I run a clinic in the United States

Chapter 336 The plan cannot keep up with the changes

Yang Xuejun slept at home all day the next day, but Zhou Qiao went to work at the County People's Hospital in high spirits early in the morning.

The agreed time was originally eight o'clock, but Zhou Qiao arrived five minutes early.

He is never late for work.

When we arrived at the County People's Hospital, Director Zheng Xinhai was already waiting with a group of people on the third floor of the hospital's administration building.

After hearing the news, a group of people hurried out to greet him.

Dean Zheng was still a little surprised. Is Dr. Zhou really so early? Isn’t it usually a little later?

The miscalculation resulted in him not waiting at the door.

"Dr. Zhou, welcome."

"Hello, Dean Zheng, hello everyone."

Zhou Qiao shook hands and greeted everyone one by one. He had met some of them last year, such as Director Zhang from the cardiac surgery department and Director Wang from the emergency department, but most of them had no impression of them.

Everyone was also very curious and looked at this young celebrity who had returned from the United States.

Some people had obvious surprise in their eyes, thinking that he was even younger than in the video and looked like a college student. However, upon closer inspection, Zhou Qiao had a maturity and stability that college students did not have.

There is also that indescribable temperament of an expert and scholar.

This kind of temperament is difficult to develop without profound knowledge.

How should I put it? It is an unparalleled confidence, but it is not frivolous and slightly heavy. Because Zhou Qiao himself has accumulated a huge amount of medical knowledge. There is that foundation.

This kind of temperament cannot be faked, and even an actor with the best acting skills will find it difficult to perform that kind of charm between the brows.

Moreover, Zhou Qiao chatted with everyone and behaved very grandly.

After all, the people he interacts with on a daily basis are all high-level bosses, such as Governor Hulk, magical queens like Loya, the governor of Texas, Nobel Prize winners, academicians, senior officials of the University of California, and bosses of the Ministry of Foreign Affairs... he has already experienced it.

While walking and chatting, Dean Zheng invited Zhou Qiao to the conference room in the administration building.

According to the schedule, the first cooperation and exchange meeting will be held in the large conference room on the third floor of the administrative building.

After arriving at the conference room, everyone sat down in a row.

The seats have been arranged in advance, and name tags are placed on the table to facilitate everyone to sit down and get to know each other.

The staff served tea, and Dean Zheng personally presided over the meeting and made the opening remarks.

Dean Zheng solemnly introduced Zhou Qiao’s identity and brilliant achievements in the past, and extended a warm welcome to Zhou Qiao’s arrival.

There was a wave of applause in the conference room.

Then, Dean Zheng introduced the content and schedule of the next meeting.

First, a vice president introduced the situation of the hospital, and then the participants introduced themselves. Those who came were all at the hospital's middle and senior levels and department directors. Therefore, it includes an introduction to their respective work and department conditions.

Some department directors, such as Director Sun of the Department of Gastrointestinal Surgery, secretly muttered that although Dr. Zhou is great and is the champion of cardiac surgery in North America, he is only in the field of cardiac surgery and has nothing to do with my gastrointestinal surgery. Well, when the time comes, I will just introduce a few words casually, as long as they make sense.

I guess the focus is still on Lao Zhang.

Lao Zhang is the director of cardiac surgery.

He is not the only one who thinks this way. Directors of many other departments such as general surgery, oncology surgery, otolaryngology, orthopedics, etc. all have similar ideas.

The most excited and anticipated person is Director Zhang from the Department of Cardiac Surgery.

After all, he has been thinking about Zhou Qiao's arrival.

The others feel more or less like they are here to “keep company”.

"Dr. Zhou, after everyone has finished the introduction, we will visit various departments, such as outpatient department, inpatient department, surgery center, testing center, etc.," Director Zheng continued to introduce the schedule, "Then we arranged a special clinic for famous foreign doctors. , on the right side of the lobby on the first floor of the outpatient building, a dedicated and very spacious room..."

……

While Dean Zheng was making introductions, the phone of Director Wang of the Emergency Department suddenly rang, which seemed very abrupt in the "quiet" conference room.

"Sorry, I'm going out to take a call." Director Wang stood up, bowed slightly to signal, and then walked out quickly.

After all, the hospital is not an ordinary unit, so the phone is not muted during meetings. Especially Director Wang of the emergency department, he dare not mute his voice. If there is an emergency and the patient's condition is delayed, who will bear the responsibility?

Dean Zheng nodded, and then asked the vice president to introduce the situation of the hospital.

The deputy dean had already prepared and turned on the big screen projection to show the exquisite PPT. Of course, he did not make this PPT himself. The people below prepared it for three days.

The deputy dean only gave suggestions for revisions and revised the draft several times before finally finalizing it. There is nothing to say about the content.

