Chapter 569 Fortunately, I Didn't Carelessly

"Oh, as long as you're satisfied." Zheng Ren's expression was a little stiff, he had something on his mind, and he couldn't care less about perfunctory Sister Zhao, and said lightly.

Seeing that Zheng Ren behaved differently than usual, Sister Zhao asked, "I think the patient's condition is quite good, Mr. Zheng, are you worried?"

"Yes, Sister Zhao." Zheng Ren said, "The patient is probably suffering from a traumatic carotid artery injury. It looks good now, and maybe in the next second a gust of blood will spurt up, and the person will be gone."

Sister Zhao was surprised that even an old clinical assistant doctor had never seen the situation Zheng Ren mentioned. She operated the machine dubiously and performed a CTA of the neck vessels on the patient.

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

He did not forget to tell Su Yun not to let the patient move.

Su Yun knew the seriousness, and Zheng Ren's worry was also his worry.

There are too many emergency patients, and there are many strange things to see. Be careful sailing for thousands of years, that's the only way to go.

Su Yun once treated a patient with spontaneous pneumothorax in the imperial capital.

The patient was walking and was diagnosed with a left spontaneous pneumothorax with 60% compression of the lung tissue. The patient reported that he had a history of pneumothorax, and he recovered after being given closed drainage.

This kind of patient has nothing to say, the medical history is simple, and the treatment is simple. If you refuse to do thoracotomy or thoracoscopic surgery, just observe it in the next chest bottle for a few days.

However, after the chest bottle went in, dark red fresh blood began to come out along the chest tube.

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

Two hours later, the drainage has reached about 200ml per hour.

Su Yun made a decisive decision, explained the condition to the patient's family, and opened the chest for exploration.

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

Because the patient had undergone closed drainage once, the lungs and pleura had adhesions. In this spontaneous pneumothorax, when the lung tissue was compressed, it caused the adhesion area of ​​the pleural dome to be torn.

On the intraoperative exploration, there was only an avulsion area as big as the thumbnail, and there was bleeding in this area.

It is just such a small amount of bleeding, and the bleeding is not obvious when the chest cavity is under positive pressure. When the air was drawn out and the chest cavity returned to normal pressure, it began to ooze profusely.

When he came on stage, the patient was already in the early stage of hemorrhagic shock.

It was almost gone.

If Su Yun is a little careless.

If there is a major rescue that day, everyone will be on stage, which will delay the observation and disposal time.

if……

Tens of millions of ifs, patients will die in the ward.

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

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

Nowadays, Zheng Ren and Su Yun treat patients with suspected carotid artery injury with this attitude.

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

When the CTA images of neck vessels appeared on the screen, both of them were stunned.

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

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

The moment Zheng Ren saw the shards of glass, he immediately picked up his cell phone and called Su Yun.

"Patient's carotid artery sees shards of glass. Do not compress left scratched area, must not!"

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

"Comfort the patient and make the patient emotionally stable."

After explaining, Zheng Ren heaved 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 this patient has passed.

This kind of operation was first performed in general surgery, after all, it is neck surgery. However, with the division of the Department of Vascular Medicine, it was assigned to the Department of Vascular Medicine.

It's not that Zheng Ren can't give it a try, but one thing is that he doesn't have any consumables that can block the carotid artery. The second is that the training time for surgery has run out now, who would dare to touch the carotid artery without some training?

As for the technical strength of the Department of Vascular Department of Haicheng No. 1 Hospital, it is possible that they will not be able to perform this operation.

But Zheng Ren didn't care either.

If you can't take it off with surgery, you can go on stage together, super-select, enter the carotid artery, and place a stent-graft on the bleeding site, which is enough.

Although the latter's handling is not rigorous and informal, the means that can save lives are all good.

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

"It is estimated that the high-speed moving glass shards pierced the skin, and the glass shards were damaged. There are no obvious signs on the body surface, but the internal condition is very serious." Zheng Ren still couldn't help being afraid when he recalled it now.

With a little carelessness, the patient would at some point bleed profusely as the glass shards dislodged from the carotid artery, and would die within a minute.

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

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

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

Small hospitals are full of irregularities.

When Zheng Ren walked in, Director Fan of the Vascular Department was coming out.

When the two met each other, Zheng Ren raised the film in his hand and said, "Director Fan, would you like to take a look?"

Director Fan nodded solemnly, Zheng Ren called the patient's lover to the office, found a film reader and inserted the film into it.

On the CTA of the neck blood vessels, the triangular glass shard less than 1cm is particularly eye-catching.

Almost like seeing a film, the shard of glass "stabs" out of the film like a horror film.

"Director Fan, prepare for the operation," Zheng Ren said.

"Sigh." Director Fan shook his head and said, "The patient's life is really serious."

Zheng Ren thought so.

If there were no many coincidences, I am afraid that the 120 ambulance pulled it to the hospital, and it would be just a corpse.

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

Recovery from this surgery is also quick.

Zheng Ren estimated that he would be discharged from the hospital in two or three days after the operation.

Many big things, once discovered, are insignificant little things.

Trauma and disease that can be fatal, the diagnosis is clear, and the patient can be discharged from the hospital within two or three days after the operation. Thinking about it, it was indeed her fate.

After working in the clinic for a long time and seeing a lot, I slowly began to believe in fate.

At the scene of the car accident, the inhuman patient who was hit was discharged home after half a month or a month.

Zheng Ren has also witnessed cases of sudden incontinence of feces and feces and loss of consciousness after three or five days in the hospital. (Note 1)

So say it, people...

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Note 1: Carotid intimal avulsion, this case was encountered by a friend of mine when he was in neurosurgery. After checking the book, the probability is one in 50,000.

As for the case of the carotid artery, I remember similar content in the American drama "The Good Doctor". This case is selected from "Journal of Vascular Surgery", and I also find it amazing in some places. But clinically, there are some small probability events.