Provincial Second Hospital, operating room.
Everyone flew up.
The old director of the Department of Orthopedics, who is about to retire, has been squatting in the operating room for nearly 24 hours. During this period, he only ate one meal and stood on the operating table the rest of the time.
There are so many injured, endless.
The equipment nurses' eyes became red while they were doing it, and one even couldn't help crying directly on the stage.
As a person in the operating room, what kind of things have you never seen? No matter how tragic and sad things are, you can look at them indifferently as an outsider.
But this time, they didn't do it.
Director Lao Jing has remained silent, but stubbornly refused all requests for him to step down and take a rest, even requests from the medical office.
After amputation, one batch of patients was completed, and another batch was sent in. It seemed that the courage was endless.
Director Jing didn't want to see what was going on ahead. I am old and my legs and feet are inconvenient. If I have to go to the front line, I will have to drag at least two or three people to take care of me.
He makes the most of it in his own way.
only…
There are simply too many patients with amputations. The number of amputations performed in a lifetime is not as many as the number of amputation surgeries performed in these 24 hours.
This is under the premise that most serious cases are sent to West China for treatment.
The Provincial Second Hospital is not ranked high in comprehensive medical strength in Chengdu, probably in the top five.
But even so, countless seriously injured people were still sent over.
Director Jing stayed up for nearly 24 hours, and his body was already exhausted. The usual joking on the operating table, about introducing her boyfriend to the nurses, etc., were not said out loud.
The atmosphere in the entire operating room was compressed, and the air pressure was at least 5 Pascals higher.
He carefully devoted all his energy to the patients. Those seriously injured patients whose limbs were smashed and crushed by heavy objects, did not receive treatment in a short period of time, developed compartment syndrome, and the scope of amputation was much larger than imagined. .
He tried very hard to save as many limbs as possible for the injured, but he couldn't do it.
Compartment syndrome is often caused by the hematoma and tissue edema of trauma and fractures, which increase the volume of the intrafascial contents or the outer packaging is too tight, and local compression reduces the volume of the intrafascial compartment, resulting in an increase in intrafascial pressure.
When the pressure reaches a certain level (8.7kpa (65mmhg) in the forearm and 7.3kpa (55mmhg) in the calf), the small arteries supplying the muscles can close, forming a vicious cycle of ischemia-edema-ischemia.
This is a common acute clinical symptom.
Normally, incision and decompression are enough, and there is no need for amputation at all.
However, in the face of natural disasters, almost all the injured did not receive treatment immediately, which was completely opposite to the situation of singing and dancing. Even most patients have heavy objects pressing on their limbs, and the huge pressure directly leads to ischemia and necrosis of the limbs.
The edema surface gradually spreads upward, spreads, and keeps spreading. Leading to avascular necrosis, compartment syndrome continues to appear above the blackened limb.
The scope of amputation expanded, and many limbs that did not need to be amputated were amputated by Director Jing. He believed that he was committing a crime.
However, failure to do so will inevitably lead to more and more complications, and the injured will fall into more difficult infections and poisonings.
Carrying huge pressure and self-blame, Director Jing silently performed one operation after another.
He knew that the three or five operating rooms next door were all arranged for orthopedic surgeries; the others were mainly neurosurgery.
However, there are not many patients in the general surgery department and the thoracic department. Due to organ bleeding or pneumothorax, it is difficult for seriously injured patients to persist for more than 48 hours.
A middle-aged man with serious injuries was carried down, and his right thigh was amputated.
Normally, the injured person only needs fracture fixation and no incision and decompression.
But now, a thigh has to be amputated...
"Next." Director Jing's voice was completely hoarse, and even he couldn't tell that the voice he squeezed out was what he had just said.
Another patient was sent to the operating table. Director Jing spent the intermission sitting on the stool in the operating room, closing his eyes and resting. The junior doctors under him are responsible for carrying patients, pre-operative disinfection and other preparations.
There was a plastic bag taped tightly with medical tape on the patient's chest. The orthopedic surgeon took off the tape without hesitation and threw the plastic bag into the red trash can.
When the circulating nurse saw this scene, she had just slept for a few hours and was still very energetic.
Yes, sleeping for only two or three hours a day and working the rest of the time can be devastating.
But under the current circumstances, she is the most energetic person here.
The circulating nurse realizes that there may be something important in the plastic bag, such as the patient's identity, so that the patient's family can find it.
She used oval pliers to take the plastic bag out of the red trash can and opened it to take a look.
"This patient's limb edema is not severe, director. Sister Su, prepare..." The orthopedic surgeon was interrupted by the circulating nurse midway through his words.
"This is the medical record left by the frontline doctors." the circulating nurse said solemnly.
"What?" The orthopedic surgeon didn't understand. Front line? doctor? Medical records
Everything is lacking on the front line, and in some places even water needs to be dropped by air. An airdrop of pure water costs at least one hundred yuan per bottle.
Even so, due to weather conditions, most of the water and food could not reach the victims. And the frontline headquarters continues to make airdrops regardless of cost.
There is such a shortage of things, and there are still doctors leaving medical records on the front line
Director Jing's eyes suddenly opened. He stretched out his hand and said, "Show me."
A piece of facial tissue was handed into Director Jing's hand. The whole paper was wet and heavy in his hand.
He looked at the messy writing on it and felt a sore nose.
What kind of difficult conditions is this medical treatment under
Although he has no personal experience, Director Jing can imagine it.
After watching for nearly three minutes, Director Jing remained silent without saying a word. The hand that carefully held the tissue trembled slightly, getting worse and worse.
"Director?" The circulating nurse only glanced at him and handed the tissue to Director Jing. When she saw something was wrong with Director Jing, she immediately asked.
Director Jing didn't speak. He wiped his face carelessly with his big hands. After calming down a little, he said, "This patient had a thrombectomy on the front line, 6 hours ago."
"..." The traveling nurse was stunned.
"..." The orthopedic surgeon who was disinfecting was also stunned.
Can thrombectomy be performed under conditions like those on the front line
In severe trauma, thrombectomy is many times more difficult than thrombectomy for general cardiovascular and cerebrovascular diseases.
Because the original normal physiological and anatomical structures are destroyed, the emboli are numerous and dense, making them difficult to remove.
This kind of surgery is rarely performed in the Second Provincial Hospital, but someone actually does it on the front line