Sleepless Doctor

The anesthesiologist was taken aback.

　　 Thinking back to the emergency tracheal intubation process, I did indeed have certain problems as Teacher Wu said.

　　 But Teacher Wu smiled, but what he said was strange, like an invisible hand, drawn on his face.

　　It hurts so much.

　　 "The operation was very successful, Teacher Chen." Wu Mian asked with a smile looking at Chen Houkun.

　　 "……"

　　 If you ask someone else, Chen Houkun will definitely stand up and say success.

　　 But Wu Mian asked... There is another patient in the intensive care unit who is more severely ill and recovers better. Chen Houkun can't say anything about the success of the operation.

"I took a look at the surgical record. The process was okay. I think it should have gone smoothly." Wu Mian's smile was still gentle. "I just said that the anesthesiologist’s problem is not very important. No matter how you can attribute the problem to the anesthesia."

　　 "The successful one-time intubation under the visual laryngoscope will not cause severe laryngeal edema. Then what is the reason for the patient's severe laryngeal edema?" Wu Mian asked.

　　 "Maybe...maybe..." Chen Houkun also thought about this for a long time, and had certain thoughts in his mind.

"The patient was in the prone position, the neck was tilted forward, and the tissue was compressed for a long time to cause venous return disorder. The patient was evaluated as a difficult airway before the operation, and the prone cervical surgery was performed for a long time, which led to postoperative laryngeal edema." Wu Mian said. , "You are considering the operation to be performed particularly smoothly. In order to prove your level, you extubated the tube in advance?"

　　 Zhu Xin, every word Zhu Xin, every word, every word is like a knife stuck in Chen Hukun's heart.

　　 Normally, for the sake of safety, the tracheal intubation needs to be indwelled for at least 24 hours after the operation. But the operation went smoothly, Chen Houkun was also a little proud, and with some careful thinking, he decided to extubate the tube.

　　 It’s a pity that it’s easy to extubate, but it’s harder to send it back without damage.

"Extubation is not impossible after the operation, but you must be very careful. It is recommended that you keep a replacement tube or probe next time you extubate the tube to avoid the emergence of an emergency airway after the extubation." Wu Mian looked at Chen Houkun, but his voice was not high. Not low, just stating one thing, without any subjective thoughts.

　　 "Later, it was found that the throat was edema, and you did the repeated attempts to re-intubate it, Mr. Wang, did you do it." After Wu Mian finished talking about Chen Houkun, he turned his attention to Wang Ziliang.

　　 "Uh... is..."

"You have more courage than them." Wu Mian said lightly, "The patient has airway obstruction and respiratory depression. Face mask ventilation, but mask ventilation is difficult, and oxygen cannot be maintained. When ventilation cannot be guaranteed, vecuronium bromide is used. 8mg　 interrupts spontaneous breathing. Can you ensure that it is not difficult to ventilate the mask after the muscle relaxant is given? Or can the tracheal intubation be successful in one go?"

　　 "But...no muscle relaxant, more..."

"I know." Wu Mian nodded. "The British "DAS2015 Adult Unexpected Difficulty Tracheal Intubation Guideline" pointed out that muscle relaxants can help improve the effect of mask ventilation, improve glottis exposure and tracheal intubation conditions. Improve laryngeal mask placement and ventilation conditions."

　　 "There is no principled error in using muscle relaxants, but what is the premise of the "DAS2015 Adult Unexpected Difficulty Endotracheal Intubation Guidelines" saying this?"

　　 Wu Mian looked at Wang Ziliang and asked in a deep voice.

　　 "……"

　　 "This guide clearly states that it is necessary to try the best-effort mask ventilation on the premise of ensuring sufficient muscle relaxation, and actively prepare for the anterior neck airway such as cricothyrotomy."

　　 "At this time, you have to explain the condition to the patient's family. If you are unsuccessful, you can use cricothyrocentesis to retrograde the wire. If it still doesn't work, why not perform a tracheotomy?" Wu Mian's voice was a little cold, and his smile was not as gentle as just before.

　　 "The patient's family refused..." Wang Ziliang said in a sigh.

"It's because that is what the gold master meant." Wu Mian shook her head slightly, "The gold master is not a doctor. They take money and you see a doctor. It is natural and righteous. But medical care is not a standard service industry, and it cannot be insisted under certain special circumstances. My own professional opinions, remedies for previous mistakes, and blindly listening to the opinions of patients’ family members, what is the use of asking a doctor."

"No one can make mistakes, and what happens to patients after surgery is not a serious complication. After all, the operation is successful, and occasionally some minor complications are normal. But Xiangjiang is the first in the world, the world’s top private hospital, everything is The money has the final say?" Wu Mian tilted his head slightly and scanned all the doctors in the room.

　　 "If the money has the final say, why don't you let the patient's family save the people by themselves?"

　　 "The Zheng family is a top chaebol in Hong Kong, but not a top doctor. In your field of expertise, can you be a little bit persistent."

　　 "Really treat yourself as a waiter?"

　　 "If you can't cook the food, the family will switch to another house. But if you can't cure the disease, what should you do if you die?"

"Okay, I'll just say this." Wu Mian scanned the people in the room again and smiled slightly. "The patients should have no problem. The level of software and hardware in the Sanatorium and Hospital is very high. It can be said to be the world's top, no problem. of."

　　 After speaking, Wu Mian stood up, bowed slightly, and walked away.

　　 Wei Dabao followed Wu Mian and glanced at the many doctors here. He didn't know any of them, but Wei Dabao could feel the breath of superior doctors from these people~www.wuxiaspot.com~ that was the arrogance that naturally appeared under the support of technology.

　　 But this group of people was trained by Section Chief Wu like a dog, bowed their heads, and didn't dare to say a word.

　　 The old doctor named Wang Ziliang replied a few words, but Section Chief Wu directly stunned him back. Gee, when can I be so breezy?

　　 Ren Haitao looks humble, he is different from Wei Dabao, he knows Wang Ziliang.

　　 I still remember that when the academic conference was held, Wang Ziliang was invited to give lectures. As the world's top expert, the academic conference also printed the words in the brochure that the famous Hong Kong critically ill expert Professor Wang Ziliang was invited to come and give guidance.

　　 At the meeting, Ren Haitao clearly remembered Wang Ziliang's recounting that he didn't understand technology very well.

　　 But in front of Mr. Wu, Professor Wang Ziliang was like a student. He was pointed out countless mistakes, stupidly like an intern.

　　 Really? Ren Haitao knew it well.

　　 What Mr. Wu said is actually correct from some perspectives. but! They can't refute it.

　　 When the family members disagree with the tracheotomy, only Teacher Wu can retrograde the guide wire up and then implant the tracheal intubation.

　　 Others can do it, but others can't, so Teacher Wu can point to the nose one by one while others can only listen.

　　 Even if I want to talk back, I feel guilty when I think of the operation just now.

　　 In fact, they are only wrong in one place-they shouldn't listen too much to the opinions of the patient's family.