Chapter 425 Working as a worker at night (please subscribe)
The road to medicine is long and difficult.
Even after graduating from a bachelor's degree, they are just waiting outside the door!
After I went to graduate school, I felt like there was a wall between different subspecialties in the same department, and they felt like they were two unfamiliar fields.
Even if you are a professor, there are blind spots in understanding between professors of different subspecialties!
A person's life is only so long, and even if he spends his whole life, he can only study slowly in one subspecialty, and there is basically little free time to master and become familiar with the operations and knowledge of other subspecialties.
Because each subspecialty is deep enough.
Trauma, surgery, joints, sports medicine, bone disease, foot and ankle, which one is not as profound as the sea, simple to all-round, they are all laymen, have never looked into it...
No, it's not enough. If you really want to subdivide it, you can still divide it.
Every time it is divided into more detailed categories, it is enough for a doctor to study for a lifetime!
This still feels a bit forced, but some people actually think that there is a discipline that can solve all diseases in various departments such as women, children, ear, nose, throat, and oral cavity. Isn’t this nonsense?
There are not so many diseases in medicine!
Every disease is not that simple.
Huang Xuanqi didn't leave, he happened to be in the surgery class.
The key is that Zhou Cheng's guidance is very accurate, so he can not panic.
Zhou Cheng only took one bone fixation and fixation cap, compared them on the operating table, and then ordered: "Old Huang, please bring seven more of this combination."
"Okay, you reserve a seat, but you agreed that I will treat you. As I said before, you have to call me when you come to Shashi. You didn't follow the first rule, but you can't break the rule of treating guests."
…
Zhou Cheng also apologized a little apologetically: "I also want everyone to get off work early."
He is definitely an excellent surgeon.
In fact, attaching an external fixator is not as difficult as imagined.
Zhou Cheng said: "No, let's go have a midnight snack. I will arrange the rest of the emergency surgeries for other general residents."
However, before Zhou Cheng could answer, the chief hospital phone rang.
"Sister Ling, will you leave a finger after you dye your nails?" Zhou Yu explained in a very cryptic way.
"Zhou Yu, you and I are from the same family."
Huang Xuanqi picked up the sharp knife and broke the skin with a steady hand. He then used curved forceps to bluntly separate the subcutaneous tissue to the bone surface, and then accurately inserted the fixing nails with an electric drill.
She thought she had seen a lot of speed battles between surgeons, but she never heard that there was anything wrong with it.
In fact, it is very limited now.
"If you are free, you can apply with your master to stay here for a few months and see if he agrees." Zhou Cheng led Huang Xuanqi towards the sink outside the operating room!
Zhou Cheng explained that everything was done in detail.
There is no need to waste too much time on repetitive operations, just use time to accumulate them slowly.
"If I had known it was you earlier, I would have come looking for you during the retest, right?"
The excitement and happiness at this moment could not be concealed at all.
"Okay. Ciao!" Huang Xuanqi cursed and accepted Zhou Cheng's pretense.
There was a constant squeaking sound as the fixation nail rubbed against the bone.
It's not as typical as what's written in the textbook.
Open fracture, tibial nerve exploration, replantation of severed finger, and the one just now, tendon suturing.
He walked out of the seventh operating room and sat down directly outside the operating room.
"Ah? Who? Who did two emergency rooms in one and a half hours?" While Kong Ling was speaking, a man in green clothes came out of the six operating rooms.
Zhou Cheng stood up with support: "I'm going back first. Brother, Sister Kong, you should get off work early."
Moreover, it is impossible to let Huang Xuanqi buy it. Now Huang Xuanqi is studying and he gets his salary.
Huang Xuanqi nodded frequently and quickly obtained the two connecting rods and the remaining seven fixing nails and fixing caps.
"We did two sets in one and a half hours. No wonder Sister Xuanxuan went back to rest. How are you playing this late at night?"
The difficulty of external fixation surgery lies in locating and determining the fracture type. Driving screws is actually a practice operation. Knowing how to screw is the key.
The patient crosses the bed onto the gurney and can be sent directly to the department!
Huang Xuanqi smiled knowingly: "This feels so good."
Bone fixation nails, connecting rods, connecting rod fixing caps.
This surprised Zhou Cheng. Huang Xuanqi still knew that it was best not to waste time on one patient when practicing.
The total number of stitches required is at least one to two hundred!
This stitching is no different from sewing clothes. It is a test for both eyes and hands.
After saying that, Zhou Cheng walked over without caring whether Zhou Yu from his family could understand.
But Huang Xuanqi's hands didn't even tremble, and he paid full attention to the changes in the voice.
