Chinese medicine: When you do things to the extreme

Chapter 237: Choice and Decisiveness

Yang Lingchong did not move. Even though he was extremely angry, he was extremely restrained and suppressed the anger in his heart.

Getting anxious or knocking Zhou Yanqing won't solve the problem at all!

He was not familiar with Zhou Yanqing, but Xiang Miao, who was standing opposite Yang Lingchong and beside Zhou Yanqing, was familiar with Zhou Yanqing and immediately handed the hemostatic forceps in his hand to Zhou Yanqing.

His eyes were rolling rapidly, thinking about how to explain to Professor Yang later.

Zhou Yanqing didn't have any extra words.

Quickly move the hemostat in your hand along the direction of your fingers, open the hemostat and then close it.

At the same time, Zhou Yanqing used the fingertips of his left hand, even through the gloves, to find out the direction of the ripples emitted by the fresh blood in the pool of blood.

He continued to stretch out his right hand, asking for hemostat.

There are two more places, after doing that, he will avoid it!

With both hands free, Zhou Yanqing quickly passed by!

In the face of life and death, what does infection matter? What does the principle of sterility matter?
Most of the operations in the emergency room now violate the principle of sterility, but lives must be saved first!
After Zhou Yanqing got two hemostatic forceps, he quickly placed them on the patient's upper abdomen, picked up one of them, and inserted it into the patient's abdominal cavity.

His eyes were staring blankly at the ceiling, but in fact all his attention was focused on the sensory endings of his left hand, slowly moving within his abdominal cavity!
Finally, at a certain moment, Zhou Yanqing felt the place where the turbulent blood flow gathered and the shape of the artery, and the hemostatic forceps in his right hand went over again without hesitation!

He pulled out his right hand quickly, bringing out a pool of blood!

Yang Lingchong came back to his senses and felt the pool of blood in the abdominal cavity decreasing under the action of the negative pressure suction device!

Quickly ordered: "Speed ​​up the infusion and establish another intravenous access!"

“The patients nowadays have more income than expenses!”

Zhou Yanqing ignored Yang Lingchong's order. After the pool of blood fell, he could clearly feel the blood bubbling up. At that time, his left hand, which was still in the abdominal cavity, quickly moved to the left and grabbed the proximal end of the artery!
The blood pool in the abdominal cavity is decreasing faster, which means that hemostasis is becoming more effective.

The negative pressure suction device had been working before, but the blood pool level did not drop, which means that the bleeding was greater than the blood sucked by the negative pressure!
At this rate of bleeding, it would take another minute, or even less than a minute!

Even with blood transfusion and intravenous infusion, the patient will inevitably die of shock!

After grabbing it with the left hand, the pool of blood quickly dried up, and only the low areas of the abdominal cavity, the intestines, and the folds of the membranes still had blood left.

Zhou Yanqing quickly and accurately pushed the hemostatic forceps in his right hand towards the artery he was holding with his left hand, then stood up.

Then he calmly looked at Yang Lingchong opposite him, lowered his head slightly, and said shamelessly: "Professor Yang, just now you said that you wanted to stop the bleeding quickly, I thought you were calling me."

As adults, you must be responsible for your own actions.

When conventional models cannot explain it clearly, we have to find a way to solve the problem instead of leaving it to fate!
Seeing that the patient's intra-abdominal active bleeding had only small arteries and blood vessels left, Xiang Miao quickly explained: "Professor Yang, this is the chief resident, Mr. Zhou, whom I told you about."

"It was him last time too!"

Although Xiang Miao is a girl, she has received professional surgical training and did not speak the truth immediately after getting excited: "He assisted me in stopping the bleeding of the artery in the abdominal cavity!"

Yang Lingchong nodded and ignored Zhou Yanqing: "Continue to stop the bleeding!"

Professor Wang Limin was even more decisive: "Pay attention to the patient's electrolytes at all times, prepare a blood purifier, ask the cardiology department for a consultation, transfer to the ICU, and contact the blood bank!"

"Quick electrolyte check in five minutes."

"Pay attention to correcting lactic acid disorder!"

"Prepare for tracheotomy, keep the airway open, move..."

"Norepinephrine intravenous pump..."

Once the surgical hemostasis operation is completed, what remains is advanced life support and correcting the patient's electrolyte imbalance.

Electrolyte imbalance may cause myocardial arrest and death.

Active bleeding can lead to shock and death. The direct causes of the two are quite different.

Zhou Yanqing pushed aside his seat and gave it to Xiang Miao and Yang Lingchong. When he turned around to make way, Zhou Yanqing also heard Deputy Chief Physician Zhou Shangqun's whispered report:
"Professor Wang, this Zhou Yanqing is the chief resident I told you about before."

