Oh, and it's good to be satisfied. Zheng Ren's expression was a little stiff, he had something in his heart, and he couldn't take care of the perfunctory Sister Zhao, so he said lightly.

Sister Zhao saw that Zheng Ren was acting differently than usual, so she asked, "I think the patient's condition is very good, Mr. Zheng, are you worried?"

"Yes, Sister Zhao. Zheng Ren said: "The patient thinks it is a traumatic carotid artery injury, and now it looks good, maybe the next second a stream of blood sprays up, and the person will be gone." ”

Sister Zhao was surprised, even the old clinical assistant doctor had never seen the situation Zheng Ren said. She was suspicious of operating the machine and performing CTA of the patient's neck blood vessels.

The examination took more than 20 minutes, and Zheng Ren asked Su Yun to send the patient back.

He also did not forget to tell Su Yun that he must not let the patient move.

Su Yun knew the severity, Zheng Ren's worries, and his worries.

There are more emergency patients, and there are many strange things. Be careful to sail the ship of ten thousand years, and this is the only way.

Su Yun was in the imperial capital and once received a patient with spontaneous pneumothorax.

The patient came walking and was diagnosed with a left-sided spontaneous pneumothorax with 60% compression of lung tissue. The patient complained of a history of pneumothorax and was relieved with closed drainage.

There is nothing to say about this kind of patient, the medical history is simple, and the treatment is simple. If you refuse to have a thoracotomy or thoracoscopic surgery, you can observe the next chest bottle for a few days.

However, as soon as the chest bottle went down, dark red fresh blood began to drain out of the chest tube.

Su Yun was not careless, moved a stool and sat next to the patient, observing the drainage of the chest bottle.

After two hours, the hourly drainage has reached about 200ml.

Su Yun immediately made a decision, explained the patient's condition to the patient's family, and opened the chest to explore.

As a result, people can't laugh or cry.

Because the patient had a closed drain, there were adhesions between the lungs and pleura. In this spontaneous pneumothorax, when the lung tissue is compressed, the adhesion area of the pleural apex is torn.

Intraoperative exploration revealed only an avulsion area the size of the fingernail of the eldest mother, and there was oozing blood in this area.

It's just a little bit of bleeding, and when the chest is under positive pressure, the bleeding is not obvious. When the air is drawn out and the pressure in the chest cavity returns to normal, it begins to bleed profusely.

By the time he came to the stage, the patient was already in the pre-stage of hemorrhagic shock.

Almost gone.

If Su Yun is a little careless.

If there is a big rescue on the day, everyone will come to the stage, delaying the observation and disposal time.

If......

Thousands of ifs, patients will die in the ward.

Therefore, there will be a problem with clinical doctors - all doubts and unreliable places will be infinitely magnified.

Perhaps, this is also a type of pessimism, and it is also a kind of obsessive-compulsive disorder.

Nowadays, Zheng Ren and Su Yun use this attitude to treat patients suspected of carotid artery scratches.

Seeing that Zheng Ren didn't leave, Sister Zhao knew that he was in a hurry, so she simply hurried the film.

When the image of the CTA of the blood vessels in the neck appeared on the screen, both were stunned.

A triangular shard of glass, inserted into the carotid artery.

Although the carotid artery bleeding was stopped, no one can say when this unstable factor will go wrong.

The moment Zheng Ren saw the glass fragments, he immediately picked up his mobile phone and called Su Yun.

"The patient's carotid artery saw shards of glass. Don't press on the left scratched area, be sure not to compress!"

"Yes, ask the vascular department to come and inform them to prepare for emergency surgery. ”

"Reassure the patient and stabilize the patient's mood. ”

After explaining, Zheng Ren breathed a sigh of relief and put away his phone.

If you can find a problem, you can solve it.

The most difficult and dangerous period for patients is over.

This kind of surgery was first done by general surgery, after all, it is neck surgery. But with the separation of the vascular department, it was done by the vascular department.

It's not that Zheng Ren can't give it a try, but first, he doesn't have consumables that can block the carotid artery. Second, now that the surgical training time has run out, who would dare to touch the carotid artery without training?

As for the technical strength of the vascular department of Haicheng First Hospital, it is possible that this operation will not be able to be taken.

But Jung in didn't care.

If you can't take the surgical operation, you can go to the stage together, over-select, enter the carotid artery, and put a stent with membrane at the bleeding site is enough.

Although the latter is not rigorous and irregular, the means that can save lives are good.

"Mr. Zheng, how did the glass get in?" Sister Zhao asked while doing post-processing.

"It is estimated that the high-speed movement of glass shards pierced the skin, and this glass splinter damage, there are no obvious signs on the body surface, but the body is very sick. Looking back now, Zheng Ren still can't help but be afraid.

With the slightest carelessness, the patient will bleed profusely as the glass shards fall off the carotid artery and die within a minute.

Holding the freshly printed film, Zheng Ren hurried back to the emergency department.

The director of the vascular department was also pulled from the cafeteria.

Because the vascular department is a small department, there are not many related surgeries, so there is no hospitalization.

Small hospitals are all kinds of non-compliant.

When Zheng Ren walked in, Director Fan of the vascular department was walking out.

The two met head-on, Zheng Ren raised the film in his hand and said, "Director Fan, take a look?"

Director Fan nodded cautiously, and Zheng Ren called the patient's lover to the office and found a film reader to plug in the film.

On the CTA of the blood vessels in the neck, the triangular glass shards of less than 1cm are particularly dazzling.

Almost when I saw the film, the glass shard was like a horror movie, "stabbed" out of the film.

"Director Fan, let's get ready for surgery. Zheng Rendao.

"Alas. Director Fan shook his head and said, "The patient's life is really big." ”

Zheng Ren thought so.

If there are not many coincidences, I am afraid that if the 120 ambulance pulls it to the hospital, it will be just a corpse.

The diagnosis was clear, there was nothing to say, the emergency surgeon issued an inpatient order, and Director Fan hurried back with the patient to prepare for surgery.

With this kind of surgery, the recovery is also very fast.

Zheng Ren estimates that he will be discharged from the hospital in two or three days after surgery.

There are a lot of big things, once discovered, they are insignificant things.

Trauma and illness that can cause death can be diagnosed clearly, and the patient can be discharged from the hospital after two or three days after surgery. Come to think of it, it's indeed her fate.

After working clinically for a long time and seeing more, I slowly began to believe in my fate.

At the scene of the car accident, the patient who was hit without a human figure was discharged home in half a month or a month.

After three or five days of hospitalization, the patient suddenly became incontinent and unconscious, and Zheng Ren also witnessed the case of loss of consciousness. (Note 1)

So, man......

……

……

Note 1: Carotid intimal avulsion, this case was encountered by a friend of mine when he was in neurosurgery. Later, I checked the book, and the probability was 1 in 50,000.

In the case of the carotid artery, I remember that there was similar content in the American drama "The Good Doctor". This case is from the Journal of Vascular Surgery, and there are some places that I also find amazing. However, there are some small probability events in clinical practice.

Read the URL: m.