Medical Immortals come from the future

Chapter 301 Regression
Although Sima Qing was too busy to grow her hands, she still didn't forget to follow the "assistants" beside her to explain the steps, essentials and reasons for what she was doing now.

The usual teaching is like a college student who has been in college for a few years and can only stay on the theoretical basis of talking on paper. No amount of theory is as good as practice. I don't think it's much better.

"You must want to ask, why don't you have an operation immediately?"

"You know, this is a very serious penetrating heart trauma! Like this kind of trauma, emergency rescue measures are very important..."

"Because the situation in the chest and abdomen is unknown, you must not open the chest cavity rashly."

"The main clinical manifestations after heart stabbing can be divided into two categories: one is hemorrhagic shock type."

"In this type of patients, the heart and pericardial knife wounds are relatively large (greater than 2 cm), and a large amount of blood gushes out of the heart quickly after the injury, which will soon lead to hemorrhagic shock and even death. Such patients have typical blood loss after injury. Generally, the diagnosis is relatively clear. As long as the vital signs have not completely disappeared (even if there is confusion, severe heart rhythm disorder, changes in respiratory rhythm, etc.), the thoracotomy should be performed immediately while the volume is expanded to resist shock.”

"The other type is cardiac tamponade."

"Pericardial tamponade refers to when there is too much fluid or blood in the pericardium, that is, in the pericardial space, it affects the relaxation of the heart, resulting in a fatal sharp drop in cardiac output and resulting in cardiac arrest."

"If there is a tamponade, then urgent pericardiocentesis is required..."

The third prince belonged to the first category, and he didn't have troublesome symptoms such as cardiac tamponade.

"Prepare for chest surgery."

This operation requires general anesthesia with endotracheal intubation.

At the beginning of the operation, a small amount of light anesthesia is given, and oxygen is given abundantly.

General anesthesia can dilate peripheral blood vessels, and positive pressure breathing can further affect venous return and easily induce cardiac arrest.Therefore, emergency thoracotomy should be prepared during induction of anesthesia, and intermittent positive pressure breathing should not be performed before pleural incision.

In the operating room, it was so quiet that only the "beep" of the instruments and machinery could be heard. Emperor Xian'an, the empress, and the second prince, who had already put on sterile clothes, were all standing behind the glass partition one meter away. , you can clearly see all the actions on the operating table, and because there is glass blocking it, it can prevent them from rushing over to destroy the operation if they may not be able to withstand the "shock" later.

Of course, before the operation, Mei Ruotian had already warned them not to watch here, they might faint from fright...but they all refused, expressing that they must see how the third prince was rescued with their own eyes.

No choice but to let them.

Beside the operating table, there were six people.

Sima Qing is the chief surgeon, Mei Ruotian, Shi Yuyi, Li Yuyi are the assistants, and there are also Liu Lao, Dr. Zeng and Wan Taiyi who are observing for the first time.

The three assistants have already cooperated with Sima Qing several times, so there is no need to give extra words, she just said: "This operation is different from the previous ones. Heart surgery requires very, very rigorous techniques and a high level of spirit. Concentrate, so, please."

Seeing her clear eyes and solemn words, several people beside the operating table suddenly felt a heroic sense of mission, nodded solemnly, and answered in unison!
With everything ready, Sima Qing started to do it.

Extensively disinfect the skin on the third prince's chest, and slowly cut it down with the scalpel.

The incision is an anterior external incision on the left chest, entering the chest through the fourth intercostal space, and cutting off the fourth and fifth costal cartilages to increase exposure.

When the entire chest was exposed in front of his eyes, a gust of bright red blood gushed out immediately, blood dripped on Sima Qing's gloves and mask in an instant.

The people next to me were startled.

Sima Qing's expression didn't change a bit, she said calmly: "It's normal, don't be nervous."

Reach out, "Hemostat."

Mei Ruotian quickly handed the hemostat to her hand.

Seeing the entire chest cavity filled with blood, looking at the beating heart, watching Sima Qing's hand holding the silver-white instrument move around inside... The three assistants are still calm, but Mr. It's all bad.

Not to mention Emperor Xian'an, Empress Empress and Second Prince on the other side.

The empress screamed in shock, then lay down beside her and retched.

Emperor Xian'an and the second prince were men after all, so they had better resistance, but at the moment they were pale with fright and their lips trembled.

This, this... is this surgery?It turns out that surgery is such a terrible thing as disembowelment and laparotomy?God, the chest is cut open like this, can you still live?Is this saving lives or killing people?How could that girl be so calm?Is she not afraid at all?Who the hell is she!
Dr. Ah Qing didn't know that she had become a monster-like image in their eyes at this time, she only knew that they were determined enough not to faint or rush out screaming.

