Chinese medicine: When you do things to the extreme

Chapter 226 Is that it?
After Zhou Yanqing hung up the phone, he looked at Lin Yuxuan's eager expression and decisively interrupted his wandering thoughts: "Brother Lin, this is my first surgery as a resident. How about you do it next time?"

This is the metaphysics that Ning Zhu once told Zhou Yanqing. Hospitalization must always have a beginning and an end, and the first and last operations must be performed by oneself!
I heard that this is a 'metaphysical' theorem summed up by many hospital inpatients.

It’s the same principle as when you are on duty in the department, if a patient gives you mangoes or dragon fruit, you should never touch them.

"Oh, okay!" Lin Yuxuan replied.

Three years of academic doctoral career gave him a great advantage in scientific research articles, defeating all other competitors.

Correspondingly, they will lose the ability to conduct clinical training and will need to continue their training after graduating from their doctorate.

Lin Yuxuan has already passed the examination for the title of attending physician, but the title of attending physician requires a special examination, and basically, as long as you have read the book, few people will fail the exam.

Undergraduate students can pass the exam after regular training, but this does not mean that their ability as attending physicians will be strong after passing the exam.

It would be a huge hassle for a chief physician from an ordinary hospital to work as a resident in Xiangya Hospital.

The operation begins with irrigation before debridement.

Neither Zhou Yanqing nor Lin Yuxuan washed their hands for disinfection. Instead, they put on examination gloves and initially rinsed the wound with a large amount of saline, then rinsed it again with complex iodine, and then rinsed it clean with saline.

After a simple disinfection and draping, Zhou Yanqing and Lin Yuxuan stood opposite each other. Lin Yuxuan enthusiastically prepared the diluted lidocaine.

Lin Yuxuan did not even ask Zhou Yanqing for his opinion before starting the operation under local anesthesia. He asked politely, "Yanqing, do you think it is better to use the tendon core suture or the peritendon suture for this position of the tendon?"

This is a very professional topic.

Tendon core suture is a suturing method in which a non-invasive suture is passed through the central area of ​​the flexor tendon and a knot is tied in the central area.

It can reduce the disruption of blood circulation in the tendon. This suturing method often requires continuous suturing around the broken ends to strengthen the suture strength of the tendon.

For example, Tang suture and Kessler suture are both tendon sutures, which belong to a large category.

"Currently, tendon-centric suture is recommended, and peritendon suture is not recommended." Zhou Yanqing replied cautiously.

Because this is a very professional topic for discussion, Zhou Yanqing did not dare to make a final statement, and instead used the words "not recommended".

Lin Yuxuan said hurriedly, "Yanqing, don't be so nervous. I'm asking you for advice. When I was doing the modified Tang method and the modified Kessler, I always felt that my hands were not turning properly."

"I don't know if there are any tricks." Lin Yuxuan's previous questions were just a prelude, and the question now was the most crucial.

The basic skill of hand surgery is suturing. The proficiency in suturing depends on the control of suturing technique and is not limited to each specific suturing method.

The modified Tang method or the modified Kessler method are both types of suturing techniques and have nothing to do with the depth of basic skills.

"This can only be understood intuitively, it is difficult to express in words."

"Brother Lin, you also know the specific techniques and suturing methods. All you need to do is practice more! Get the feel for it." Zhou Yanqing has not found a shortcut to learning suturing techniques yet.

When he taught others, he used the simplest demonstration and practice method. He taught infinitely and others learned infinitely.

Zhou Yanqing has not had much exposure to the more general teaching methods and principles of correcting errors during operation.

This is something you should gradually consider and ponder during the associate professor stage.

"That's right! I thought you had some special tricks for dealing with this."

"It's okay, I just asked casually!" After Lin Yuxuan finished the anesthesia, he gave the operating field to Zhou Yanqing.

The purpose of practicing suture skills is to practice the ability to control, so that the needle can follow the hand and go as you wish!
Each simple suturing technique is a processing skill and a flexible application of suturing in different situations.

Zhou Yanqing's suturing method does not have too many "special techniques". It is nothing more than taking what his predecessors taught him and mastering every step to the extreme.

Lin Yuxuan did not take any action, and it was easier for Zhou Yanqing to deal with such "injury" than drinking water.

After directly expanding the Z-shaped incision, the retracted tendon was pulled out in a standard manner. After puncturing and fixing it on the skin with the assistance of a syringe needle, Zhou Yanqing quickly sutured it.

The modified MTtang suture method is used, which, in Lin Yuxuan's opinion, is no secret at all.

