Sometimes, simple things become complicated for some reason.
A family member of a patient suffered an acute myocardial infarction in the hospital, and the doctor stayed up all night to save him. This was originally a very positive thing.
But I don’t know what happened, but it made all departments of the hospital feel as if they were facing a powerful enemy and were extremely nervous.
Dean Sun is quite concerned about this matter, as is Director Zhao, or even more concerned.
During working hours the next day, Dean Sun completed the general shift and handed over the matter to the medical office.
The general duty is held by the leaders of the administrative department in turns. During night off hours or holidays, the administrative leaders are in rest mode. The general duty, as the temporary top leader of the hospital, handles emergencies, such as coordinating major rescues, handling various disputes, etc.<
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Once it is time to go to work, the overall duty of duty will be automatically canceled.
Director Zhao understood what happened in detail, took the matter very seriously, and believed that there were signs of a dispute.
When it comes to judging potential disputes, Director Zhao has never been emotional. He has his own method. He designed a scoring table himself. Each risk factor is given a certain score, and the incident is scored against the table. If it exceeds a certain score,
, it is judged as high risk.
When he went to work in the morning, Director Zhao looked at the form, like a divination, scoring items one by one. After scoring, Director Zhao saw it---it turned out to be a high-risk event.
As for Xiao Minmin's surgery, it stands to reason that we should wait and see how things turn out.
No matter whether the old lady's condition is stable or not, the key to any dispute is their son.
Their son is currently in a detention center. It is still unknown whether he will be convicted. If he is not convicted, it is very likely that he will use this matter to cause trouble with the hospital, with a simple purpose of extorting a sum of money.
How could an adult man who was living off his old age, without a legitimate job, and idle around, let go of using two people as blackmail to get a sum of money?
In fact, all medical disputes that are not willing to go through formal channels are without exception, and the direct purpose is money.
If you don’t take the formal route, you will naturally choose medical trouble.
No matter what they say, it's not for money, it's just for justice, it's still for money.
Because they know very well that they cannot make money by going through formal channels, conducting medical evaluations, and making judgments through courts.
I had no choice but to take a gamble and make a fuss, hoping to make some money.
Yang Ping is unwilling to postpone the operation, so the medical department must protect him.
Director Zhao sorted out the matter, asked the clerk to notify the neighborhood committee where the elderly lived, and also notified the police station handling Xiao Minmin's case, and then asked the clerk to make a trip in person.
The hospital's legal department lawyer, director of the publicity department, and director of the security department were all invited to the office by Director Zhao to intervene in advance and make preparations to prevent real disputes from happening and put them in a passive position.
Doing good deeds requires strength and skills. Sometimes without strength and skills, doing good deeds can easily lead to trouble.
In the past, Sanbo Hospital did not have a legal department, and the security department only had a few security guards in their 40s and 50s.
In order to strengthen the hospital's ability to handle medical disputes, President Xia established a legal department and a security department. The legal department not only has full-time lawyers, but also cooperates with big-name law firms with the most experience in handling medical lawsuits in the city.
The Security Department recruits all young veterans to build a disciplined and combat-effective team.
If not for anything else, it is to prevent doctors from being beaten or hacked.
When an outstanding young ophthalmology professor in the imperial capital was maimed by a patient, Dean Xia felt a pang in his heart. He sent four strong security guards to the building where Yang Ping worked that day, two in the lobby downstairs and two in the ward upstairs. This is why the building where Yang Ping works has full-time security guards.
A rare talent must not have such a heartbreaking thing happen. Dean Xia was a little scared when he thought about it.
This is also a helpless move. To survive and develop in a complex environment, there must be a way.
After finishing his shift, Yang Ping took Song Zimo and Xu Zhiliang to the CCU to visit Minmin's grandma. The rescue was timely and things were going well. The old lady was awake and could have a simple conversation.
She recognized Yang Ping immediately and asked if Minmin's surgery had been done. Yang Ping said she would do it later.
The old lady said that Professor Yang must worry about it.
Yang Ping asked her to rest assured and recover from her illness.
Yang Ping returned to the department and Minmin had been sent to the operating room.
Zhang Lin's wife, Dr. Li, a pediatrician, was preparing to leave with her belly full and an empty lunch box. She was bringing breakfast to Zhang Lin.
When he saw Yang Ping, Dr. Li respectfully called out: "Professor Yang!"
"Still working now? No rest?" Yang Ping greeted.
