In the pouring rain, a white van drove into the emergency area of the hospital with double flashes.After the emergency brake, the door opened, and the driver jumped down and shouted to the emergency hall where no one was there: "Help."
Someone was killed. ”Due to the holiday and rain, there were no patients in the emergency hall.This shout immediately alarmed everyone.…… Li Min answered the call from the outpatient clinic and ran to the emergency department, but he was out of breath when he ran to the emergency department.The emergency nurse was taking her blood pressure and found Dr.
B squeezing the couplant into the abdomen of a patient lying on a flat car."
There is fluid in the liver area and a large amount of fluid in the spleen fossa.Both liver and spleen have rupture. ”"90/60, heart rate 101."
Li Min shouted at the top of his voice: "Draw blood, do blood crossing."
Open the liquid channel, sugar and salt water, and prick the feet.Dextran skin test, time. ”The patient's left arm must be fractured, and the right arm should be set aside to measure blood pressure, so he can only be infused in his foot."
Let's take a few bedside films."
The X-ray machine was pushed over.Li Min got out of the way, grabbed a nurse and said, "Call the general surgery and orthopedic departments, and ask the doctor on duty to hurry to the operating room." ”The outpatient doctor stuffed a handful of test sheets into her: "Dr.
Li, can you see what is still missing?"
”"Call the operating room and prepare for an exploratory laparotomy.Have the medical officer on duty sign it. ”Li Min didn't care who was talking to him, so he hurriedly ordered the matter.She was anxious, she didn't know who was on the night shift today, this patient had liver and spleen damage, don't be Dr.
Huang or her classmates, it was too late to transfer to the hospital and find someone.After a few X-rays were taken, Li Min also finished reading the list in his hand, stuffed it to the outpatient doctor and said, "It's all complete."
Trauma surgery.To medical elevators. ”"Dr.
Li, sign the temporary doctor's order."
The emergency nurse tugged her."
Okay."
Li Min glanced at the ones he had only shouted.quickly signed his name one by one, scribbled a big S in the middle, and stuffed it back to the nurse."
Is 20ml OK?""
That's it."
After the nurse finished drawing blood, Li Min shoved these pages of rescue medical instructions under the patient's head, pushed the flat car and ran to the elevator.An emergency nurse ran after her, and she had to pay attention to two infusion bottles.After entering the operating room, Li Min learned that Director Xie was on night duty and had already changed clothes in the locker room, and her heart was put back in her stomach.She quickly changed her hand-washing clothes, and when she left the locker room, she saw Officer Lu standing in the hall, talking to a tall, thin man with glasses in his hand-washing clothes.This should be Deputy Director Xie - the husband of Su Ying in obstetrics.Officer Lu nodded with a smile, "Director Xie, you can rest assured that you will go for surgery, and I will handle these things according to your requirements." ”His attitude towards Director Xie is completely different from that towards those old directors and Li Min.Li Min nodded at the two of them and went to the bathroom.Officer Bilu opened his mouth to stop her.Director Xie walked towards Li Min with a slight bow."
Dr.
Li, is this patient admitted to your department?
I heard that there is a high possibility of ruptured liver and spleen, so it is safer to be admitted to general surgery. ”Well, that's a lot of money from hospitalization.Li Min frowned and said, "Officer Lu, what are the rules of the hospital?"
Otherwise, ask Dean Chen, who is in charge of surgery.Or call and ask Director Zhang.I don't dare promise you this.Tell them about it.I'm going to brush my hands. ”Li Min left Officer Lu and walked away, who is impatient to talk to you about this in emergency surgery.Because the operation was expected to be short, she first went to the bathroom to empty her bladder and then hurriedly brushed her hands.* In the brush room, a tall and burly young doctor is holding a hand brush as if it is not his own arm.Li Min felt pain when he looked at it, so he was too busy not to look at it.When Director Xie saw Li Min coming in, he quickly turned around and fastened the belt of the hand-washing clothes he was wearing, and hurriedly went to get the handwashing brush, and asked, "Are you Li Min?"
Is it the patient you went to the emergency room to pick up?
”"Yes."
Li Min crackled and reported what she knew about the patient's situation and her handling in the emergency department.After the two of them finished brushing their hands, they went to the alcohol bucket next to each other to soak their hands."
Director Xie, I'll disinfect it."
Dr.
Kim wiped his hands and asked for instructions."
Hmm.Dr.
Kim, the disinfection range ranges from the bilateral nipple/head line to the mid-thigh, and the sides to the midaxillary line. ”Director Xie only went to the operating room to do a simple physical examination for the patient because of the speed at which Li Min came over to brush his hands, and it was he who went to the operating room to do a simple physical examination.
