Back in 2002 as a doctor

Page 200

"Isn't it okay to put it all at the end?" Chen Houkun asked.

"I was planning to put it all at the end to avoid disinfection, but our hospital's infectious disease department didn't know what was wrong, so we insisted that we divide it into two operating rooms, with cleaning and ultraviolet disinfection for an hour in between."

"Who have you offended? This is to trip up your thoracic surgery department on purpose." Chen Houkun didn't care too much, and asked with a laugh.

"I've offended so many people that I don't even know who they are." Zhou Congwen didn't care too much. It would be better if similar things could be separated from the Yin and Yang worlds earlier. There are fewer emergency operations now, and there will be more adjustments in the future.

Instead of being in a hurry, it's better to let the little doctor below get acquainted with it now.

"Xiao Zhou, be careful." Chen Houkun warned, "People's hearts are sinister."

"I know." Zhou Congwen said.

"People's hearts are more sinister than you think, and it has nothing to do with ability." Chen Houkun said, "I have a classmate in Didu, and now he is a member of the health care team."

"sharp."

"Yes, I also think it is very good. But last year at our classmate reunion, he even said that he is still not a doctoral supervisor, and he is a little bit worse every year when he evaluates the supervisor." (Note)

Zhou Congwen frowned, and instantly thought of who Chen Houkun was talking about.

"Although the third courtyard is small, but according to that sentence, the little demon in the temple is strong, and there are more than eight kings in Chiqian."

"Yes, Brother Chen, I will be more careful."

When I came to the hospital, I saw the patient at the bedside, and after watching the first one, I sent it directly to the operating room.

Li Qinghua wrote out the order of picking up and dropping off the patients and handed them over to Shen Lang and Li Ran, and he emphasized countless times that he had to do three checks and seven pairs when picking up the patients.

Zhou Congwen estimated that something serious happened to the People's Hospital, which caused Li Qinghua to have a psychological shadow.

Similar things include patients being sent to the wrong ward, doctors taking the wrong film, and so on.

The left breast was supposed to be opened, but in fact the right breast was opened.

Once this kind of thing happens, no matter who is on the operating table, he will be dumbfounded.

Therefore, the more experienced the doctor, the more cautious he is, for fear that the operation will be performed quickly, and only after the operation is completed will he find out that he has done something wrong.

This is a very serious medical malpractice. Zhou Congwen has also heard of a bad case where appendicitis was opened in the wrong place, and the surgeon emptied his intestines to find the appendix.

Therefore, there is no problem with being cautious before the operation, and it should be done.

Although the operation of thoracoscopic pulmonary nodules is simple, even Li Ran, who has just come to the thoracic department, has seen it well, but there are too many things involved before and after the operation, and accidents will happen if one is not taken care of.

The last time Chen Houkun came for surgery, something happened.

Before the operation, in front of the patient's family members, he was told not to eat or drink the next morning.It was well said, and the patient's children were also there, so everything was safe.

But Chen Houkun came to see the patient early in the morning and asked casually, and the patient actually drank porridge early in the morning.

No way, the operation had to be cancelled.

Later, after Li Qinghua discussed with the head nurse, he simply changed the preoperative education to not allow anything to be eaten or drunk.

In short, there are too many strange things encountered in clinical practice. Whether it is doctors, nurses, patients, and family members of patients, they may make mistakes anytime and anywhere.

Halfway through the first operation, the doctor in charge stepped onto the stage to replace Li Qinghua.He and Zhou Congwen went to Yangjian to prescribe another patient, and then as long as Chen Houkun stepped down and changed his hands to shoot in another surgery room, it would be fine.

Everyone is familiar with the similar operation sequence and cooperate tacitly.

Today's operation is a bit slow, because although the two patients in Yangjian are both positive for hepatitis B, they still need to be disinfected.

The third hospital is not a laminar flow operating room. After cleaning up, it needs to be disinfected by ultraviolet light, and the speed is slower.

At [-]:[-] noon, Chen Houkun shot and destroyed the small pulmonary nodules of the last patient.

After another six operations, Li Qinghua had a smile in his eyes.

"Mr. Chen, do you want to drink mutton soup later?" Li Qinghua asked.

Chen Houkun likes mutton soup, it is simple and worry-free, and he never goes to any high-end restaurants. Li Qinghua especially likes Chen Houkun.

"Well, I'll go back after eating casually." Chen Houkun held the wedge-shaped lung lobe in his hand, felt the location of the small pulmonary nodules, and made sure for the last time.

