Huang Jiacai brother and sister, never let go of the chain at critical moments. This set of equipment is really unique in the city, because it was customized by Huang Jiacai. The connecting rod between the guide and the steel plate is lengthened, which is suitable for particularly obese patients. He also customized some other comparisons
Weird instruments, such as extended plate screws, are available for emergencies.
After the fracture was reduced, the steel plate was successfully placed, and under the guidance of the guide, the locking screws were placed. With the long steel plate and high span, the stress was dispersed and the fracture was bridged.
"How come other people have equipment but yours doesn't? Are you trying to cause trouble?"
Director Ouyang was so embarrassed and embarrassed on the stage that he lost his temper at the equipment dealer and the stage.
He just asked him to dig three feet into the ground to get the equipment, but he still couldn't get it. Several larger companies have asked if anyone can make a set of equipment for a patient weighing 400 pounds. It's useless to scold people to death.
.However, the equipment dealer in Yangping had it and delivered it. Director Ouyang had reason to suspect that the equipment dealer was not interested.
If it weren't for Yang Ping's rescue, and if it weren't for the power of Yang Ping's equipment dealer, this operation would really not have been possible.
"I'm sorry, I'm sorry, I'm sorry. We didn't do our job well. Our manager will be here soon and come over to apologize in person." The equipment dealer who followed the stage did not dare to refute even a single sentence.
Director Ouyang is pretty good, but if you meet Director Bai and something hits you, you can only nod and bow and smile.
At this time, no matter whether there is any mistake or not, this can only be done until Director Ouyang is angry. Now the equipment dealer is a punching bag and a sandbag to be beaten. In this industry, if you don’t have the ability to pretend to be a grandchild, you can’t make money, especially when you are in charge of surgery.
It’s difficult, I don’t know how to use any equipment, and I get scolded.
After the screws were drilled, the C-arm X-ray machine showed no problem. Dr. Jin used the electrosurgical wire to measure the force lines of the lower limbs, the anterior superior iliac spine, the center of the patella, and the middle of the first and second toes. It was just like aiming with a gun, three points and one line.
, normal.
This surgery is an innovative result of fracture treatment technology. It is called biological fixation and is suitable for long bone fractures of the limbs. Of course, this cannot be done for fractures of the radius and ulna. Because of the precise rotation function of the radius and ulna, it is treated as an intra-articular fracture and requires anatomical reduction and strengthening.
Fixed.
This kind of femoral shaft fracture does not require anatomical reduction or restoration. As long as the length and line of force are restored to normal, even if the purpose is achieved, the messy bone fragments in the middle can be ignored. These broken bone fragments seem to be a mess, and there is no need to do anything.
Treatment, in fact, the blood supply is protected, and they will eventually grow into one piece, and the human body will then reshape it. In the future, the femur will not be different from its normal shape and will not have any impact on its function.
This is the progress of medicine, the innovation of concepts, which brings about the innovation of surgical techniques and equipment, and finally improves the treatment effect.
"What a crappy thing, don't bring this thing again." Director Ouyang fiddled with the original guide a few times and threw it directly into the trash can, so that his anger could be relieved a little.
The manager of the equipment manufacturer, who was indeed coming, hurried to the operating room and kept hunching over: "Director Ouyang, our service has not kept up, and we have caused trouble for you. Look, give us a chance, and come together after get off work." Juju, let me make a proper apology to my brothers?"
Being scolded like a grandson, let the director calm down his anger, and then invite him to eat and drink. This is indispensable. The quality of this meal cannot be low.
I feel comfortable in every aspect, and the business must be done. After all, this is not a subjective mistake, but that I really do not have the equipment, and I have also transferred goods to the brother company, but nothing is available.
The manager asked the attendant in a low voice to learn about the situation, and then he learned that a small company had sent equipment. In response to Director Ouyang's urgency, the manager glanced at Huang Jiahui, a girl who was inexperienced in the world.
I took another look at the special guide placed on the instrument table, and I didn’t understand why there was such a weird guide. I have been immersed in the industry for so many years, and I can be considered an expert in equipment.
Director Ouyang took off his surgical gown. The manager quickly went up to apologize and helped untie the laces. The attendant moved the stool and adjusted the height. Director Ouyang did not sit down, but walked to the reading light to watch the movie. Yang Ping stood there.<
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"Lao Jin, explain clearly to the family members that these bone fragments do not need to be reset and will not affect their functions." Director Ouyang told Dr. Jin.
The most difficult part of this kind of surgery is the family members. They don’t understand. When they saw the X-rays after the surgery, they thought the doctor was too poor, the surgery was not done well, and the bones were in a mess.
The doctor explained a lot of medical principles, but the family members didn't understand anything. The last sentence was: The bones seen on the X-ray are almost the same as before the operation.