However, it seemed that Wang Liming ignored him. Instead, he kept staring at the patient's vital signs and watched seven or eight nurses preparing various other rescue equipment in an orderly manner!

A life is not so easy to save.

The only point is that as long as the patient did not die of shock, it doesn’t matter who Zhou Yanqing is.

Zhou Yanqing and Yan Huanyu stepped back a few steps and looked at each other.

Yan Huanyu looked at Zhou Yanqing and said, "Yanqing, go change your clothes first. I'll watch here..."

The corners of Yan Huanyu's mouth twitched.

If I hadn't called Zhou Yanqing today, then even if the patient died, Zhou Yanqing wouldn't have to take any risks, and the most he could do would be that the rescue was ineffective...

Now, if the family really wants to investigate, the people in the emergency department and vascular surgery department may have sold out Zhou Yanqing. This is the corresponding risk.

And just tell the truth about what happened during the rescue!

It is very dangerous for an orthopedic hospital patient to always appear in the rescue record of the abdominal vascular hemostasis operation of the vascular surgery department.

The emergency department of Xiangya Hospital is very powerful, especially its life support and poisoning rescue in emergency situations, which ranks among the best in the country!

The emergency department has mature ECMO, mechanical ventilation and other related teams, and the mortality rate of patients admitted to the emergency department is very low every year.

Those who died outside the hospital are naturally not included in the statistics.

After the rescue was carried out in an orderly manner for six minutes, Zhou Yanqing returned to the emergency room and changed into a new white coat!

He has to be ready to enter the operating room at any time to deal with arterial bleeding in the limbs.

Temporary clamping with hemostatic forceps is, after all, only a temporary treatment.

After the patient's vital signs were slightly stabilized, real surgery was still needed to stop the bleeding.

Professor Wang Limin looked at the patient's current blood test indicators again and again, and then looked up: "The patient's current blood pressure has stabilized, hemostasis is effective, and the blood transfusion rate is stable."

"Notify the emergency operating room anesthesia department and be ready to receive patients at any time!"

"The emergency department arranges surgery, notifies the family, and signs outside the operating room. Surgery first, then signature. Otherwise, the life will be lost."

"The family members have signed everything!" an attending physician from the emergency department replied, "All the documents are here."

"Zhou Shangqun, you lead the team to send the patient to the emergency operating room." Wang Liming gave the order quickly, and then walked towards the intensive care unit area he was in charge of.

Quite decisive and experienced, without any hesitation or delay.

Deputy Chief Physician Zhou Shangqun quickly urged the staff and nurses in the department to rush the patient, along with the ECG monitor, temporary oxygen pillow, blood transfusion bag, etc., to the emergency operating room.

After everyone dispersed, Yang Lingchong looked at Xiang Miao and said, "Go to the operating room immediately and stop the bleeding and provide blood supply as quickly as possible."

"If there is anything that cannot be solved during the operation, please ask Dr. Zhou for help." Yang Lingchong said, and stretched out his right hand. His voice was cold and expressionless: "Vascular Surgery, Yang Lingchong."

"Zhou Yanqing, hello, Professor Yang." Zhou Yanqing felt a little guilty.

"The situation just now was extremely urgent, so I came here without asking for permission!"

Yang Ling bared his teeth and said coldly, "You are doing this because you think I am incapable of saving this patient, right?"

Zhou Yanqing shook his head subconsciously.

Yang Lingchong shouted coldly: "You are dying to save face, but you are suffering in life. You dare not say what you think!"

"If I were the only one here, I really wouldn't be able to save this patient."

"The mortality rate of massive intra-abdominal arterial hemorrhage is too high!"

"The mortality rate is higher than that of mesenchymal fractures. The mortality rate at the scene of the accident is even higher, almost as high as 70%. 60% of the patients cannot be saved even if they are brought to the hospital!"

"In total, the number of patients with real massive arterial hemorrhage who can be saved is less than 10%. There is nothing to be ashamed of admitting this."

Yang Lingchong's voice was stern, but what he said didn't sound like he was criticizing Zhou Yanqing. Instead, he was mocking him for being too timid.

"Professor Yang, I, I don't know how to say it." Zhou Yanqing still expressed his meaning tactfully.

"A good emergency doctor needs to be cautious and careful before his or her abilities are recognized. After being recognized, he or she must first overcome the fear of his or her superiors!"

“Even overcoming the fear of the patient’s death.”

"If you don't treat this patient and he dies, will you regret it?"

"Do you feel guilty about it?"

"You took action, but he still died. What do you think?" Yang Lingchong said as he turned around.

