My Medical Skills Give Me Experiences

"All those in the ICU are critically ill. Even if something happens, they won't be taken to the operating room for emergency treatment, right?"

Zhou Can felt that there was a mystery in this matter.

Even if it is necessary to rescue patients, it is usually carried out in the ICU ward.

There are various rescue facilities inside.

Defibrillators, micro-injection pumps, ventilators, multifunctional blood purification instruments, a full set of life monitoring instruments, and even the extremely expensive ecmo. It can be said that no matter how serious the patient is in the ICU, as long as the family members do not agree to extubation, they will basically die.

No breathing, put on a ventilator.

My heart stopped beating and my breathing stopped. It doesn't matter, go to ecmo.

Modern medical technology is highly developed and has indeed created many miracles of life for human beings.

The patient lives in the ICU, and the cost of treatment is high, but it is not for nothing. Nurses generally serve as a pair, and a doctor can manage up to three patients with one bed, and even the attending doctor sits in charge. Then wipe the excrement and urine, turn over, beat the back and other tasks, there are special nurses to do it.

There are so many people around a patient, if the patient still can't survive, the hospital has tried its best to rescue it, and there is no responsibility.

Pulled to the operating room for rescue, this nature has changed.

Based on Zhou Can's intuition, he chose to drag the patient to the operating room when his life was dying, or to do some necessary examinations or auxiliary surgery. Either the medical staff on duty had major negligence and were responsible.

At this time, a mistake has been made, and the best remedy is to find ways to rescue the patient.

"I don't know the specific situation. Director Wu happened to go to the school to give a lecture, and he won't be able to come back in a while. The doctors in their group have always regarded themselves as high-minded, and they really want to save face. If there is no other way, they can't easily tell me Ask for help. Let's go and have a look, and try to help if we can."

Director Wen's age is not very old, he is less than sixty years old.

Walk with the wind.

In a short while, he rushed over with Zhou Can, Dr. Zou, and Tang Li.

None of the residents were called.

In this case, bringing two attending doctors to rush there can not only show that he takes this matter seriously, but also let the two attending doctors see him.

Can you help me at critical moments.

As for bringing Zhou Can to the past, in addition to cultivation, it is also dependent on Zhou Can.

Zhou Can's endoscopic surgery is very good, and his pathological diagnosis is also very good. He is completely a main force.

The four of them were stopped by a fat middle-aged doctor before they reached the operating room.

"Director Wen, I've waited for you here. That patient is dying, please take a look!" The 45-year-old male doctor seemed to have seen a savior, and pulled Director Wen forward to help .

Zhou Can knew this male doctor, he was a deputy chief physician under Wu Baihe, and his name was Kuang Shenfeng.

Although everyone is not in the same group, but after working in Shenwai for two months, he is basically familiar with the nurses and doctors in Shenwai.

It is different from the humble familiarity of the interns.

Many of the interns are senior doctors and nurses who they know in the department, but it is difficult for the senior doctors and nurses to remember the names of the interns. It's just a slight impression.

From this point of view, it makes sense that interns have no human rights in the hospital, not even the cleaning lady.

Gui Peisheng's status is much higher.

Still limited though.

Zhou Can is an exception.

His status outside the gods is quite high. Needless to say, Director Wen's group, everyone treats him as the main doctor.

In other groups, the doctors have gradually heard or seen Zhou Can's endoscopic surgery skills, and when they met, many of them even greeted him with a smile.

Not to mention the nurse girls, all of them are human beings.

Even a nurse girl from the ICU will smile and say hello when she sees Zhou Can, and it is possible to chat a few words.

"Where is the patient?"

Director Wen asked directly.

It doesn't seem to be taken to the operating room.

"It's right here, and I'm about to take someone for a CT scan."

Lying on the mobile bed was a skinny male patient who described as withered, and his age should be around 40 or 50 years old.

The urinary tube was inserted underneath, and the trachea was cut open, and the tube was also inserted.

On a ventilator.

Even so, you can still feel the patient's shortness of breath and panting.

