Chapter 299

Put on surgical gowns and sterile gloves as quickly as possible.

The CT film that had just been urgently sent by the imaging department was inserted on the projection lamp.

The director of surgery, who had not yet caught his breath, looked at the film sideways while considering the most suitable surgical position for the injured.

"The injured has a fractured right rib and collapsed sternum. For thoracic and cardiovascular surgery, the left side lying position is definitely the best."

"But the injured has a ruptured left spleen and a combined chest and abdominal injury. Neither the left or right side lying position is suitable. Otherwise, lie on your back directly. When performing the operation, everyone should accommodate each other a little."

Xia Tao, a thoracic and cardiovascular surgeon, is experienced. After taking a look at the film, he directly made suggestions.

The directors on the stage also found this problem.

Although specialist surgery adopts a supine position, it has a certain impact on the surgical field of view and operation.

But this is a combined operation for multiple injuries, so it naturally cannot be performed as a conventional operation.

"Xiao Xiao, what do you think?"

Xia Tao had just discussed the countermeasures and saw Xiao Chenguang on the stage and immediately asked for his opinion.

Although their director came more often, the leading power of this operation still lies with Xiao Chenguang.

After all, he was the one who made the visit, the one who rescued the patients on the spot, and the one who initiated the trauma emergency plan.

As the director of the emergency department, he is also the director of the general surgery department. At this moment, in front of all the surgical directors, Xiao Chenguang is the main surgeon of this operation.

"Okay."

On the way here, Xiao Chenguang had already judged the patient's condition.

Just as Xia Tao said.

The injured were mainly injured on the right side. If it was just a simple thoracic and cardiovascular surgery, there was no need to consider other things, and the surgery could be performed directly in the left side lying position.

But now Han Xiaoxiao is involved in a joint operation of general surgery, thoracic and cardiovascular surgery, gastrointestinal surgery, urology and trauma orthopedics.

If they want to perform it on the same stage, they can only make some concessions.

Fortunately, the surgeons present are all experienced doctors with many years of experience, and their surgical abilities are unquestionable.

Even if the field of vision is a little worse, the operation will not be greatly affected.

This side of the operation, because it is a combined chest and abdomen operation, the operating table in front of Li Wenxia, ​​not only prepared the incision bag, but also the chest and abdominal bags have been opened by the patrol.

Various metal instruments are counted and arranged in Li Wenxia's hands.

A crisp sound rang out in the operating room.

All surgical instruments are placed in the most appropriate position in order to gain the greatest convenience for the surgeon.

"Director Xia, we will start first, and the other directors will wait in the audience. We will make adjustments based on the exploration situation and the progress of the operation."

"I know."

"I understand."

Even if it is a combined operation, there must be priorities. When Xiao Chenguang's words fell, the director of the trauma orthopedics department had already sat on the round stool in the audience naturally.

After all, as long as the fractured patients have no blood vessels injured, they will wait until the patient's vital signs are stable before considering surgical plate fixation and reduction.

Now Han Xiaoxiao's vital signs are unstable, and life-threatening injuries must be treated first.

This is also one of the procedures in Director Xiao's establishment of the trauma center.

The director of gastrointestinal and urology also stepped down.

After all, intestinal rupture and renal contusion are not as serious as massive bleeding in the chest and abdomen, so they can only obey Xiao Chenguang's call for a while.

As for the director of cranial and cerebral surgery who came with him, he had already left the operating room after seeing that the patient's skull and brain tissue had no obvious damage on the brain CT film.

"Xiao Xiao, do a combined incision?"

At this moment, Xiao Chenguang and Xia Tao stood on the right side of the patient on the stage, and Lin Gaoyang and Gong Liang were on the left.

Liu Tie, the anesthesiologist at the head of the bed, and Li Wenxia, ​​the instrument nurse standing at the end of the bed, guarding the operating table.

The entire operation was already full of people performing surgery on the stage.

This did not include the circulating nurses who walked back and forth, responsible for recording and hanging liquids, and the directors of surgery who sat neatly on a row of small benches under the stage.

"The right chest closed drainage has been bleeding out, the amount is very large, it is estimated that the pulmonary blood vessels are broken. The abdominal bleeding is serious and the bleeding cannot be stopped. Direct joint incision, save life first, and don't consider other things first."

While speaking, Lin Gaoyang, who has been in the auxiliary position and has not said a word, has completed the disinfection of the wounded's skin.

No one chatted during this operation, and all the topics revolved around the operation of the wounded.

As the second assistant, Gong Liang was helping. He was usually talkative, but at this moment he didn't dare to say a word.

On the stage and off the stage, except for the department director, there were old seniors who had worked for more than ten years.

At this moment, it seemed that except for the instrument nurse Li Wenxia, ​​he was the only one with the lowest level.

"Director Xiao, scalpel."

At this time, Li Wenxia spoke.

After hearing that Xiao Chenguang wanted to make a joint incision, she didn't need to be reminded at all. She had already selected the handle and blade, and quickly combined and handed it over.

Seeing this scene, Gong Liang dared not breathe, and had to focus all his attention on this operation.

One knife went down, from top to bottom, through the chest and abdomen.

The long cut, straight as an arrow, was astonishing.

But because of the blood loss, there was no trace of blood on the entire surface of the incision.

The subcutaneous tissue, muscle layer and fascia layer, which should have been rosy, were as pale as snow.

"Is the blood coming?"

"It has been transfused." Xunxuan replied.

"Stop the other fluids first, double-channel, pressurized infusion, and be careful not to drain the blood."

Xiao Chenguang did not forget to remind him while doing blunt separation.

The patient's blood volume was seriously insufficient, and pressurized blood transfusion was the only way to increase blood pressure and maintain circulation.

But the disadvantage of pressurized blood transfusion is that people need to keep an eye on the blood volume at all times, and the phenomenon of dripping out cannot occur.

For general blood transfusion and infusion, after dripping out, the liquid level will stop dropping due to atmospheric pressure and vascular tension.

Naturally, there will be no symptoms of air entering the blood vessels and causing embolism.

But pressurized blood transfusion is different.

If you are not careful, it will cause air embolism. In the case of the injured person in front of you, it will be the last straw that breaks the camel's back.

"I understand, I will keep an eye on the blood transfusion." The circulating nurse understood what Xiao Chenguang meant.

She was also very clear about the unexpected situation of pressurized blood transfusion.

Not daring to be careless, she pinched the leather bag with her hand and increased the pressure of the pressure-reducing bag little by little.

After the blood bag inside was squeezed, a bag of 300ml of red blood cells was immediately transfused into the patient's body in just a few minutes.

Blood pressure was instantly raised.

The alarm volume on the monitor gradually became smaller, and the blood pressure rose and the heart rate recovered, giving everyone present great confidence.

On the stage, Xiao Chenguang had already opened the peritoneum.

Retractor, warm saline gauze protection, open the peritoneum, blood gushed out continuously.

Taking the negative pressure suction tube handed over, a large amount of non-coagulated blood was drawn into the waste liquid collector.

Looking at the collector that was about to be full, the circulating nurse immediately opened all the red blood cells brought by the blood transfusion department, squeezed the balloon frantically, and gave the patient a pressurized blood transfusion.