Chapter 320
The patient's pre-operative conversation went smoothly. Due to the urgency of the condition, the family members basically signed everything once.
We contacted the surgery urgently because it was an emergency at night and the anesthetist on duty had to rush to the hospital from home.
Taking advantage of this period of time, the blood that needed to be checked urgently before the operation, as well as the blood type and cross-matching blood required for intraoperative blood were all drawn out.
The patient's body temperature became higher and higher, and soon rose to 42°C.
Immediately, even the thermometer under my armpit was going to explode.
There are also symptoms of septic shock.
Fever reduction, fluid replenishment, and antibiotic administration were ineffective.
The most important thing is to have surgery immediately.
The phone at the nurse's station rang, followed by the nurse's voice.
"Director Xiao, I called from the operating room and said you can go on stage."
"good."
Xiao Chenguang and Lin Gaoyang pushed the patient to the operating room together.
The nurse was waiting at the door and took over the patient. Xiao Chenguang and the others went to the dressing room to change clothes.
"Gao Yang, you've worked hard during this time."
Xiao Chenguang, who had changed into his hand-washing clothes, suddenly said: "I've been busy with the emergency department recently. Thanks to you in the general surgery department, otherwise I would definitely not be able to take care of so many patients every day."
After hearing this, Lin Gaoyang quickly shook his head and said: "Boss, it's not hard at all. Really, you are giving me a chance to practice. I will definitely cherish it and never lose the boss's people."
You know, in the hospital there are many old attendings, and many people are vying for the position of chief resident in order to be promoted to deputy director.
Lin Gaoyang had only been in the hospital for a few years and was already the chief resident of the general surgery department.
The future is limitless, and the deputy director position is a certainty from now on.
All this is because of the boss.
"I plan to cancel the rotation system in the emergency department. I need to recruit people. I may transfer Gong Liang to the emergency department in a few days. You may have a heavier burden in the future."
"Rotation should really be cancelled. There are doctors from all emergency departments. It is difficult to manage and the mind will not be in one place."
After this period of hospitalization experience, Lin Gaoyang has obviously matured a lot and thinks about things more comprehensively.
He had done rotations in the emergency department before and knew exactly how these rotating doctors thought.
Don’t seek merit, but seek no faults.
If you can survive the three months in the emergency department, you can return to the original department. Who will make suggestions and make great efforts for the development of the emergency department.
This is also the reason why the emergency department has never developed.
"Boss, can you wait until this wave of patients goes away before transferring Gong Liang to the emergency room?"
Xiao Chenguang was a little surprised when he said this.
"I remember that you didn't want to see Gong Liang in the past. Why can't you let him go this time?"
"That's not true. The key is that his communication skills are so good. This wave of patients like to come to Gong Liang for feedback on their condition. It can be said that Corey knows the basic situation of each patient best, not me, but Gong Liang."
Xiao Chenguang smiled after hearing this.
This is in line with Xiao Chenguang's expectations for Gong Liang. It was for this reason that he wanted to put Gong Liang in the emergency room to help him.
After all, the disputes that emergencies sometimes have to deal with are really quite speechless. Basically, all kinds of people can see them, and communication is time-consuming and laborious.
But at this time, if Gong Liang is here, everything will be different.
"Okay, then tell me after you have taken care of the general surgery affairs. Also help me find out if there are any suitable candidates to come to the emergency department in the near future. Just tell me the name, and I will communicate the rest."
"Okay, boss."
They were in the corridor, talking as they walked.
He has only told Lin Gaoyang about canceling the emergency room rotation, saying that he would not fight an unprepared battle. This matter is very important and must be taken seriously.
The two came to the operating room. The patient was already lying on the operating table. The anesthesiologist who had just arrived was making preparations for preoperative anesthesia.
The drugs used are propofol, dextromethamine, the muscle relaxant vecuronium, and the gas anesthesia sevoflurane.
"Doctor, will I be okay?"
Seeing Xiao Chenguang who had changed his clothes, the man who had not yet been anesthetized asked nervously.
"It's okay. The operation is not slow, but the recovery period will be longer and you will need to stay in the hospital for a few more days."
"Doctor, I'm not afraid of being hospitalized for injections. I'm afraid of pain. Can I get more injections and medicines during the surgery?"