The doctors and nurses pushing the ventilator and the hospital bed all had nervous expressions.

"This blood pressure is a bit low! The blood oxygen index is also a bit scary... Briefly describe the cause of the disease and the basic condition of the patient."

Director Wen looked a little more solemn after reading it.

"Oh! It's my fault to say it. When I was on duty, I felt a little uncomfortable in my stomach and ran to the toilet. Not long after, the nurse called me and said that the patient was short of breath and a little wheezing. I was fine when I left , this happened suddenly, so I didn’t pay much attention to it. In addition, this patient often fell into a coma, stayed in bed for many days, had a tracheotomy, and stayed in the ICU all the time.”

"It's been fine for so many days, so the possibility of a sudden major change should not be great. I had a severe stomachache at the time, and I probably wouldn't be able to go out of the toilet for a while. So I asked the patient a few things. The nurse responded that the patient did not have cyanosis of the lips. The blood oxygen saturation at the fingertips is not low. Based on the above symptoms, I diagnosed that the patient should have a lung infection."

"The patient's lung infection has actually been happening for some time. He had a malignant brain tumor. He underwent tumor resection and chemotherapy, but the effect was not satisfactory. The family members insisted on treatment, so they could only be placed in the ICU."

Tracheal intubation for a long time is very prone to inflammation and infection.

The patient already had a lung infection, so he had asthma and shortness of breath. In addition, the blood oxygen did not drop. Most doctors would think that the problem is not serious.

At least compared with other dangerous conditions in the intensive care unit, shortness of breath is really nothing.

"I told the nurse to **** the patient's sputum first, turn sideways, and pat the back. If you are still a little breathless, you can perform airway nebulization."

Deputy Chief Physician Kuang Shenfeng gave a brief introduction to the situation at that time.

Although this handling is a bit sloppy, it is quite satisfactory and I don't think there is anything wrong.

"Later, the nurse didn't call me again. I didn't feel so anxious. An Xin went to the toilet. When she came out, her legs were so numb. She sat outside for a while before returning to the ICU. After I went in, I checked the patient's condition and found that he was still a little short of breath, and there was no other abnormality."

"It happened that another patient had ventricular fibrillation, so I hurried over to deal with it. Less than an hour later, the patient's monitor suddenly sounded an alarm. I saw how the blood pressure plummeted? The heart rate and breathing were all abnormal. This Only then did I realize that what I asked the nurse to do might have been hasty."

When Kuang Shenfeng mentioned the situation at that time, he was still full of annoyance.

In Zhou Can's impression, Kuang Shenfeng's surgical ability is very strong, and among the many doctors under Wu Baihe, he is firmly in the top spot.

He can be rated as a deputy senior professional title, which is enough to explain everything.

So, sometimes accidents are really just a thought.

Doctors or nurses, as long as they are negligent for a while, it is very likely that a life will wither.

"Why not directly rescue in the ICU?"

Director Wen believed that Kuang Shenfeng would understand the meaning of these words.

"Because the patient has been bedridden for a long time, I seriously suspect that the patient has a pulmonary embolism. This disease is extremely dangerous. It has been delayed for more than an hour because of my misdiagnosis and negligence. I thought about taking it directly to the operating room for rescue. At least our active rescue An attitude can make it easier for family members to accept, and if something happens, the family members may make a lot of trouble."

When Kuang Shenfeng said these words, he hesitated.

Clearly some words were left unsaid.

If something goes wrong and the family makes a fuss, the higher authorities will definitely investigate the cause of the patient's death. Misdiagnosis, dereliction of duty, delay in rescue, these crimes are enough to put Kuang Shenfeng in serious crisis.

At least it will be much better if you have a positive rescue attitude.

"Pulmonary embolism is a real possibility. Have you been tested?"

"Only an electrocardiogram was done for the time being. I sent it to director Wu, and he also thought that pulmonary embolism was very likely. Now I'm going to take it to the CT room for a contrast examination. After the cause is determined, see if it is direct thrombolysis or Need to intervene in thrombectomy?"

