more suitable than you, but the problem is that there is no time to communicate."

Liu Wei was stunned and shut up.

He felt pressure from Zhou Congwen, severe pressure.

"Children with congenital esophageal atresia and esophagotracheal fistula have a lot of oral secretions after birth, and the children may suffocate at any time, and even have cardiac and respiratory arrest. After I go there, the emergency department will be opened, and I have no time to train another anesthesia nurse. .”

"Old Liu, everyone is destined to die. It is your great opportunity to meet this patient."

"912 didn't have anesthesia nurses, and now there are none in the whole country. If you can do it perfectly, you have a place in Huang Lao's heart. In 912, you also have a place."

Zhou Congwen's simple words moved Liu Wei's heart.

912, Huang Lao, a place.

Liu Wei never thought that he would still have this day in his life. He nodded solemnly and said regretfully, "I didn't take a notebook, so I should write it down."

"No, I pretended to be an anesthesiologist along the way, and we have to practice repeatedly." Zhou Congwen said, "To a certain extent, the success or failure of the operation depends on your performance."

"Why." Liu Wei was a little timid.

Is this dumping the pot?A cauldron from 912, I can't carry my small frame, Liu Wei immediately felt fearful again.

"Because the person in charge of anesthesia on 912 must be the director of the anesthesia department. Old Liu, you don't think you are better than him. He is definitely not the weakest point, so the problem lies with you. Don't worry, it's not about throwing the blame away."

"..."

Liu Wei was so excited that he almost fainted.

I didn't feel it before, but when Zhou Congwen mentioned the director of the anesthesiology department of 912, Liu Wei's whole body became hot, and he was more excited than seeing any beautiful women.

In a daze, Zhou Congwen frowned at him.

"Why do you have a nosebleed?"

0489 - Anesthetized Nurse

"Old Liu, if you anesthetize, what kind of tube are you going to use?" Zhou Congwen asked.

"Our hospital doesn't have one, and I haven't seen it in the provincial capital, so I don't have any idea." Liu Wei replied seriously.

He knew Zhou Congwen was serious.

"There is no double-lumen endotracheal tube suitable for newborns to ventilate the left lung, so I think the boss should choose a single-lumen endotracheal tube No. 3.0." Zhou Congwen did not discuss with Liu Wei, and began to explain with gestures.

"It's not important, you just need to know that a 3.0 single-lumen endotracheal tube will be used.

After opening the stage, the itinerant nurse assists the anesthetist nurse... that is, you, to adjust the focus of the bronchoscope under aseptic operation, and apply sterile liquid paraffin to the rod of the bronchoscope, and put it in a sterile tray for later use. "

Liu Weizai listened carefully, the excitement of playing mahjong and Baobao just now was gone, as if it was something in the last century.

"Because the child has a lot of secretions in the blind bag, you must prepare a suction device before entering the operation, and wait for the child to absorb the secretions after entering the operating room. Otherwise, there will be too much secretions, and the intubation will have no vision at all.

Old Liu, you have to remember this well, otherwise the director of the anesthesiology department of 912 will definitely be unhappy. "

"Yeah, and then." Liu Wei nodded repeatedly.

"Then the cotton swab that is ready to be opened is placed on the bedside to facilitate the removal of oropharyngeal superficial secretions. This is the detail. You put yourself in and remember what you need. It is not difficult."

"After the newborn comes in, you stand on the left side of the patient. At this time, you have to call the roving nurses to come over and direct them to help you."

"Huh?" Liu Wei was taken aback.

He knew very well how aggressive the itinerant nurses were in the operating room.

Not only the Third Hospital, but also the People's Hospital and the Affiliated Hospital of the Medical University in the provincial capital, all the itinerant nurses he had seen were particularly aggressive.

The nurses in the operating room all started as instrument nurses, and they will become itinerant nurses when they get older. They have experienced many battles, and they don't even blush when the surgeon is driving.

Some itinerant nurses can even drive their cars into the ditch.

When the operation goes wrong, if the operator gets angry, the strong itinerant nurse will immediately scold him back, and almost all the operators can only endure it.

This existence, let yourself greet?Do you want to guide them to do things?Liu Wei has a certainty in his heart and has begun to be afraid.