Zhang Lin took over: "Keli asked her to take leave, but she didn't want to. There is a shortage of pediatric staff. She is not on duty now. She usually goes out to the outpatient clinic. If she really wants to give birth, she will be pushed directly to the delivery room."
At this time, head nurse Cai came over and took Dr. Li's hand: "When is the due date?"
"Just these few days!" Zhang Lin said.
The head nurse said to Zhang Lin: "You always talk about these days, it's almost half a year."
"It's just the past few days." Zhang Lin chuckled. For a man who is about to become a father, his voice has become less aggressive.
The head nurse blamed Zhang Lin: "You are about to give birth, and you still ask your wife to bring you breakfast?"
Dr. Li smiled and said: "I have nothing to do. Walking around is more conducive to production. He is working hard."
A few people stood in the corridor of the ward and chatted for a few words, and then hurried to the operating room.
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Xiao Minmin's surgery started as usual, and she was relieved of the pain as soon as possible.
Fatty Liang moved quickly, asking Minmin to inhale some anesthetic, quickly completed the intubation, and connected the anesthesia machine.
Zhou Can got an indwelling needle for Minmin's scalp and placed the color Doppler ultrasound machine nearby.
We disinfected our hands, put on our clothes, and chatted while opening the stage. The atmosphere was very relaxed.
It’s easy first and then difficult. Fine needles on the limbs are relatively easier to remove than fine needles on the chest and abdomen.
The groin area of the thigh is also the area where nerves and blood vessels are concentrated. The femoral artery, femoral vein, and femoral nerve pass through here.
The ultrasound probe used during the operation is sterile, and the coupling agent is also sterile. Yang Ping applied the coupling agent on Min Min's skin, pressed the ultrasound probe to the groin, and the sound of blood flow was heard immediately.<
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Subcutaneous, fascia, muscles, blood vessels and nerves, various images appeared on the screen. Slowly, the needle also appeared on the screen. Following the planned extraction direction, Yang Ping used a sharp knife to make a small opening of 0.5 cm. Put the mosquito vascular forceps in from the small opening. Under the supervision of the color ultrasound, watch the forceps tip steadily avoid the nerves and blood vessels, tightly clamp the tail of the thin needle, and then slowly withdraw the mosquito forceps, and the first needle
Appears in the bend.
Color ultrasound images are flat. It is actually very difficult to locate the fine needle in three-dimensional space based on the flat image.
Even the incisional surgery would not be so smooth, but Yang Ping got it right in one go.
The needle is like a fish in the water. If the fish swims in the water, the picture that the person gets does not have three-dimensional vision, it is just a flat image. Then all the fish, regardless of depth, swim on the same plane, and the person who catches the fish cannot
Distinguishing its depth makes catching fish very difficult.
The tissues of the human body are not water, but layers of solid tissues. These solid tissues are just a flat image on the color ultrasound screen. It is difficult to find a needle hidden in any layer.
This is why the operation to remove a small foreign body looks very close on the X-ray, but cannot be found.
Rinse the surgical area, suture the small incision, and then remove the fine needle from the other groin area.
After making a small incision, insert the mosquito-type vascular forceps, clamp the needle tail, and then pull out the fine needle. The action is done in one go. No action needs to be repeated twice. Yang Ping can easily remove the fine needle from the entire lower limb in this way.
Next, four thin needles were removed from the chest. Special thoracoscopy instruments borrowed from the Provincial Department of Maternity and Child Surgery for pediatric surgery came in handy. First, color ultrasound was used to detect the position. A small opening was made in the intercostal space on the left side of the chest, and a lens was inserted. Yang Ping carefully
Under the microscope, cut the pericardium bit by bit, a few millimeters, and separate it slightly.
Under the microscope, you can see a little needle tail, and the pericardial incision is just at the needle tail.
Song Zimo and Xu Zhiliang looked at this young professor at the same time. He was really amazing. How could he have such a strong positioning ability?
No matter how many times it takes to find it, it’s all right at once, as if he was the one who inserted the needle.
It's like a hidden object game. A small toy is hidden in the room for you to find, and you find the toy directly.
Either you hid this toy, or you watched someone else hide it, otherwise you have to look for it anyway.
And this is not a needle, the needles in the limbs are like this, and now the needles in the pericardium are like this.
Can you act normal?
Song Zimo drew ten thousand question marks and exclamation points in his heart.
Clamp the tail of the thin needle with the grasping pliers, carefully pull it out, and place it in the bending plate.