However, even the more classic operating techniques seem to have reached the level of being able to do whatever one wants in Zhou Yanqing's hands.

The insertion, removal and needle point of the suture needle are all controlled very well.

Zhou Yanqing really didn't lie. He relied not on skills but on pure basic skills. All his operations were very methodical.

When observing in this way, there is no question of finding shortcuts. You can only experience the feel of Zhou Yanqing in every step of the operation.

While Lin Yuxuan was stunned, Zhou Yanqing had already sutured one tendon and was about to start working on the second one.

So fast?
After smacking his lips, Lin Yuxuan quickly gathered his spiritual sense, not daring to disperse it again, in order to avoid wasting such a good observation opportunity.

Watching high-quality surgeries many times will help improve your own touch and cognitive level.

This patient had arterial damage and small vein damage, but no nerve damage!
Therefore, it took Zhou Yanqing nineteen minutes from skin incision to skin suture.

After Zhou Yanqing finished sewing the outer opening of the skin, he began to pack the sterile cotton pads.

After Zhou Yanqing temporarily fixed the plaster, he said to the girl, "Your brace hasn't arrived yet. I've asked her to buy one online. Use the plaster to temporarily fix it. When the brace arrives, you can change and adjust it."

"When the time comes, you'd better come to our hospital's hand surgery department again. You don't need to register, just come directly to the department to find the chief resident."

"Okay, thank you doctor." The girl's voice was soft, and it was one of the few words she said.

It's just that his voice is a little low, probably because he hasn't completely gotten over the loss of a 'one-sided' breakup.

"In fact, you are quite smart. It's just a skin injury, not a wrist cut that damages the aorta."

"Go to the emergency department and get another tetanus shot. Then just pay attention to functional exercises in the future and you'll be fine."

"Your wound is on the palm, and the scar is also on the center of your palm, so I don't recommend using cosmetic sutures. After healing, the scar left behind won't be very big."

"There's no need to waste money," Zhou Yanqing explained.

The girl loves beauty, and when they were talking, she suggested cosmetic stitching, but was rejected by Zhou Yanqing. The girl agreed at the time, but Zhou Yanqing was afraid that she would regret it later, so he explained it more.

"Thank you, doctor!" The girl held the plaster with her healthy hand, her face full of guilt and regret.

In fact, after experiencing the pain, she realized that all the previous things and money were insignificant.

But she felt like the sky was falling at that time.

"Do your functional exercises well and study hard."

"The only thing left is changing the dressing. You can go to the school hospital to change it. It's cheap and affordable there, and you can also remove the stitches there." Zhou Yanqing gave these instructions.

"But the tetanus shot must be given in our hospital as soon as possible. In principle, the sooner the better." Zhou Yanqing was rather talkative. After she left the house, she gave her companion some instructions before letting the two girls leave the operating room door and go to the emergency department.

……

After doing all this, Zhou Yanqing's task was not completed. Although this was an emergency operation, he still had to write an operation record, and later he would have to hand her the medical record with the simple operation record.

This makes it convenient to archive electronic files in the medical system, and also allows girls to look at more detailed medical instructions.

There were two idle computers in the emergency surgery clinic. After Zhou Yanqing and Lin Yuxuan explained, they walked over there.

After turning on the computer, Zhou Yanqing discovered that he seemed to have no unique account and password!

Of course, this doesn’t matter. I have a sub-account affiliated with Associate Professor Huang Xianming, and it will be the same if I sign my own name there.

However, I still have to call the medical department to report this matter in time.

Zhou Yanqing is currently only a PhD student, and PhD students are not given their own work number and password. The medical department did not expect that Zhou Yanqing would be temporarily promoted to the position of chief resident.

No one could predict the future, otherwise Lin Yuxuan would not have been able to stay in the hospital for seven days.

Zhou Yanqing had just finished writing the surgical record. After reviewing it, he clicked Submit, Save and Print.

Huang Yaqin's queue of patients had been cleared, so she was free. She stood up, picked up the dark blue water cup, drank water, and patted Zhou Yanqing on the shoulder: "Are you the chief resident of the hand surgery department?"

"Yes, Sister Qin." Zhou Yanqing stared at the printer!
I was complaining in my heart that for such a big hospital like Xiangya Hospital, the hardware facilities were like a J8, all of which were old equipment.

It takes more than 30 seconds to wait for a printer.

While glancing at Huang Yaqin.

Huang Yaqin frowned slightly: "The residents in your hand surgery department are getting younger and younger now."