Kuang Shenfeng replied.

It seems that Zhou Can misunderstood and thought that Kuang Shenfeng took the patient directly to the operating room.

It's a bit shocking to think about it.

At any rate, he was at the level of deputy chief physician, so no matter how flustered he was in an emergency, he could tell the seriousness of it. When doing things, there is still a sense of propriety.

It is very correct to pull it for inspection first.

"I have also seen the electrocardiogram, and I can basically confirm that it is a pulmonary embolism."

Du Leng was also involved in the rescue at the scene.

Most members of the medical team will be particularly united.

In the face of various sudden illnesses, we must also unite in order to save the lives of patients in time.

What he said still carries weight.

At least from the confident tone of his voice, it can be seen that he regards himself as a character.

The other doctors and nurses also treated him with respect.

"Doctor Zhou, what do you think?"

Director Wen was not in a hurry to express his opinion after learning about the situation. Instead, he turned around and asked Zhou Can behind him.

Everyone's eyes immediately fell on Zhou Can's face.

Some people even secretly compared Zhou Can with Du Leng.

Both of them are the best of this year's regular trainees, and they performed very well.

During the two months of Zhou Can's regular training in Shenwai, he didn't meet Du Leng many times.

Sometimes Zhou Can and Du Leng can appear on the same occasion when they consult with the department, and Wu Baihe and Director Wen perform joint surgery.

During the consultation, Zhou Can generally does not express his opinions easily.

Du Leng is very high-profile.

From time to time, there will be debates with several directors.

As for surgery, Du Leng's surgical ability is very average. For third- and fourth-level surgeries, he can basically only watch them.

Some key parts of endoscopic surgery are often solved by Zhou Can.

It is also for this reason that Zhou Can and Du Leng are jokingly called surgical geniuses and theoretical geniuses by doctors and nurses in the same department.

At this moment, Director Wen asked Zhou Can's diagnostic opinions in public, and it was on the premise that both Wu Baihe and Du Leng had already issued their diagnostic opinions. It is enough for everyone to recognize Zhou Can's weight in Director Wen's mind.

"I remember that when I first entered the regular training of the emergency department, my teacher once said to me that terminally ill patients who have been bedridden for a long time are admitted to the hospital for treatment. Maybe they are not waiting for a medical miracle. They are waiting for a medical accident. arrival."

Zhou Can did not give a diagnostic opinion first, but said such a rebellious sentence, which may exacerbate the fallacy of the doctor-patient relationship.

Many doctors and nurses looked at him with contempt.

What time is it now? I am not in a hurry to rescue the patient, but here I say that the patient has ulterior motives and deliberately waits for a medical accident to come.

If you say such **** words, there should be a thunderclap.

"you mean?"

Kuang Shenfeng's tone was cold.

He has always been arrogant, and he even looks down on several doctors under Director Wen from the bottom of his heart.

Zhou Can's words undoubtedly stirred his tense nerves severely.

The four words of medical accident are definitely the four words that Kuang Zhufeng is most taboo to hear now.

"He shouldn't have a pulmonary embolism. If you really rescued him by lysing the embolism, it must be a medical accident." Zhou Can looked very calm, and didn't care about the contemptuous looks of other doctors at all.

After hearing this, Kuang Zhufeng's face turned even colder.

Looking at Zhou Can's gaze is full of contempt and disgust.

"Director Wen, let's take the patient for CT imaging first, and ask you to help rescue the patient after we find out the nature and grade of the pulmonary embolism."

Kuang Shenfeng obviously took Zhou Can's diagnosis opinion as fart.

It was only because of Director Wen's face that it didn't happen.

"OK!"

Director Wen naturally wouldn't stop him.

It was supposed to bring someone over to help.

It must be based on the other party's diagnosis and treatment opinions. To put it bluntly, if the patient really couldn't be rescued, or there was an accident, he patted his **** and took the doctors in his group to leave.

Will never accept any responsibility.

"Doctor Zhou really thinks that this patient is not a pulmonary embolism?"