She quickly rummaged through the blood-filled chest, and pressed a piece of hemostatic cotton from time to time, but the bleeding was too fast, a piece of white cotton wool was pressed down, and it was immediately soaked red, and Mei Ruotian quickly picked it up with pliers Putting it on the tray aside, my hands were trembling.

Luckily, Sima Qing was not affected by this situation at all. She has performed countless surgeries on aortic ruptures. The blood spurting out doesn't look like it came out of a human body...

So she still looks composed, calm and composed, so calm that she hardly looks like a person.

At least that's how it looked to those watching from the operating table.

Soon, she found the biggest bleeding point.

The crossbow bolt almost penetrated the right atrium. Fortunately, it didn't hurt the largest heart vessel, which was only a centimeter away. If it touched it, it would almost kill him on the spot.

However, this wound should not be underestimated. It was about four centimeters long, and blood kept pouring out from it. Fortunately, the blood supply prepared earlier was still sufficient.

"Myocardium is too large to be sutured directly."

"It can be filled with pericardium or pedicled muscle, and then do mattress suture; or block the blood return of the superior and inferior vena cava for 60 to 90 seconds. When the heart filling blood volume decreases, quickly place sutures, and then ligate the sutures when blocking again."

"The most appropriate way is to immediately establish extracorporeal circulation for repair. In the case of left thoracotomy, a venous return line can be inserted in the right ventricular outflow tract or pulmonary artery, and an arterial supply can be inserted in the descending aorta or femoral artery."

While she was meticulously repairing and suturing the myocardial rupture with polyester woven pieces, she told them the process steps in a voice without any emotional ups and downs.

If it weren't for the sweat constantly oozing from her forehead, others would really think that she was just playing house, effortless and leisurely.

After about two hours, she finally repaired the fatal wound, exhaled, and looked up at the Western clock on the wall, with disappointment flashing in her eyes.

Regressed, regressed.

Mei Ruotian noticed it and asked her in a low voice: "What's wrong?"

She smiled, her eyes fell back on the beating heart, and said softly: "It's nothing, I just feel that my movements are too slow."

Mei Ruotian was speechless immediately, assistants Shi and Li were also speechless when they heard it, and Elder Zeng, Elder Liu and Imperial Physician Wan were even more speechless when they heard it.

To be precise, it should be speechless.

Gu Liang, with your hand speed, you still say that you are too slow to make people die?

A few of them felt that even if they practiced for decades, it would be impossible for them to reach such a level.

"Hey, the blood seems to have stopped!" Elder Liu said in surprise, looking at the beating chest.

After more than two hours, he looked at this "scene" much better, and he no longer felt nauseous and retching. Although he still had a little fear, he still dared to look directly at it.

"Isn't it? The blood doesn't flow much anymore, is it because the wound just now was... sewn shut?" Dr. Zeng also stared at him with wide eyes.

"Of course! Why he bleeds so much is because of the hole in the heart! Do you know what the heart is? The heart is the most important organ in the human body. Its main function is to provide pressure and move the blood to the Every part of the body..." Doctor Shi said proudly, showing off "I am Dr. Ah Qing's proud disciple" and "My master is so powerful and knows so many medical skills."

However, Dr. Zeng, Mr. Liu, and Dr. Wan did not despise him, but showed a look of envy.

But Sima Qing is not in the mood to pay attention to their thoughts at this time, the operation is not over yet!

After repairing the biggest wound, although I told them that the blood was not bleeding much, but!It's "not much flow: not "not flow at all".

This means that apart from this wound, there are other gaps in the heart that have not been found.

Passing the suture thread and suture forceps to Mei Ruotian, Mei Ruotian thought it was over, but she said without thinking, "Pliers."

"Ah?" Mei Ruotian didn't react for a moment.

Sima Qing raised her eyes and furrowed her eyebrows: "I said give me the pliers, what are you thinking?"

This is the first time Sima Qing has spoken to him in this tone, and this look in his eyes has never been seen before.

This made Mei Ruotian even more stunned.

Seeing him like this, Sima Qing was even more angry, and said sharply: "If you are not qualified for this job, then don't be brave, just leave now, so as not to cause more trouble! The operation is not over yet!"

Seeing her suddenly lose her temper, the others also looked at each other in blank dismay, and quickly fell silent.They were all her grandparents at the same age, but they all had a kind of awe towards her, as if they had forgotten that the person in front of them was just a little girl who was only [-] years old.

As for Mei Ruotian, he had already regained his composure at this moment. Regarding Sima Qing's inexplicable temper, he just lowered his eyes slightly and said softly, "I'm sorry, it's my fault." into her hand, silent.

(End of this chapter)