After Ren Min left Tianhua, the third medical team is currently in disarray.
The team members did not trust Deng Lun's ability.
The three treatment groups, which were previously the number one team in the department, have been reduced to the bottom.
The team members who were not convinced by Deng Lun all wanted to see Deng Lun make a fool of himself.
Especially those senior attendings who are several years older than Deng Lun.
They originally thought that after Ren Min left, they would take over the position of treatment team leader.
Deng Lun suddenly airborne, making them very unconvinced.
Two senior attendings formed a separate group, excluding Zhao Yuan, Sun Liang, and Deng Lun.
Although they were on vacation, the two of them were not idle, chatting and gossiping.
"I just heard that Team Leader Deng received a patient with a broken leg and foot and chest injury. Wow, Team Leader Deng is really courageous and confident!"
"Did he perform such a difficult operation?"
"It's okay. If we can't do it, Director Xie and Director Tong will wipe the bastard's ass."
"Oh, I miss the days when the boss was here. We were not afraid of any surgery at that time."
…
Operating Room 8.
Doctors and nurses are busy making preparations for surgery.
"Zhao Yuan, Sun Liang, you two are responsible for suturing the tendons and blood vessels of the limbs, and I will be responsible for the gunshot wound in the chest." Deng Lun entered the operating room and arranged the next division of labor.
Experienced doctors all know that although the muscles in the hands and feet have been severed, which looks terrible, it is not the most serious problem for the patient at the moment.
The gunshot wound to the chest is fatal and must be treated urgently. If you are not careful, the patient will die.
"Senior brother, how about I take charge of the gunshot wound in the chest? The bullet did not completely penetrate, and there is a high probability that it remains in the body. There may be scattered projectiles in the heart and lungs." Zhao Yuan said with a solemn expression.
"Why this conclusion?" Deng Lun didn't have much exposure to gunshot wounds. Most of it was theoretical knowledge he came into contact with during school.
Zhao Yuan explained patiently, "The bullet has strong inertia. If it penetrates completely after being fired from the front, there will be a lot of trauma on the back. But now there is no window in the back and no penetration is caused, so it should be a shotgun and it will directly penetrate the body."
Explode."
"Do you also know about gunshot wounds?" Deng Lun looked at Zhao Yuan in surprise.
Zhao Yuan was all too familiar with gunshot wounds.
He nodded, opened his eyes and told lies, "I am a military fan and have studied trauma ballistics. The murderer used a 12-caliber shotgun containing 9 projectiles."
"Okay!" Deng Lun sighed, "Try to deal with it, don't force it."
With Deng Lun's authorization, Zhao Yuan asked the anesthesiologist to quickly administer anesthesia.
Deng Lun and Sun Liang were still studying treatment options for the wrist, while Zhao Yuan had already used a sternum saw to open the chest.
Deng Lun knew that this was not a minor operation. It involved a thoracotomy and usually required a specialist in thoracic and cardiac surgery.
But Deng Lun had confidence in Zhao Yuan.
Zhao Yuan will not fight an uncertain battle.
Xie Changtian was undergoing surgery at this time. Hearing that there was a special patient, he rushed to the operating room.
There were not many people in the operating room, and his expression became serious.
"Why wait for me!" Xie Changtian frowned and looked at Deng Lun.
Deng Lun said: "The patient's condition is very bad and there is no need to delay, so we will do first aid first."
Deng Lun knew why Xie Changtian was unhappy.
First, the patient has a special status, and the superiors put pressure on him to ensure the treatment effect.
Second, the patient's condition is special, so it is best to apply for multi-department surgery to ensure the success rate of the surgery.
Third, Xie Changtian complained about Deng Lun. If such an important operation fails, he must bear the corresponding consequences.
I can also understand Deng Lun’s thoughts.
He urgently needs a major surgery to prove his worth.
Dang, a crisp sound.
Xie Changtian followed the sound and saw a yellow-orange bullet taken out of the cavity by Zhao Yuan and placed on a silver tray.
Zhao Yuan took out the first projectile in the shortest time.
Deng Lun breathed a sigh of relief and said softly to Xie Changtian: "No problem, please don't worry."
Xie Changtian chose to stand aside and watch. If Deng Lun and others could not control it, he would step in and take over.