The anesthesiologist was stunned when he heard this.
"Don't worry, just lie here and have a good sleep. The operation will be done after a good sleep."
As he spoke, the anesthesiologist fastened the mask with inhaled sevoflurane gas anesthesia on the man's mouth and nose.
"Doctor, your mask makes me a little scared. How long will it take for the operation to be done..."
Most people will chatter and talk incessantly when they are highly nervous.
As the anesthetic was inhaled into his body, the man fell asleep and lost consciousness.
Open the airway, intubate the trachea under anesthesia, connect the ventilator smoothly, adjust breathing parameters, and give pure oxygen.
After a while, the patient's blood oxygen saturation reached 100%
After everyone got into position, the equipment nurse pushed the operating table and started packing and checking the equipment with the tour guide.
Xiao Chenguang brushed his hands, put on sterile gloves and surgical clothes, and naturally stood at the surgeon's position, while Lin Gaoyang acted as a mirror supporter and stood at the assistant's position.
Disinfect skin and create stamp card.
Start the carbon dioxide cylinder and inflate it into the patient's abdominal cavity in an orderly manner according to the stamp card.
Soon, pneumoperitoneum is established.
"We will try to get the patient off the stage smoothly within an hour."
Xiao Chenguang looked around and looked at everyone.
"no problem."
"With Director Xiao here, one hour is considered conservative. Let's add more oil and complete the operation in half an hour."
Although the patient was undergoing emergency surgery, everyone was still chatting enthusiastically in the operating room.
For them, patients are most at ease during surgeries in this kind of atmosphere.
If it were the patient injured in the car accident this morning, everyone must have a serious expression, and this would definitely not be the case.
"Free the surrounding tissue, expose the common bile duct, and prepare for incision, stone removal, and drainage."
Xiao Chenguang moved skillfully, controlling the instrument with both hands, following the poke card, and operated on the patient's liver and gallbladder area.
The separation forceps are used together with the electrocoagulation knife to remove the surrounding adherent tissues one by one.
Soon, as the surgical area was gradually exposed, an obviously swollen common bile duct appeared on the screen.
The stone is stuck in the middle, and it can be seen that the surrounding area has begun to become inflamed and suppurative.
The lumen is slippery and difficult to secure with clamps.
Seeing this scene, everyone's hearts sank, and the originally bustling operating room became quiet.
"Boss, this is a bit difficult."
Lin Gaoyang turned the camera, trying to find a suitable position for easy fixation.
But after all the effort, he still couldn't catch the common bile duct, and Lin Gaoyang was so anxious that sweat began to form on his forehead.
"It's okay, just hold the camera and I'll do the rest."
Xiao Chenguang handed the instrument in his hand to Lin Gaoyang and took the long pliers in his hand with his backhand.
Fixing the common bile duct requires precise control of force.
If the clamp is too light, problems may arise such as slippage of the lumen and loose fixation.
But if it is too heavy, it is likely to tear the wall of the tube, causing the accumulated bile to leak out and contaminate the abdominal cavity.
The patient himself has severe infection, but it is only limited to the hepatobiliary area. Once an operation error occurs, bile extravasates and contaminates the entire abdominal cavity.
It took more than an hour to clean up the entire abdomen.
Everyone also discovered this problem at this moment. No one spoke at the scene. Everyone was staring at the screen intently. Even their breathing was deliberately controlled for fear of affecting Xiao Chenguang's operation.
The atmosphere was a little dull.
Xiao Chenguang's expression remained normal as he manipulated the long forceps to reach the common bile duct. On the screen, the closed long forceps slowly opened, revealing its fangs.
Then the fan blades closed gently.
The clamps exuding metallic luster firmly bite the common bile duct, allowing the common bile duct that was originally swaying with breathing to be smoothly fixed.
The lumen is intact without any damage.
This scene was pleasing to the eyes of everyone, and they even felt that Director Xiao's operation was a bit better than before.
"Director Xiao is still very good. I thought this surgery would take another all-nighter."
"Yeah, last time I encountered such severe suppuration, the whole organ was so slippery that I couldn't even clamp it. The surgery lasted all night and I could barely stand up straight."
With the common bile duct clamped, everyone seemed to be celebrating the end of the operation in advance, and the atmosphere in the operating room became lively again.
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