Zhou Cheng sat at the door of the operating room and continued to relax his strength.
"The sense of participation is directly proportional to the reward. Is that okay?" Zhou Cheng looked at Huang Xuanqi.
Zhou Cheng smiled bitterly upon hearing this and said, "Are you looking for me during the re-examination? I guess no one here knows me yet!"
With the first nail, the second nail was easy. He carefully looked at the X-ray again. After determining the location of the fracture, he took about 3cm below the fracture line and broke the skin again...
"We need to insert three fixing nails at the proximal and distal ends of the fracture at the same time, and then form a triangle and insert two fixing nails,"
"It's okay, take your time."
"It's so tiring, Brother Cheng, isn't it easy for you too?" Huang Xuanqi sighed.
"We're going to install a tripod today."
Especially the tendon suturing in the last one, Zhou Cheng was in charge of the whole process!
Six minutes later, Huang Xuanqi completed the six fixation nails in the front area of the tibia.
"Finally, the position of the fixed cap is reserved. For such a fracture, we have to break it into two semi-open triangles, so the position of the fixed cap must be reserved on the inside of the fixed rod."
When Zhou Cheng heard this, he immediately laughed back: "Whether it's guidance or fingering, it's not for men, right? It's called fingering at most."
Huang Xuanqi's hands are also very steady, basically not shaking much!
Such a surgeon has a strong psychological quality. After he works in the future,
"Ah?" Huang Xuanqi was startled!
In one year, you have become like this?
"Of course I am, Brother Cheng. In our hospital, you are someone else's child in our hospital. My master has mentioned you more than once. I just don't dare to recognize that he is my brother, right?"
Of course Zhou Cheng was not particularly reassured and continued to talk about some key points:
"First fix the distal end of the tibia so that it is in line with the nail layer I drove, and use the connecting rod to align it. It cannot be deviated."
Zhou Yu was stunned for a moment and shouted from a distance: "That's interesting, brother, you have used another word in the vocabulary."
Zhou Yu stretched himself and then walked out of the operating room. His operation was nearing the end, and the rest was left to the graduate students. He was going to take a rest.
Then when he was about to push himself up and stand up.
This is already the fourth emergency surgery performed by Zhou Cheng and Huang Xuanqi.
After Huang Xuanqi read it, he said: "You have seen it clearly, there should be no problem."
Zhou Cheng can understand Huang Xuanqi's current feeling of powerlessness.
Zhou Cheng didn't teach Huang Xuanqi as an ordinary student, at least not now: "Old Huang? For this kind of tibial shaft fracture, either a circular external fixator or a triangular bracket will work. Choose the upper connecting bracket."
Huang Xuanqi's re-examination should have been at the end of last year. At that time, he was still preparing for his doctoral defense, and his influence in the Orthopedics Department of Shonan University Affiliated Hospital was really limited.
“When inserting fixation nails, be sure to insert the needle perpendicularly to the bone cortex and choose the position in the anterior tibial area.”
Ding Changle had promised to give other general residents a chance to practice.
About an hour and a half later.
"This forms a semi-open triangle, which can also be stable."
Kong Ling said: "This is it, Brother Yu. You don't know, today the Department of Orthopedics occupies two operating rooms in our operating room. It is also the replantation of a severed finger. He completed one, and then added another one for debridement or tendon suturing."
, the other one only had two fingers connected.”
First, Zhou Cheng accurately drove the nails into the bone. After two breakthroughs, he immediately stopped driving the nails.
"Okay!~ Brother Cheng, let's go together and save some time for the patient." Huang Xuanqi said.
After doing this, he breathed a sigh of relief——
If it weren't for Huang Xuanqi, Zhou Cheng would not have to go to the emergency room for surgery like this, just deal with some minor problems and then hand them over to the bosses of other departments.
Huang Xuanqi tilted his head and smiled: "Can we go slower?"
Kong Ling asked: "Are you driving again? Why didn't I understand?"
"Okay, I'll go down and make a reservation first." Huang Xuanqi thought Zhou Cheng was giving him a hint.
"The one I just finished was about suturing the tendons of four fingers. It took forty-six minutes."
When you encounter difficulties, the only person you can ask is yourself. Others will only solve the problem for you, but will not teach you how to solve the problem.
Zhou Cheng was almost feeding him.
"I just asked why Sister Xuan told me that he was exhausted."
"Let go of your hands first, and let's prepare the things for the external fixation bracket together."
Kong Ling suddenly realized it, but she didn't mean to blush. She was also a person who had been in the racing circuit for a long time, and said: "I never do my nails."
