Admitting the patient to the emergency ward, preoperative preparations, and preoperative instructions were very tedious.
Even if he simplified the process during the emergency department, he was still busy for at least half an hour when the patient's condition allowed it. Su Yun pushed the patient to the operating theater.
When the patient was pushed onto the stage, the patient's blood pressure had dropped to 90 mm Hg.
The continuous drop in blood pressure indicated that the patient's condition was not as simple as it appeared.
After anesthesia, Su Yun adjusted the patient's position and spread the first layer of sterile drapes before going to scrub in again. At this time, Zheng Ren put on the sterile clothes and began to lay the second layer of sheet.
The operation officially began.
Zheng Ren reached out and a pair of hemostatic forceps with iodophor gauze was slapped into his hand.
After disinfecting, he placed the forceps on the patient's leg. Then, he reached out and slapped the scalpel on the patient's leg.
A 20cm incision was made, followed by incision layer by layer, blunt dissection, and electrocautery to stop the bleeding.
Cao Guozhen was already in the operating theater. He stood behind Zheng Ren and watched the surgery from the surgeon's point of view.
The thoracotomy process was almost perfect, and the amount of blood loss was minimal.
Although Cao Guozhen was still unconvinced, he silently cursed that he would not bleed much if he cut open his chest.
Opening the chest and opening the abdomen were two completely different ways of opening.
Many years ago, before electrocautery was widely used in clinical practice, it was necessary to perform a thoracotomy for 500 ml of blood.
However, there was no visible bleeding in the surgery. Some of the larger blood vessels were directly removed from the tissue with hemostatic forceps and stitched up.
Only after the muscle was severed would the electricity be used to burn off the oozing blood in the muscle.
The surgery was done cleanly. The more Cao Guozhen watched, the more afraid he became.
How did this monster from the emergency ward become so good at thoracic surgery? It was not easy to snatch the Thoracic Department's emergency treatment.
Tacitly, they did not perform rib fracture internal fixation. Instead, they opened the chest cavity first.
Because there was no strong evidence to allow for thoracotomy, they could only say that internal fixation of rib fractures was needed.
This …
He was already stepping on the line.
If the patient did not recover well after the surgery and the patient's family was unreasonable, they might be in trouble.
Of course,
They brought this trouble upon themselves.
The sneer under Cao Guozhen's mask became more and more pronounced. These two fellows from the emergency department were really presumptuous.
Didn't they know that the diagnosis and treatment procedures were against the rules?
The patient's surname was neither Zheng nor Su. Was there a need to do this?
Or was he too full of himself that he didn't even know his own surname?
Although he did not see any problems after the thoracotomy, he could directly do internal fixation of the rib fracture. The patient's family did not know, and he would not stir up trouble.
However, there was no such thing as not getting your shoes wet if you always walked by the river.
Just let them be so arrogant. It wouldn't be long before they got into trouble.
Cao Guozhen watched them open their chests. Zheng Ren raised his hand and a heavy automatic retractor appeared in his hand.
The thoracic cavity was opened, and the automatic retractor was used to widen the surgical field by about eight centimeters.
Under normal circumstances, the surgical field would not be this large. However, the patient had a rib fracture. At this moment, the rib was not as elastic and tough, so the surgical field was wider than before.
"In the beginning, I wanted to do thoracic surgery for this kind of surgical field." Su Yun complained that the operating room was too quiet and began to nag, "It's so spacious and bright. There's no need to pull out the intestines and dig out the feces. Boss, don't you think so? "
As the automatic retractor was unscrewed, the lungs appeared before his eyes.
The middle lobe and the lower lobe of the right lung each had a huge hole. The edge of the hole was dark red and appeared in the operative view.
Zheng Ren and Su Yun heaved a sigh of relief.
There really was something wrong. His intuition was right!
Zheng Ren felt a lingering fear and cursed the System inwardly. It had only said that the lung was ruptured, but it had not marked the size.
How could a 0.5-centimeter rupture be the same as a 10-centimeter long and 10-centimeter deep rupture?
Zheng Ren probed with the hemostatic forceps. Only when all the forceps were inserted did he probe to the bottom.
The middle lobe of the right lung had almost been punctured.
Cao Guozhen, who stood behind Zheng Ren, was stunned.
What was going on?
Why was there no hemopneumothorax in such a large rupture? That was impossible!
It was impossible!
He was confused.
Cao Guozhen had been a doctor for ten years and had seen countless external injuries, but this was the first time he had encountered such a situation.
What was going on?
Su Yun nagged as Zheng Ren probed. "Boss, I think the force of the steel bar was too strong. The rib fracture was like a dagger, injuring the middle and lower lobes of the right lung. Then, due to the natural elasticity of the rib, it retracted.
The force was too strong and the injury was too severe. It was similar to a sharp object injury. At the moment of injury, the bronchial arteries were damaged in many places and a large amount of blood gushed out, filling the lungs. "
The process Zheng Ren recalled was similar to what Su Yun had said. There was not much discrepancy.
"Therefore, from the radiographic films, it was similar to traumatic wet lung. Because the blood was filling the right lung's bronchi and capillaries, there was no hemopneumothorax. The lung itself was not compressed, so the pressure was great and the blood could not flow, so there was no hemopneumothorax. "
"This case is simply too misleading." Su Yun was especially happy after he finished probing the patient's lungs. He did not stop talking.
Compared to his previous cautiousness, it was like he was a different person.
Cao Guozhen, who stood behind Zheng Ren, was petrified.
Su Yun's words made sense. However, if it were him, would he dare to open the chest with such a guess?
He pondered for a long time and was sure that he would not dare.
If the thoracotomy was performed without any surgical indications, the patient's family members who harbored evil intentions might sue the Medical Investigation Commission.
These two people … were simply too daring.
However, the more he thought about it, the more Cao Guozhen broke out in a cold sweat.
If Zheng Ren and Su Yun had not insisted on an exploratory thoracotomy, the patient would not have bled out of the thoracic cavity but through the upper respiratory tract after a few more hours of observation.
It was similar to the process of drowning, but this time, the patient's breathing was affected by his own blood.
This was even more troublesome than drowning. Once the blood coagulated, the airway would be blocked …
The patient would die in the thoracic surgery department.
Cao Guozhen was dumbfounded when he thought about how the patient was fine when he was hospitalized but died in the thoracic surgery department within one night.
Just thinking about it was like watching the scariest horror movie, sending chills down his spine.
The blood in his body seemed to have frozen. His mind recalled a case of aortic dissection caused by a rib fracture. During the CT scan, the dissection was not serious, so it was not detected. A few hours later, the dissection ruptured and the patient died.
After the patient's death, dozens of family members came to the family, wearing mourning clothes, and placed the body at the entrance of the thoracic surgery department to burn joss paper and mourn.
Cao Guozhen's legs turned to jelly at the thought of that scene.
It was not that the doctors were careless, nor was it that the patient's family wanted to cause trouble. Who could bear the thought of a perfectly fine person dying like that?
However, ten or eight CT scans a night to prevent it?
The thoracic surgery department accepted hundreds of fractures a year. The patient's family would probably sue them to death.
It was too scary. Cao Guozhen's palms were wet with sweat as he thought about it.
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