*Li Min was early, and Director Xie took a few steps into the operating room.The patient's left forearm has been temporarily immobilized in a twisted position.The patient's two feet have been opened with liquid access, and the general anesthesia has been intubated, and Director Liu and another doctor on duty in the anesthesiology department are performing anesthesia operations.The doctor on duty in the radiology department stood at the door with a wet film and said, "There is a skull fracture, and no intracranial hemorrhage has been found for the time being."
The ribs are fine.When the front and side of the left forearm are dry, I will hang it on the reader for you. ”"Okay, thank you."
Li Min couldn't help but be anxious when he saw Dr.
Jin's disinfection, can you hurry up!"
Give me a surgical gown."
As soon as the instrument nurse opened the laparotomy exploration bag, the patrol nurse used oval forceps to open another package and shouted, "Director Xie, Dr.
Li, here." ”Director Xie stepped forward and grabbed a surgical gown and put it on, and Li Min followed suit.The two of them each found a place to shake off their robes and put them on their bodies.And Dr.
Kim finally sent the curved disc and oval forceps to the designated place.The door of the operating room was slammed open by Dr.
Kim, and after swinging back and forth several times, it slowly came to a standstill.Director Xie shook off the surgical gown and put it on, and asked Director Liu, "Xiao Liu, what is your blood pressure?"
”"80/50, heart rate 115, oxygen saturation 87%.""
Sugar and salt water, hurry up.Chase the blood bank and see how the blood match goes.Is it time for dextroside sensitization?
”The patrol nurse put down the equipment that was being checked and quickly adjusted the speed of the infusion fluid.Then go out and call the blood bank.came back and glanced at the time record of the trial min, and said to Director Xie, "There are still 3 minutes left."
But it doesn't look like an allergy. ”Director Xie looked at the busy logarithmic patrol nurses and instrument nurses, and went to the instrument table to pick out a pair of gloves, and the instrument nurse stared at him and screamed: "Don't mess me here." ”Director Xie walked with gloves on, pretending not to hear the little nurse shouting to him.The patrol nurse rushed over to tie the strap of the surgical gown to Director Xie, and then Li Min's.Li Min and other instrument nurses handed them gloves, which were one step slower than Director Xie.Ignoring the instrument nurse tying her robe, she dragged the instrument nurse to the operating table and laid the last layer of the surgical sheet with Director Xie: the large hole sheet.The surgical gown she was wearing was very large and dragged to the instep of her foot, and the instrument nurse reminded her: "Dr.
Li, you should be careful for a while, don't step on your surgical gown and trip." ”Most of these reminders are useless, and they will be thrown to the back of their minds in a short time, but the patrol nurse still has to say.Dr.
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Kim came in with his back against the door.But the remaining surgical gown was very small, and the tall Dr.
Jin put on the surgical gown, which hung pitifully between the calves.Fortunately, it was wide enough and fat enough so that it would not shackle his shoulders and affect his movements.The patrol nurse said, "How do you two wear clothes?"
”The spearhead of the instrument nurse was aimed at Director Xie: "It's all Director Xie who grabbed it when he came up, so I couldn't care about looking at the clothes bag."
Wash your hands. ”Six hands reached into the basin that had been handed to them.Below was a large basin of dirt, splashing and not sparing everyone's feet.Director Xie ignored the little nurse who accused him, and asked Li Min and Dr.
Jin, "Which of you two will be a helper?"
”The three of them have never had surgery together, so Director Xie asked.But Dr.
Jin is a five-year undergraduate student from another province who was assigned last year.Asking this question is already to promote Li Min."
I'll come."
Li Min didn't wait for Dr.
Jin from the orthopedic department to speak, and immediately kicked the prepared footstool to the position of Ichisuke, and stood up with a surgical gown."
Xiao Liu, are you okay?"
Director Xie asked for a scalpel and gauze in his hand, turned his head and asked Director Liu."
Alright."
As soon as the word fell, Director Xie's knife had fallen.He did not draw a line, but directly chose a laparotomy in the middle of the abdomen to explore the large incision, and Li Min followed behind him with gauze pressing, hemostatic forceps, etc.The two of them moved too fast, and when they reached the skin, they squeezed Dr.
Jin so much that they couldn't intervene."
What kind of laparotomy did Dr.
Li have done recently?""
I went to splenectomy with Director Liang and Dean Chen.He did two cases of gastric perforation repair with Director Li. ”Li Min picked up an answer similar to this operation, and the speed of the hemostatic forceps on his left and right hands did not slow down at all.It may be that the patient has lost a lot of blood in the abdominal cavity, and there are not many bleeding spots at the incision, and there is no oozing blood."
