The patient was transferred to the provincial hospital for the purpose of surgery.But they held Li Min's preoperative explanation in their hands and discussed it in a whisper for a while, but they hesitated and didn't dare to sign.Look at this pre-operative explanation, is there anything more scary?!
Anesthesia accident - 84-year-old man, what does an accident mean, who doesn't understand it very well in his heart!
Cardiac arrest, postoperative infection, sepsis, non-union of incisions......
Sky!
Anything written on this piece of paper can scare people to death.Li Min felt that he had explained to them one by one, so he didn't urge them to sign quickly.She still has a critical illness notice to write.She filled it out by herself, signed her name, and then showed it to Director Li."
Director Li, do you think this is okay?"
After Director Li read it carefully, he signed his name, and then beckoned to the brothers and sisters: "Your family members can let go of the preoperative explanation first, and sign this critical illness notice first." ”Li Min filled out the critical illness notice to the medical department for backup.The three siblings, who had been hesitant to have surgery, were now frightened by the critical illness notice that they immediately wanted to sign.The faces of the three of them changed in unison.Or the woman asked, "Director Li, what will happen if my dad doesn't have surgery?"
”"His blood pressure is dropping, you remember the blood pressure you measured at the district hospital yesterday!
Based on my 40 years of clinical experience, he will soon develop into a state of shock.Even if we go to operate on him now, it will be a dead horse as a live horse doctor. ”Director Li continued to speak despite the drastic changes in the faces of the patient's children."
We are a provincial hospital, and we cannot refuse to accept patients transferred from district hospitals.But I'll tell you the truth with your family: he has pus in his stomach and doesn't even have a fever, is there anything you don't understand?
We want to operate on him now, and we are doing our best to do our best and then listen to God's will.When he was unconscious, there was no room for surgery. ”Director Li seemed to have seen his end from receiving this patient.How could the district hospital not bring the medical records of the transfer?
The most likely thing is that the district hospital issued a critical illness notice, and told the patient's children that there was a danger of not being able to come to the stage after the operation, and that there was a greater possibility of death during the operation, so they brought the old man to the provincial hospital.I asked for surgery when I came in just now, but now I don't sign it with my preoperative explanation......
Director Li's calm eyes quietly gathered these two people."
If our provincial hospital asks the district hospital for yesterday's medical records, although the provincial city is large, one or two hours is enough for them to send it over."
He seems to know everything?
The patient's daughter immediately said urgently, "I sign, we sign." ”"Sister, these anesthesia accidents, cardiac arrest ......"
"There are also postoperative wounds that do not heal, sister, do you really have to have surgery?"
The woman said fiercely: "If the wound does not heal, our father is alive."
Didn't you hear Director Li say that when you fall into a coma, you can't operate?!
”The two sons followed behind to sign.Li Min pursed her lips and muttered in her heart: The patient is really unconscious, and I am afraid that the medical department will have to sign the operation.It's not just your family signing a letter of refusal to receive treatment."
Xiao Zhai, stamp this with the seal of trauma surgery and find someone to send it to the medical department."
Li Min handed Xiao Zhai a backup of the completed critical illness notice.There should be no one step less and no mistake at all.Director Li stood up and said, "Let's go, let's push the patient to the operating room." ”Deputy Director Liu came over with an anesthesiologist in his thirties."
Director Li, Xiao Li, this is Zhao Ma who came back from our scientific training.This is Director Li of the Department of Trauma Surgery, and Xiao Li is my junior sister. ”Li Min nodded to him and said with a smile, "Take care of me." ”Zhao Ma smiled and said, "Take care of each other." ”Director Li looked Zhao Ma up and down several times and asked, "Who are you, Dean Zhao?"
”"It's my father."
Director Li's "um" sound was no more.Director Liu began to position the patient, explaining as he posed.Li Min moved a step stool for herself, placed it on the right side of the operating table, and then asked Director Li, "I'm going to brush my hands now?"
”"Go ahead."
Li Min made an audit while brushing his palms, is this surgery just for the two of us?
When she was soaking her hands, Director Li came over to brush her hands."
Let's do it first, Dean Chen will be there in a while.""
Can't find Dr.
Wang and Dr.
Liu?""
They deliberately hid out, what are they looking for?!
Dr.
Liu learned the cunning of Dr.
