Doctor Peerless

Chapter 640 I Sign

With great power comes great responsibility.

The decision made by Zhou Sheng also bears huge risks.

Especially when the patient is unconscious and the patient's family members are not present.

If something happens and the family members make a fuss, it is very likely that they will not even need to be a doctor in this life.

The consequences may be worse than the previous Tang Aiyun.

But Zhou Yisheng is not afraid, he has just completed the master-level dungeon, coupled with the systematic help in the realization, he is confident to repair this broken heart!

Not to mention the 90% rescue success rate.Even with a lower success rate than this, Zhou Sheng also dealt with it in the dungeon.

Zhou Sheng is confident that he is not afraid.

Although Su Quan was a little worried, he also had some confidence in Zhou Shengsheng in his heart. His brother was not a reckless person. Since he dared to do this, he must have his reasons. At the moment, saving people is the most important thing, so he didn't say any more. Greeting Cao Xin to push the patient to do a chest X-ray.

Zhou Sheng contacted the anesthesia and the operating room.

The emergency chest X-ray was also very fast. When Zhou Sheng found the operating room, the chest X-ray was already out.

The chest X-ray showed massive bleeding in the chest...

At this time, Zhou Sheng's system scan is following up.

The patient's heart is still bleeding.

The rescue probability has dropped to 80%.

As Zhou Sheng predicted, as the bleeding continued, the chances of rescue decreased a little bit.

Now that the time has come without delay, Zhou Yisheng made a decisive decision and notified Su Quan and Cao Xin to carry out emergency surgery.

Something big.

At this time, Su Quan reminded again: "Should we wait until the family members are contacted, in case the patient cannot get off the operating table, we..."

Zhou Sheng is well aware of the current situation, and there is absolutely no delay.

For every time lost, life is lost.

He said in a deep voice, "I'll sign it, and I'll be responsible for any problems."

Legally speaking, if neither the patient nor his family can sign, the person in charge of the medical institution can sign.

In the emergency center, the biggest person in charge is Director Jiang.

If it is during the daytime, when Director Jiang is on duty, and this kind of patient is unconscious, and his family members cannot be found, if he needs surgical rescue, he must ask Director Jiang to sign.

However, due to the special nature of the emergency department, many operations need to be performed urgently.

Therefore, during the night shift, the greatest power is the team leader on duty.

Although the level of the team leader is not high, the power is not small.

But this kind of power is no joke.

Signing represents a kind of responsibility. If something happens, you have to be responsible.

If in the past, Liu Zhengqing was the team leader, he would definitely not dare to sign for this kind of operation.Even if Zhou Sheng explained to him that he could do it, Liu Zhengqing would not dare.

Dean Cheng gave Zhou Sheng the position of team leader.

This gave Zhou Sheng more room for development.

The current position of team leader has played a role at this moment.

Zhou Sheng doesn't need to ask anyone for instructions now, he can decide on the surgery.

"What are you doing in a daze, get ready, you will be the second assistant, and Cao Xin will be the third assistant."

Su Quan was taken aback for a moment, he had a thoracotomy, and he might have to move his heart. For such a major operation, he was a second assistant, so he felt a little guilty!
He hesitated for a moment, and said: "Group Leader Zhou, I have never had this kind of surgery. Should I ask Teacher Bai and the others to come over, and I will make soy sauce and be a third assistant."

Zhou Yisheng stared and said, "What, are you scared? Are you a jerk? I'm the surgeon, and you can do the second job. Teacher Bai is doing an appendix operation, and it will take time for others to find it, so you will do it."

Su Quan couldn't stand being so excited, he thought to himself, when will I, Su Quan, ever be a softie? Since you are not afraid of being the main surgeon in Zhou Yisheng, what should I be afraid of as a second assistant.

He straightened his back: "I'm afraid of a hammer! Go!"

Zhou Sheng patted Su Quan on the shoulder and said, "Don't look forward and backward, it's over."

Having said that, he looked at Cao Xin again and said, "How are you doing?"

Of course, Cao Xin has no problem. Outside of his heart, with Cao Xiangwen's halo, he has also been on stage several times. He knows that Sansuke is almost there to visit and study.

So he immediately nodded in agreement.

A surgical team is formed.

Emergency rescue surgery.

There was no time to do any pre-operative planning research.

Even inspections can be saved, try to save as much as possible.

The patient is wheeled into the operating room.

Zhou Sheng, Su Quan and Cao Xin changed into surgical gowns and followed them in.

Thoracotomy requires general anesthesia and endotracheal intubation to assist breathing.

These are the responsibility of the anesthetist.

Femoral vein catheterization has been performed on the wounded in the operating room, which saves a lot of time for anesthesia.

Anesthesia induction started: dexamethasone 10 mg, midazolam 2 mg, rocuronium bromide 50 mg, etomidate 12 mg, fentanyl 0.1 mg for rapid induction intubation.The endotracheal intubation was successful, and the breathing was controlled by machine.

插管后血压为45/36mm Hg，心跳为85次/分，分次给予去氧肾上腺素500μg、麻黄碱20 mg、肾上腺素80μg，血压略有上升、心跳略增快。

The anesthetist assessed the condition of the injured and surgery was possible.

The following work was handed over to Zhou Sheng.

In reality, Zhou Sheng had undergone extra-cardiac surgery for the first time.

For Zhou Sheng, it is also a big challenge.

Although this heart repair surgery seems to be very urgent, the difficulty is not the top level of extra-cardiac difficulty, compared with heart transplantation and multi-valve replacement.Still need a lower level of surgery.

However, for operations such as heart transplantation, before the operation, a large number of auxiliary examinations can be carried out, such as radiography, CT, and MRI. There are a lot of films that can be taken, and the operation plan can also be studied slowly.

For example, where to cut the knife, how big the incision is, and so on, all of these can be studied well, so that you can be confident.

However, in the current rescue operation, the chest can only be opened first, and the next operation can only be performed after seeing the heart.

This tests the resilience and judgment of an operator.

Zhou Sheng has an innate advantage here.

That is even without prior inspection.

Zhou Sheng is in the operation, as long as the auxiliary scanning function is turned on.

You can clearly know the physical condition of the patient.

This is much stronger than any radiography and CT.

open chest surgery.

There are two options for incisions.

One is a midline chest incision, which can well expose the four chambers of the heart and the ascending aorta. If necessary, extracorporeal circulation can be established, and it can also be extended down to the upper abdomen for laparotomy.

The other is the left anterolateral thoracotomy, which does not require special sternal expansion instruments, and is quick and easy to enter the chest. Once the cardiac tamponade is relieved and the bleeding is controlled, the incision can be extended by transecting the sternum to increase the exposure of the surgical field of view.

Internal bleeding from a car accident like this one.

Due to not doing a lot of checking.

A midline chest incision is a good option.After dealing with the heart problem, a laparotomy can be performed to check for other bleeding points.

But there are advantages and disadvantages. This kind of operation needs to open the sternum.A lot of time will be wasted.

With systematic help, Zhou Sheng has already identified the bleeding point.

So he was going to open the chest from the left side anteriorly.

Zhou Sheng directly picked up the scalpel.

……

(End of this chapter)