After the external fixator was installed, Zhou Cheng asked Huang Xuanqi to debridement.
"After connecting with two connecting rods, two stable incomplete triangles are formed, which can achieve the best fixing position."
Now Zhou Cheng is not only a classmate, but also a teacher.
I wiped the sweat off my head and sniffed.
Zhou Cheng did not respond.
Then he said: "Old Huang, don't be too restrained, you can be more comfortable."
The previous operating room was in the emergency operating room.
Zhou Cheng made the hole and installed the fixing nails on the electric drill: "I'll hit two of them, you old cow is very strong, how many more will you hit?!"
Zhou Chengcai said: "Fix the connecting rod with the fixed cap. Fix one side at the bottom, and then drive the remaining two fixing nails from a direction about 45-90 degrees to the side of the connecting rod now, and then fix the upper connecting rod!
"
A person must learn to return to zero many times in his life.
Emergency surgeries are generally arranged in emergency operating rooms as much as possible, and then arranged in operating rooms 1-10 in the surgical building.
"I am from the Department of Urology. Brother, if you have any questions in this area, I can give you some guidance. Haha!" The man in green clothes named Zhou Yu made a joke as if he still knew how to play.
After correcting his mentality, Huang Xuanqi felt much more free and easy in an instant. He watched Zhou Cheng carefully looking for a set of external fixation devices and memorized them one by one.
After two breakthroughs, he immediately stopped, and then used the handle to push the fixing nail into the tightest position.
Zhou Cheng not only had to perform consultations, but also performed surgeries. Such a workload was even difficult for Huang Xuanqi, and Zhou Cheng was able to do it all.
Zhou Cheng and Huang Xuanqi came from the surgical building.
At the end of the operation, Zhou Cheng took care of Huang Xuanqi's operation a little, and then applied VAC negative pressure suction.
"From front to back, this can best avoid hitting nerves and blood vessels, but be careful not to hit the outside of the tibialis anterior muscle, because this is where the anterior tibial artery takes its shape..."
This should be the first surgery in which he actively participated in a relatively critical operation.
Moreover, Huang Xuanqi’s operational ability and talent are not bad at all, but the opportunities he usually gets may be too few!
Zhou Cheng raised his head and grinned: "Yes, Sister Kong."
With his eyes widened, he asked: "Have you finished it again? This is the second channel, right?"
The debridement operation is quite simple.
"Okay!" Huang Xuanqi only said one word, but the meaning was all in this word.
The anesthesiologist looked at the two classmates of similar age interacting so much on the stage, as if they were watching a play.
It was the first time I had an external fixator installed. If I wasn't nervous, I must be pretending. In fact, my forehead was already covered with fine sweat.
Huang Xuanqi's heart was shaken, but he quickly adjusted his mentality.
Zhou Cheng was quite tactful, fearing that Huang Xuanqi didn't even know what external fixation brackets were used for.
The circulating nurse in the six operating rooms of the emergency operating room ran out to get supplies and saw Zhou Cheng sitting at the door!
"There are three over there, and the broken finger here is five. Just tell me, this little motor is the same."
This is where the lower-level hospitals are more helpless. The superiors are unwilling to give you the full answer. You have no choice but to do what you can do and then take the responsibility yourself.
You must learn to have this mentality.
Zhou Cheng actually sometimes gets more scared the more he studies, and feels more and more confused.
Zhou Cheng's heart moved and he remembered the first two years of his residency.
It doesn't matter if you don't know clearly, you can learn slowly, but I'm afraid Huang Xuanqi will feel burdened.
"Okay!" Zhou Cheng understood very well and slowed down his speech slightly...
Learn from scratch, learn slowly, learn one, get one, understand one, and get one more.
The tour named Kong Ling immediately covered her forehead: "Who are you? Can you show some respect to emergency surgery?"
"I'm a little tired!" Zhou Cheng pulled off his mask, his mouth was dry and turned into a shell, and he moistened it with his tongue.
"I'm going to get something."
Huang Xuanqi sat for a while, then got up again and said, "I'm going to buy some drinks."
"But I'm still a little tired." Huang Xuanqi smiled naively.
Then use a special handle to bury the threads of the fixation nail completely under the skin. At this time, the best fixation effect can be achieved.
But just after walking a few steps, I heard another stone patient coming to the emergency department: "Just ask him to go back and drink water, or use some dilator."
"What, so big? 3.0? Are you kidding me?"
"Okay, I'll come down and take a look."
For a 3.0cm kidney stone, conservative treatment is definitely not effective. Zhou Yu ran down, disappeared into the passage of the operating room, and turned into a night worker...