Chapter 1914 The Thickness of Blood Vessels

Many diseases are like deaf and mute marriages, especially some traumas. It is equivalent to a group of people carrying the bride, spreading her legs, and sending her directly into the bridal chamber. As for the next step, it depends on whether the groom has seen the world. Wrong way.

Hospitals below level 3 are like a young man who gets excited for a long time when he sees a male and female donkey fighting. Such hospitals have the right to refuse this disease. After all, there is a difference between using live ammunition and watching pornographic films.

As for tertiary hospitals, especially key tertiary hospitals in a province, no matter what you encounter today, you can hardly open your mouth and say, it’s too big to handle.

 Trauma surgeries, most life-threatening trauma surgeries, are like this. After being sent in, the doctor’s ability is directly linked to the patient’s life.

This kind of moment is a matter of fighting to the death, both for patients and doctors.

  Sometimes there is no time for anesthesia, let alone various related examinations. The disease at this time is like a man showing his hairy legs, pointing at the hair on his legs and asking strangers to guess his name. It is really embarrassing.

For example, during this operation in the middle of the night, Ma Yichen could only judge the possible injured organs from the entrance of the meat stick. But he couldn't figure out which one it was. Sometimes this kind of guess that could not be accurately judged was actually not much different from not knowing anything.

　　Just like guessing the father of the child through the belly, this person only knows that the woman is pregnant, and the rest is entirely up to God.

“Raise the indoor temperature, transfuse blood, and increase the amount of crystalloids.”

Zhang Fan glanced at the anesthesia while giving oral medical orders to the tour.

The director of the anesthesiology department nodded to Zhang Fan. If there is any department in the hospital that has the most cost-effective improvement, then it must be the anesthesiology department in the operating room.

 In other departments, if they want to improve a little bit, they have to spend real money on it. Some departments, such as obstetrics and gynecology, even lie down and ask for money. As for the anesthesiology department, due to the increasing number of surgeries in the hospital and the cooperation with experts from all over the country, the style of surgeons from the north and south can now be handled by the Anesthesiology Department.

 Lower blood pressure and heart rate, and then Zhang Fan started the operation.

Gauze filling is very simple. Make a piece of gauze into a ball, find the place where blood bubbles appear, and stuff it down. It is just like a girl stuffing something into her underwear. They are all spherical objects.

 When it is desirable, it is different.

 This thing stuffed into underwear will be slowly taken out when someone is gentle, and it will be pulled out immediately when someone is rough. During the operation, this thing should be taken out while pressing, and the two hands should alternate with each other.

 This is to prevent bleeding.

"Fishing line! Double line!" The equipment nurse quickly pulled out two silk threads, and the needle holder clicked to lock one end of the silk thread. With a snap, the needle holder was placed in Zhang Fan's hand.

Fishing line is not really a silk thread for fishing, but one end is long and the other end is bitten with a needle holder. This is to facilitate knotting inside the abdominal cavity.

Then, Zhang Fan stretched out a finger along the gap in the gauze and inserted it into the warm gauze soaked in blood.

Then, use force again to let your fingers pass through the gauze layer, and then close your eyes. This time, it is not about entering the system, but relying on the feeling transmitted by the fingertips.

 The sensitivity of a surgeon's fingers is generally not reflected, and some doctors may not use it in their lifetime, but top doctors may often encounter operations that require sensitivity.

Of course, the hand care of top surgeons is not as perverted as that of a piano player. In most cases, this can be used as an excuse not to wash the pot.

 The pulp of his **** slowly moved toward the hepatic portal vein, and Zhang Fan felt the direction of blood flow.

If it is bleeding from the hepatic portal vein, you can feel an oncoming blow from this direction when your fingertips are in the gauze group, just like the feeling of being peed on your hand, with impact, and the temperature is slightly higher than the gauze.

This kind of judgment must be accurate and cannot be specious. If you say something like hepatic portal vein rupture, the assistant on the operating table will throw down the surgical forceps and strike for you.

In this kind of surgery, the surgeon can hardly say suspicious words, otherwise the assistant will not know whether he should cooperate next. If the surgeon cannot make a judgment, he will ask a superior doctor to help make a judgment.

After Zhang Fan put his fingers in, it only took about ten seconds for him to close his eyes and open them. Men are naturally more curious about things with holes. When he was young, he put his fingers into the cracks of the earth wall and let the earth scorpions bite him. There are many boys.

However, relying on the sensitivity of the fingertips, it is estimated that even a craftsman may not be able to do it well, and it has to be done in a short time and in a hurry. Therefore, if you want to surpass most doctors in this thing, medical treatment, you really have no talent. No.

“Not on the hepatic portal vein!” After Zhang Fan finished speaking, he immediately said, “Inferior vena cava.”

Ma Yichen was stunned. This thing had pierced a thicker blood vessel.

This method of judgment is unconventional. According to the conventional method of judgment, that is, the method of ordinary doctors is: first ligate the blood vessels around the liver portal, and then make a comparison to see if the bleeding volume is reduced, and then move it Move the liver to see if the bleeding will worsen. The only advantage of this method is that it is easy, and any general surgeon who can perform ligation can make the judgment.

