My Medical Skills Give Me Experiences

"OK."

The waiter quickly delivered two takeaway boxes.

As far as the service attitude is concerned, the attitude of these ordinary stores and restaurants is warm and thoughtful. The service attitude of banks and luxury stores is relatively double-standard. If you have money, you can enjoy VIP service, but if you have no money, you will be treated with cold eyes.

"I've discussed with Du Leng about getting married this year, and then you all have to come and drink my wedding wine!"

Ma Xiaolan put some crayfish, lamb skewers, and leeks into the box.

At the same time, a shocking news was announced to them.

When she first fell in love with Du Leng, there were probably not many people who liked her.

Zhou Can even felt that Du Leng was just playing for fun, and the two would break up soon. I really didn't expect that the two had reached the point where they were talking about marriage.

"Xiaolan is married, I will definitely go. I'm just a little afraid that I won't be able to ask for leave."

Qiao Yu was the first to express his opinion.

"Boss, getting married is a great event, it only happens once in a lifetime. You have to give everyone a leave of absence."

Ma Xiaolan immediately looked at Zhou Can.

"I'm sure I won't get you stuck here. It's just that doctors and nurses are special professions. It's really not very likely that everyone will take vacation at the same time. If it's a wedding in this city, I can arrange two or three hours of vacation. It's not a big problem. "

Zhou Can didn't dare to agree indiscriminately.

Medical staff is the worst profession to ask for leave. Because patients can't afford to wait, they must be treated in time when they arrive at the hospital.

The nurses in the hospital are usually very tight, and many clinical nurses do the work of two people alone. Not only did the hospital not allow them to ask for leave, but they also wanted to make them work overtime day and night.

Especially in large hospitals, this phenomenon is extremely common.

In the event of a flu outbreak, the medicines in the treatment room can be placed from the end of the cabinet. Each patient's medicine needs to be checked at least twice, prepared in advance, and then given to the patient within the required time.

Even if it only takes one minute to dispense the medicine for a patient, two to ten minutes for the infusion and injection, and about one minute to collect the waste bottle after the injection, pull out the needle or dispose of the indwelling needle.

It takes at least five to ten minutes, or even longer, to fully treat a patient.

Even if the working hours of nurses are extended to twelve hours a day, when there are too many patients, it is still far from enough.

After there are more patients, there is another terrible phenomenon, which is prone to severe patients and accidents.

This will lead to severe crowding of multiple nurse resources.

Therefore, it is difficult for nurses to ask for leave.

Doctors are more special than nurses, and each doctor specializes in different fields. The more senior the doctor, the lower the substitutability in the department.

If a certain chief physician takes a break, that department may not be able to treat that type of patients.

General doctors are very replaceable, but they do a lot of work!

The more low-level doctors such as interns and regular trainees, the more work they do. Thinking that interns can hold both hands to watch the superior doctor operate and learn slowly is really overthinking.

Take the emergency department where Zhou Can works as an example. When the superior doctor is not present, the interns have to come to rescue patients.

It is almost impossible for Ma Xiaolan to get married and let the surgical team take a day off collectively.

It is easier to get approval for temporarily asking for two or three hours of leave from the department.

Everyone was happily eating delicious food when Zhou Can's cell phone rang.

I took it out and saw that it was a call from the emergency department of the hospital.

connected.

"Doctor Zhou, please hurry back to the emergency department of the hospital. A patient with myocardial infarction has been sent here. The condition is very dangerous."

"Okay! I'll be right there!"

Zhou Can stood up and hurriedly said to everyone, "I can't stay with you anymore. A patient came to the emergency department, and I have to rush there immediately. Just be open about what food and condiments you like, and ask me for reimbursement tomorrow."

After speaking, Zhou Can left quickly.

Fortunately, the alley where he had supper was very close to Tuya Hospital, so he trotted back to the emergency department of the hospital.

When he arrived, the patient had already pushed into the emergency room.

Patients with myocardial infarction must be rescued in time, otherwise they will die soon.

"Xiao Zhou, come and see how this patient is doing!"

Director Lou's brow was sweating.

It seems that he has led the emergency department nurses and doctors to launch a round of rescue for the patient.

So far, no doctors from cardiothoracic surgery or cardiovascular medicine have come for consultation.

Both departments are capable of treating patients with myocardial infarction.

The emergency department currently does not have the ability to treat patients, and simple vascular thrombolysis and cardiopulmonary resuscitation are no problem.

Zhou Can walked quickly to the emergency bed, and when he saw the patient's face, he couldn't help but froze.

