Chapter 569: Fortunately, he was not careless
“Oh, as long as you’re satisfied, ” Zheng Ren’s expression was a little stiff. He had something on his mind, so he did not bother to brush off sister Zhao and said lightly.
Sister Zhao saw that Zheng Ren was behaving differently than usual, so she asked, “I think the patient’s condition is quite good. Are you worried, chief Zheng? ”
“Yes, Sister Zhao, ” zheng ren said, “The patient considered it to be a traumatic carotid artery injury. Now that it looks good, perhaps the next second, a stream of blood will spurt out, and the patient will be gone. ”
Sister Zhao was surprised. Even a veteran clinical a.s.sistant doctor had never seen such a situation as Zheng Ren had described. She operated the machine half-believingly and gave the patient a CTA of the blood vessels in his neck.
The examination took more than 20 minutes. Zheng Ren asked Su Yun to send the patient back.
He did not forget to remind Su Yun to not let the patient move.
Su Yun knew the severity of the situation. Zheng Ren’s concern was also his concern.
He had received many emergency patients, and he had seen many strange things. It was better to be careful than to be careful. This was the only way.
Su Yun had once received a patient with spontaneous pneumothorax in the capital.
The patient came on foot. The diagnosis was spontaneous pneumothorax on the left side. The lung tissue was compressed by 60% . The patient told him that he had a history of pneumothorax. He was treated with closed drainage and recovered.
There was nothing to say about this kind of patient. The history was simple, and the treatment was simple. If the patient refused to have thoracotomy or thoracoscopic surgery, the next chest bottle would be observed for a few days.
However, after the chest bottle was inserted, dark red fresh blood began to flow out of the chest tube.
Su Yun was not careless. She moved a stool to sit next to the patient and observed the drainage of the chest bottle.
Two hours later, the drainage had reached about 200 ml per hour.
Su Yun made a prompt decision. She told the patient’s family about the condition and opened the chest for an examination.
The result was that she did not know whether to laugh or cry.
Because the patient had done a closed drainage, there was adhesion between the lung and the pleura. This time, when the lung tissue was compressed, the parietal adhesion area was torn.
During the operation, there was an avulsion area the size of a thumb and a fingernail. There was blood oozing from that area.
It was just this small amount of blood oozing. When the chest cavity was pressurized, the blood oozing was not obvious. When the air was drawn out and the chest cavity returned to normal pressure, there was a large amount of blood oozing.
When he went on stage, the patient was already in the early stage of hemorrhagic shock.
He was almost gone.
If Su Yun had been a little careless.
If there had been a major rescue on the same day and everyone had gone on stage, it would have delayed the time for observation and treatment.
If..
There were thousands of IFS, and the patient would have died in the ward.
Therefore, there was a problem with doctors who worked in the clinic. All the places of doubt and unconfidence would be infinitely magnified.
Perhaps this was also a kind of pessimism and an obsessive-compulsive disorder.
Now, Zheng Ren and Su Yun used this att.i.tude to treat patients with suspected carotid artery scratches.
Seeing that Zheng Ren did not leave, sister Zhao knew that he was anxious, so she rushed to get an X-ray.
When the image of the carotid artery CTA appeared on the screen, both of them were stunned.
A triangular gla.s.s fragment was inserted into the carotid artery.
Although it prevented the carotid artery from bleeding, no one could tell when this unstable factor would go wrong.
The moment Zheng Ren saw the gla.s.s fragment, he immediately picked up his phone and called Su Yun.
“The patient saw the gla.s.s fragment in the carotid artery. Don’t press on the left side of the cut area. Don’t press on it! ”
“Yes, Ask the vascular department to consult and inform them to prepare for emergency surgery. ”
“Comfort the patient and make the patient emotionally stable. ”
After that, Zheng Ren heaved a sigh of relief and put away his phone.
If he could find the problem, he could solve it.
The most difficult and dangerous period for the patient had pa.s.sed.
This type of surgery was initially performed by the General Surgery Department. After all, it was a neck surgery. However, as the vascular department was a.s.signed to other departments, the vascular department took over the responsibility.
It was not that Zheng Ren could not give it a try, but firstly, he did not have any suitable consumables that could block the carotid artery. Secondly, the time for surgical training had run out. If he did not train, who would dare to touch the carotid artery?
As for the technical strength of the first hospital of Haicheng City’s vascular department, it was possible that they would not be able to take down the surgery.
However, Zheng Ren did not care.
If the surgery could not be taken down, he could go on stage together, superselect, enter the carotid artery, and place a membrane stent at the bleeding spot. That would be enough.
Although the treatment of the latter was not rigorous and formal, the methods that could save lives were all good.
“President Zheng, how did the gla.s.s get in? ” Sister Zhao asked as she did the post-treatment.
“It’s probably because the high-speed moving gla.s.s fragments pierced the skin. Moreover, this kind of gla.s.s fragment is damaged. There are no obvious physical signs on the surface of the body, but the illness inside the body is very serious. ” Zheng Ren could not help but be afraid when he recalled it now.
If he was slightly careless, this patient would unknowingly bleed out as the gla.s.s shard fell off the carotid artery, and then he would die within a minute.
Holding the newly printed film, Zheng Ren hurriedly returned to the emergency department.
The director of the Vascular Department was also dragged over from the cafeteria.
Because the vascular department was a small department, there were not many related surgeries, so there was not even a chief resident.
A small hospital was full of all kinds of non-compliance.
When Zheng Ren walked in, director fan of the Vascular Department was walking out.
The two of them b.u.mped into each other. Zheng Ren waved the film in his hand and said, “Director fan, take a look? ”
Director fan nodded cautiously. Zheng Ren called the patient’s lover to his office and found a film reader to insert the film.
On the CTA of the blood vessels in the neck, the triangular piece of gla.s.s that was less than 1 cm was particularly eye-catching.
Almost at the sight of the slide, the piece of gla.s.s was like a horror film, “Stabbing” out of the slide.
“Director fan, prepare for the surgery, ” Zheng Ren said.
“Sigh. ” Director fan shook his head and said, “The patient’s life is really big. ”
Zheng Ren agreed with him.
If there weren’t so many coincidences, the ambulance that arrived at the hospital with the number 120 ambulance would only have been a corpse.
The diagnosis was clear, and there was nothing much to say. The emergency surgeon issued the hospitalization form, and director fan brought the patient back in a hurry to prepare for the surgery.
This kind of surgery would recover very quickly.
Zheng Ren estimated that he would be discharged from the hospital two to three days after the surgery.
There were many big things, but once it was discovered, it was a trivial matter.
The fatal trauma, illness, and diagnosis were clear. The patient could be discharged two to three days after the surgery. Thinking about it, she was indeed lucky.
After working in the clinic for a long time and seeing a lot of things, she slowly began to believe in her fate.
At the scene of the car accident, the patient who was. .h.i.t and did not have a human shape was discharged from the hospital in half a month, one month, and then returned home.
The patient was fine with a small scratch, but there was a 1 in 50,000 chance of a delayed carotid endarterectomy. After three to five days in the hospital, he suddenly lost control of his bowels and urine. Zheng Ren had also witnessed the case of losing consciousness. (Note 1)
So, people..
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Note 1: carotid endarterectomy. This case was encountered by a friend of mine when he was in the neurosurgery department. When I looked it up, it was one in 50,000.
The carotid case. I remember something similar from the American TV series good doctor. This case is from the Journal of Vascular Surgery, and there are some places where I find it amazing. But there are some clinical cases with very small probabilities.