Just when Zhou Sheng was about to go under the knife.
Su Quan on the side suddenly reminded him, "Brother, have you thought clearly? This is a big deal. Do you want to do a pericardiocentesis first to see if he has a heart hemorrhage?"
The pericardium is a membranous sac that covers the surface of the heart. The pericardium wraps the entire atrium and ventricle of the heart and plays a role in protecting the heart. If there is heart bleeding, there will definitely be blood accumulation in the pericardium.
There were few people in the operating room, so Su Quan no longer called Team Leader Zhou, but called him brother, which further proved that this was a private and well-intentioned reminder.
Su Quan was worried that if the patient's heart didn't bleed with this knife, things would get worse.
A pericardiocentesis can be done to check whether there is blood accumulation in the pericardium, which is safer.
This is also the procedure in the textbook for normal diagnosis of cardiac bleeding.
Although Su Quan has never had heart repair surgery, he still has this kind of theoretical knowledge.
And there is another very important point. Su Quan has never seen Zhou Yisheng undergo any extracardiac surgery. Not to mention this kind of open-heart surgery. He has never seen even the simplest extracardiac pericardiocentesis.
Su Quan was a little worried, whether Zhou Sheng had recently been promoted to a regular position and promoted to a leader. Despite everything going smoothly, he was overheated.
In order to stand out, he underwent an operation that he was not capable of.
Pericardiocentesis is an introductory extracardiac surgery. If you are skilled in this operation, it proves that Zhou Yisheng has studied extracardiac surgery. Su Quan will feel more at ease.
Of course, Zhou Sheng could understand Su Quan's thoughts at a glance.
But he didn't have time to talk to Su Quan.
While pushing the scalpel and cutting open the victim's skin, he said: "If it's not urgent, pericardiocentesis is feasible. It's an emergency now, but we don't have so much time. You must trust your clinical examination, Beck's Triple
Symptoms are the standard for judging pericardial effusion. Let’s open the chest and see what the situation is.”
As Zhou Sheng was talking, he kept moving his hands, incising the skin, and then the subcutaneous tissue...
Su Quan also shut up at this time.
Before going under the knife, Su Quan, as the second assistant and brother, had the obligation to remind Zhou Sheng. But once Zhou Sheng made the decision.
Su Quan did his best to assist.
The process of opening the chest is not too complicated.
Especially the entry point for Zhousheng's left anterolateral thoracotomy also avoided the need to deal with the sternum, so the progress was very smooth.
In fact, this process should be able to be completed if Su Quan handles it.
But of course Zhou Yisheng would not let Su Quan handle it.
Because it is rescue, knowing and being proficient are two completely different concepts.
Only with proficiency can you have speed.
Speed saves lives.
At this moment, Cao Xin was worried about the position of his third assistant.
This was his first time seeing Zhou Sheng undergo surgery, and it was a thoracotomy.
If he hadn't known Zhou Sheng a little before, he would have found it inconceivable that such an operation outside the heart would require a highly qualified attending physician to complete it.
Unexpectedly, Zhou Sheng, a newly promoted emergency resident physician, would dare to operate.
Zhou Sheng is indeed a ruthless person!
Cao Xin has also seen some open heart surgeries.
For example, Director Tian did it, his uncle Cao Xiangwen did it, and some attending doctors did it.
So he can understand a little bit.
He would definitely want to compare Zhou Sheng's operation at this moment.
There is no risk in chest opening, it mainly depends on your proficiency.
Judging from the speed of chest opening, Zhou Yisheng is faster than Director Tian and Uncle.
On this point alone, Zhou Yisheng would still be better than them.
This week in my life, I am not only ruthless, but also very powerful.
When Cao Xin finished sighing.
Zhou Sheng has completed the first step of thoracotomy for cardiac suturing.
The heart is now exposed to the surgical field.
Su Quan looked nervously to see if it was really a heart bleeding.
At this moment, I saw that there was a rupture of about 2cm on the pericardium of the injured person.
There was blood oozing out from the rupture.
There is no need to do pericardiocentesis, the situation is already obvious.
There is hemorrhage in the pericardium.
The next step is to open the pericardium.
This is a technical life about a professional outside of the heart.
Earlier it was said that the pericardium is a membrane.
It’s not accurate enough. This membrane specifically has two layers, the fiber layer and the serous layer.
The fibrous layer is tough and closely adheres to the wall layer of the serous layer, and has very little elasticity. The serous layer is very thin, smooth and moist, and is divided into a parietal layer and a visceral layer. The wall layer is closely attached to the inner surface of the fibrous layer.
The visceral layer is attached to the surface of the heart, the epicardium.
There is a cavity between the two layers of the wall of the heart, called the pericardial cavity. The cavity contains a small amount of fluid, called pericardial fluid, which is the filtrate of serum and contains a small amount of protein. The pericardial fluid has a lubricating effect and can reduce friction during heart movement.
.
The condition of the injured person now is that the pericardial cavity is filled with not only pericardial fluid but also blood.
The blood accumulation must be in the heart.
So if you want to treat the heart wound, you need to open the pericardium.
Zhou Sheng carefully incised the pericardial wall layer and visceral fiberboard. At this time, the myocardial pulse could be seen and bulged toward the pericardial incision edge...
Su Quan opened his eyes wide. He had never seen the pericardium open before. Today was an eye-opener. He didn't expect that such a major surgery could be seen in the emergency center. He felt a little excited.
When the pericardium was completely opened, it was obvious that the right atrium was ruptured by 1cm. During the contraction of the heart, blood suddenly shot out.
Cao Xin was startled and screamed: "Blood! There is blood!"
Su Quan did not call, Cao Xin called first, there is a reason.
Su Quan had never seen what the pericardium looked like after it was opened.
Cao Xin had seen it on the extracardiac operating table.
However, he has never experienced a heart rupture.
After the pericardium he had seen was opened, they all looked peaceful and peaceful, waiting for surgery such as mitral valve replacement.
When the fight started on Zhou Sheng, the scene was grand and the blood flowed out.
So Cao Xin shouted out on the spot.
At this time, Su Quan also realized something was wrong, "My heart is bleeding! What should I do?"
Of course Zhou Sheng knew it well.
Heart Suture Technique has also been updated a lot in the dungeon.
There is no need to be polite when dealing with this kind of wound. Stopping the bleeding quickly is the first priority, so get started!
That’s right!
Just get started!
Acupressure to stop bleeding!
Don't think that this method of stopping bleeding is only for trauma.
It can also be used during surgery when quick treatment is needed to stop bleeding.
Zhou was born with eye disease and quick hands. He directly pressed the rupture of the heart with the index finger of his left hand, and then began to use a non-invasive suture with a pad to pass through the rupture of the full-thickness myocardium for mattress suture.
Here Zhou Sheng has to do bleeding control and suturing, which cannot be done by one person.
Second assistant Su Quan has a place to play.
Following Zhou Sheng's instructions, when Zhou Sheng's fingertips moved down to reveal the upper end of the crack, Su Quan immediately tied the sutures to close the crack, and gradually performed interrupted sutures.
Suturing is a basic operation in surgery.
Su Quan, who can perform appendix surgery, is naturally no longer a problem.
At the beginning, I was a little nervous, but after one injection, I got used to it completely.
Unfortunately, the wound was only 1 centimeter, and it was sutured after two stitches.