In the emergency department, myocardial infarction is the highest priority disease and must be treated immediately.
Some patients complain of chest tightness, and they may be in danger in the next second.
Zhao Yuan's diagnostic ability is recognized.
Since he said it was myocardial infarction, it's not wrong.
Sun Liang, standing next to Zhao Yuan, secretly sighed that Zhao Yuan had won the respect of everyone in the emergency surgery department.
Although he is young, he speaks with strength.
His stunning performances time after time won the trust of others.
In the battlefield of emergency surgery, whether a person has authority depends not on hearsay about his reputation as an expert, but on proving his reputation through actual battles one after another.
Zhao Yuan's physical examination is different from others, adding elements similar to those of traditional Chinese medicine.
He will look at the patient's respiratory rate, look at the patient's fingernails and lips, and more importantly, the patient's muscle condition.
Zhao Yuan is also very good at using a stethoscope to identify possible conditions through the murmurs in the patient's body.
Most doctors can perform physical examinations, but only a handful of them can truly understand it.
This is somewhat similar to solving a math problem.
The calculation skills required to solve a difficult problem may be the most basic, but clever thinking is the key to successfully solving the problem.
"Send to the emergency room and ask family members to sign. Are family members at the scene?" Deng Yunlun ordered.
A resident doctor reported, “My family members also have food poisoning and are receiving treatment.”
Deng Yunlun sighed and walked towards the family members.
The family member was in great pain. When she heard that her husband was seriously ill, she completely lost control of her emotions and broke down crying. Deng Yunlun comforted her and reminded her to sign quickly.
The family members had a hard time signing it.
There are many types of acute myocardial infarction, and the first step in treatment is thrombolysis.
The patient's blood vessels are blocked, causing hypoxia in the heart. Medication is pushed in through interventional means to open up the blocked area, and then a stent is installed to prevent blockage again.
After the patient lay down, Sun Liang pushed the ECG monitor over.
Sun Liang looked at the data and his expression darkened, "ST segment elevation in leads v1-v6, acute myocardial infarction in the anterior wall."
Zhao Yuan knew it well and did not look at the ECG monitoring. "The thrombus exists in the proximal left anterior descending artery. In addition to the anterior wall being affected, the ventricular septum and lateral wall will also be affected."
Sun Liang studied the bands again and couldn't figure out why Zhao Yuan made such a judgment.
However, at this moment, Sun Liang had no doubts about Zhao Yuan's judgment.
"Carry out thrombectomy directly." Zhao Yuan glanced at the circulating nurse, "Prepare the coronary thrombus removal catheter."
Although Zhao Yuan's voice was not loud, every order was so powerful that no one could question it.
Deng Yunlun watched from the side and secretly admired him.
After I became the leader of the third treatment team, many people said behind my back that my level was not as good as the interns below me.
Deng Yunlun felt very uncomfortable at first, but as time went by, he became more accepting of her.
Zhao Yuan's level is obvious to all. Even the deputy directors of the Emergency Surgery Department dare not say that he is much better than Zhao Yuan.
In particular, Zhao Yuan's strength in cardiac surgery has been highly recognized by the Department of Thoracic and Cardiac Surgery, and he can now perform aortic dissection surgery independently.
Therefore, the emergency treatment of myocardial infarction was left to Zhao Yuan without any problems.
The patient was lying on the operating table and suddenly became conscious.
"Doctor, will I die?"
Sun Liang smiled and said, "No!"
The patient glanced at Zhao Yuan, "Why is he so young? Could it be that he is using me as a guinea pig to let interns practice swordsmanship?"
Sun Liang burst into laughter and teased Zhao Yuan, "Dr. Zhao, what should you do if others question you?"
Zhao Yuan patiently said to the patient, "Don't be nervous. When you are nervous, your blood vessels will constrict and your condition will worsen. Lao Sun, please think of a way to stop him from thinking wildly."
Sun Liang was silent for a few seconds, patted his forehead, took out his mobile phone, clicked on a page, and placed it in front of the patient's eyes.
"Although Dr. Zhao is young, he can perform fourth-level heart surgery. Although myocardial infarction is not easy, it is not an obstacle to him. He can remove a bullet from the heart and an embolus, so it doesn't matter."
The patient's mood was indeed much better.
"I'm sorry, doctor, I shouldn't judge people by their appearance. In addition, something happened suddenly today and I don't have any money with me. I will give you a big red envelope later. I have to give the anesthetist a red envelope too. Oh, please take it seriously...
…”
When Sun Liang saw the patient saying this, he almost laughed out loud.
Zhao Yuan was as calm as ever, "Put the red envelope or not on the second priority. Please make sure to lose weight after you recover. Otherwise, the doctor will cause a lot of trouble when operating. Your myocardial infarction is related to food poisoning on the one hand and food poisoning on the other."
One aspect is related to obesity."
The patient quickly promised, "Okay, I will definitely lose weight in the future. I am mainly greedy and have no resistance to delicious food."
Zhao Yuandao: "The main thing is to exercise more! I also like food, but I keep running every day."
The patient said, "The relationship is good. When you are discharged from the hospital, I will take you to eat all over Baiyun."
The conversation between Zhao Yuan and the patient made the atmosphere in the operating room less tense.
Sun Liang knew that Zhao Yuan rarely spoke during surgery.
But today's patient is in a special situation.
He was in a rather nervous mood.
Obese patients are less friendly to surgeons.
Taking laparotomy as an example, it only takes a thin person a minute or two to enter the abdominal cavity.
For obese people, it may take more than ten minutes for the doctor to cut through the skin, thick subcutaneous fat, muscles and a thick layer of extraperitoneal fat to enter the abdominal cavity.
In addition, obese patients are not very friendly to the resident doctor responsible for retracting the hook.
The belly of a thin person is thin and is easier to pull open, while the belly of a fat person is too thick, so the resident doctor responsible for retracting the hook will be very hard and need to use a lot of strength. A five-hour operation can make the resident collapse.
Moreover, obese people not only have belly fat, but also have a large amount of visceral fat in the abdominal cavity. The omentum and mesentery are all fatty tissues.
Fat tissue occupies a large amount of space in the abdominal cavity, resulting in less space for surgical operations.
There are also difficulties with interventional surgeries.
Many nurses can't find blood vessels when putting fluids on obese patients because the fat is too thick and the blood vessels cannot be seen.
In addition, after the catheter is inserted, due to the thick skin and thick flesh, the situation inside may not be clearly visible under ultrasound, and a sufficient surgical field cannot be provided.
The anesthesiologist anesthetizes the patient.
The operating room is instantly quiet!
Sun Liang was thinking about what to do if he was the chief surgeon.
Zhao Yuan has completed the puncture, established the channel, sent the catheter sheath into it, and the guide wire entered the patient's body along the sheath.
Sun Liang took a look at the imaging and found that it was as difficult to see clearly as he imagined.
"Thrombus removal catheter." Zhao Yuan ordered the instrument nurse.
Bai Lu wore a lead suit and placed the catheter on Zhao Yuan's hand.
Sun Liang raised his head and glanced at the screen. He saw something dark and started to walk out.
When the reaction came over, a 1cm-sized embolism appeared on the white gauze.
