Chapter 758： 1st patient

"The patient ... should be under anesthesia." Salina, who was translating, whispered, her inner fear was self-evident.

Ling Ran's "En" sound did not immediately start, but she quietly observed the patient and said, "We use the shortest possible time and the fewest steps to treat the patient's wound to maintain life. "

He explained as clearly as possible. There were insufficient staff in the operating room and the experience of the assistants was even worse ... In fact, he lacked even the assistants. Only the nurses and a translator who washed their hands had to teach and do it. .

In this case, doing a complete surgery is challenging the limit.

Lingran himself doesn't mind challenging the limit, but he can also make judgments with gallstones. The patient absolutely does not want to accept the limit challenge. Moreover, the time required for a complete surgery is also a disadvantage for the rescue of subsequent patients.

Therefore, although Ling Ran instinctively wanted to have a complete operation, at this time, Huo Congjun's roar also sounded in his mind: "Save your life before you cure the disease!"

I spent a long time in Yunyi's emergency center. Ling Ran really agreed with Huo Congjun's idea.

Ling Ran gently flipped the patient, looked at the numbers on the monitor to determine the depth of his anesthesia, and reiterated: "Also pay attention to the volume of urine during the operation. If you can notice it, report the amount of bleeding and irrigation. . "

"How much is normal?" Salina wanted to take the job.

Ling Ran shook her head: "According to the weight of the patient, the normal urine output per kilogram per hour should be 1 milliliter, but there are other factors affecting it, so you can report the number. The main concern is that the urine output decreases and increases. Generally The problem is not big. "

"Okay." Salina then whispered to the nurse, raised her head, and saw that Ling Ran looked like a salted fish again, turning over the patient.

Sarina looked at the patient's bleeding wound, and could not help but substitute for the doctor's identity, and said, "Dr. Ling, haven't you started?"

"Wait a second," Ling Ran said.

"Why?"

"As far as possible to ensure the depth of anesthesia." Ling Ran answered.

Sarina did not understand the meaning, and repeated it with a little doubt: "Depth of anesthesia?"

"Well, if the depth of anesthesia is insufficient, there may be intraoperative awareness." Ling Ran said lightly, but it actually described the greatest terror in surgery.

The so-called intraoperative awareness is that the patient wakes up during general anesthesia.

Imagine a group of people cutting your body, and then you wake up. However, this is not the most terrifying place. The most terrifying place is that because the current anesthesia method is combined anesthesia, the patient knows even if it happens during surgery. Because of the use of drugs such as muscle relaxant, he may not be able to make any form of expression.

In other words, the patient's consciousness is awake and the pain is constant when known during the operation. Only the patient cannot speak, cannot shake his head, or even tighten muscles to resist.

If this is not scary enough, the greater horror of intraoperative awareness lies in the fact that most patients who are aware of intraoperatively after awakening do not know that intraoperative awareness has occurred.

Because of the use of narcotic drugs, a wake-up patient may have forgotten the hell-like pain of an hour or two ago.

It is very difficult to avoid knowing itself during surgery. Because everyone's constitution is different, anesthetic drugs cannot be used without limit.

凌 For Ling Ran, the use of narcotics for beginners is even more difficult to control.

Therefore, Ling Ran needs to observe more. At the same time, it is necessary to reduce the operation time as much as possible. As far as the current environment is concerned, this is beneficial and harmless.

In the operating room, it was a little quiet.

Soon afterwards, Ling Ran took out a scalpel and quickly cut open the patient's abdominal wound.

"Intestinal injury." Ling Ran said, then cleaned and sutured the wound, then cleaned and perfused antibiotics, placed the drainage tube, and began to close the abdomen.

Tongguan abdomen is not a complete closed abdomen, but a simple suture to keep the stomach open.

It is actually a challenge for Ling Ran to use expedient measures for the land of rights and interests.

"Now handle the shoulders." Ling Ran explained, and began to change the posture of the patient.

The intestines and shoulders are actually not within Ling Ran's skill range. However, if the wound is simply treated, the difference between the various parts will not be too great, especially the emergency department treatment, which is always very rough.

Ling Ran is not pursuing any delicate operation now, just like an ordinary emergency department inpatient, who is fussy doing surgery that he is not very good at.

估计 It is estimated that the complications will not be less. For the same patients, putting them down in a large hospital for emergency treatment, or leaving a specialty to perform surgery, hospitalization time, etc. will have obvious differences. Not to mention the conditions now.

In fact, the patients in front of you must be in the palace twice. If you are unlucky, you may need to enter the palace three times, but you can survive.

Ling Ran seemed like a novice, and opened his shoulders sparsely to reset the patient.

This time, there is no skill to assist, or even the guidance of a superior doctor, only Ling Ran can rely on past experience and existing knowledge to give him operation.

Ling Ran is slower, but his movements are quite proficient.

After all, he is good at orthopedic surgery. Even if he hasn't touched it, the difficulty of orthopedics is not as complicated as liver and pancreas.

The most important thing is that Ling Ran has to perform this operation. Otherwise, the patient's shoulder will become more and more painful. If the painkillers are not enough, he must shout his throat.

Fortunately, Ling Ran knew how to make Chris fracture, and it was a perfect Chris fracture. The technique of anatomical reduction was not a problem for him.

His upper limb anatomy experience is also huge, the system has been given more than 3000 times, and he has done a lot of surgery.

Compared with ordinary doctors, Ling Ran may have a deeper understanding of the anatomy of the shoulder.

I am not familiar with the surgical approach and procedures.

After all, the purpose of surgery is to repair the patient's body.

Whether it is open surgery or laparoscopic surgery, after all, they are all dojos in the spiral lion shell. The doctor must treat the patient with as little trauma as possible, so when opened, it cannot be how the doctor can easily operate, but to find a location that can avoid important nerve blood vessels and even muscles, and can achieve surgery Goal.

Such a position and path is the surgical approach. Generally speaking, a surgical approach is a multi-generation clinician, which is accumulated and perfected every year. Inexperienced doctors, except for learning and memory Other than that, there is basically no other choice.

If you want to create a new surgical approach ~ www.novelhall.com ~ without ten or eight years of clinical experience, it is simply a dream. Of course, more clinicians can only remember the popular approach in two or three decades.

Ling Ran has always had a good memory. Slowly taking pictures of cats and tigers finally managed to treat the fracture of the shoulder, and the forehead was sweating for the second time.

"Salina wipes my sweat, Nandaman, you bandage." Ling Ran gave the nurse a hand and started bandaging the wound.

Sarina and the nurse nodded at the same time, both looked at Ling Ran for a while.

"Sweating so much, I'm too tired." Salina wiped Ling Ran and couldn't help it. "It's just one arm, don't be too hard ... Well, I mean, there are still many patients behind Then. "

"Well, it makes sense to do one and then the next." Ling Ran nodded.

"Dr. Ling is here, and everyone will be lucky when they encounter the flood." Salina carefully wiped Ling Ran's sweat carefully and let go of her hands reluctantly.