Yang Lingchong is a vascular surgeon, and he knows that there are also experts in hemostasis in the orthopedics department.

Because arterial injuries in the limbs occur frequently, people in the emergency department will call trauma surgeons and vascular surgeons first.

No matter which of the two inpatients arrived first, neither of them dared to remain indifferent.

Trauma surgery is still the "technology gathering place" for hemostasis and emergency rescue!
"I tried my best!" Zhou Yanqing replied.

"That's it!"

"Luckily, Xiang Miao came forward for you today. Otherwise, if no one knew your ability, you would have been driven away long ago!"

"The emergency department does not hide its shortcomings. It is best to inform in advance and do the best you can. Not all patients can be saved."

"I'll remember you!~" Yang Lingchong looked at Zhou Yanqing's name tag, and then without saying anything else, he walked directly to the emergency vascular surgery clinic.

Zhou Yanqing turned back to see the patient leave the emergency room, and then went to the office area of ​​the emergency room.

In the Second Emergency Rescue Area, the only deputy chief physician and above on duty are Deputy Chief Physician Zhou Shangqun and Associate Professor He Qingqing.

Wang Liming is a senior professor and the big boss on duty. Unless it is an extremely urgent situation, he will not show up easily and must stay in the ICU all the time!
Zhou Shangqun went to send the patient to the emergency operating room. He Qingqing was the only superior in there. She instructed them to quickly check the examination records of the other two patients in the emergency room who had not yet been sent to the specialist department.

"Is there anything I can do for you?" She lowered her head to look at the documents, but she also saw Zhou Yanqing at the door. She did not look up and spoke in a crisp voice.

Zhou Yanqing took a few steps forward and said quickly, "Teacher He, I'm the chief resident of the Department of Hand Surgery. The emergency consultation of our Department of Orthopedics has been restructured."

"I'm here to report to you. If in the future..." Zhou Yanqing quickly and simply expressed the orthopedic duty mechanism.

This is to report to He Qingqing and others about the convenience that the emergency department will have in the future.

At the same time, he also made it clear that when he was not on duty, calling the orthopedic department's main inpatient telephone number was useless!

He Qingqing glanced at Zhou Yanqing and said, "You are quite enthusiastic. If it were someone else, they would have avoided you by now."

"For this patient, increase the dosage of norepinephrine. His blood pressure is a little low now." He Qingqing turned her head and instructed a young man in a white coat.

Another person quickly switched the patient's medical order interface and then tapped on the keyboard.

"Teacher He, I still have surgery."

"I'll leave first." Zhou Yanqing said, turned and left.

"Okay, I got it." He Qingqing then glanced at Zhou Yanqing's back, then raised her head and looked at the ceiling.

"A very interesting person!"

After Zhou Yanqing left, a young man wearing glasses and a white coat turned around and said, "Teacher He, this resident looks so cool, a bit like someone in a TV drama."

"It's obvious that even Professor Yang from the Vascular Surgery Department couldn't handle this patient just now."

"How did he blindly determine the bleeding point?"

The emergency department is not always a serious place. On the contrary, because there are so many patients and quite a few girls there, the atmosphere of gossip is unabated.

"I don't know!" He Qingqing shook her head and said to the girl wearing glasses, "Get me the electrolyte and blood gas analysis results for Bed 3. I always feel like he's a little weird."

"If the situation is not good, you still have to be transferred to the emergency ICU."

"Mr. Zhou has strong technical skills and is very responsible in handling matters."

The girl with glasses had very thin eyebrows. She quickly brought up the test results page and squinted her glasses and said, "Teacher He, you think so too, right?"

"Just now, he looked very manly."

He Qingqing looked at her student's infatuated expression and tapped her: "Zhou Yanqing explained to us clearly that several chief residents in the orthopedics department have drawn clear boundaries."

"It is up to the other hospitalized patients to decide how to choose, but Zhou Yanqing himself can help as appropriate. Otherwise, he should not embarrass his colleagues."

"Didn't Zhou Shangqun confront the orthopedic department staff yesterday?"

"He reported to us for a second purpose, which was to let us know that when he was on duty, there was an alternative plan, which was resource reserve."

"After all, our emergency department is the fastest and most direct way to get help!" He Qingqing said, and then looked at her students.

He felt that the other party was just a Teletubbie, and did not understand the ways of the world deeply enough, so he added: "When you want to take risks, you must protect your family from harm."

"You must make a good choice between the pros and cons! ~"

"This is the real reason why Zhou Yanqing came to see me."

"Learn from this. How can someone be promoted to chief resident at such a young age? You are only a master's degree holder."

The girl was a little unhappy, and said in a crisp and arrogant tone: "Teacher, he must be older than me!~"

(End of this chapter)