"You look about twenty-five?"

"I'm twenty-eight this year, Sister Qin." Zhou Yanqing replied quickly.

"Oh, that's fine."

"But next time, remember not to be too hasty when performing the surgery. The patient is a little girl and has arterial damage, so the surgery needs to be done more carefully."

"If something is not done well, it may affect others for the rest of their lives."

Huang Yaqin said this, suddenly waved her hand, and raised her voice: "Here, you need a doctor's order for a tetanus shot."

Zhou Yanqing's eardrums were vibrated and jumped slightly.

Turning around, Zhou Yanqing also saw the two girls coming back, so he waved and said, "You came at the right time. Here are your medical records and doctor's orders. If you can't remember them, you can take a look."

"I've basically explained it all to you!"

Huang Yaqin quickly prescribed tetanus shots for the two people, and then hurriedly printed out the medical records for the emergency surgery department!

"Scan the QR code in the upper left corner to pay, and then go to the nurse's station to get your injection."

"Remember to keep the wound away from water after you go back, and it's best not to take a shower. If you really want to take a shower, you have to buy a larger waterproof and sealed sleeve."

Huang Yaqin is a bold and careful person, and she knows more common sense about life than Zhou Yanqing.

Although Zhou Yanqing didn't say anything on the surface, he secretly said in his heart, yes, times have changed now, and I have learned a new point of knowledge.

Then, Zhou Yanqing saw a middle-aged man with his head covered walking in from outside!

So Zhou Yanqing and Huang Yaqin both tacitly did not speak.

Zhou Yanqing walked out the door and was about to turn back to the department when he heard a "beep, beep, beep" sound outside the emergency department, and a 120 ambulance doctor in green clothes ran in quickly.

He shouted to the white-coated doctors in the emergency department who were coming to greet the car, "The upper arm was sawed off. There are no other injuries."

The leader was a middle-aged woman in a white coat. She continued to move forward calmly and said, "Call the emergency consultation number of the hand surgery resident. Record the time of the limb amputation and report it truthfully later."

When Zhou Yanqing heard this, he couldn't help but sigh that the world is so small and what a coincidence.

Without thinking too much, he pulled up his mask and went to meet him: "No need to call, I am the chief resident of hand surgery, the teacher who followed the car, have you asked the patient if he has any underlying diseases?"

"Where are the family members? When will they arrive?"

"The police have already notified the family. They are probably in the back. They were pulled here from the factory."

"You might want to notify the chief duty officer."

Basically every hospital has a general duty officer, except for small hospitals.

The main responsibilities of the hospital's general duty system include handling medical, administrative and temporary matters outside office hours.

Communicate and handle instructions and emergency notices from superiors, sign for important documents, check the work status of staff at various posts at night, coordinate the consultation and rescue of critically ill patients, and handle emergencies or other situations outside the department's responsibilities.

For example, if the doctors in our hospital encounter a situation that is beyond their authority but is particularly urgent, they can immediately ask other people in the department to ask the chief on duty for temporary authorization. At least let the chief on duty know that you can't wait!
The same is true for surgical privileges.

Skipping surgeries like those in TV dramas or novels, where critical situations are reported without warning, will only happen outside the hospital, not inside the hospital.

Even if it was staged, it’s because the screenwriter didn’t understand the hospital system!
Zhou Yanqing glanced at the woman in a white coat next to him.

"Cao De, call the chief on-duty officer and ask for temporary authorization. He said the family can't make it here and the right upper arm is severed!"

"We must rush to get the surgery time."

"Doctor Zhou, what preparations do you need to make before the operation? Besides the routine ones." Associate Chief Physician He Qingqing said succinctly.

Routine preoperative examinations include chest X-ray, electrocardiogram, liver and kidney coagulation function, and four items of sexually transmitted diseases.

Some doctors may have different personal understandings!
"Does the patient have any underlying diseases?" Zhou Yanqing asked the doctor on the transfer.

"There's only one case of hypertension." The 120 ambulance doctor, who was currently handing over information to another doctor from the emergency department, turned around and added.

"It's only been an hour since I got hurt."

"We took some blood samples urgently in the car, and the test results are out."

"We have been registered!" The other party responded one sentence at a time, sealing all of Zhou Yanqing's doubts, quite straightforward and tactful.

"I'll go deliver the surgery order." Zhou Yanqing turned and left.

The emergency room cannot be delayed, nor is it a place to waste time. It is a place to save time!
(End of this chapter)