How could it be him?

The patient on the rescue bed was Zhang Qilian, the director of the Third Hospital who had met twice.

At this moment, his face was pale, his eyes were indifferent, his breathing was short, and his heart rate was extremely unstable.

"Have you had a radiography?"

"Not yet. The patient was transferred from the third hospital. The results of biochemical tests showed that the patient's myocardial enzymes were severely elevated. After checking the electrocardiogram, it can basically be diagnosed as myocardial infarction."

Director Lou showed the patient's examination data to Zhou Can for review.

"Looking at his blood pressure, heart rate, and complexion, as well as the st-t dynamic changes of the electrocardiogram, the size of the myocardial infarction should be quite large. It would be great if he could be sent here earlier, but now I am afraid that he needs to be sent to the cardiac catheterization laboratory for interventional treatment immediately. "

After seeing the patient's condition, Zhou Can quickly gave rescue suggestions.

This is the difference between high level and average level.

Even though Director Lou and others knew that the patient had a myocardial infarction, they could only do some routine rescue, and they had to stabilize the patient's life first.

After Zhou Can read it, he was able to give a specific rescue plan directly.

"Contact the cardiac catheterization laboratory immediately and send the patient there. I will communicate with the family members."

Director Lou is also very decisive.

…

After nearly two hours of rescue, Zhang Qilian's life was saved, but because the ischemia time was too long, serious sequelae would definitely be left.

Heart failure, arrhythmia, and ventricular aneurysm.

The main manifestation is heart failure.

In the future, he will feel out of breath if he takes two steps casually, and the quality of life for the rest of his life will be seriously reduced.

The only solution is to replace the artificial heart or a heart transplant.

Both myocardial infarction and cerebral infarction are irreversible damage.

In fact, prolonged ischemia of any tissue in the body may cause irreversible damage.

However, some parts are quite special. Even if the large blood vessels are blocked, some arteries can still supply blood. In this case, the body will have serious symptoms, as long as it is treated in time, most of the sequelae will not be left.

Zhang Qilian's interventional thrombectomy was very difficult.

His blood vessels are very special.

Doctors in the Interventional Department were unsuccessful no matter whether they intervened from the femoral artery, radial artery, or percutaneous coronary intervention.

Later, it was Zhou Can who made the move, with the help of six-level injection and six-level implantation, and finally found the problem.

It turned out that there were two serious arterial plaques in the path from Zhang Qilian's femoral artery to the coronary artery. As a result, the two blood vessels were abnormally narrowed, especially at a turning point, where the blockage was quite serious.

Invisibly, it also greatly increases the difficulty of the guide wire passing through the blood vessel.

If only the femoral artery access is blocked, interventional doctors are still not afraid. It can also be accessed from the radial artery.

In clinical emergencies, the radial artery approach is used more.

It is a pity that Zhang Qilian's radial artery-coronary artery was blocked more seriously, and the blood vessel was seriously deformed. This situation is very rare in clinical practice.

At least it was Zhou Can's first time seeing a patient with such a serious vascular malformation.

Even, he found that the patient's coronary artery was severely deformed through coronary angiography.

This made him have to wonder if this kind of lesion occurred in the arteries of the patient's whole body? Or is it a special constitution, born like this?

What is the reason, we can only wait to find out later.

Zhang Qilian's blood vessel condition is so special, no wonder the Japanese cardiologist in the Third Hospital was helpless.

Through this treatment, Zhou Can has stronger confidence in his level of interventional therapy.

Before he knew it, his level of intervention had surpassed that of many 'experts'.

When he walked out of the cardiac catheterization room, he had roughly deduced the whole process of Zhang Qilian's illness - treatment in his mind.

It is very likely that in the court, Zhou Can made a big counterattack, which made Zhang Qilian find it difficult to accept.

The age is too old, and there are serious lesions in the arteries and vessels of the whole body. After severe mental stimulation, the blood pressure soars, which aggravates the blockage of blood vessels, and eventually causes myocardial infarction.

Some people will be curious, when the blood pressure rises, the blood circulation in the body should be accelerated, and the blood flow should be smoother, so why would myocardial infarction occur instead?

The pathogenic mechanism should be analyzed from multiple angles.

First, high blood pressure can promote the process of atherosclerosis, which directly leads to narrowing of the arteries.

Zhang Qilian's arterial vascular disease is so serious, it is likely that he has been in a state of high blood pressure for a long time.

Secondly, poor blood pressure control for a long time can easily cause target organ damage and enlargement of the left ventricle.

As the left ventricle becomes enlarged, its ability to eject blood will decrease.

