Ling Ran scrubbed his hands seriously.
It took time to scrub his hands, because it took time for the soap to kill all the germs. Although the patient in the operating theater was quite urgent, Ling Ran was not in a hurry since his assistants were in charge.
The doctors in Huo Congjun's group were still wandering around the crush injury patient. Lu Wenbin, Yu Yuan, and Zuo Cidian from Ling Treatment Group got the chance, but they were a little helpless in the operating theater.
In other treatment groups, there would be one or two senior attending physicians or associate chief physicians under the chief physicians or chief physicians who were in charge. For a low-ranking resident doctor like Lu Wenbin, he could not stand in the position of chief surgeon except for work such as removing foreign objects and fish bones.
Of course, Lu Wenbin could not be considered a chief surgeon now. He was just standing in the position of chief surgeon.
"What should we do?" Lu Wenbin asked Yu Yuan, who was beside him.
Yu Yuan did not stand in the position of chief surgeon, and she pouted unhappily. "If you don't know what to do, why did you run up so quickly?"
"Didn't I see you turn around and go to the back?" Lu Wenbin felt wronged.
Yu Yuan's face turned green. "I went to get the stepping stool!"
Lu Wenbin's mouth twitched a few times. He was too embarrassed to laugh out loud, so he forced himself to say, "This kind of thing needs to be prepared in advance. Besides, you can't move it yourself, you have to ask others for help."
Yu Yuan stared at Lu Wenbin, and her face was full of 'Are you serious?' Expression. She then said, "If I put two stepping stool at the chief surgeon's position in advance, how can Doctor Ling use it? If I don't find the stepping stool myself, how can I ask someone to move it? "
"Yu Yuan, you're very thoughtful." Zuo Cidian could not listen to her anymore. If he continued to listen, he would laugh out loud.
Lu Wenbin chuckled, lowered his head, and said, "Let's talk about the surgery first …"
Yu Yuan obviously did not want to continue this topic. She snorted a few times and said, "It's not our turn to perform the surgery. Now, let's check the surgery preparations. First, the full set of CPR, defibrillator, ventilator, tracheotomy kit …"
Yu Yuan had been a chief resident for more than a month, and her aura was completely different. Most importantly, she was much more confident.
It was just like a student who stayed in school every day, studying for more than ten hours every day, and only went home for a week or two to take a shower. Two months later, there would definitely be shocking changes — at the very least, he would know where his limits were, which questions he could challenge, and which questions he could not …
It was the same for Yu Yuan.
She had never been good at surgery. Before this, she always felt that she just didn't get the chance …
After she became a chief resident, Yu Yuan gradually understood that she was really not good at surgeries!
However, not being good at surgeries did not mean that Yu Yuan was not good at surgeries, and it did not mean that she could not develop in the field of medicine either. After being a chief resident for a long time, Yu Yuan understood this problem.
She was the chief resident in the emergency department, and most of the patients she encountered did not require surgery. Even if they needed surgery, there were very few who required surgery in the operating theater.
For these patients, Yu Yuan could always transfer them to doctors who were good at surgery, or she could call doctors from other departments for consultation …
Therefore, Yu Yuan saw her limits, and she also saw her strengths …
She seriously completed the preoperative examination, paid attention to the patient's vital signs at all times, and frequently ordered the use of drugs.
Other than not opening the abdominal cavity, Yu Yuan did everything that she could …
Ling Ran walked into the operating theater.
He first looked at the monitor, and then asked Su Jiafu, who was beside him, "How's the patient's condition?"
"It's still stable, but there's a lot of blood loss. Look at the drainage bag below, it's almost full." Su Jiafu was a little overwhelmed. For anesthetists, it was very difficult to maintain stability for such a patient.
"This means that there's still active bleeding control in the abdominal cavity." Ling Ran turned around and asked, "Has the patient's family signed the informed consent form?"
"I'll make the call." The circulating nurse immediately went to make the call.
At this moment, Huo Congjun had just waited for the patient's parents' Volkswagen Jetta.
Ling Ran nodded silently, and with the help of the circulating nurse, he put on his surgical gown and gloves.