Director Wen attaches great importance to Zhou Can's opinion.

Because during these two months, Zhou Can has a different point of view in many consultations. And the accuracy rate is as high as 100%.

Zhou Can's way of thinking about diagnosis is very different from that of ordinary people.

"It should not be pulmonary embolism. Some superficial symptoms look similar, but intuitively, it may have something to do with the lungs. It is not the key cause." Zhou Can has his own identification.

He would never blindly follow the doctor who gave the diagnosis because of his high level and authority in this medical field.

"Let's wait until the patient's examination results come out! During this period of time, we can just look at the patient's previous examination data and learn about the patient's etiology, medical history, etc."

Director Wen called several people into a nearby conference room, and held a consultation with the patient's medical records and examination reports.

At this time, it can be seen that there are still some barriers between groups.

The four of them sat in a small meeting room to discuss the patient's cause, while the doctors in Wu Baihe's group sat on the other side, led by Kuang Shenfeng and Du Leng, conducting their discussion.

Director Wen and Zhou Can are discussing what is the cause of the patient?

Kuang Shenfeng and Du Leng were discussing how to rescue them after the pulmonary embolism test results came out.

The risk of pulling a patient into the operating room for interventional surgery is quite high.

This must be communicated with the family first.

As long as the patient is helped to overcome this hurdle, the responsibility caused by Kuang Shenfeng's negligence can also be uncovered.

Soon, the results of the imaging examination came out.

CT showed fluid accumulation in the lungs, and after CTA inspection, no obvious pulmonary embolism was found.

It's just that the patient's blood supply is poor.

It is normal for patients who have been bedridden for a long time to suffer from qi stagnation and blood stasis.

This result greatly exceeded everyone's expectations.

At this moment, Kuang Shenfeng thought of what Zhou Can said before.

So many doctors participated in the rescue, only Zhou Can diagnosed that the patient was not a pulmonary embolism.

"Doctor Kuang, after the examination, the patient's breathing became weaker. The systolic blood pressure is already lower than 110. I'm afraid he won't last long. Do you think it's best to send him back to the ICU first, or what?"

In this case, it is actually not meaningful to send it back to the ICU for emergency treatment.

If the cause cannot be found, the patient will still die.

No matter how advanced the ICU equipment is~www.wuxiax.com~, it is not a panacea after all.

Faced with many situations, it is actually powerless.

Doctors and nurses who have worked in the ICU know that patients use all kinds of expensive medical equipment, but the alarms of life monitors still keep coming and going.

An alarm sounded from every bed, which meant that something was in danger.

If it is not treated in time, let alone a ventilator, even if it is on ecmo, even if the most expensive medicine is used, it is still dead.

When Kuang Shenfeng heard the bad news, it was like hearing the death knell.

There is no longer the arrogance and calmness before.

Cold sweat kept breaking out from his forehead, and his eyes were flustered.

He took out his mobile phone and called Wu Baihe.

Briefly report the situation here.

"Teacher, what should we do if we find out that the patient is not a pulmonary embolism? The patient's breathing is already very weak, and the systolic blood pressure has dropped below 110." Kuang Shenfeng first asked Wu Baihe for help, indicating that deep down he did not trust Director Wen.

It's a matter of future and destiny, he only believes in Wu Baihe.

In his heart, Wu Baihe is like a god.

"I heard that Dr. Zhou Can diagnosed the patient without pulmonary embolism, right?" Wu Baihe's eyes and ears were really good, and he knew the situation at the scene.

"Um!"

Kuang Shenfeng responded with difficulty.

Whether he admits it or not, reality has given him a big slap in the face.

Zhou Can's words were harsh, but they were all correct.

"I've rushed back to the hospital ahead of time, and I'll be there in about 20 minutes. To be honest, I might not be able to handle such a difficult condition by the side. Listen to Dr. Zhou Can, what he tells you to do, Just do what you want, maybe this is the only chance."

Wu Baihe actually said such words, and Kuang Shenfeng was stunned when he heard it.