Sleepless Doctor

"Don't worry, take your time. Director Peng, half of what I said just now, please tell me about today's surgery." Wu Mian said.

"Teacher Wu, this is a film of the cervical spine. Give me a palm." Director Peng took out the phone, found the prepared picture, and gave the phone to Wu Mian.

With four cervical spine radiographs and cervical spine CT, Wu Mian looked at the imaging data and said, "You continue."

"The patient has undergone two block anesthesia in a few months. The first and second planetary ganglion block has no abnormalities. This is the third operation." Director Peng continued, "The operation was fairly smooth. After the bolus injection, the patient complained of hand numbness, dizziness and discomfort. Then..."

"Director Peng, talk about the process of your drug introduction in detail." Wu Mian said, watching the film carefully.

"The patient is in a supine position with a thin pillow under the shoulder. I stand on the affected side of the patient and use the fingertips of my left **** to press against the upper edge of the sternoclavicular joint. The sternocleidomastoid muscle and its deep common carotid sheath are pushed outward."

"Press down with your fingertips to touch the transverse process of the seventh cervical vertebra, hold a 3.5cm-long No. 7 puncture needle in your right hand, pierce the skin vertically along the fingertips of your left middle finger, and insert the needle until you reach the bone, which is the transverse process of the seventh cervical vertebra. Needle, no blood and no cerebrospinal fluid were drawn back, and 10 mL of diluted lidocaine was injected."

Director Peng could almost memorize the whole process.

Now repeat the narrative again, thinking carefully that there is no problem with the operation process, and every step is clear and plain.

Not everyone can reach Wanchang old drivers.

This is called stellate ganglion block anesthesia, and the time is relatively short, and Peng Peng can do nearly 10,000 cases. If the surgery is changed, many doctors can do thousands of cases in a lifetime.

There will definitely be no problems with the process just described!

During the whole process, only a small amount of fresh blood was drawn in the first and second withdrawals. It seemed something was wrong.

At that time, it sucked back and there was a small amount of fresh blood in the syringe. He thought it was a capillary rupture, which should have nothing to do with the vertebral artery. So Director Peng didn't care, and tried to explain the whole process clearly and concisely.

"What are the complications of stellate ganglion block?" Wu Mian asked.

"Local anesthetic poisoning; total spinal anesthesia; recurrent laryngeal nerve block; phrenic nerve block or spasm; hemorrhage and hematoma formation; and then there is complicated pneumothorax."

"Well, it's almost like this." Wu Mian nodded.

"Professor Wu……"

“Needle strayed into the vertebral artery and total spinal anesthesia are both dangerous. Both will cause heartbeat and respiratory arrest. However, the puncture of the arachnoid membrane is caused by the puncture of the arachnoid and the drug solution strays into the subarachnoid space. The main feature is the rapid after injection. Development of extensive sensory and motor nerve block."

"Director Peng, I want to ask you something." Wu Mian put down Peng Peng's cell phone, looked at him seriously, and said, "Since you know these complications, why don't you have a ventilator in the clinic?"

"..." Peng Peng wanted to say something, but his lips moved slightly, and finally he swallowed everything back.

"Patients with severe complications will have symptoms of hypotension and bradycardia, and sometimes respiratory arrest. The patient who just had a planetary ganglion block injection immediately experienced hand numbness, dizziness and discomfort, and gradually had difficulty breathing for 5 minutes. After that, breathing stopped, loss of consciousness, blood pressure, and heart rate dropped significantly."

"Normally, this is something to be expected, just the probability. In this case, you must immediately intubate the trachea. You may say that the ventilator is too expensive and the hospital does not provide it." Wu Mian smiled, Tap the fingers of the right hand on the table lightly, "But if something happens, do you think the dean in charge will think it's his own mistake?"

"..." Peng Peng was sweating coldly.

At first he thought that Teacher Wu was just a kind of academic doctor. Most of the doctors who came back from studying abroad were academics, thinking that the machine was not good enough, and constantly complaining that even the head nurse would have to take care of things like wearing a glove.

But the following words prove that Mr. Wu is well-versed in clinical tricks.

"Maybe the hospital leader who rejected your request at that time has retired. Even if you are not retiring, what evidence do you have? Do you apply for a report? It's strange that the hospital leader can take care of you." Wu Mian said with a smile, "Domestic hospital leaders are good at It is to toss small things into big things, and there are not many leaders who can make things easier."

Speaking of this, not only Peng Peng, but also Zhang Zimo and Director Qian have a confidant feeling. Mr. Wu is really a clinician and knows that clinical work is difficult to do.

"But!" Wu Mian raised the volume slightly, and the force of his right hand finger on the desktop was also a little bit stronger at the same time.

"The work is not meticulous, this is your problem. If you don't have a ventilator, you can intubate first. If you don't have a tracheal intubation, you can use an airbag first. You don't have anything to prepare. Your feelings are luck?"

Wu Mian looked at Peng Peng jokingly and stared at each other. Director Peng immediately lowered his head and didn't dare to look at Wu Mian's eyes~www.wuxiaspot.com~ Nothing happened, that was lucky. If something happens, the entire business may be delayed. "Wu Mian smiled, and his tone was not as harsh as during the video-guided rescue. "Many years ago, when painless gastrointestinal endoscopy was first carried out in some cities, it was because of insufficient preparations that the patient died. "

This... is true, not to mention many cities, even the branches of the Provincial Medical University.

The profession of a doctor is different from other professions. It is particularly prone to various problems when accumulating experience. The big deal in other industries is economic loss, while the price in the medical industry is human lives.

It cannot be expected that everyone's level is as standard as a machine, reaching the world's top level. In that case, the world is no longer what it is.

But Wu Mian's cognition is that any operation must be cautious, cautious, cautious, cautious, cautious, cautious. Even if you have obsessive-compulsive disorder, you can't be too careful, and no preparation is unnecessary.

Peng Peng, a veteran driver like tens of thousands, can't avoid mistakes, so what about others?

However, if you do not develop new technologies for fear of complications, it is a passive sabotage, and residents within the radiation area of ​​the hospital will have to pay even greater intangible costs for this.

"Teacher Wu, you are right." Director Peng lowered his head, and said with some frustration.

"Haha." Wu Mian smiled, "I just say a few more words. I have one more question. I want to ask Director Peng you."

"..."

Peng Peng's heels were cool.

Unlike the criticisms made by the leaders of the academy, those are laymen who guide the experts and will only oppress others.

Teacher Wu, this is another situation. He said that he is more expert in stellate ganglion block anesthesia than his own veteran driver of Wanchang.

Peng Peng was really afraid of Teacher Wu Mianwu and slapped the table and scolded him, and it was not surprising that he even smeared the coffee cup in front of him on his face.