It's like a house, where a family of three originally lived, and they lived very warmly. One day, the house was expanded and the area was much larger, but there were still three people living in it, so it would look empty.

The same goes for the ventricle.

As the ventricle enlarges, so much blood still enters, and its ability to eject blood naturally weakens.

At the same time, the enlargement of the ventricles causes the heart muscle to become weak, which is also an important reason for the weakened ejection ability.

If the left ventricle is enlarged and left alone, it will affect the blood supply to the myocardium in the long run. At this time, the patient's risk of developing coronary spasm will be seriously increased.

With the above-mentioned conditions, the patient is stimulated, and the blood pressure suddenly rises, and the unstable atherosclerotic plaque will directly fall off. At this time, a thrombus will form, eventually causing coronary artery blockage,

Therefore, when communicating with those patients with heart disease, we must pay attention to the way of speech.

Excessive action will cause the patient's blood pressure to rise, which is dangerous at this time.

In case of losing popularity, there will be a lawsuit in all likelihood.

Zhang Qilian lost the battle in court, his blood pressure rose, and unfortunately he suffered a myocardial infarction.

His own hospital specializes in cardiac surgery, so he naturally prefers his own hospital for diagnosis and treatment. It's just that he never expected that the highly paid Japanese cardiologist in the hospital would be such rubbish.

At the critical moment, the chain was dropped again.

In the end, after many efforts, there was still no way to help him remove the thrombus and clear the blocked arteries and cardiovascular vessels.

At this time there is no other way.

After discussion with the family members, Vice President Zhang and others, they chose to believe in Tuya's medical technology and dragged him directly to Tuya for rescue.

Facts have proved that their decision is very correct.

After more than two hours of hard work, Zhou Can placed two stents in the path from the patient's femoral artery to the coronary artery. After the severely narrowed blood vessel was stretched, the guide wire was able to pass through smoothly.

Finally, thrombectomy was successfully completed.

According to Zhou Can's criteria, he felt that at least hundreds of vascular stents should be placed in the patient's body.

Even so, I am afraid it still cannot completely solve the problem.

Zhang Qilian is still at risk of arterial blockage.

In any case, he successfully rescued the man, which will definitely increase his reputation again.

After coming out of the intervention room, family members surrounded him.

"Doctor, how is my husband?"

Zhang Qilian's wife looks very young, well maintained, with exquisite makeup.

If it weren't for her nasolabial folds, slight crow's feet at the corners of her eyes, and her eyes that didn't match her youthful appearance, Zhou Can would have thought that this woman was only in her twenties.

The skin is not only fair, but also very shiny.

The figure is also maintained very well.

The temperament is gentle, the kind that is beautiful and intelligent.

Zhang Qilian acted viciously, viciously, and was not handsome, but he married such a beautiful wife. This reminded Zhou Can not help but think of another sentence, flowers love to grow on cow dung.

"The patient is out of danger temporarily. However, his systemic arterial vascular disease is very serious, and he needs to be extra careful in the later stage, and he must not get angry again. And because he was sent too late, the best rescue time was missed, and the patient may have a heart attack after recovery. Aging phenomenon, unable to do heavy work, unable to engage in strenuous exercise."

Zhou Can and Zhang Qilian are enemies.

But whether in the rescue process or now, he embodies the sacredness and nobility of the doctor's profession.

Always be considerate of the patient.

"Su Qing らしい!"

After she finished listening, she put her hands together and a happy smile appeared on her face.

It could be seen that she cared about Zhang Qilian very much.

The love between the two should be very sweet.

What she said just now was in Japanese, which was also an instinctive reaction. This made Zhou Can understand that this woman was probably from Japan.

Subconsciously, he glanced down at her legs.

Sure enough, the standard bowlegged.

"Thank you, thank you!"

She thanked Zhou Can again and again.

"You're welcome! You can see the patient later~www.wuxiax.com~ It may take about three to seven days in the hospital."

Zhou Can nodded to her and left.

…

The next day, after checking the ward of the emergency department in the morning, Zhou Can went to check on Zhang Qilian's recovery.

As soon as I arrived at the inpatient ward of the cardiovascular department, I saw a familiar figure.

Vice President Zhang, who was taken away by the security last time, was standing outside the ward talking on the phone.

As the deputy dean, now that the dean is down, his work will definitely be very busy.

Seeing Zhou Can approaching, Zhang Mingxing's face showed a subtle change.

More of an embarrassment.

"Morning Dean Zhang!"

Zhou Can was very generous and greeted with a smile.