In fact, doing this will heal the fracture faster and better than cutting it open and putting the bone pieces back together.
This kind of surgery cannot be done for joint fractures. Joint fractures must be pieced together piece by piece, so that the broken mirror can be reunited.
Director Ouyang came over and planned to ask Yang Ping how to achieve a successful pry reset in one go, but the equipment manager was nearby and could not ask him due to face.
Yang Ping does not have a lecture impulsive disorder, so he will naturally not take the initiative to explain. Some people like to learn, and some people do not like to learn. Everyone is free to do so. If you want to know more, just ask him directly and he will explain. If you don’t ask, he will not take the initiative to explain.
You tell me, except for Song Zimo.
After the operation is over, it is also challenging for the patient to pass the bed.
When I entered the operating room, the flat car was not wide enough, so I used a bed to push it in directly. Now that the bed is being passed, the horizontal width of the bed sheet is not enough, so the nurse thought of a way to use a few bed sheets to lay them horizontally, so that it can work.
Six people, three on each side, pulled hard on one side and pushed on the other side. The patient only moved a little bit until the lumbar disc was almost herniated.
I had to add two more young men, and the five of them pulled together to pull the patient onto the bed.
The manager of the equipment dealer and the attendants also participated and worked very hard. At this time, they wanted to prove their efforts to Director Ouyang.
The patient was under general anesthesia with tracheal intubation. The commonly used anesthesia for this kind of surgery is sciatic nerve and femoral nerve block, or combined spinal and epidural anesthesia. However, no matter which one, positioning is extremely difficult because the fat is too thick.
Combined spinal and epidural anesthesia requires injecting anesthetic into the spinal canal. The anesthesiologist's conventional lumbar puncture needle may not be able to reach the spinal canal at all. The puncture path is too thick and the conventional puncture needle is relatively too short.
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"Wei Danian, wake up!" The anesthesiologist slapped the patient's face, hoping to wake him up through stimulation and prepare for extubation.
Dr. Jin reminded the anesthetist: "To put it another way, not long ago, in the emergency department of a hospital, an old lady suffered cardiac and respiratory arrest. The doctor used a hammering method to induce cardioversion, and with one punch, the old lady and her son were killed.
Slap, you bastard, people are like this, and you still hit people, and you hit them in front of me, you are so bully, you are bullying me, a fool."
The anesthetist was so frightened that he stopped. This was a bad habit, so he still moved his mouth but not his hands. He shouted at the patient at the top of his voice: "Wei Danian, wake up, the operation is done."
The patient was dazed. He opened his eyes to answer the call, then closed his eyes again. He opened his eyes and was breathing spontaneously. He could be extubated. The anesthetist used a suction device to clear the secretions from the respiratory tract again and successfully pulled out the tracheal tube.<
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"The blood pressure has come down!"
Dr. Jin kept staring at the monitor. His blood pressure actually dropped to 76/35mmHg, his breathing became deeper and deeper, and the patient inhaled and exhaled fiercely.
"Ketoacidosis?"
The patient had diabetes, took deep breaths, and his blood pressure dropped. The anesthesiologist immediately thought of ketoacidosis.
"Re-intubate!" The anesthesiologist quickly re-inserted the tracheal tube.
"Check fingertip blood sugar with a blood glucose meter, draw blood to check blood routine, biochemistry, liver and kidney function, blood gas analysis---" the anesthesiologist reported a series of oral medical instructions.
He was experienced and took a deep breath. This was acidosis. The patient had diabetes and his blood sugar was 38mmol/l when he was admitted. He did not dare to operate until the insulin was adjusted to satisfaction. Could it be that the surgery stimulated the blood sugar to spike up?
In the operating room, the patient's life safety is the responsibility of the anesthesiologist, so the anesthesiologist is naturally nervous.
"Blood sugar 6.2mmol/l" the nurse looked at the data on the blood glucose meter.
"It's not high? What's going on?" the anesthesiologist was confused.
Director Ouyang and Dr. Jin also became nervous. They suspected that fat embolism caused pulmonary embolism, but the blood oxygen was not low.
"Check blood lactate!" Yang Ping suggested.
"Well, check the blood lactate." the anesthesiologist told the nurse.
Emergency specimen transportation does not require manual transportation. The hospital has a dedicated automated logistics system. The nurse only needs to label the specimen, scan it into the computer, and then put it into the logistics tube, and it will automatically be sent to the laboratory department through the transportation pipeline.
The results came out quickly: bicarbonate ions were 8mmol/l, pH value was 7.14, and blood lactate concentration was 2.8mmol/l.
"Acidosis is correct, it's lactic acidosis, not ketoacidosis!"
The prognosis of lactic acidosis is critical and the mortality rate is high.