In the blink of an eye, Zhao Yuan had already taken out seven projectiles.
His expression became more solemn.
There are still two projectiles not found.
It is absolutely impossible for a 12-gauge shotgun to have only seven pellets.
The only explanation is that the projectile ran to a place where it could not be seen.
Xie Changtian noticed something was wrong and frowned: "What's wrong?"
Zhao Yuan made a judgment based on experience and said in a deep voice: "Two projectiles have entered the heart."
Deng Lun questioned, "If the bullet hits the heart, won't it directly break the bullet into pieces? Judging from the appearance, there are no signs of trauma to the heart."
Zhao Yuan pointed to the location of the subclavian vein, "There are traces of fractures at this location. It entered from the subclavian vein and did not shoot directly to the heart."
Xie Changtian was silent for a few seconds.
He has no such experience either.
"We have to ask someone from the cardiothoracic surgery department to come and take a look."
Jiang Qiang arrived very quickly, taking Gao Qian and a director-level doctor with him.
On the way, Gao Qian expressed dissatisfaction with Jiang Qiang.
"Director Jiang, Zhao Yuan has not participated in the training these days. Although he has been removed from the list, he still has to participate in the training, right?"
Jiang Qiang said with a smile: "Zhao Yuan's level is pretty good. It doesn't matter whether he participates in the training camp or not. He does surgeries every day, so you don't have to worry about him having a hand. If there are more classic surgeries, we can notify him in advance and let him participate."
Zhao Yuan’s specifications are too high!
Gao Qian was a little dissatisfied with Jiang Qiang for indulging Zhao Yuan.
She knew that Zhao Yuan was very strong.
But he is not as familiar with Zhao Yuan as Jiang Qiang is.
Arriving at the operating room, Jiang Qiang and the other two people took the shortest time to figure out the situation.
Like everyone else, Jiang Qiang also looked confused.
"The heart has rich blood supply. If a bullet is drilled into the heart, symptoms of pericardial tamponade will appear. However, the patient has no signs. It is difficult to confirm that a bullet is drilled into the heart." Gao Qian asked.
Zhao Yuan was very sure, "I have seen similar cases in the New England Journal of Medicine."
Jiang Qiang pondered slightly and did not express his position.
He has also seen similar reports.
However, there are great risks involved.
What should I do if the pericardium is cut open and no bullet is found?
This would be a medical incident!
However, if Zhao Yuan's judgment is correct and the bullet remains in the patient's heart, it is absolutely impossible for the patient to undergo another thoracotomy operation, which will eventually cause a cardiac embolism. Who will bear the consequences?
Seeing that Jiang Qiang and others were still hesitating, Zhao Yuan suggested: "Is it possible to perform interventional surgery without opening the pericardium? In this way, even if the bullet cannot be found, the damage to the patient will be minimized."
Gao Qian couldn't hide her surprise.
Zhao Yuan’s idea is too bold!
…
The senior attending surgeons in the three groups have received information from the operating room through certain channels.
There was a heated discussion in the WeChat group.
"Did I hear you correctly? The bullet traveled to the right ventricle? It's unbelievable! Such a ridiculous idea. Is this Zhao Yuan doing Deng Lun a disservice?"
"I have seen a case before. A female patient suffered an unexplained left neck trauma near the shooting range. There was a small amount of bleeding, and she was sutured after simple debridement. Fourteen years later, she went to the cardiac surgery department with the main complaint of asthma, and it was found that the bullet had passed through the neck.
Vein, innominate vein, superior vena cava, right atrium and enters the right ventricle, and finally deposits on the diaphragm surface of the right ventricle."
"The probability is lower than winning the lottery jackpot."
"Nonsense! If I find a bullet in the pericardium, I will eat the bullet."
…
Operating room.
After a brief discussion between Jiang Qiang and Xie Changtian, they decided to trust Zhao Yuan's judgment.
Don't be afraid of ten thousand, just be afraid of the worst.
It was not just the first time that Zhao Yuan broke the rules.
He's proven right every time.
What's more, Zhao Yuan's plan is sound.
With interventional methods, even if no bullet is found, it will not cause excessive damage to the patient.
Zhao Yuan completed the "oblique puncture".
The guide wire and catheter entered smoothly.
The guidewire passes from the inferior vena cava into the pericardial cavity.
