"No." Zheng Ren handed the suction device in his hand to Su Yun, opened the peritoneum, and protected it.
The director of the chest department, whose surname is Zhang, is a short, fat man. He wears a sterile mask and looks a bit vulgar between his brows.
This person is famous in the courtyard for being stingy and vindictive. There is usually nothing important and few people deal with him.
Director Zhang felt a little embarrassed and hesitated in front of the operating table.
Seeing that there was no movement, Director Pan came back after urging the blood transfusion department and happened to hear this conversation and gave him a hard look.
I don’t dare to go on stage without complaining about the chest department. Now Yang Lili’s blood pressure is still undetectable. She has undergone thoracotomy and abdominal surgery at the same time, and the possibility of getting off stage alive is really not very high.
"Let's do a thoracotomy for exploration." Director Pan said directly when he saw that Director Zhang was still hesitant.
If there weren't a lot of hospital leaders standing in the operating room, Director Zhang really wanted to refuse this operation.
He really wanted to say that he was already dead, so why bother
Up to now, the blood pressure on the ECG monitor is still undetectable, and the heart rate is extremely fast. Atrial fibrillation has already begun.
But seeing how fast the emergency general surgery was, I stood here for a few minutes and found the damaged mesenteric artery and started to ligate it.
Director Zhang sighed and said, "Just do your best."
"Su Yun, go help Director Zhang." Zheng Ren reached out without raising his head, and a piece of warm salt water gauze fell on his hand. While covering the intestines to see which section of the intestine has symptoms of necrosis, look for stab wounds on the intestines.
Um? Director Zhang was startled for a moment and looked sideways at Old Director Pan. Seeing that he didn't express any objection to Zheng Ren's words, his heart immediately began to stir.
Director Zhang knew that the emergency department "robbed" emergency surgery of general surgery. This time, was he trying to steal emergency surgery of thoracic surgery
There are not many guns in the emergency department, but the appetite is really big.
Without looking at Director Zhang, Su Yun turned around and stepped off the stage. He began to disinfect the chest incision, then brushed his hands again and put on surgical gown.
Director Zhang was very helpless, what the hell was going on.
But it’s not easy to get angry in front of so many hospital leaders. Mainly because Director Pan was a big mountain he didn't dare to offend.
If an attack occurs... Liu Tianxing is still hospitalized. It is said that he has liver disease due to depression.
You should bow your head when you should. Director Zhang began to communicate with the head nurse of the emergency operating room and wanted to go to the operating room to pick up the sterile bags from the chest department.
Su Yun ignored Director Zhang. After finishing the disinfection, he started to lay out the sheets, brushed his hands, and stood next to Zheng Ren. The two surgeries started at the same time.
The Shay people became even busier.
Because it is an unconventional technique, the tacit understanding without speaking has become a luxury.
Zheng Ren and Su Yun kept whispering for equipment, but Xie Yiren was barely able to do it.
After Director Zhang and the head nurse of the operating room of the hospital explained the needed sterile bags and sent his own hospital manager to get them, he turned back and saw that Su Yun had already opened his chest and was furious.
"Are you kidding me? You don't have any equipment and you're going to do it blindly?! This is a chest surgery, not an emergency surgery for you!"
What he said makes sense. There are ribs in the chest, so special equipment is needed to open the chest wall and expose the surgical field. Several retractors can be used for general surgery, but not for chest surgery.
Twenty years earlier, thoracic surgery would have required the removal of a rib to make the surgical field wider.
It makes sense, but in emergency rescue, every minute and every second is more precious than gold.
Su Yun concentrated on opening the chest. The rising star of cardiothoracic surgery had his own confidence and pride. How could he ignore the clamor of a director of Haicheng City No. 1 Hospital
No one paid attention to him. Zheng Ren and Su Yun were busy. Dean Xiao and Director Lao Pan stood behind Zheng Ren and watched the operation intently. They didn't seem to hear what Director Zhang said.
Director Zhang was helpless and did not dare to complain too much, so he had no choice but to go on stage.
Two operations are being performed at the same time, so there is simply no room for so many people. Normally, at least three people are required to perform thoracic thoracotomy surgery. But at this moment, only Director Zhang and Su Yun can do everything.
At this time, Yang Lei, who was standing at the first assistant position, became the busiest person.
On the one hand, I have to pull the hook and on the other hand, I have to pass the equipment.
Zheng Ren was preoccupied with two things, his eyes aimed at Su Yun.
