medical simulator

Now that his relatives were injured, it must be a very important relative who was injured. He came here in the name of his family members!

Zhou Cheng is also a doctor, and if they are all colleagues, Zhe Ben has not lost the principle of empathy. This doctor hopes to help if he can.

All people are not limited to doctors. After taking off the white coat and occupational factors, only the human attribute remains. No matter how many additional attributes or occupations, he is only a doctor after all. And that's all.

……

Finally, with the help of kind people, Zhou Cheng wandered into the operating room.

After carefully reading the films, Zhou Cheng spent a long time before he found a first-line hope and solution to the problem, knowing that this time is no longer an opportunity to hide his clumsiness.

So after seeing that you understood, Zhou Chengcheng said abruptly, "Teachers, I have an idea. I don't know if it is possible."

Almost no one paid attention to it, and everyone looked at Zhou Cheng's age as if it was a joke, so they ignored it even more.

Zhou Chengcheng continued.

"Teachers, you can see that the most important diagnosis room for patients is shock. The reason for pigs to cause shock is in the patient's active bleeding points, and most of these bleeding points are gathered near the limbs!"

"Although the internal organs have liver contusion and spleen rupture, as long as the spleen is removed or sutured according to the situation, the amount of bleeding will not be much. The hematoma in the brain can also be cleaned up."

Zhou Cheng was tentatively asking for opinions and giving his own perfect solution.As for whether it can be adopted, that is the opinion of others.

Therefore, for the best curative effect and the safest measures, Zhou Cheng didn't hold much back.

"Then can we embolize his bilateral brachial and femoral arteries first?"

"You also know that there is a certain life window for muscle ischemia and necrosis in the limbs. Our body, in order to ensure the blood supply to the body, often shunts the blood."

As soon as Zhou Chengbu said this, several people turned their heads one after another.

It's just that they looked at Zhou Cheng with the same kind of eyes, guessing whether Zhou Cheng was a student or a newborn calf who was not afraid of taking care of him, and he still had some brain problems.

The bleeding here has not been resolved, you blocked the human aorta? ? ?

Then the blood clots and the limbs are amputated?

I'm going to amputate now, isn't it delicious?

Several doubtful eyes swept over Zhou Cheng, and after finally confirming that Zhou Cheng is a child with no hair, one of the hot-tempered professors immediately cursed: "Young people should not think that they are powerful, they should read more books and less Speaking, not to mention whether the embolism can stop the bleeding, if there is no arterial blood flowing out, how will the venous blood return?"

"Just leave but not return?"

"Look carefully, don't get in the way."

These words were originally intended to persuade Zhou Cheng not to push him any more, to delay other people's thinking about the overall condition and how to solve it.

But Zhou Cheng didn't blame them, he knew that their choice was better based on conventional thinking.

"No matter the upper arm, the femoral artery and the venous fistula will be used for external circulation. After the splenectomy or suturing, the blood flow in the upper and lower limbs will be restored, and the small arteries and branch arteries will be embolized from the femoral artery to stop the bleeding." Since Zhou Cheng proposed this plan, Of course there are alternatives.

It's just that the alternative plan depends on the idea. If you think there is an idea, you can naturally be desperate.

Everyone has their own independence, but they all have their own choices!This is permitted by law, so Zhou Cheng can only express his own opinion:

As for the few people with hot tempers, they turned their heads one after another, and the person who spoke before became even more angry, and said, "What's your name? Which department?"

"Who is the director of your ward?" The other party was quite cautious, hoping to find out the root of Lu Cheng.

"Teacher, hello, I'm Zhou Cheng, but I'm not from our hospital. I'm from the Affiliated Hospital of Shonan University. I came here after receiving Luo Yun's order." Zhou Cheng knew that if he wanted to take To get permission for surgery, you must first report yourself immediately.

Because there is not much time.

Although he temporarily blocked the large blood vessels of the limbs, this caused more blood vessels to produce complex diseases.

However, treating a disease with a disease is not necessarily a solution.The unimportant blood vessels are blocked to reduce temporary bleeding!

This is also one of the ideas.

However, Zhou Cheng's answer made a group of associate professors and professors standing on the operating table in a dazed state. All these people looked at Zhou Cheng with serious eyes.

What the hell is this?

Are you just a student at the Second Affiliated Hospital of Shonan University?

Then you dare to speak nonsense here?