The anesthesiologist happily gave the medicine to wake him up, when suddenly there were hurried footsteps in the corridor.

"Director Li, there is a pregnant woman next door. The child has already given birth, and the blood oxygen saturation suddenly drops. It happens that you are here, could you please take a look?" An anesthesiologist came in and said humbly.

"Low oxygen saturation? Did you have cardiopulmonary disease before the operation?"

"No, the mother was in good health before the operation. She only had gestational diabetes, which was well controlled with insulin. I don't know why she was fine on stage, but suddenly she pulled a small flag."

Zhou Congwen frowned slightly, "Director, I'll take a look."

……

……

Note: the real thing.

Chapter 0347 The blame?

In the next operating room was a pregnant woman who had a cesarean section, and she had just heard the clear and loud cries of the child when she was born.

Of all the departments, only the obstetrics and gynecology department is the most festive, but if something happens in the obstetrics department, it will be a big event like the sky falling.

The parturient was healthy in the past, but myocardial infarction occurred during caesarean section?Zhou Congwen already had an idea.

"Ding dong~"

The system task came immediately, and Zhou Congwen was more convinced by that guy who never forgot to squeeze the wool.

As far as Zhou Congwen is concerned, he would rather systematically promulgate a long-term main task for himself, such as [historical transcendence], the task of the Thoracic Surgery Department of the Third Hospital surpassing the Thoracic Surgery Department of the People's Hospital.

There are many rewards and it is not difficult to do it.

But after the rebirth of the system and itself, it seems that AI is not enough. It only knows how to pick up some scattered small wool, and it can't perceive the big wool at all.

Alas, Zhou Congwen sighed, and walked quickly to the surgery room next to him.

"The blood oxygen saturation of the parturient is low. It's an anesthesia problem. Let the anesthesiology department take a good look at the machine. Xiao Zhou even wants to join in this kind of excitement?" Chen Houkun stared at the TV screen, looking at the blood in the rinsed saline. No fresh blood.

"If you want to watch Congwen, go watch it. I guess it's not just to watch the excitement." Although Li Qinghua couldn't figure out what Zhou Congwen was doing, he said empathetically, "A lot of times Congwen has to look back to understand what Zhou Congwen does."

Chen Houkun nodded and continued to perform the operation. He just said what he just said casually, without thinking at all.

All his attention was on the operation. As for what Zhou Congwen was going to do, Chen Houkun just asked casually.

……

……

When Zhou Congwen came to the next-door operating room, the monitor was beeping, not very sharply.

The maternal blood oxygen saturation is 82%, which is very low.Zhou Congwen squinted his eyes and scanned the ECG monitoring, and finally walked to the head anesthesia cart for the parturient, and picked up the medical records and anesthesia sheet.

The patient was a 36-year-old female, 36 weeks pregnant, G2P1, who underwent labor induction due to suspected abnormal placenta.Had a history of bariatric surgery; had a history of gestational diabetes mellitus and was treated with insulin; no other cardiovascular risk factors.

The medical records are clearly written, and there are no serious past diseases.

Zhou Congwen continued to quickly review the medical records and anesthesia sheets. This operation was a cesarean section, and the patient underwent spinal anesthesia. There were no complications during the operation.

Ten minutes after the operation began, the fetus was delivered smoothly, and the patient's cardiovascular system responded well without abnormalities.

After delivery of the placenta, carbetocin 30 μg was administered intravenously.

5 minutes earlier, the patient had developed bradycardia and hypotension while complaining of severe headache, substernal crushing pain, and a feeling of near-death.

The next anesthesiologist didn't write, probably because he didn't have time to participate in the rescue.

"What medicine did you use?" Zhou Congwen asked the anesthesiologist without auscultation or physical examination.

"Atropine 0.5mg, ephedrine 9mg and midazolam 2mg intravenously."

"I suspect the myocardial infarction caused by oxytocin, prepare..." Zhou Congwen didn't finish his words, and the alarm sound of the ECG monitoring suddenly became sharp.

"Zhou Congwen, it's enough for the thoracic surgeon to take care of your own illness. Why did the blood oxygen saturation drop?"

"The anesthesiology department asked you for a consultation, not pointing fingers at me and teaching me how to do things. Who are you, you said it was a problem with oxytocin in front of me?"

"Do you know the ingredients and dosage of the medicine? Nonsense, go back! Tell your director to come here!"

The middle-aged woman standing in the operator's position on the operating table reprimanded very dissatisfied.

