Including Xiao Ke and Doctor Qiao, everyone was unexpected.
"Get the patient to the emergency room!"
The patient was loaded onto the operating trolley and moved quickly toward the emergency room.
Xiao Ke thought that Zhao Yuan would be at a loss and retreat.
However, Zhao Yuan used all his time to conduct emergency physical examinations on the patients while on the move.
In addition to the location of chest pain, the patient's pupils, tongue coating and cochlea...
No detail is spared.
Treating patients is important.
Xiao Ke no longer planned to use this matter to make things difficult for Zhao Yuan, and said impatiently, "Zhao Yuan, the patient's condition is very critical. You don't have to worry about the patient. Just find a quiet place to stay!"
"Show me the inspection report!"
Zhao Yuan didn't pay attention to what Xiao Ke said to him, and focused on the patient.
He has completed the physical examination and has a basic understanding of the patient's condition.
He needs to read the report to confirm his judgment.
Before anyone could react, Zhao Yuan had already taken the report from Doctor Qiao's arms.
The surgical flat cart is about to be pushed into the emergency room.
Zhao Yuan confirmed the condition: "It's a ruptured heart!"
The family members were shocked when they heard that the heart had ruptured.
"Okay, why did his heart break? He has a physical examination every year, and his health is always good. There is no history of heart disease in our family."
Dr. Qiao found that Zhao Yuan was very unfamiliar. Not only was he curious about who this guy was, he also questioned, "How did you come to the conclusion?"
"There is pericardial effusion at this location." Pericardial effusion means fluid leakage from the pericardium.
Dr. Qiao followed Zhao Yuan's fingers and looked towards the CT film, his eyes gradually became serious and he said nothing.
"In addition, there are high-density lesions in the esophagus and heart. If you don't look carefully, you will see them as calcification lesions."
After Zhao Yuan repeatedly reminded him, Dr. Qiao finally thought of something.
"High-density lesions? Could it be bone foreign bodies!"
"Yes, it is a bone spur to be precise. It is extremely difficult to see a bone spur on a chest CT film. Because the image of the foreign body is very small, it is easy to misread it as an arterial calcification. Doctors in the radiology department can also make mistakes when reading pictures, so this is not reflected in the CT report.
in conclusion."
Dr. Qiao was silent.
I missed the diagnosis myself.
"So, the patient's heart ruptured because a fish bone or chicken bone pierced the esophagus and inserted it into the heart! Now he needs a cardiac interventional surgery." Zhao Yuan explained very quickly.
Zhao Yuan then asked the patient's family members, which also proved that his judgment was correct.
The patient had spicy chicken for dinner, and a chicken bone stuck in his throat. It only stung slightly and he didn't pay much attention.
In fact, the chicken bone had already punctured the esophagus at that time, and after running ten kilometers at night, the chicken bone not only punctured the esophagus, but also punctured the heart!
What sounds incredible happened so unbelievably!
Xiao Ke, who was always silent, had a terrifyingly gloomy square face.
To become a chief resident, Xiao Ke is extremely experienced.
He also saw problems with pericardial effusion and high-density lesions.
However, thoracoscopy is needed to find out what the problem is.
I thought that the problem that could stump the three-year resident doctor could also stump Zhao Yuan, but Zhao Yuan discovered it!
He is just an intern and does not have a lot of medical experience, so why can he make such an accurate judgment?
How could Xiao Ke have imagined that Zhao Yuan relied on his keen intuition gained from practicing medicine on the battlefield.
On the battlefield, there are not so many detection equipment.
A moment's hesitation may cost a living life.
What's wrong with the patient requires the doctor to develop a keen eye.
"Zhao Yuan, your conclusion is valid! Notify the cardiothoracic surgery department immediately and prepare for consultation!"
There was a sound of approval from behind, and it was Xie Changtian who had just changed into white clothes and hurried over.
…
If the heart is involved, a level 3 or above operation is required.
Different levels of surgery have strict requirements on the qualifications of the chief surgeon, and only deputy chief physicians can perform level three to level four surgeries.
Xie Changtian immediately applied for multi-department linkage.
Jiang Qiang, director of the cardiothoracic surgery department, arrived quickly. He first studied the film and said in surprise: "Just from the film alone, it is difficult to tell that bone spurs are the culprit."
With the help of a thoracoscope, Jiang Qiang searched carefully and finally found that a chicken bone spur was inserted straight into the pericardium of the patient's right ventricle. As the heart beat, it kept rubbing against the right ventricle, creating a deep cut on the ventricle.
The scratches indicate that the ventricle has been ruptured.
"The patient is very lucky. The outer edge of the heart has already been ruptured. If he had hesitated for a few minutes, he would have suffered cardiac tamponade due to massive bleeding, and he might not be able to save his life."
At this time, Jiang Qiang couldn't help but take another look at Zhao Yuan.
I learned from Xie Changtian that the intern judged the patient's condition by relying on his eyesight.