Wang, and he thought it was smart. ”Li Min felt that he agreed with such words, but he just listened to it.She knows her weight and is not qualified to judge the actions of these "seniors".When Li Min soaked his hands and then entered the operating room, the patient had already been "numb"."
Senior sister, can you disinfect?""
That's it."
Li Min holds a "U"-shaped enamel plate in his left hand, on which are three cotton balls wrapped in gauze, each soaked in iodine wine.Holding the cotton ball with oval forceps in the right hand, the first stroke begins at the mapillary/cephalic line, starting in the middle of the sternum, and descending through the umbilicus to the pubic symphysis.Today, Li Min thinks that the lower part to the groin is enough, and there is no need to disinfect the upper third of the femur.Both sides are still the axillary fronts.When Li Min was doing the second deiodization, Director Li came in with his hand raised."
Xiao Li, have you thought about how to do this surgery?""
Do simple tinkering, right?"
Li Min clamped the towel pliers, and she left the position of the incision in the middle of the upper abdomen.For this laparotomy exploration, it is relatively safe.Director Li nodded, and cooperated with her to lay the last layer of big holes.At this time, Chen Wenqiang pushed the door in.He said while wearing a mask: "Lao Li, I'm going to brush my hands." ”Director Li waved his hand: "You don't have to rush to brush your hands first."
Xiao Li and I will do it first, and you can brush your hands when you need to. ”"It's fine."
Chen Wenqiang nodded, and found a round stool to sit down and rest.Li Min came back with her hands, and Chen Wenqiang went over to help her tie the strap of the surgical gown.While still asking Director Li about the patient's condition."
I heard that this patient is 84 years old, what are his vital signs?""
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Not so good.Abdominal puncture to extract pus, the blood pressure measured before disinfection is 86/54, just admitted to our department is still 100.He was so old that he simply had a piercing repair. ”Li Min added: "The district hospital didn't bring anything."
I don't think his original basal blood pressure would be so low at his age. ”Chen Wenqiang smiled, he was really young."
How could the district hospital not give them a transfer summary?
The family didn't want to take it out.Okay, that's it. ”Li Min wanted to move his stepping stool back and forth, leaving a place for Chen Wenqiang to take the stage.Director Li opened his mouth to stop her."
I asked the nurse to set the footstool for you.You can be a helper and let Lao Chen watch from the side. ”Li Min burst with joy from the bottom of his heart, and quickly nodded and stood up."
Director Liu, it's up to you to bother today."
Director Li was very polite to Li Min's senior sister."
Director Li rest assured.""
And we're open?""
Let's go."
Director Li took Li Min to have several surgeries, so he wasn't very worried that the two of them wouldn't be able to do it.The surgical plan was already in his mind.Regardless of the cause of the patient's gastrointestinal perforation, the perforation can only be repaired, and nothing more can be done.And he also asked the nurse to prepare an automatic retractor in case Chen Wenqiang couldn't come over to participate in the operation.Access to the abdominal cavity was smooth......
The aspirator stopped after a moment of noise.Chen Wenqiang moved a footstool and stood behind Li Min to probe, "Lao Li, you called me over redundantly." ”"How can you do it if you don't tell you?!
Does this patient need me to say more?
If you don't come to the medical department, you have to come in.Wash your hands with salt water. ”Li Min followed Director Li to wash his hands.......
"It's as terrible as you say."
This abdominal cavity looks okay, and there is no food residue. ”"Yes, you can.It's also a shame that he hasn't eaten since the night before.Otherwise, the pus in the stomach mixed with food residues will go into shock.It seems that our Xiao Li's abdominal piercing is still passable. ”Director Liu said, "That's natural. ”"Automatic retractor.""
Salt water gauze."
Pushing open the omentum gathered in the anterior wall of the stomach, I immediately saw an ulcer perforation in the sinus of the pylorus, the size was about 1 cm, the texture of the ulcer was hard, and a small amount of yellowish bile and gastric juice overflow could be seen at the ulcer."
Sure enough, it was a perforated stomach.Has Xiao Li sewn his stomach?
”"I haven't sewn anyone."
Li Min replied naturally."
Medium round needle line 4.To Dr.
Lee.Do full-thickness sutures. ”Director Li gave Li Min the opportunity to stitch up.Li Min took the needle holder and large tweezers from the instrument nurse's hand, trying to restrain the excitement in his heart."
How are you going to sew?"
Director Li asked her."