Even if your student is humble.

Just to increase the bargaining chip, Zhou Cheng could only say: "If you don't believe me, professors, you can call Professor Xue Xiude from the Ninth Academy of Shanghai."

Zhou Cheng spoke very formally.

It's not that I don't believe it!

It's just that the plan proposed by Zhou Cheng is too bold, because if this one is not good, there is a possibility of amputation or even loss of life.

After embolization of the large arteries, it will not only slow down the blood flow in the large blood vessels, but also slow down the blood flow in the whole blood vessels!

Such a process is to cause the whole process of embolism, what should be done at that time?

Can only be amputation or waiting to die!

How does this differ from the current situation?

So a few thoughtless people asked: "You say that, when the time comes, the blood vessels of the extremities will be embolized all the way, how to deal with it? Or amputation?"

This is considered very polite, and the degree of transformation into a Yin-Yang master is considered light.

This is like an emergency patient, whether the left leg or the right leg is amputated is the same, it is undoubtedly just taking off his pants and farting.

"It's not impossible. Although the blood supply to the extremities is reduced, and it may induce multiple blood clots, in this way, the patient's life can be saved in a short period of time!"

"It can buy us more time!" Zhou Cheng knew very well that the more critical the time, the less reckless he should be, and the more careful he should be.

when no one answered.

Zhou Cheng added at the time: "It's fine to take it out after the whole process of thrombus, but it's much more troublesome if you want to replant the amputated limb."

It's not that Zhou Cheng doesn't know how to replant a broken limb, or the technique of transplanting a broken limb, but a task that can be done with a dollar's worth of money, why do he have to take two weeks to solve it?

"You don't need amputation if you say you don't need amputation? Can you call the blood vessel and it will open?" Maybe it's because Zhou Cheng's previous mention at least provided a solution.

The professor who answered Zhou Cheng's question was a bit rushed when he spoke!

But it's just a bit offensive, not to the extent of yin and yang.

"Teacher, if the blood vessel is blocked. But we can take the healthy side blood vessel. Even if the thrombus occurs, we can still treat it with anticoagulant drugs." Zhou Cheng still replied calmly and seriously.

The more anxious you are, the less you can get angry.

"Did you take it?" One of the professors lost his temper when he saw a young man like Zhou Cheng?

I saw that I had never experienced beatings from society, so I hurriedly said.

"How about not being cured? How can you afford such a doom?"

If Zhou Cheng's opinion is adopted, and there is no prospective research or theory and big bosses to support it, then other people beating Zhou Cheng is beating a child.

This is a very real world, and there is no need to talk about it when people leave the tea.

People sigh long before the tea is cold.

Zhou Cheng nodded: "Well, I'll take it."

Hearing Zhou Cheng's words, some professors felt that Zhou Cheng was a little clueless, and were about to start scolding, but the professor of vascular surgery suddenly came to his senses, and he immediately asked, "What did you say is your name?"

"Zhou Cheng." Zhou Cheng replied, not disgusted.

"Is that Zhou Cheng?" A professor of vascular surgery suddenly changed his expression slightly, and even changed the subject.

"Don't have the same first and last name."

"If there is no other one, it will be me. Teacher, I sincerely hope that you can consider my suggestion. There is still time! If there is any further delay and the amount of bleeding continues to increase, even if the blood transfusion continues, it will be at the expense of saving the patient's life." Words may not help." At this time, Zhou Cheng once again brought out a pleading tone, please, promise me quickly, okay?

This is not something that can be done.

Until now, Zhou Cheng has discovered the biggest drawback, that is, when he said something, a lot of people interrupted, and only a very small number of people would support it. This is still a lack of level and support.

If Zhou Cheng was a professor-level task, it would be completely different.

The words of a professor, the words of an attending physician, and the words of a general hospitalist are very clear.

However, no one refused Zhou Cheng's words, and the professor of vascular surgery who had answered the question immediately said, "I think we can temporarily listen to Xiao Zhou's suggestion, this Xiao Zhou is still very interesting in terms of thrombectomy. I know and understand him!"

"Where are the other professors?" The professor of vascular surgery actually agreed with Zhou Cheng's idea at once.

This remark shocked everyone, and after looking at each other, they said, "Since Professor Fang has said so, then we also agree with Professor Fang's idea."

