"When it comes to ophthalmology, you may not know that the gallbladder has been removed." Su Yun stared at the ECG monitor, moved a footstool to the patient's left side, and chatted wordlessly with Mr. Yu.
"Uh, do you have a gut reflex?" Mr. Yu asked.
"Yes, what are you most afraid of when having gallbladder removed? Cutting off the common bile duct is very serious, but it is not as serious as the biliary-cardiac reflex. Like the oculocardiac reflex, the gallbladder is involved in biliary tract surgery, or the heart rate slows down or is caused by exploring the biliary tract. Blood pressure drops, and in severe cases, reflex coronary artery spasm can lead to myocardial ischemia, arrhythmia, and even cardiac arrest."
"Especially when rescuing patients with hemorrhagic shock, the probability is rising exponentially."
Fortunately, Mr. Yu is the resident chief of 912 after all. But Gu Xiaoran's heart was pounding while listening.
He has already started undergoing related surgeries at the hospital in his hometown.
The hospital across from home was smaller, and the departments were not so detailed. The director had connections with Zhou Chunyong, so Gu Xiaoran seized an opportunity that no one wanted to come to and went to the Imperial Capital.
Coming to the imperial capital for further study this time has really brought about huge changes in Gu Xiaoran's life. Every day he has a new change. For example... today.
When he thought about what he usually explained to the patient's family before cholecystectomy, he had no bile and cardiac reflex at all, and he had no idea what the bile and cardiac reflex was.
Not to mention Gu Xiaoran, not even their director should know. The probability of this happening is extremely low. Even if you perform 1,000 surgeries, you may not encounter even one, let alone a rookie like Gu Xiaoran.
"Brother Yun, what will you do when you show up?" Gu Xiaoran asked in a low voice.
"Rescue, can you still watch the patient die?" Su Yun said disdainfully: "If you are not sure, call over the big guns in your hospital, whoever is the most powerful can be called. Of course, you just need to As long as you don't cry on the operating table, it'll be fine no matter what. If you contaminate the surgical area, it's not enough to cause trouble."
Su Yun finally laughed at Gu Xiaoran.
"Hehe." Gu Xiaoran smiled, but his smile was stiffer than Mr. Yu's.
"Xiaoran, right?" Mr. Yu said, "The bile-cardiac reflex is really rare, and it is even rarer for urinary retention in the bladder to pull the vagus nerve. Otherwise, why would Boss Zheng always feel that something is wrong before the operation, but can't remember it? what is it then."
Gu Xiaoran glanced at Boss Zheng and saw him sitting in the corner of the operating room, his eyes seemed to be staring at the ECG monitoring like Brother Yun's.
Boss Zheng was still worried about the patient, and Gu Xiaoran felt slightly strange in his heart. I always hear Boss Zheng talk about rich clinical experience... What is rich clinical experience? This is it.
Although Boss Zheng did not discover it at the earliest time, he stepped forward immediately and presided over the rescue successfully. There should be no problem with the patient.
Thinking of this, Gu Xiaoran took another look at the patient.
He opened his eyes in confusion, as if he had just slept and didn't know what happened.
"The probabilities are different. The heart-eye reflex in eye surgery has a 90% chance of occurring, but the probability of the bladder inducing the heart reflex is too low." Su Yundao.
"Uh... I remembered that once I had an operation and I saw the patient's appendix after the laparotomy." Mr. Yu had already completed the ostomy and asked the circulating nurse to drain the urine from the bladder in 2-3 times. "I As long as the patient exerts force when pulling the hook, the patient's heart rate will change, which was fun at the time."
"It's caused by a reflex. The vagus nerve reflex in the gastrointestinal tract is also very rare, and even after it happens, you don't know what happened." Su Yun stood on the footstool, a little taller, and said with a bird's eye view of the ECG monitoring.
"More or less, I had no experience at that time. Brother Yun, it should be fine this time."
"It should be fine." Su Yun glanced at his boss and saw him sitting firmly on the stool. Although he didn't say a word, even though he was sitting there, he gave people a sense of peace of mind.
As long as this guy is here, nothing will happen. Su Yun gradually accepted this reality in his heart.
What a wealth of clinical experience? Or is this guy born with a keen sense of smell, like Heizi
Su Yun glanced at his boss and thought about it.
Before this accident, he didn't seem to know what would happen. At the moment of cardiac arrest, he began to preside over the rescue. Alas, why is this boss so willing to steal the limelight? Su Yun sighed deeply in his heart.
"There are many cases of cardiac arrest due to full bladder." Zheng Ren said suddenly.
"Um?"
"But generally speaking, we don't think that it is caused by a full bladder." Zheng Ren continued: "I hold my urine in the morning, then suddenly urinate, and then I fall into the bathroom. Such examples are often seen, but usually I went to the circulatory department for treatment.”
"..." Mr. Yu was startled.
"When the hollow organs receive expansion stimulation, they can pass through the celiac plexus or the vagus nerve afferent center, and the excitement is conducted to the parasympathetic low-level center in the medulla oblongata and the dorsal nucleus of the vagus nerve. The impulse is released and then reaches the heart through the parasympathetic fibers in the left vagus nerve." Zheng Rendao, "A very clear reflex arc."
"Uh..." Gu Xiaoran suddenly made a startled sound, and then said: "Boss Zheng, our old director once had an operation and had a heart attack during the operation! Now I think it may be because he was holding in his urine."
"Huh? What happened next?"
"Heart attack."
"Have you been rescued?" Zheng Ren asked.
"Oh, after all, he was rescued in the operating room." Gu Xiaoran said, "While thrombolytic, I contacted the municipal hospital and the 120 ambulance sent the stent."
"You guys can't even remove the bracket?" Su Yun asked.
"Yeah." Gu Xiaoran nodded, "I went with you. The doctor in the city said it was just a little bit close. Fortunately, I got sick in the operating room. I felt lucky at the time, but now I think it was probably because I was holding in my urine. .”
"Boss, do you think this is a work-related injury?"
"Have you ever heard of work-related injuries in the hospital?" Zheng Ren asked rarely.
Seeing that he had not finished speaking, Gu Xiaoran changed the subject again. He quickly asked: "Boss Zheng, the vagus nerve is excited, what next?"
"The results of vagus nerve excitation are coronary vasospasm, reduced excitability of the sinoatrial node, slowed conduction velocity of the specific conduction system, weakened myocardial contractility, reduced cardiac output, decreased blood pressure, and even cardiac arrest." Zheng Rendao .
"It's amazing." Gu Xiaoran whispered.
"It's not great. I never thought about it before." Zheng Ren sighed and said, "Now that I have experience, I will be fine in the future. Su Yun, you are right."
"What the hell am I right about?" Su Yun glanced at Zheng Ren and asked.
"Clinical experience is accumulated bit by bit. That Korean professor is a hooligan." Zheng Ren said seriously.