When doctors have a simulated operating room
Chapter 142
The wound was so severe that the patient was lying on the ground.
"Hiss!"
Huang Lei groaned.
Other doctors and nurses looked at him.
Only then did they realize that the boy was too excited while doing the debridement, and accidentally scratched his left index finger!
Zhang Yi's first reaction was...
Oh no, this guy is not exposed to occupational factors!
(Occupational exposure refers to exposure to risk factors due to occupational relationships, thereby endangering one's health.
The most common occupational exposure in hospitals is that medical staff come into contact with the blood of patients with infectious sources when rescuing patients, which may also cause them to be infected.
There is also radiation exposure, such as doctors in the imaging department, who work in the radiology room all year round and will also affect their own health.)
Of course, as long as the young man in front of him does not have an infectious disease, it is not considered occupational exposure.
"Whether this person has an infectious disease or not, you should wash it first."
Zhang Yi said hurriedly.
The results of the patient's infectious disease test have not come out yet.
The first thing to do after occupational exposure is to go to the running faucet and rinse repeatedly with soap.
The blood should also be squeezed from the proximal end to the distal end.
Let the blood drain out as quickly as possible.
Be prepared for the worst.
Huang Lei also understood and immediately took off his gloves and started to rinse.
Zhang Yi continued to clean a large area.
Huang Lei went on strike, so Zhang Yi had to do the next operation himself.
After rinsing for more than ten minutes, Huang Lei returned to the radio and said with a sad face:
"The wound is not deep but there is still some blood. Ouch! I hope this person doesn't have any infectious diseases!"
Otherwise, I would be in big trouble!
Zhang Yi looked at the patient in front of him and could only say:
"I hope so, but you should not operate on the wound yet. Wrap it with gauze first."
Aside, the nurse also brought a gauze over, disinfected Huang Lei and then wrapped it around his index finger.
With Huang Lei's operation, Zhang Yi did not dare to let him operate on the wound again, lest there be any accidents.
Two hours later, Zhang Yi completed the debridement by himself.
In the eyes of the admiring people around him, the patient's leg was saved.
It's just that a lot of skin area is missing, so this can only wait for the second skin graft.
The nurse in the operating room said to Zhang Yi gratefully:
"Fortunately, you are the surgeon, Assistant Zhang. It's only three o'clock after the operation. I can still take a nap."
"Okay, hurry up and pack up and send the patient to the general surgery department, and then you should rest. You've worked hard in the middle of the night."
Everyone nodded: "Okay, Assistant Zhang~"
Only Huang Lei looked worried.
He had been praying silently in his heart, hoping that it would not be a job exposure!
Huang Lei sighed to the sky, if he had known, he would not rush to show off in front of Zhang Yi...
Now think about it, how could he possibly show off more than Zhang Yi? !
Now it's good, I can only hope that the laboratory department will get the results as soon as possible.
I hope this guy is not sick!
After the operation, I went downstairs and looked at the time. It was almost 3:30 in the morning.
In a few hours, I will go to work again.
Zhang Yi was too lazy to go back to the dormitory and slept directly in the duty room.
The next morning.
Seeing Zhang Yi coming out of the duty room, Lu Jing was still very surprised and asked:
"Zhang Yi? Were you on duty yesterday?"
"No, another patient with fasciitis came in the middle of the night yesterday, and Huang Lei asked me to come and help."
Lu Jing nodded:
"Then you must not have rested well? How about you sleep a little longer?"
Zhang Yi waved his hand: "No, 7-8 hours of sleep is enough."
The two walked into the office side by side.
Suddenly, Huang Lei's wailing sounded:
"Oh my god! It's actually AIDS!!"
Zhang Yi walked quickly to Huang Lei's side after hearing this.
Huang Lei was holding the infectious disease checklist of the young man yesterday.
(Infectious diseases are a must-check item for every patient admitted to the hospital)
All five items of HBV hepatitis B were negative.
(All negatives mean that there is no virus in the body and no hepatitis B vaccine; if the column of 'hepatitis B surface antibody' is positive, it means that the vaccine has been given, or the hepatitis B has been contracted, but the body has cleared the virus and produced antibodies. Any of these two situations on the test sheet is fine.)
HCV hepatitis C antibody, negative.
TP syphilis helix antibody, negative.
HIV human immunodeficiency virus antibody, positive.
A big '+' sign appeared after HIV.
Zhang Yi was shocked. No wonder he felt that the blood of this young man named Wei Dian was a little different from others.
Same!
So there really is a problem? !
At this time, almost all the people who were going to work in the morning in the department were here.
When they heard that Huang Lei was exposed by his occupation, they immediately showed a horrified expression.
"Fuck! So unlucky?!"
"Did you wash it at that time? Go and wash it again quickly."
Lv Jing also walked closer to take a look.
It's really HIV positive!
He hurriedly said: "Hurry up and call the hospital infection department and ask them to get blocking drugs."
After occupational exposure to AIDS, the first thing to do is to clean and disinfect the wound, and then take blocking drugs within 24 hours.
Tenofovir, emtricitabine, raltegravir or dolutegravir are used in combination.
The sooner you take the medicine, the better.
The effect of blocking drugs is still very good. As long as you take the medicine in time, you will hardly be infected.
And occupational exposure is also graded.
The wound like Huang Lei's is not very deep, it only scratches the subcutaneous part, and the amount of bleeding is not much.
It is considered a secondary exposure.
It is also necessary to check whether the patient's viral load is high.
If the viral load is low and the blocking drug is taken in time, it is basically not infected.
If the viral load is high, as long as the blocking drug is taken in time, the chance of infection is also extremely small.
However, during the medication period, the infected person will be under great psychological pressure.
They will be anxious and afraid of being infected every day.
It affects the mood.
Soon, Zhang Yi called the general surgery inpatient department upstairs and said that the patient Wei Dian was an HIV carrier.
The people upstairs also understood, and immediately re-tested the blood and did a viral load test.
In less than half an hour, the hospital infection department came to the emergency room with medicine.
Huang Lei saw the medicine as if he saw a life-saving straw.
He quickly swallowed it.
"Oh... so unlucky!" After taking the medicine, Huang Lei collapsed in a chair in shock.
Something happened in the department, and Lu Jing also went to the operating room to watch the surveillance.
After reading it, Lu Jing returned to the emergency room with a bad expression and said:
"Except for the emergency room and the emergency clinic, everyone else should come to a meeting."
At the command, everyone else did it obediently.
Including Huang Lei, who worked the night shift yesterday and has not finished get off work at this time.
In the office.
Lu Jing glanced at Huang Lei and said:
"I watched the video of the operation last night. To be honest, as a chief physician, Huang Lei, your operation was indeed sloppy.
No one wants to be exposed to occupational exposure, especially HIV.
But I still want to use this incident to remind everyone.
In the future, any operation must be careful and slow!
Especially in emergency operations and we don't know whether the patient is carrying an infectious virus.
We should be more careful and cautious.
This is to protect ourselves!
Doctors are also considered half high-risk professions and often come into contact with these viruses and infectious sources.
Can't we be steady and slow?
Not everyone is Zhang Yi, who is fast and steady.
If we can't do it, don't learn from him. Just be steady.
If we operate step by step and slowly, won't the operation be successful?"
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