The person who can make Professor Fang change like this is definitely not an ordinary person, at least not an ordinary attending in the department, at least an associate professor of vascular surgery!

Chapter 4 Multi-disciplinary and multi-skilled!

Professor Fang Jingsheng's words made the other professors drop their jaws in shock!

Although they didn't speak, they all looked at Fang Jingsheng, the vascular surgeon, with questioning eyes. The meaning contained in those small eyes seemed to be saying, big brother?

Are you serious?Do you really want to call so many of us, and just listen to such a kid with no hair yet?

Can you be responsible?

"I also believe in Xiao Zhou." One of them, who looked young and wore thick glasses, said suddenly.

"This person should be Zhou Cheng and Xiao Zhou who had stayed in the Ninth Hospital of Shanghai for a while. It's hard to say about other fields, but in orthopedics, he is indeed a very good teacher."

"Director Tong of our department has many words of praise for him!"

"Professor Fang, Professor Du! Professor Ni!" Although Zhou Cheng didn't know the person who spoke, he knew the others.

Tong Dawei, as the director of the Trauma Surgery Department, they were all at the professor level during the emergency surgery and had the most contact with them.

As long as Fu Youhan has a bit of a brain, he won't pull the banner of Tong Dawei's reputation for Zhou Cheng!

"Professor Ni, you can open the abdomen directly. Professor Du, you continue to deal with the intracranial hematoma. After I embolize the artery, I will open an arteriovenous fistula and restore the external circulation. In this way, the amount of bleeding in the limbs will be reduced. Even if it disappears, the blood pressure should go up." Fang Jingsheng also said with certainty.

When Zhou Cheng was in Shanghai No. [-] Hospital, he had also been exposed to vascular surgery, so he was very confident in Zhou Cheng's thrombus removal.Now that Zhou Cheng is here, the whole embolism after the embolism is not so scary!

Being able to save one's life, and perhaps one or two limbs in the end, is already an excellent result!

What are you still struggling with?

The patient is about to die, emergency and emergency, life-saving is the most important thing!

Where is there so much time to make choices and hesitate?

If it's an elective surgery, what if we gossip together for three days and three nights?

This is an emergency operation, and 3 minutes is enough to kill, making the difference between life and death.

"Okay!" Since Fang Jingsheng knew Zhou Cheng, he also recognized Zhou Cheng!In addition, people in orthopedics also have a certain understanding of him.

It proves that this young man really has something!

Now that I can't think of a better way in a short period of time, I can only bite the bullet and treat the dead horse as a living horse doctor.

It's just that after hearing Zhou Cheng's words, the professor of the anesthesiology department stopped playing with everyone——

"No? Professor Fang, I didn't mean to disturb and interrupt you? It's just that you clinically blocked the arteries of all four limbs? How can I monitor blood pressure?"

Are you still playing?

The anesthesiology department should not interfere with clinical treatment options. That’s right, and I didn’t push too much, but I want to monitor and monitor the whole process, and adjust the patient’s vital signs at any time. If you don’t show me the patient’s blood pressure, I will play with you. A chicken feather?

I don't know anything about his death.

In the operating room, the surgeon only treats the disease, and it is the anesthesiologist who really hangs the patient's life.Do you really think highly of me?

"Professor Chu, let's monitor CVP directly! I'll prescribe it to you!" Fang Jingsheng said.

Central venous pressure (CVP) is the pressure at the place where the superior and inferior vena cava enter the right atrium. It is measured through the superior and inferior vena cava or the right atrium built-in catheter. It reflects the right atrial pressure and is one of the main indicators for clinical observation of hemodynamics. .It is more suitable for the monitoring of critically ill patients than the pressure measured from the limbs.

Indications for CVP detection: 1. Critically ill patients with severe trauma, various types of shock, and acute circulatory failure. 2. All kinds of major and medium operations, especially major operations on cardiovascular, brain and abdomen.

Fang Jingsheng is from the Department of Vascular Surgery. It is not difficult for him to place the monitor himself.

Professor Chu from the Department of Anesthesiology heard this, what else could he say?

I can only nod and say yes!

This is a better monitoring standard.

It's just that if he is not allowed to monitor his blood pressure, then he wants to run away on the spot.Damn, I'm going to be anesthetized, and you won't let me monitor my blood pressure, how can I play with you?

Being able to monitor CVP is naturally more standard and more reassuring.

Then, the operation started step by step.