I want to stitch the whole layer in the middle first, and then add one stitch in the front and back.May I?
”"Good.Forceps oval. ”Director Li helped Li Min lift the stomach wall on one side, Li Min cautiously pricked the first needle, and used large tweezers to clamp the exposed needle tip on the other side, and then loosened the needle tail clamped by the needle holder, and immediately moved the needle holder slightly, quickly clamped the needle tip, and pulled out the round needle along the arc of the round needle and handed it to the nurse.Director Li didn't mean to reach out to tie the knot, Li Min stretched the silk thread himself and asked, "Surgical knot?"
”"Okay.Double surgical knots.Don't slip. ”"Yes."
After the three stitches were sewn, Director Li had to stretch the three knots with big tweezers, and carefully checked that it was not a slippery knot to rest assured."
It's a good sewn.Warm saline and flush the abdominal cavity. ”Li Min asked for saline gauze, wrapped the head of the suction device, and prepared to suck the saline that cleaned the abdominal cavity.After Director Li flushed the abdominal cavity, he did an abdominal cavity exploration and found no abnormalities in other places, so he smiled and said to Li Min: "You come to close the abdomen." ”"Good.Thank you, Director Li. ”The patrol nurse said, "I thought you would ask for gut."
Luckily, I didn't cut the bubble just now. ”Director Li asked for wire scissors and cut holes in the rubber tube by himself.When he heard this, he said, "What kind of gut do you use?"
He is so old, if he doesn't wait for the perforation to grow, the intestines will be absorbed first, wouldn't it be a big trouble. ”Chen Wenqiang said: "In the future, Dr.
Li can do simple gastric perforation surgery by himself." ”Li Min heard the words and hung on his fingers.She pretended not to hear Chen Wenqiang's words, and only after stitching did she say, "I'm still far away, Dean Chen."
Director Li is worried that I won't be able to help, so I want to ask you to come and prepare for the rescue. ”"He's afraid of the same as yesterday.Isn't it, Lao Li?
”"That's it.Yesterday was Lao Liang, and another person may not be able to get off the stage.You say who has so many eyes, slippery like a loach.I took Xiao Li to consult for a while, and when I came back, I was gone. ”After the operation was successfully completed, Director Li began to complain."
His eyes.Hey, this is a general surgery, why didn't he rush to have this patient today?
”Chen Wenqiang asked Director Li."
Learn to be good.Start by asking what the patient is and what the disease is.As soon as I heard 84, people were silent. ”The disdain in Director Li's tone could be heard by anyone in the operating room.Zhao Ma said on the side: "73, 84, the king of Hades does not invite himself. ”Chen Wenqiang immediately stopped: "Don't say that.The patient's family hears the complaint and complains about you. ”"Lao Chen, who do you think he looks like?""
With a mask, I can tell who it looks like.""
It turns out that Dean Zhao's son.""
Oh."
Chen Wenqiang let out a long sigh, and then asked Zhao Ma: "How old are you?"
Is your mom okay?
”"I'm the third, and I'm the fifth.My mom is fine, she went to my eldest sister this year. ”"When did you get anesthetized, why haven't we heard about it?""
I graduated from the medical college, just in time for the provincial hospital to build this new inpatient building, so I went directly to the medical university to study anesthesia."
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Li Min calculated in his heart, wouldn't that be the anesthesia that he had studied at the Medical University for three years?
O man of God.When Li Min stitched the last stitch, Director Li, who was slowly knotting behind her, spoke: "Dr.
Li went to give the postoperative doctor's order, and I came here." ”"Okay."
The rest is dressing, dressing, over the bed, so many people in the operating room, no problem.Li Min took Zhao Ma's pen and wrote on the small table under anesthesia.When the patient crossed the flat car, she also finished the postoperative medical order."
Director Li, can you see if this is okay?"
Li Min showed the long-term medical order to Director Li."
Yes."
Li Min took the medical record folder and chased it out a few steps and stuffed it under the patient's head."
Zhao Ma, you can help me hand this over to the nurse in Cory.I'll be back soon. ”"Okay.""
Thank you."
Zhao Ma smiled and pushed the patient away.※※※※※※※※※※※※※※※※※※※※ thanks to the little angel who voted for me or irrigated the nutrient solution~ Thank you to the little angel who irrigated [nutrient solution]: 5 bottles; Thank you very much for your support, I will continue to work hard!
() The distance is a bit far