Lao Xie, your junior sister is humble.The gastric perforation she said was actually her operator. ”Director Liu poured out his hand and added on the side: "That pancreatic tail cancer, she also squeezed Dr.
Wang's help, isn't it a senior sister?"
”Li Min was shy: "It wasn't intentional. ”"Hah, then I'm lucky tonight.I'll just say, how dare Su Ying, our family, let the junior sister who has just graduated help with a cesarean section. ”Director Xie is very fast, he has more than ten years of clinical experience, and he is only over 30 years old, and he is approaching the golden age of a surgeon.The tall Dr.
Kim leaned back against the instrument table, he hadn't operated on a girl side by side for a long time.He always kept not touching Li Min's sleeve, and wanted to pour more positions for Li Min.Xu Li, the instrument nurse, immediately guarded the instrument table and shouted: "Don't lean on this side."
Knocked over the instrument table. ”Dr.
Kim stood slightly diagonally in embarrassment.I tried my best to shrink my body so that I didn't take up a little space.What makes him even more nervous is that he has not been exposed to general surgery since his graduation internship, and he has not had much experience in orthopedics for more than a year.Seeing that Li Min was able to keep up with Director Xie's movements, he was dazzled and began to feel ashamed at the same time."
Dextrose is not allergic, hung up.""
Good.Re-induce blood.Be quick," the patrol nurse was so busy that she hit the back of her head and went out to make a phone call.* "Peritoneal Protector."
Dutchman. ”"Suction device.Get it for you. ”Li Min wanted to pass through the suction device, pass it through the small bend hemostat, and then clamp the small bend on the large hole to fix it, adjust the length, hand it to Dr.
Kim, and then throw the lower section down.The patrol nurse squatted down to connect the negative pressure suction tank."
Dr.
Kim, you step on it and try it."
The nurse who patrolled the station was in her forties, and when she saw Dr.
Jin's embarrassment, she reminded him softly and gently."
Keep up, suck from the knife."
The rumbling suction device sounded, and the voices in the operating room had to be louder.As the suction tip is inserted into the abdominal cavity, the black and red blood flows into the suction tank.Preoperative emergency ultrasound showed fluid in the liver area and fluid in the spleen fossa.The most likely is a rupture of the liver and spleen.Fortunately, the general condition of the patient is okay, and there is no damage to the chest cavity, otherwise this operation is really not something that Director Xie can take down tonight."
Here."
Director Xie snatched the suction device, and asked for a "sharp knife" in his right hand, he preferred to pick with a sharp knife and peel off bluntly with the handle.A scalpel was turned upside down by him and used to produce flowers.Li Min took advantage of the moment when Director Xie exposed his spleen, left Xiaobend and stretched out his right hand to go in and pinch it, and stretched out his left hand: "Forceps oval." ”She was afraid that Xiaobend would break her spleen."
Choked?"
Director Xie was happy, nervous and worried about Li Min's courage to pinch his spleen with his hands."
Yes."
Li Min gave Director Xie an affirmative answer.The shattered spleen in the field is shocking.As the spleen was pinched, the amount of bleeding in the field began to decrease, but blood was still pouring out."
Hurry up and urge blood."
Director Xie became impatient, and sweat appeared on his forehead again.It's certainly not just a ruptured spleen.After a while, the liver will be sewn, and if there is no blood, the patient will have to be explained on the operating table.…… After the last spleen removal, Li Min kept up with Director Xie's spleen resection process.Director Xie quickly took out the spleen that had been broken into several pieces.* "The blood came, the blood came. ”The nurses on the tour were elated."
Heat and pressurize it.Dr.
Jin pulled the hook to this point and gave the suction device to Dr.
Li. ”The ruptured part of the liver was examined, and Director Xie saw sweat on his forehead.He tapped the hook with the handle of his scalpel, and Dr.
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Kim was so frightened that he didn't know what to do.Director Xie couldn't do it, so he threw the scalpel and held the suction device in his left hand to put the hook in the position of Dr.
Jin.Tell him to be careful: "Your hand is the liver." ”"Yes."
Dr.
Kim felt aggrieved.I was interning in the fall of the previous year, but after a gap of two years, I was pulled to the operating table of the general surgery to pull the hook, and I obviously couldn't remember what to do.Alas!
What a shame!
Could it be that my life is too comfortable, and God can't see it?"
How much urine is there?"
Director Xie set up the position of the retractor and asked the nurse of the patrol station."
Nearly 200.Yellow. ”"Take a urine specific gravity."
Director Xie picked up the scalpel and continued to peel it along the ruptured part of the liver with the handle of the knife.() The distance is a bit far