"You might not know about ophthalmology, but I've had a cholecystectomy before, right?" Su Yun's eyes were fixed on the ECG monitor. He moved a footstool to the patient's left and chatted with Chief Yu.
"Uh, gallbladder reflex?" Director Yu asked.
"Yeah, what's the scariest thing about cholecystectomy? Choledochotomy was serious, but it was not as serious as choledochocardial reflex. Just like the oculocardiac reflex, during biliary tract surgery, gallbladder involvement or exploration of the biliary tract will cause the heart rate to slow down and blood pressure to drop. In severe cases, reflex coronary artery spasm may lead to myocardial ischemia, arrhythmia, or even cardiac arrest.
"Especially when rescuing patients with hemorrhagic shock, the probability is increasing exponentially."
Chief Yu was still alright. After all, he was the Chief Resident of the 912. However, Gu Xiaoran's heart was pounding as she listened.
He had already started performing related surgeries in the hospital in his hometown.
The hospital where Gu Xiaoran lived was relatively small, and the division of departments was not as detailed. The director had a connection with Zhou Chunyong, so Gu Xiaoran seized an opportunity that no one was willing to come to and came to Imperial Capital.
Gu Xiaoran's life had changed tremendously during this trip to the Imperial Capital. Every day, he experienced new changes. For example … today.
When he thought about what he usually told the patient's family members before performing cholecystectomy, he realized that he did not have a gallbladder reflex at all, and he did not even know what a gallbladder reflex was.
Not to mention Gu Xiaoran, even their director probably didn't know. The probability of this happening was extremely low. There might not even be one in a thousand surgeries, let alone a rookie like Gu Xiaoran.
"Brother Yun, what do we do after it appears?" Gu Xiaoran asked softly.
"Save him. Can you just watch the patient die?" Su Yun said disdainfully, "If you're not sure, call the best doctor in your hospital over. Call whoever is the best. Of course, as long as you don't cry on the operating table, it's fine. If you pollute the area, it won't be enough to cause trouble. "
Su Yun even joked with Gu Xiaoran.
"Hehe." Gu Xiaoran smiled, but his smile was even stiffer than President Yu's.
"Xiao Ran, right?" President Yu said, "Gallbladder reflex is really rare. Urinary retention in the bladder involving the vagus nerve is even rarer. Otherwise, why did Boss Zheng always feel that something was wrong before the operation, but he couldn't remember what it was? "
Gu Xiaoran glanced at Boss Zheng and saw that he was sitting in the corner of the operating theater. His eyes seemed to be staring at the ECG monitor like Brother Yun.
Boss Zheng was still worried about the patient. A strange feeling rose in Gu Xiaoran's heart. Usually, he always heard Boss Zheng talk about rich clinical experience … What was rich clinical experience? That was it.
Although Boss Zheng did not discover it at the earliest moment, he stepped forward at the first moment and presided over the successful rescue. The patient should be fine.
With that in mind, Gu Xiaoran took another look at the patient.
He opened his eyes in a daze, as if he had just fallen asleep and did not know what had happened.
"The probability is different. There is a 90% probability of the occurrence of the cardio-eye reflex during ophthalmology surgery, but the probability of the bladder triggering the cardio-eye reflex is too low," Su Yun said.
"Uh … I remember now. There was a surgery. After the laparotomy, I saw the patient's appendix." Chief Yu had already finished the fistula. He also instructed the circulating nurse to discharge the urine in the bladder in two to three times. "When I pulled the retractor, as long as I exerted force, the patient's heart rate would change. At that time, I thought it was fun."
"That was caused by the reflex. The vagus nerve reflex of the gastrointestinal tract is also very rare, and after it happens, I don't know what's going on." Su Yun stood on the footstool and said as he looked at the ECG monitor from a bird's eye view.
"More or less. At that time, I didn't have experience. Brother Yun, it should be fine this time, right? "
"It should be fine." Su Yun glanced at his boss and saw that he was sitting steadily on the stool. Although he did not say a word, even if he was sitting there, he gave people a very secure feeling in their hearts.
As long as this guy was there, there would definitely be nothing wrong. Su Yun's heart gradually accepted this reality.
Was it really because of his rich clinical experience? Or was this guy born with a keen sense of smell, like Hei Zi?
Su Yun glanced at his boss and pondered in his heart.
Before this accident, he did not seem to know what would happen. It was just that the moment the heart stopped, he began to preside over the rescue. Sigh, why was the boss so willing to steal the limelight? Su Yun sighed deeply in his heart.
"It's not uncommon for a full bladder to cause a cardiac arrest," Zheng Ren suddenly said.
"Huh?"
"But generally speaking, they would not think that it was caused by a full bladder," Zheng Ren continued. "In the morning, they held their urine and suddenly emptied it, causing their entire body to fall in the bathroom. Such cases are common, but they are usually sent to the Department of Circulatory Medicine for treatment. "
"…" Chief Yu was stunned for a moment.
"When the hollow organs receive dilation stimulation, it can pass through the celiac plexus or vagus nerve afferent center, excitedly conducting to the low-level parasympathetic center in the medulla oblongata, the dorsal vagus nucleus, releasing impulses and then through the parasympathetic fibers in the left vagus nerve to the heart," Zheng Ren said. "It's a very clear reflex arc."
"Uh …" Gu Xiaoran suddenly let out a startled sound and then said, "Boss Zheng, our old chief once had a sudden heart attack during surgery! Now that I think about it, it might be because he was holding back his urine. "
"Huh? What happened after that? "
"Heart attack."
"Was he saved?" Zheng Ren asked.
"Oh, it was in the operating room after all. He was saved," Gu Xiaoran said. "While doing thrombolysis, we contacted the city hospital and sent the first-aid ambulance to send the stent."
"You can't even get the stent down?" Su Yun asked.
"Yes." Gu Xiaoran nodded. "I accompanied him. The city doctor said he was almost there. Fortunately, it was in the operating room. At that time, I felt quite lucky. Now that I think about it, it might be because he was holding back his urine. "
"Boss, do you think this is considered a work injury?"
"Have you ever heard of a work injury in the hospital?" Zheng Ren asked, which was rare.
Gu Xiaoran saw that he was not finished and quickly changed the topic. He quickly asked, "Boss Zheng, the vagus nerve is excited, and then?"
"The result of excitation of the vagus nerve is coronary vasospasm, decreased sinoatrial node excitability, decreased conduction speed of the specific conduction system, decreased myocardial contractility, decreased cardiac output, decreased blood pressure, and even cardiac arrest," Zheng Ren said.
"That's amazing," Gu Xiaoran whispered.
"It's not amazing. I never thought about it before." Zheng Ren sighed and said, "Now that I have experience, it will be better in the future. Su Yun, you're right. "
"What do you mean I'm right?" Su Yun glanced at Zheng Ren and asked.
"Clinical experience is accumulated bit by bit. That Korean professor is a hooligan," Zheng Ren said seriously.
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