Seeing that Su Yun's skills were skillful, he was indeed a doctor with a thoracic background, and was more than a little better than a general surgeon who had become a monk in the process.
In fact, Zheng Ren asked Su Yun to arrange the stage for Director Zhang because he had taken a fancy to the fact that Su Yun had already undergone a heart transplant in the imperial capital.
You can perform the most advanced thoracic surgery, but an emergency room can’t handle it
joke!
In order to better cooperate with Su Yun, Zheng Ren did not hesitate and ordered a master-level skill book to add to the cardiothoracic surgery skill tree.
Yang Lili was first stabbed twice in the chest, and then she hugged the gangster's arm with all her strength. After she broke free, she was stabbed several times in the abdomen.
The liver and spleen were not injured, but there were seven or eight breaks in the intestines, and some of the intestines were even penetrated.
There was serious contamination in the abdominal cavity.
After repeated flushing with warm saline, suction, and ligation of part of the injured mesenteric artery, the surgical field became much clearer.
The repair of the damaged intestines was a small problem. Zheng Ren quickly repaired every part of the problem with flying stitches.
The big problem is that the patient's mesenteric artery is punctured, causing ischemia and necrosis of the mesentery. After ligating part of the mesenteric artery, the intestine supplied by the ligated artery will inevitably become necrotic.
The main task of abdominal surgery is the resection and anastomosis of the intestines.
But for Zheng Ren, it is best to have an assistant. If not, it is enough to do it alone.
Gradually, Yang Lei helped Su Yun do more work, while Zheng Ren was just a hook to help expose the surgical field.
Even the work of tying knots and cutting threads was done by Zheng Ren himself. The scissors are held in the palm of the hand and appear and disappear like magic without any delay in hand movements.
The necrotic part of Yang Lili's intestine is about 60cm, which is at an acceptable level. If it is longer, you will have to be careful about complications such as jejunal syndrome after surgery.
Fifteen minutes after the laparotomy, Zheng Ren had already removed the necrotic intestine and completed the anastomosis of the normal intestine.
At this time, fresh frozen red blood cells and fresh frozen plasma had just been retrieved.
"One bag per person." Director Pan first picked up a bag of red blood cells and heated them with his hands.
Dean Xiao frowned and watched the operation.
But he also saw the blood arriving and asked Director Ding to get him a bag of red blood cells as well.
With the dean setting an example, who among the hospital leaders who come can say "no"
"There is no blood in the blood transfusion department." The phone rang, and the head nurse of the emergency operating room answered it and said.
"Director Ding, contact the downtown blood bank." Dean Xiao said: "At least 20u red blood cells must be prepared."
"Platelets and fibrinogen are also required." Su Yun was performing the surgery, but he also paid attention to the situation behind it.
Dean Xiao has a clinical background and knows that even if the patient is able to step down due to his current condition, he will still have to face numerous organ ischemia-reperfusion injuries and complications of DIC after massive blood transfusion.
He nodded.
Director Ding immediately ran out to make a phone call and contacted the central blood bank.
Soon, he ran back, approached Dean Xiao and whispered: "Dean, the central blood bank does not have that much type B rh-positive blood."
The city’s blood supply comes from the downtown blood bank. There may be insufficient blood for some rare blood types, or for blood types that have been used more recently.
"Contact the blood bank and the hospital to find people with the corresponding blood type to donate blood. Hurry!" Dean Xiao's face turned pale as he watched the operation.
"Okay." Director Ding immediately left the operating room and went out to talk about these things.
Generally speaking, even if someone donates blood, the central blood bank has its own set of cumbersome procedures, and blood cannot be transfused in a day.
At this time, the words of the chief director of the city's largest hospital still carry a certain weight.
Zheng Ren felt much more at ease when he heard the subsequent conversation.
The hospital came forward to clean up the face, which meant that there would be no shortage of platelets and fibrinogen.
These two things are necessary for patients to survive the stage, but they are rarely available now, especially fibrinogen.
Due to lack of fibrinogen, many portal azygos devascularization procedures cannot be performed.
After the intestinal anastomosis is completed, cover it with warm saline gauze for five minutes. Zheng Ren searched the abdominal cavity and found no other untreated injuries. He opened the warm saline gauze and saw a slight blood color at both ends of the intestinal anastomosis.
This proves that there is no ischemic necrotic tissue left, and postoperative intestinal anastomosis should not be a problem.
Flush the abdominal cavity again and start closing the abdomen.
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