"Can you relax a little? Don't be nervous, auntie." Liu Jingyun tried to calm the patient's emotions.
"I can't bend down, I can't bend down." The aunt kept yelling that her back hurts.
Liu Jingyun looked back at the clock, the surgeon might be coming later, and if she saw that the patient was not well anesthetized, she would probably be angry. This is an operation at noon, and the surgeon sacrificed his rest time to do it urgently for the patient.
As a result of the surgeon's anger, just like the emergency department last time, he finally sued the anesthesiology department: It's just a simple spinal anesthesia, and the people in your anesthesiology department can't do it well
"Don't be nervous, take a deep breath, auntie. Shall I hold your hand first?" Liu Jingyun held the patient's hand, wishing she could take the pain of the patient instead.
Xie Wanying looked at the state of the patient, and showed the patient from head to toe to see what went wrong.
Lumbar disc herniation, so back pain? Is the patient's complaint exaggerated? Say it hurts too much to bend over? Some patients are nervous when they enter the operating room, and they are too nervous to amplify their pain.
On the monitor, the patient's heart rate is a little fast, but the blood pressure is strange, a little low
"Elder Sister." Xie Wanying called Senior Sister again.
Liu Jingyun turned her head and asked her junior sister suspiciously, "What's wrong?"
"Shouldn't be able to do back anesthesia."
Maybe the junior sister doesn't understand that lumbar disc herniation can be treated for spinal anesthesia. Liu Jingyun was going to give a lecture to the younger junior sister.
Walking around the end of the patient's bed and walking to the elder sister on the opposite side, Xie Wanying whispered, "Maybe we need to rule out spinal problems, such as ankylosing spondylitis?"
Spine problem? Liu Jingyun was taken aback.
"Emergency patients? How many tests have you done?" Xie Wanying asked.
Liu Jingyun looked back at the medical records on the treatment car, it was true that she was an emergency patient. It may be that the emergency doctor was afraid of what would happen to the anus, so he rushed to perform the operation.
What is the specific situation, Liu Jingyun walked back, picked up the medical records and checked again. It turned out that the patient had an anal fistula. He had undergone anal surgery before, and local anesthesia was used at that time. There is no risk of local anesthesia, and the treatment is a low anal fistula. Later, it was found that the recurrence was serious, which may have involved a high anal fistula. Came in from the emergency room, this time into the operating room, probably wanting to do a thorough anal operation.
For surgery, some basic preoperative examinations will be done, such as electrocardiogram, generally there is no problem, blood test, coagulation is no problem. Because of anal fistula, there must be infection, and the white blood cells are higher, so surgery is required.
Liu Jingyun thought over and over again, why did the junior sister suspect that there was a problem with the spine
"The pain is so painful, could it be that the spine is deformed? The local anesthesia operation last time may not need to bend over." Xie Wanying said, "The patient is thin and has high white blood cells. It is said to be caused by anal fistula, but could there be other causes? What caused it?"
Bending and waist pain, generally do not say that the pain is so bad, even a little bending is not enough, patients say that the head hurts too.
If there is a problem with the spine, it is definitely not possible to do spinal anesthesia. This is a contraindication for spinal anesthesia.
It is right to be cautious, but in order to find out whether this is the reason, it is necessary to ask the patient to take an X-ray and contact a clinician for consultation. If the other teachers are alright, today is that director Zhang, Liu Jingyun would feel dizzy thinking about it.
Putting down the medical records, Liu Jingyun walked back to the patient's bedside, and stretched out her hand to touch the patient's back to check the condition of the patient's spine. This was the positioning action she had to do before anesthesia. After touching it carefully, I found that the patient's back muscles were very stiff, which was obviously different from ordinary people, and it felt that something was really wrong.
"Didn't you have a chest X-ray?"
"A non-hospital patient, coming in from the emergency department, it's too late to take pictures." Xie Wanying helped the senior sister look through the medical records and said.