What did you say? "Chang Yue asked in surprise.
"Uh …" Lao He scratched his head. He knew that Chang Yue did not perform surgeries and was only responsible for writing medical records. "During the appendicitis surgery, the epidural catheter broke during continuous epidural anesthesia. It's said that it should be about six centimeters inside."
Zheng Ren was about to speak when he suddenly heard a "ding dong ~" sound.
This sound had not been heard for a long time. Ever since he won the Nobel Prize, the System had not issued any more missions. Zheng Ren could only rely on the continuous mission [The Best Surgeon] to obtain insignificant skill points and experience points.
[Urgent Mission: One in a Million.
Mission Content: Remove one broken epidural catheter.
Mission Reward: System data calculation. Different methods of removal will give different rewards.
Mission Time: 24 hours.]
Zheng Ren really cursed the System in his heart. The mission reward was still being calculated, and it was already issued? This was a little too careless.
Moreover, the focus was on the six words "different methods of removal".
Originally, Zheng Ren's first thought was to remove the broken epidural catheter through surgery. However, after seeing the six words, Zheng Ren hesitated for a moment. Since the System had given him a hint, it was not impossible to try the interventional surgery method.
Zheng Ren entered the System's operating theater without hesitation and clicked on the purchase of surgical training. The System's operating theater rose from the ground, and he strode in. To be honest, Zheng Ren was also a little interested in anesthesia. After experiencing such a thing, if he encountered it, he would not be so numb.
"Anesthesia catheter? It can even break like this? Is it made of paper? "Chang Yue was particularly surprised.
Not only ordinary people, but for an internist, it was unimaginable for the catheter of epidural anesthesia to break.
What exactly was it? Why was it so weak! It was simply too magical.
"Little Chang, the situation of this catheter breaking is not particularly rare …" Lao He hesitated for a moment, but in the end, he still told the truth. "According to domestic statistics, the incidence rate is 0.06% to 0.2%, and the incidence rate abroad is 0.0017% to 0.04%."
"Why is there such a big difference?" Chang Yue asked in surprise.
"Look at your ignorant face," Su Yun said disdainfully. It was as if he had forgotten that he had just drunk so much that he was carried home. "Different materials and different ways of avoiding certain positions during anesthesia will cause similar things."
"Yes, I heard about it from someone else recently. The trainee pulled out the tube and didn't use the right strength, so the catheter broke inside. "Lao He said seriously," If we look into it carefully, there are many possibilities. "
As he spoke, he put down his phone and started to count with his fingers.
"The causes of epidural catheter rupture during surgical anesthesia are complicated. Most of them are related to the anesthesiologist's operation, pathological or physiological changes at the puncture site, and catheter factors."
"For example, the main cause of catheter rupture during catheter insertion is due to catheter insertion being too deep.
It's possible for it to fracture. "
As he spoke, he pressed his left thumb down with his right hand, indicating that this was the first possibility.
"Also, when the catheter was placed, the anesthetist panicked a little when he encountered resistance. He used too much force, withdrew the catheter, and adjusted the catheter. However, the Tuohy needle did not move with the catheter during the operation, causing the angle to distort and the catheter to break."
With that said, the second finger pressed down.
Su Yun suddenly said, "Brother Yang, do you know why the boss and I have been praising you?"
Professor Yang was speechless. Everything could really be linked to him. Speaking of which, it seemed like he was right to use Unparalleled the other day … Hopefully, he would be able to use Unparalleled anytime and anywhere in the future.
"Yes, what Professor Yang did that day was right. Whether it's surgery or anesthesia, it's really not suitable to use violence," Lao He said. "Also, the position of the Tuohy needle in the epidural space is inappropriate, and the catheter is located between the needle tip and the bone surface, or stuck in the intervertebral joint or bone seam. This requires a lot of experience in anesthesia, and it's also a place where it's easier to make mistakes. "
The third finger pressed down.
"The cause of catheter rupture during catheter removal is related to excessive force when the catheter is removed and repeated attempts to pull out the catheter that has been knotted or entangled with the surrounding tissue."
"Other than that, the patient's own spinal stenosis, bone hyperplasia, pregnancy, connective tissue hyperplasia in the epidural space, changes in body position, and other pathological and physiological factors are also important reasons for the rupture of the epidural catheter during the insertion or extraction process."
"The medical supplies are also related," Zheng Ren suddenly said.
"Are you sure? The probability of it happening in China is much higher than abroad. The quality of the medical supplies is one of the reasons," Su Yun said.
"The material and model of the epidural catheter … I remember that there are literature reports that nylon or polyurethane catheters are stronger than Teflon or polyethylene catheters, and the 19G catheter has a tendency to break at a fixed position near the tip." After Zheng Ren finished speaking, he wiped his mouth and looked at Lao He.
Lao He immediately became serious.
Boss Zheng's meaning was very clear. However, Lao He felt that he could not guess. It was better to listen to Boss Zheng's opinion.
"Lao He, what does that mean?" Zheng Ren asked.
"I saw the WeChat message. The person who had the accident was the director of the anesthesiology department in the lower city and county. From the content, it should be a group message," Lao He said. "He did not raise his head to greet him, nor did he finish thanking him. I reckon that the other side is already confused and does not know how to deal with it."
With just one sentence and one question, Lao He could see many things.
"What does he mean?" Zheng Ren asked.
"Boss Zheng, take a look at WeChat." Lao He held his phone, bent down, and jogged to Zheng Ren's side.
[Have you encountered a rupture of the epidural catheter? Other than being conservative, what other solution is there?]
It was a very simple message. The person who sent the message was really confused. He did not even have the most basic thank you.
It looked a little vulgar, but many people were confused when they encountered unexpected situations. It was just like the first time he went to the province and encountered Wang Hai pushing the catheter in for cerebral angiography.
At that time, Dr. Wang seemed to be completely dumbfounded. Liu Zewei and Gao Shaojie took turns to take the guide wire. After they failed, he did not say a word. When he took out the guide wire himself, he held his hand and did not know what to say.
Therefore, Zheng Ren understood and could guess what the person who sent the message meant.
"Lao He, ask him if he needs a hand," Zheng Ren said. "Oh right, make it clear where he is."
"Okay." Lao He agreed without hesitation.
Although it was a job to clean up after him, Lao He still did not complain at all. He seized the time to contact him.
"Boss, you really do all kinds of work." Su Yun had long guessed that his boss's hands would be itchy, but when he said that sentence, he could not help but criticize in his heart and directly spat it out.
(End of this chapter)
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