When he turned around, Ling Ran looked at the monitor and the patient again, and he fell into deep thought.
In terms of work in the Emergency Department, Ling Ran could be said to be at ease.
Indeed, he was still not very good at some surgical methods and treatment plans. However, after staying in the Emergency Department for a year, Ling Ran had mastered enough skills. In addition to the gifts from the system, he had also learned a lot during his long career in surgery.
Even so, the patient in front of him could be said to be beyond cure.
* Ring, ring, ring. *
The phone in the operating theater rang.
The circulating nurse quickly picked up the phone from the wall. A few seconds later, she said loudly, "The patient's family has signed."
"Laparotomy." Ling Ran extended his hand without hesitation.
The scrub nurse for this surgery was still the nurse he was most familiar with, Wang Jia. Ling Ran did not need to shout out the specific name of the instrument, and Wang Jia handed it to Ling Ran.
Ling Ran only used a few seconds to open the patient's abdomen.
The moment the abdominal cavity was opened, the patient's blood mixed with blood clots flowed all over the operating table.
"This … there's too much blood." Lu Wenbin was a little stunned on the spot.
Yu Yuan's experience as a chief resident came into play a little. "Should we aspirate? Doctor Ling? "
Ling Ran shook his head gently and said, "Remove the gauze first, then ask for blood."
"Yes." When the circulating nurse heard about her own matter, she immediately went to make a phone call.
"Forceps." Ling Ran began to bend over and take out the gauze.
One piece, two pieces, three pieces …
"The abdominal cavity is full of gauze …" Zuo Cidian was the one who operated the retractor. He saw everything clearly, and he was speechless.
"Packing to stop the bleeding, but the liver has ruptured. No matter how much gauze is stuffed in, it's useless." Ling Ran explained the situation of the surgery, and he was also teaching them on the spot.
When all the gauze was taken out, the patient's blood loss naturally increased.
Su Jiafu was shocked when he saw this. He stomped on the ground and rode the chair to the pressurized and heated blood transfusion device. He quickly adjusted the parameters.
He also stuffed all the blood transfusion bags that came along with it into the bag.
In some small hospitals that did not have the necessary conditions, it was common to see medical staff holding blood bags or squeezing blood bags with their hands. Blood products were stored at low temperatures, and the patient's body temperature was a major issue related to the survival rate. When it came to the time of emergency blood transfusion, medical staff could only use their body temperature to heat up the blood bags and squeeze them with their hands to pressurize the blood bags so that they could transfuse blood with a suitable temperature to the patient as soon as possible.
Similar photos were often labeled with heart-warming names, and some people who did not know the truth would go viral.
However, the reality was that the speed of body temperature heating was very slow, and it could only alleviate emergency situations. In the end, most of the blood that was transfused into the patient's body was still too cold. Not only was the speed of hand squeezing blood bags not ideal, but the blood cells and platelets were also largely destroyed, and the quality of the blood was greatly reduced (Note 1).
Top hospitals like Yun Hua Hospital began to use pressurized and heated blood transfusion devices more than ten years ago. It could not only ensure the quality of the blood, but also reduce the workload of doctors.
Most importantly, different plans would have a great impact on the patient.
Moreover, the chief surgeon could also save his energy when he was at the operating table and focus his attention on more important aspects.
Ling Ran stared at the bleeding point and slowly extended his left hand. He gently pressed down on the blood vessels that entered the liver and gently clamped them with the vascular forceps.
Almost at the same time, Huo Congjun rushed outside the operating theater and shouted through the door, "I'm going to wash my hands now. How's the situation?"
"I want to cut off the patient's right lobe of the liver," Ling Ran also answered loudly.
Huo Congjun could not see the situation in the operating theater. He could only lower his head and brush his hands desperately.
…..
[Application of Pressurized Blood Transfusion Bags in Surgical Rescue] (Practical Nursing Journal, Volume 13, Number 12, Issue 156, 1997) [Dalian Third People's Hospital, Cui Wen, Sun Dongqing, Fan Hongwei]
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