While the vice president was talking, Director Wang from the emergency department came in angrily: "Dean, there is an emergency now. An injured person in a car accident has been brought here. Now we need the surgery, orthopedics, and dental departments to participate in the rescue."

Dean Zheng said: "Then hurry up."

Several department directors who were present at the meeting became impatient and followed Director Wang. They not only deployed the backbone of the undergraduate department, but also went to the emergency room themselves.

In the conference room, the meeting continued.

However, not long after, Dean Zheng's phone rang.

Dean Zheng didn't go out and picked up the call directly because the caller was Director Wang and the situation was probably quite urgent.

Dean Zheng listened for a moment and frowned: "What about the transfer? Hurry up and transfer to the provincial capital!"

On the other end of the phone, Director Wang said: "It's probably too late, it's quite serious. Otherwise, give up the rescue?"

"What are you talking about?!" Dean Zheng immediately slapped the table and stood up, with an angry look on his face.

On the other end of the phone, Director Wang was in a dilemma: "Everyone else has seen it, and there is really nothing we can do. The injured carotid artery was severely damaged, which is a clinically recognized problem. Even if we fly to the provincial capital immediately, there is a high probability that the hospital in the provincial capital will He also gave up on treatment.”

The situation was urgent, both of them spoke loudly, and the conference room was relatively quiet. Zhou Qiao sat not far from Dean Zheng. Even though Dean Zheng didn't turn on the speakerphone, Zhou Qiao still listened to Director Wang's voice on the other end of the phone. Clearly.

In fact, the soundproofing effect of Dean Zheng's mobile phone was not good, and other department directors sitting far away in the conference room also heard it.

Zhou Qiao pondered for a moment and then said, "Dean Zheng, how about I go take a look."

"Ah?" Dean Zheng was stunned and thought to himself, "You are a cardiac surgeon. This patient's carotid artery was seriously damaged. Can you do it?"

Everyone else also looked at each other, which probably meant the same thing.

Zhou Qiao didn't have time to explain, so he stood up and said: "Rescuing people is like putting out fire, let's go there quickly."

After all, there is a "war" going on in the emergency department, so it doesn't make sense that they are still holding a "welcome ceremony" here, right?

"Then take a walk." Dean Zheng was also anxious and couldn't care so much. He quickly took Zhou Qiao to the emergency department.

Others followed suit.

Anyway, let’s go and take a look first. If the plan cannot keep up with the changes, it will be impossible to continue.

A large number of middle and high-level people in the hospital, headed by Zhou Qiao and Dean Zheng, rushed to the emergency department in a hurry.

Along the way, many people were surprised and gave way.

Because, when I saw this battle and thought about the sound of ambulances in front of the emergency building, I knew that someone might be dying.

After Zhou Qiao arrived, he quickly learned about the injury.

Sure enough, it falls into the category of frontline giving up treatment. No wonder Director Wang was so embarrassed before and thought of giving up.

The injured was a young man in his twenties who had a tragic car accident on the highway. The right side of his neck was penetrated by a foreign object flying at high speed with great impact, causing injuries to his right common carotid, internal cervical, and cervical vertebrae. The external artery was severely damaged.

The foreign body entered from the front of the injured person's right side of the neck, penetrated the right submandibular gland, and shattered the carotid artery from below the broken submandibular gland along the front edge of the sternocleidomastoid muscle, causing a partial fracture of the transverse process of the cervical vertebrae.

After being sent to the emergency department of the County People's Hospital, the injured person was in shock and his right pupil was dilated.

The emergency department teamed up with key personnel from other departments to provide emergency rescue, including neck compression to stop bleeding, tracheal intubation, blood transfusion, fluid rehydration, etc.

Unfortunately, the injured person's injuries were too severe and there was basically no way to save him.

The open wound on the right side of his neck was seven to eight centimeters long, with the submandibular gland exposed in the deep part, and the right carotid artery pulse could no longer be touched.

This is equivalent to having your neck cut.

There is an idiom called "cutting one's neck to death". When committing suicide, one touches the neck with a sword and the person dies.

This is almost the case with this guy.

Got "cut on the neck".

In the tissue behind the young man's neck, a 2cm*2cm metal foreign object was lying quietly inside.

Emergency neck vascular CT showed that the right common carotid artery and internal and external carotid arteries were occluded.

Although tracheal intubation was performed and the wound was compressed to stop bleeding, the blood pressure of the injured person continued to decrease.

The carotid artery is very important. Unlike injuries to the arteries of the extremities, the neck where the carotid artery is located is an "anatomical artery". It is adjacent to the trachea, esophagus, and jugular vein on the inside. The hematoma formed can easily compress the trachea and cause suffocation.