There are of course many shortcomings. A slower doctor may bleed and bleed before the ligation is completed.

 Furthermore, rupture of large veins and arteries is extremely prone to air embolism, with a mortality rate of over 90%.

 When many people go to get an intravenous drip, the nurse will take the medicine and squirt it into the ground to expel air. Of course, this amount of air does not reach the amount of embolism. A few small bubbles enter the blood vessels, and the blood can directly dissolve the air.

However, it is also to prevent accidents, so sometimes, it is okay if a few air bubbles enter the blood vessels during the intravenous drip. You don’t have to hold the nurse like an eagle catching a chicken, pinching the neck of others and insisting on giving them. You **** it out.

 But the big blood vessels are different. This kind of embolism is no different from fat embolism. It enters the heart, myocardial infarction, the brain, cerebral infarction, and the lungs. Therefore, when he heard that it was the inferior vena cava, Ma Yichen felt that it was over and he was going to be on the stage today.

 “Extend the incision!” Zhang Fan’s tone began to become more serious.

  The scalpel is extended directly along the incision in the middle of the abdomen, upwards, and directly to the chest. The patient on the operating table feels like a new pig in a butcher's shop, almost being split in half.

 “Don’t touch the liver, lots of gauze, hurry!”

 The gauze in the hospital is actually placed in a pot before entering the operating room.

 It is just like the old-fashioned large aluminum pot for steaming steamed buns at home. It is estimated that no one younger than me has ever seen this kind of pot.

 Because it requires high-pressure sterilization, the gauze is put into a pot for high-pressure sterilization. If it is not used within 12 hours, or cannot be used up, regardless of whether it has been opened or not, it must be high-pressure sterilized again when it is used again.

 So, sometimes many people think that dressing in the hospital is no different from dressing at home.

Why don't you just apply some iodine and cover it with some gauze? A skilled person can do it more beautifully than a rough doctor.

 In fact, no, with only sterile conditions, it is impossible to achieve the same level of treatment at home as in the hospital.

 After all, no one is rich enough to buy a big pot and boil gauze under high pressure just for a wound.

Three circulating nurses held the pot, like waiters serving food in a restaurant, opening the lid one after another, and then poured the gauze on the instrument table.

It was too late to use oval forceps.

Zhang Fan pressed the liver with his hands and kept stuffing it with gauze.

  Pressing the liver is to prevent someone from trying to open the liver to find the bleeding point. This is quick, but if the liver is opened, a large amount of air may enter the inferior cavity muscles, and then the bleeding point will be found and the patient will be killed directly.

 “Cut the whole stem blood flow?”

Ma Yichen asked. He already had a needle holder and suture in his hand.

"No, it's too late. Zhang Yuan, we need a blood transfusion. The hematology department only prepared 5000cc of type B blood tonight." Director Huang of the anesthesiology department directly interrupted Ma Yichen's question.

This kind of suturing must first cut off all the channels of the liver, from top to bottom, from the upper cavity to the lower cavity, and from the lower intestine to the intestine. After blocking, the liver is then opened and sutured under direct vision.

 Suturing small blood vessels and suturing large blood vessels are two different things.

 Small blood vessels, especially those without names, are often ligated with a few needles.

 The so-called blood vessels with names are probably blood vessels that are about as thick as an oil pen refill.

In terms of thickness, this is a way to express the importance of the blood vessel system. Just like men, they are afraid of being called thin dogs by others, especially women, because if they are too thin, they will be abandoned.

 As for the large blood vessels, they need to be sutured in three layers.

 When Zhang Fan heard this, he didn’t have enough blood.

 “Go and ask the Tea Center Blood Bank.”

Before the roving nurse picked up the phone, she heard Old Chen outside the door, using the intercom to ask the roving nurse, "When you have time, please tell Zhang Yuan that Ms. Zeng has already gone to the hospital with several bosses from the High-tech Zone. .

They fully support it, providing money, people, and medicines. "

“Organize blood donation in their high-tech zone.” Zhang Fan was stunned for a moment, then said quickly, he was really dozing off and hit the pillow.

 In big cities, central blood banks often store more blood than key hospitals, but this is not the case in small cities, especially in Qiansu. The development of Tea Su Hospital not only killed a group of certain hospitals, but also the epidemic prevention station and other tertiary hospitals were swallowed up. As for the blood bank, it was not to mention.

 The people working in the blood bank now have no one to invite them to dinner.

 Among all medical units, in terms of leisure and reputation, the Central Blood Bank can definitely be ranked among the top three.

 Especially some directors of blood banks, they have hardly eaten at home because there are too many people using blood and not everyone has a blood donation certificate within three days. At this time...

Ms. Zeng’s words to Zhang Fan were quite polite, as if she was advancing and retreating together with Zhang Fan and the others.

 But outside the operating room, I almost pointed at my nose and cursed at a leader who couldn't raise his hand during a gastrointestinal meeting.

"Our employees were beaten to critical illness for no reason. Do we, the investors, still dare to invest? How did you guarantee it in the first place? Leaders, please be careful and create something good for us." environment!”

 The leader’s face was ashen, one side was angry, the other side was also angry, he was so bullying.

 (End of this chapter)