"Lao Jiang, Zhao Yuan's contribution is not small. Let me make a suggestion, can he be an assistant in the next operation?" Xie Changtian said.
Xiao Ke, who had now become a melon-eater, was shocked!
Xie Changtian is too partial to Zhao Yuan!
Xiao Ke was unwilling to accept it and tried to stop it, "Cardiac intervention is a third-level or higher surgery. Is he qualified?"
This is a level three surgery!
What emergency surgery encounters are generally secondary surgeries!
Xiao Ke also wants to participate in this level of surgery, even as a second assistant.
Xie Changtian ignored Xiao Ke and continued to recommend to Jiang Qiang, "Zhao Yuan had successfully performed cardiothoracic surgery before being admitted to the hospital. What's more, he only participated as an assistant. With you to watch over him, will he fail? If something goes wrong, I will be responsible for it."
as a result of."
Jiang Qiang remembered that Vice Dean Chang Hongbo mentioned this matter.
An intern led by Zhou Guangchen was deeply involved in repairing tears after heart valve surgery during the high-speed rail rescue operation.
Zhou Guangchen and Jiang Qiang are both experts in cardiothoracic surgery and have been friends for many years.
It turns out that the young man in front of me is the intern.
Xie Changtian still needs to be given some face.
Jiang Qiang agreed, "Zhao Yuan will serve as the first assistant!"
…
The operating room is very quiet.
Everyone performs their duties.
The anesthesiologist made a gesture to activate the autologous blood recovery and reinfusion device, and the operation officially began.
As the first assistant, Zhao Yuan took the lead, holding a thin blade and cutting steadily.
The moment of blunt separation!
Everyone froze in an instant.
Xiao Ke, the melon-eater, was the first to come to his senses and almost stopped laughing.
What are you doing? Do you think it’s a minimally invasive surgery?
A general thoracotomy requires a large incision of twenty centimeters, but Zhao Yuan's incision was very small, only ten centimeters.
And the location is weird.
This birdman is indeed inexperienced and can only use small knives, but does not have the courage to use large knives.
Xie Changtian's face was gloomy and he couldn't figure out Zhao Yuan's intention.
How large an incision should be made for thoracotomy is common knowledge among medical students.
Previously, Zhao Yuan performed a wonderful atypical operation through a small incision during gallbladder surgery.
Could it be that he wants to follow that idea again.
However, the two surgeries cannot be compared.
Now it's a cardiac interventional surgery.
The degree of difficulty of cardiac interventional surgery reaches level 3 to level 4, which is many times more dangerous than level 2 surgery.
Jiang Qiang frowned and was about to say a reminder: Open the knife edge wider.
Um?
Zhao Yuan had already used pliers to quickly pick out a three-centimeter bone spur.
Such a fast speed shocked Jiang Qiang!
Without locking the location of the bone spur through the surgical field, the bone spur was removed just by feeling!
The purpose of large incision is to obtain enough surgical field and find the location of the injury.
If only a ten centimeter incision is needed to achieve the goal, there is no need to make a large incision.
The smaller the incision, the less damage to the patient.
Blind exercise!
Xie Changtian reacted.
Tong Zheng mentioned that Zhao Yuan would do it blindly.
This is the confidence to make small incisions!
Bai Lu took out the tray and Zhao Yuan placed the culprit - "bone spur" in the tray.
This is not the first time that Bai Xiaohu and Zhao Yuan have cooperated, and they have begun to adapt to Zhao Yuan's operating habits.
His speed in finding lesions is much faster than other surgeons, as if he has a built-in scanning lock function.
As for the equipment requirements, they will be at least five seconds ahead of other doctors.
Next comes heart and esophageal repair.
Zhao Yuan pressed the crack with his fingers, and the blood became obedient and stopped flowing out.
Zhao Yuan quickly used an instrument to suck out the accumulated blood in the cavity and began to repair the wound.
The second assistant on the side looked at his teacher anxiously and blinked at him hard, indicating whether he could be allowed to play.
He also wants to touch the knife!
Unfortunately, the teacher's focus has always been on Zhao Yuan's operation.
Jiang Qiang seemed to have "forgot" to interrupt Zhao Yuan.
Even intoxicated...
Many of Zhao Yuan's operations seemed "risky", but the patient's physical condition was stable.
In the field of cardiothoracic surgery in China, Jiang Qiang is a well-known expert and has performed countless level 3 surgeries.
This was his first time seeing such an operation.
A young man who looks gentle and humble on the outside, but every step he takes is so wild and elegant, yet precise and capable.
No wonder Xie Changtian regards him as his treasure!
An impulse arose in his heart: recruit Zhao Yuan to the cardiothoracic surgery department at all costs.
It would be a waste of money to store such good embryos in emergency surgery.
Should be transferred to cardiothoracic surgery.
If you train them well, they will definitely be a weapon for the department to generate income in the future!