At the same time, the carotid artery is the main blood supply artery to the brain, directly supplying 3/5 of the blood flow to the brain. Damage can cause cerebral ischemia, which can easily lead to disability or even death.

For the vast majority of doctors, there is no way to save the patient's serious injuries like the one in front of him, and there is no need for treatment at all.

After everyone understood the situation, they all felt that Director Wang was right. What else is there to save?

It’s too late to transfer to the provincial capital by helicopter.

It is better to let the families of the injured accept the reality as soon as possible, express condolences and accept the change.

In fact, the injured family members had long been in despair. With such serious injuries, there was really little hope. Outside, the injured family members were crying so hard, especially the injured old mother, who had fainted three times. It took a lot of effort to raise such a son, but just one year after graduating from college, something unexpected happened.

"Doctor Zhou, is there any way?" Dean Zheng looked at Zhou Qiao.

With the attitude of treating a dead horse as a living horse, Dean Zheng also knew that Zhou Qiao might not be able to do anything.

After all, Zhou Qiao is a famous heart surgeon, and everyone knows that his heart surgery skills are at the pinnacle, but now...

Zhou Qiao pondered for a moment and said: "Considering acute contusion and thrombosis of the right carotid artery, we do not rule out the possibility of complete damage to the blood vessel. The surgical risk and difficulty of vascular reconstruction are extremely high. The top priority is to quickly explore and stop bleeding and identify the location of the blood vessel injury. and nature, whether there is nerve damage and other side injuries, blood pressure needs to be maintained stable to prevent hypoperfusion cerebral infarction. In addition, the operating room needs to be prepared quickly, and right carotid artery exploration, carotid angiography, and carotid artery thrombectomy are required. Preparing for common cervical-internal carotid artery autologous vascular bypass surgery."

Although Zhou Qiao spoke fast, he was calm and powerful, and his thoughts were clear. Everyone was shocked. Is there really a way?

Judging from Zhou Qiao's tone, although he was serious, he still had some confidence.

Therefore, Dean Zheng gave an order, and the relevant departments began to take action to fully cooperate with Zhou Qiao's rescue operation.

Soon, the injured was pushed into the operating room.

The turbulent operation has begun, and the real decisive battle has begun!

In addition to surgeon Zhou Qiao, many doctors came to the scene. Those who couldn't get in were observed in the monitoring room.

Everyone dare not show off their arrogance because they all know that this is a tough battle and a huge challenge.

In the operating room, Zhou Qiao used his skills to quickly locate, cut and separate blood vessels layer by layer...

During the operation, it can be seen that the main trunk of the patient's right external carotid artery was completely shattered, and the branches of the external carotid artery such as the superior thyroid artery, facial artery, and lingual artery were also not spared. It can be said that the injured neck blood vessels were impacted beyond recognition.

The anatomy is messy and the bleeding is violent.

Zhou Qiao took his time and carefully searched for every ruptured and bleeding artery. Whenever he found one, he quickly tied it off to stop the bleeding.

Sometimes, his fingers even brought up afterimages, so that no one could see his movements clearly.

If it was normal teaching, Zhou Qiao could slow down and take his time, but at this critical moment, he could not afford to waste even a second.

Although he is not in a hurry, it refers to his mentality and calmness, but his hands are not slow.

Everyone present admired Dr. Zhou's hand speed as being...unparalleled.

I don’t know how much time passed, which seemed very long or very short. Finally, the active bleeding in the injured person’s neck was resolved, and the injured person’s blood pressure and heart rate gradually stabilized.

However, everyone still dared not breathe.

Because this is only the first step.

Next, it is necessary to "unblock" the injured person's common carotid artery and internal carotid artery occlusion.

In other words, the right side of the injured person's brain is still in a state of severe acute ischemia.

If this problem is not solved, it will still cause death and disability at a high rate.

With gentle movements of his hands, Zhou Qiao trimmed the stump of the patient's right common carotid artery and internal carotid artery, and then removed the thrombus in the lumen of the stump.

It sounds simple, but in operation it is extremely technically difficult and complex.

Finally, the patient's common carotid artery resumed spouting blood, and the internal carotid artery also resumed blood return.

However, the challenge is not over yet.

Complex surgery, each step is difficult and each step is difficult!

The patient's carotid artery also had a defect of seven to eight centimeters long, making it impossible for the carotid arteries at both ends to anastomose directly.

How to do this?

Everyone looked at Zhou Qiao.

Time was tight and there was no time to discuss the surgical plan beforehand. Zhou Qiao did not tell them the specific details of the operation.

In fact, this tests the clinical performance of the surgeon.

Many times, because the condition is unclear, it is impossible to formulate a specific plan in advance.

Even if it is drafted, it may not be applicable.