Sure enough, the needle was rusty, and the tip had penetrated the heart wall for at least two millimeters. Fortunately, the needle was pulled out in time, otherwise it would slowly penetrate deeper and deeper with the contraction of the myocardium, and finally penetrate the heart wall.
Break the heart.
"How did this needle go in? From the intercostal space? How could it be so deep?" Zhang Lin asked.
Xiao Wu replied: "The needle does not stay still after entering. With the breathing movement of the chest and the contraction of the heart, the needle will continue to move. The current position is not the original position."
Two good buddies stood on the operating table with nothing to do.
The patient was a baby, and there was no room to stand in the crowd, so the two brothers stayed away from the operating table and simply chatted.
Larger, blunt foreign objects, such as shrapnel, rarely move.
However, such sharp and thin needles are easy to move, and some needles can enter blood vessels, which can be life-threatening.
Based on the positioning of the color ultrasound, Yang Ping used a thoracoscope to find three other needles, one hidden in the mediastinum, one in the space between the two lobes of the right lung, and one attached to the wall of the aorta.
The remaining three needles in the chest were found, especially the thin needle attached to the aortic wall, which made everyone sweat.
"Damn it, Mom, how dark-hearted can you be to kill such a young child?" Zhang Lin cursed.
Xu Zhiliang raised his head and turned to look at Zhang Lin.
Zhang Lin thought that Lao Xu was going to scold him again, so he immediately put on a smile.
"His grandma, this is not a human being at all!" Xu Zhiliang cursed and lowered his head to perform the operation.
The operation continues and begins to remove fine needles from the abdominal cavity.
At this time, Director Zhao came in: "How about it, Professor Yang!"
"Oh, this is the fine needle inside? It makes my scalp numb."
Director Zhao looked at the curved plate on the instrument table, and there were already twenty or thirty needles. He was very uncomfortable.
"There are still four abdominal tubes that have not been removed, and we are about to remove them."
Song Zimo sutured several small incisions on the chest, and Yang Ping was using color ultrasound to locate the six fine needles in the abdominal cavity. Sure enough, the positions of two of them were completely different.
Regarding the title of Professor Yang, in fact, every time these big guys call him, he will say: "Call me Xiao Yang, or Dr. Yang."
But it seems that this has no effect. Even Dean Xia is like this, still talking about Professor Yang.
Yang Ping simply stopped being polite, it was just a title.
However, the title Professor Yang is quite pleasant.
"Removing needles is a technical job, don't rush, take your time." Director Zhao said a few words politely.
Dr. Jin from the Department of Traumatology and Orthopedics didn’t know when he appeared behind Director Zhao, and he said: “It’s true.”
The voice happened to be close to Director Zhao's ear, which startled Director Zhao. When he moved away, Dr. Jin suddenly appeared behind him.
"I used to take out a thin needle and use the high-pressure air gun used by workers to penetrate it into the right upper arm. The patient had no obvious symptoms, but it had to be taken out. There was no other way, so I had to cut it open and take it out. I repeated the C-arm X-ray machine and got four
After five hours, I just couldn't find the needle. I couldn't find the needle when I saw it in this position. It was really annoying. Then I touched the tissue layer by layer with my hands. I kept touching for more than an hour, but still couldn't find it.
I had no choice but to give up the operation. The patient was discharged from the hospital and came to see me for a follow-up consultation. He said he didn’t feel any discomfort at that time, but now he sometimes feels that the posture of his right arm is wrong, and the tiger’s mouth area of his right hand is numb and hurts like a pinprick.”
"Did this thin needle go from the upper arm to the mouth of the hand? Is it so evil?" Zhang Lin was very interested.
Dr. Jin continued: "I thought at the time, it's not that evil. Then I went to Director Han for advice. Director Han said, if you take another X-ray, if the needle is still on the right upper arm, there is a high probability that it will be there."
Inside the radial nerve."
"Later, I did what Director Han said. The needle position did not move and remained in place. I gave the patient a preliminary diagnosis of the projection of the radial nerve on the upper arm body surface. Sure enough, as soon as I pressed it, the patient felt a strange sensation in the right radial nerve control area.
, especially the tiger’s mouth area, he said it was as numb as acupuncture.”
"I immediately suggested that the patient undergo another operation. The patient was obedient and agreed to the operation. This time I followed the positioning on the X-ray and opened the epicardium of the radial nerve at that location. My dear, the very small needle was lying vertically.
There."
Lao Jin told this clinical case with ups and downs.
At this time, Yang Ping had already inserted the laparoscope, prepared pneumoperitoneum, and started looking for the six needles in the abdominal cavity.