"Because during the induction of anesthesia, the pressurized mask gas enters the stomach from the esophagotracheal fistula, causing gastric dilatation and gastric juice reflux into the trachea and inhalation into the lungs.

At this time, a team is needed. You call the roving nurses to come and help. Don't worry, the 912 nurses are very understanding. "

Liu Wei smiled wryly, is it reasonable?All right.

"You instruct the roving nurse to stand on the right side of the child, and when the director of the anesthesiology department pressurizes, ask her to press the child's stomach with her fingertips to prevent gas from entering the stomach and increase the pressure of the stomach, causing gastric juice to flow back from the fistula to the patient's stomach. Lungs cause pneumonia exacerbations."

"I really want to teach her?" Liu Wei asked in a daze.

"Well, a simple demonstration is fine." Zhou Congwen said, "Generally, everyone will cooperate with the boss's operation, as long as what you say makes sense."

Liu Wei felt that he was not far away from being scolded, and he even faintly heard scolding from the roving nurse in the 912 operating room.

"Don't be afraid, really don't be afraid." Zhou Congwen understood what Liu Wei was thinking, and comforted him.

"At this time, the director of the anesthesiology department...cough cough cough."

"what happened?"

"The carina of the child's trachea is connected to the distal end of the esophagus. Even if the intubation is guided by a bronchofiberscope, even if the director of the 912 Anesthesiology Department performs the operation himself, it is difficult to successfully insert the left main bronchus beyond the fistula at one time."

"..."

Liu Wei looked at Zhou Congwen with a mournful face.

He knew very well what the face of the director of the anesthesiology department would look like in such a situation—it must be terribly ugly!

And at that time, I was an outsider standing beside him, still some kind of anesthesia nurse, and I didn't scold myself for scolding anyone.

Liu Wei has passed the technical level, and because of this, he knows how difficult the operation is from Zhou Congwen's description.

Before the operation started, the anesthesia alone gave me a splitting headache.

How bad-tempered the head of the anesthesiology department of 912 would be at that time... Liu Wei has already seen his own tragic future.

It's not easy to be called a dog.

"You have to be smart. Remember the steps I said before. Otherwise, Director Zou will start swearing, and the boss won't be able to intercede. And the boss didn't have time at that time, we were brushing our hands." Zhou Congwen later confirmed Liu Wei's intention guess.

"I...I...try my best." Liu Wei stammered.

"It is possible that the oxygen saturation in the patient's blood will continue to drop during intubation, leading to the anesthesia risk of hypoxemia."

"In such a situation, Director Zou of the Anesthesiology Department will definitely go berserk."

"At this time, what you have to do is to assist Director Zou of the Department of Anesthesiology to ventilate both lungs first, and after confirming the success of intubation of both lungs, perform left lung ventilation with the guidance of fiberoptic bronchoscope.

When guiding the bronchoscope, you first fix the catheter with your hands to prevent the catheter from protruding. Anesthetist Zou stands on the pedal and prepares the bronchoscope.

You assist Director Zou to insert the bronchoscope into the endotracheal tube. You should pay more attention during the process of inserting the bronchoscope into the tube, and keep the tube fixed by hand to prevent it from falling out.

After the bronchoscope was successfully inserted into the catheter, Director Zou of the Department of Anesthesiology guided the catheter into the left main bronchus through the bronchoscope. "

Zhou Congwen said a lot, and Liu Wei's eyes kept wandering, and he had already outlined the scene at that time.

Then Zhou Congwen talked a lot more, gesticulating while speaking, simulating the operation at that time.

Fortunately, Liu Wei is the best anesthesiologist in the Third Hospital, and he can do many operations.

Another person has never even seen a fiberoptic bronchoscope, let alone assisted.

Zhou Congwen had a lot to say. It took four and a half hours from Jianghai City to the provincial capital airport. He talked all the way. He drank two bottles of Wahaha purified water, but he still didn't finish.

Liu Wei was not dizzy from what Zhou Congwen said, he had already brought himself in, as if he was standing in the 912 emergency room, with the chief anesthesiologist doing intubation beside him.

Various details came one after another, and Liu Wei tried his best to remember them all.