"Use the patient's great saphenous vein."

Zhou Qiao made a prompt decision to remove the patient's own great saphenous vein, intending to use it as a "bridge vessel" to perform a right common carotid artery-internal carotid artery bypass surgery.

The patient's carotid artery was damaged for seven to eight centimeters, and the internal carotid artery was only about 1 centimeter away from the normal lumen of the skull base. It was very difficult to expose the blood vessels. It was necessary to complete a vascular anastomosis of about five millimeters in diameter in such a small space. , to ensure that the blood vessels are unobstructed and there is no bleeding after anastomosis, you can imagine how difficult it is!

However, such a delicate and difficult operation was performed easily by Zhou Qiao's hands.

This made the doctors present dumbfounded.

"Oh my god, what a godlike operation."

"What a show!"

"awesome!"

Everyone exclaimed inwardly.

Of course, Zhou Qiao's surgery cannot be done without the cooperation of others.

For example, the anesthesia team needs to make every effort to ensure the patient's hemodynamic stability and blood supply to various organs, especially the intracranial blood supply. At the same time, they must also try their best to maintain blood vessel tension to ensure the smooth progress of vascular anastomosis.

For example, the equipment nurse needs to deliver the corresponding equipment to Zhou Qiao in a timely manner.

The equipment nurse was very stressed and sweated on her forehead.

This equipment nurse is indeed not as smooth as Elena, but now is not the time to be picky about this.

Instead, Zhou Qiao took the initiative to comfort the equipment nurse and not be nervous. At the same time, Zhou Qiao tried his best to tell what he needed in advance or give timely reminders.

With the full cooperation of the anesthesia and surgical nursing teams, Zhou Qiao performed the patient's autologous blood vessel transplantation quickly.

……

At the same time, on the right side of the first floor of the outpatient building, there was already a long queue in the waiting area in front of the famous foreign doctor's clinic.

"Didn't you agree to start seeing the doctor at nine-thirty? Where is the doctor? Why hasn't he come yet?"

"That's it, such a big show? The famous doctor I promised to see you, but why is there no sign of him?"

The nurse hurriedly came over and explained: "Everyone, please be patient and patient. Dr. Zhou is already here, but someone in the emergency department had a serious car accident. Dr. Zhou went to help with the rescue and surgery. Please wait patiently." , how about waiting for Dr. Zhou to finish the operation and then come to treat everyone?"

As soon as this was said, everyone stopped making trouble. There was a lot of discussion.

"I told you, it turns out we went to rescue him."

"Understandable."

"Who is so unlucky during the Chinese New Year?"

"I heard it was a car accident on the highway."

"Hey, I asked you why ambulances and police cars were screaming."

……

In the operating room, time is ticking minute by minute.

Zhou Qiao operated step by step, methodically but very quickly, and everyone was amazed by his surgical skills.

When the clamp on the carotid artery was opened, everyone couldn't help but cheer and burst into applause, because the reconstructed carotid artery was filled with blood and began to beat regularly!

Blood vessel pulsation means that this operation that "should have given up treatment" and that should be "impossible to succeed" has succeeded!

The patient's life was snatched back by Zhou Qiao from the hands of Black and White!

Next, Zhou Qiao took a "halftime break" and handed the baton to the doctors at the County People's Hospital.

Because the follow-up was the finishing work, the patient still had some "trivial" injuries to his mouth, some of the transverse processes of his cervical vertebra were fractured, and one of his ribs was fractured.

Compared with the previous "key points", these are nothing.

Zhou Qiao did not leave and watched other doctors perform operations. He never expected that on his first day here, he would perform such a thrilling operation so early in the morning.

Dean Zheng also did not expect that the first day of the cooperation and exchange program would start in such a way.

The original plan was for everyone to have a meeting in the morning, exchange feelings, and then take him around for a tour. Then Zhou Qiao would go to the clinic of a famous foreign aid doctor for a consultation. At noon, everyone would go to a restaurant for a meal together, and then continue the consultation in the afternoon.

While attending the consultation, I helped guide the doctors from the County People’s Hospital.

This cooperation and exchange should have started in a very pleasant and relaxed atmosphere.

Little did you know that the first day was like fighting a war.

After the operation, the hospital cafeteria.

"The reception was not good. This is really not good hospitality." Dean Zheng lamented. Since it was past meal time, many patients had made appointments with famous foreign doctors. They had no time to go out to eat, so they had to ask for help in the hospital cafeteria. Zhou Qiao ate a box lunch.

He didn't even have time to turn on the small stove.

"It's okay, the food is delicious, the taste of hometown." Zhou Qiao said with a smile.

Dean Zheng invited: "Let's go have a good meal after get off work. I have reserved a private room. Don't refuse."

(End of this chapter)