When doctors have a simulated operating room
Chapter 14
The doctor said that the operation was a big success.
"Zhang Yi, do you want to learn in this operation?"
"Me?"
Zhang Yi turned around and found that it was Deputy Director Li Yan.
"Yes, if you want to go, I will arrange for you to go. It just so happens that you young doctors also need this opportunity to learn."
"Okay, I'll go! Thank you, Director Li!" Zhang Yi nodded gratefully.
Although he can perform surgery every day in the simulated operating room, Zhang Yi is still eager to perform a real operation once.
After a while, Zhang Yi appeared in the little girl's operating room.
Of course, as a young doctor, he is definitely not qualified to operate, and he is not even qualified to be an assistant.
Only after Li Yan said hello did Jiao Yong allow an intern who had just been admitted to the hospital to enter his operating room.
"What's your name?" Jiao Yong looked at Zhang Yi and asked.
"Hello, Teacher Jiao, my name is Zhang Yi."
Jiao Yong asked expressionlessly: "You are an intern who has just been admitted to the hospital, right? Which departments have you interned in before? Have you ever been to the operating room?"
"Um... I have been to general surgery, neurosurgery, neurosurgery, ICU, and the operating room more than a dozen times in total."
Zhang Yi didn't know why he asked this, so he could only answer truthfully.
The next second, Jiao Yong looked at Zhang Yi very seriously, and there was a little disdain in his eyes?
"Listen carefully, the operations in our cardiac surgery department are different from those in other departments. I never let useless interns enter my operating room. If Director Li hadn't spoken for you, I would have kicked you out right now."
"But since you're here, you have to follow the rules. In my operating room, inexperienced interns and resident doctors can only watch from the side. Remember not to touch any surgical instruments. Do you understand?"
Zhang Yi was slightly upset by Jiao Yong's contemptuous tone.
Still can't touch surgical instruments? !
I can control the entire operation by myself in the simulated operating room, can you?
Thinking of this, Zhang Yi stood far away. He wanted to see what level this doctor who had worked in cardiac surgery for ten years was.
"I know."
After that, Jiao Yong didn't give Zhang Yi a look, but prepared to start the operation.
The anesthesiologist had already given the anesthesia, and the little girl was sleeping soundly now, not feeling any pain at all.
"Report TPRBP and time."
"Okay, T36.3℃, P112 times/min, R22 times/min, BP114/80mmhg, SPO2 95%, time 10:32 am."
"Pay attention to blood oxygen saturation at any time and report in time."
"Okay."
"The operation begins!"
Because the girl's heart showed enlargement of both the atrium and ventricle.
Considering that it is difficult to clearly see the entire surgical field with minimally invasive surgery, a thoracotomy was chosen.
The median sternotomy incision, considering the child's young age and the need for postoperative aesthetic effects, Jiao Yong controlled the incision diameter to within five centimeters.
"Forceps, pull the pleura and subcutaneous tissue apart to prepare for cutting the sternum."
After cutting the sternum, the position of the entire heart is exposed.
Suspend the aorta, pulmonary artery, superior and inferior vena cava, insert the catheter of the extracorporeal circulation machine, and establish extracorporeal circulation.
Put a certain amount of condensate around the heart to protect the heart.
"How is the circulation?" Jiao Yong looked at the anesthesiologist and asked.
"No problem, all vital signs are normal."
After the establishment of the extracorporeal circulation machine, it means that the human heart temporarily stops working. The normal operation of the extracorporeal circulation machine must be ensured before the next operation can be carried out.
Zhang Yi watched Jiao Yong's every step from the side.
Not bad, as expected of an old cardiologist who has worked for ten years, the operation still looks very stable.
But the next second, when Jiao Yong was holding a scalpel and preparing to cut open the pericardium between the atrium and the ventricle, a stream of blood spurted out instantly!
The blood splashed on Jiao Yong's goggles and mask, and even the surgical gown on his chest was stained with a little.
"What's going on? Why is the pericardial pressure so high?!" Jiao Yong's tone was a little panic.
Not only that, the anesthesiologist also brought bad news!
"Doctor Jiao, blood pressure and heart rate are dropping! The drop is very sudden!"
Jiao Yong looked embarrassed: "Oh no, this child has high pericardial pressure and can't withstand the pressure difference of the extracorporeal circulation machine in a short time!"
"Ah? Then... what should I do?" The assistant on the side asked worriedly.
"Hurry up and remove the extracorporeal circulation machine! Xiao Li, you come and suture the chest cavity. I'll call Director Wang and ask him to come over and take a look. I'll go out and talk to my family.
"Explain it to the subordinate."
Jiao Yong thought for a moment and made a decision. For now, he could only suspend the operation.
Everyone has different physiques and different tolerances.
Especially since the girl had congenital heart disease, Jiao Yong did not dare to do the operation rashly.
If something went wrong, it would be a life!
So he decided to find the head of cardiac surgery, Director Wang Mingjun, to make the final decision.
Jiao Yong walked out of the operating room, and the other two cardiac surgery assistants continued to deal with the follow-up matters.
Zhang Yi walked to the operating table and saw that the blood flow path of the girl's whole body was fine.
The high pressure difference is because too much blood has accumulated in the right atrium. , suddenly releasing the pressure will cause the entire heart to suddenly lose pressure.
But...
It's not that there is no chance at all!
Use pressor drugs to stabilize blood pressure, complete valve replacement and suture the pericardium in just five minutes, then this operation can be successful!
Because Zhang Yi also experienced the same situation in the simulated operating room last night!
After being fined one thousand yuan, Zhang Yi finally completed the operation.
What Zhang Yi didn't expect was that after practicing last night, he would actually encounter this situation today!
I don't know if it's a coincidence? !
"Alas, it's a pity for this little girl. I don't know if the knife on her chest today was in vain?" The assistant said helplessly.
"Wait! Don't rush to turn off the extracorporeal circulation machine!" Zhang Yi walked to the assistant and reminded him.
In the operating room, an anesthesiologist, two nurses and two assistants all cast puzzled eyes.
"Who are you? Do you have the right to speak here?"
"That's right, you are an intern, don't talk nonsense! "
Several people ignored Zhang Yi's existence.
Who would listen to an intern who had just transferred to regular training?
"Use 1 mg of epinephrine intravenously! After that, I will complete the valve replacement within five minutes!"
Faced with Zhang Yi speaking again, the other people turned their heads and looked at Zhang Yi like a fool.
What's wrong with this person?
Is he crazy?
Does he not know that he is a white-timer who knows nothing?
Does he think his opinion can really save this little girl?
Seeing that others did not respond, Zhang Yi had to do it himself!
He picked up the emergency medicine beside him, drew out the empty needle, and injected it into the needle tube of the indwelling needle.
"Alas! You can't do this!" The nurse on the side reacted and hurriedly stopped it.
But the drug has entered the girl's body and started to work!
The girl's blood pressure began to rise!
"Oh, you can't do it without authorization! Who will be responsible if something goes wrong!" An assistant shouted hurriedly.
"Don't worry, I will be responsible if something goes wrong! "Zhang Yi said as he picked up the scalpel.
"You...!"
Just when everyone was about to pull Zhang Yi away, Zhang Yi started the operation.
The quick, accurate and steady operation method made several assistants and nurses around him stunned on the spot!
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