She is Lei Chunyu, the director of obstetrics.

Director Lei immediately became upset when he heard that the new responsible doctor from the Chest Department came in and put the blame on himself.

"Xiao Zhou." The anesthesiologist saw that Director Lei was very upset. He moved his feet slightly, moved to Zhou Congwen's side and pulled his isolation suit pants to remind Zhou Congwen not to have a dispute with Director Lei.

But Zhou Congwen didn't seem to feel any abnormality. Whether it was the scolding from the director of obstetrics or the kind reminder from the anesthetist, his eyes were always on the ECG monitor.

Just now the patient's ECG was a bit messy, but there was no major problem, just sinus bradycardia.

But now the electrocardiogram has become abnormal, from sinus bradycardia to supraventricular tachycardia, the alarm sound of the monitor is shrill, and the back of the listener feels cold.

"Prepare norepinephrine." Zhou Congwen said coldly.

"Zhou Congwen, I'm warning you!" The director of the obstetrics department screamed like a cat whose tail has been stepped on, "This is my operation, get the fuck out of here, don't tell me what to do, let your director come here! "

"Xiao Zhou, wait a moment." The anesthesiologist said in a low voice as his hands became numb looking at the messy electrocardiogram.

Immediately, the anesthetist ran out quickly, and ran back in only a dozen seconds.

Liu Wei followed behind him, turning his head slightly to listen to what the anesthetist said just now.

Since the operation of thoracic surgery has started, although it is a qualitative change for the third hospital, the specific quantity is not high.

Who is Liu Wei?The first anesthesiologist in the Third Hospital to learn single-chamber ventilation!He has a clever mind and saw the future of thoracic surgery early on.

His qualifications are old, he has a faint sign of a deputy director, and he has high prestige among anesthesiologists, so the emergency anesthesiologist can't solve the problem and goes to the next door to pull Liu Wei over.

"Supraventricular tachycardia?" Liu Wei glanced at the ECG monitor, "Call the director!"

"it is good."

"Zhou, what do you think?" Liu Wei came over and asked.

"Prepare norepinephrine, now." Zhou Congwen said.

"Liu Wei!" Director Lei screamed, "I want you anesthetists to look at the narcotic drugs, you..."

"Director Lei, I'm working on it. I need your permission to prescribe the medicine? Why don't you go to heaven then!"

Liu Wei seemed to have a good temper, but the supraventricular tachycardia on the ECG monitoring seemed to be "contagious" to him, so he took Director Lei's words back without hesitation.

"..." Director Lei was speechless.

"Norepinephrine, what else?" Liu Wei immediately asked his assistant to prepare the medicine.

"Oxygen mask, 40% oxygen, ready for cardiopulmonary resuscitation." Zhou Congwen said.

"..." Liu Wei was also stunned. He knew that the patient's condition had some problems, but could he perform cardiopulmonary resuscitation?It doesn't seem to be.

Even though I think so, I still have to listen to Zhou Congwen's words. The last person who fought against Zhou Congwen in everything has already gone to the outpatient clinic, counting the registered tickets every day.

"This is my operation. Your chest department sent a bullshit doctor over here and said it was a problem with oxytocin. The director is dead..."

Director Lei's scolding hadn't finished yet, when he saw Liu Wei rushing to the patient's side with a "swoosh", and a footstool appeared under him.

She was startled for a moment, but immediately saw that Liu Wei had started to perform chest compressions.

The QRS-T wave on the patient's electrocardiogram disappeared completely.

Chapter 0348 Repeater

Director Lei doesn't know how to read the ECG.

Of course, I can read the simple ones, but the heart is extremely complicated, no one in the third courtyard dares to say that they can read them except for those from the circulatory department.

The patient's supraventricular tachycardia was messy just now, but now it is much more regular.

It's just... Although it can't be said to be a complete straight line, the normal QRS-T wave pattern on the electrocardiogram disappeared completely...

Director Lei's mind went blank instantly, and the patient's heartbeat really stopped!

Just now the monitor alarmed, she was not afraid, and saw several patients with intraoperative supraventricular tachycardia every year.

Under normal circumstances, similar patients do not need any treatment, and they will recover on their own within ten to twenty minutes.

Director Lei didn't know the specific reason at all. For her, these belonged to clinical experience.

However, Director Lei understood what the disappearance of QRS-T wave meant. It was written in the textbook, and the waveform was also very simple - ventricular fibrillation, one foot of the patient had already entered the gate of death.