The low level of his first orthopedic medical skill might be related to the fact that he had no foundation in orthopedic surgery.
Separation and anastomosis are both level three once acquired, because they are advanced medical skills derived from basic surgical techniques such as incision, suturing and ligation.
He had no experience in bone reconnection surgery.
He was able to successfully set bones the first time, one reason was that he was very talented, and the other was that everything in the world was connected. His four basic surgical skills were already at the attending physician level, which allowed him to apply what he had learned to other cases.
When it comes to bone setting, they are definitely much better than real novices.
"Orthopedics is an unavoidable hurdle in surgical skills, and it has many application scenarios. Now that I have acquired this medical skill, it would be good to find opportunities to improve it little by little."
Zhou Can always likes to plan ahead.
Instead of asking for help from others when you need surgery in the future, it is better to learn more medical skills.
The field of surgery is very finely divided, and there are almost no all-round doctors.
Complex surgeries often require multidisciplinary collaboration.
For example, if the ribs are completely broken and there is a risk of piercing the heart or other important organs, open-chest fixation surgery may be required.
At this time, cardiothoracic surgeons and orthopedic surgeons often work together.
Every time Zhou Can acquires a new medical skill, he will have fewer opportunities to ask for help when performing surgery in the future.
Moreover, various medical skills are inextricably linked and complement each other. Learning more medical skills will be of great benefit to improving his overall medical skills.
…
"Teacher, do you think the phalanges can be joined?"
"Well, it went very well. Let's hurry up and complete the subsequent surgery!"
Doctor Xu nodded with satisfaction.
It's very good to be able to receive it so well on the first try.
In finger replantation surgery, reconnecting the patient's finger bones is only the first step of the operation.
The subsequent tendon suture, vascular anastomosis, and nerve anastomosis are all difficult. If any step is not done well, the finger replantation surgery may fail.
Fortunately, Zhou Can is fully capable of doing them well.
Tendon suturing mainly tests the two medical skills of suturing and ligation, as well as the relevant knowledge of tendon repair.
An intermediate level of resident medicine is fully capable of doing this job.
Both of Zhou Can's medical skills are at the attending physician level, enough to sew the broken tendon very well.
After nearly forty minutes, all the tendons and blood vessels had been anastomosed.
In the blood circulation test, within thirty seconds, a hint of redness appeared on the severed fingertip.
Perfect.
When Dr. Xu saw this, he was very relieved.
He smiled and went back to his work.
Zhou Can continued to complete the subsequent nerve anastomosis and skin suture for the patient.
After more than an hour of hard work, the severed finger replantation operation was finally successfully completed.
He also earned more surgical experience points.
I also learned a skill in orthopedics.
This feeling of steady improvement is great.
The growth of a famous doctor is achieved step by step through countless surgeries, rescues, and diagnostic experiences, and through continuous learning.
The operations continued one after another.
Tian Tian still chatted with Dr. Lu and Shishi Li from time to time.
She wanted to chat with Zhou Can, but unfortunately Zhou Can was too busy with his work to pay any attention to her.
After being uninterested a few times, she changed the subject of the conversation.
Around 3pm, a patient came in for a surgery to suture a wound. He had a fractured jaw from a fall, and he was very young, only nine and a half years old, a boy.
There were still traces of tears on his face.
Children of this age are in the playful stage of climbing up roofs and playing in the mud on the ground.
It is common to fall and get injured while playing and fighting.
Considering that the part being sutured is the face and the child is a child, the suture requirements are relatively high.
Dr. Xu then handed the patient over to Zhou Can.
Dr. Lu's suture was too careless, and if it left an ugly scar on the child's chin, it might affect the child's life.
Zhou Can learned the traceless suture method from Dr. Xu a long time ago.
I couldn’t try it before because of my low suturing skills.
Since his suturing skills were raised to the attending level, he began to look for opportunities to try the scarless suturing method.
With practice and many consultations with Dr. Xu, he has been able to do it quite well.
After Zhou Can took over the operation, he first checked the child's examination report.
There are no injuries to the bones, just skin injuries.
not bad.
The amount of bleeding was not heavy, indicating that no larger arteries were damaged.
This operation can only be regarded as a very minor debridement and surgery.
Tian Tian and Li Shishi were having a happy chat.
I don’t know why she is so happy today?
She said she will be able to pass the intermediate nursing exam this year and has great hopes.
Generally speaking, the promotion of nurses is different from that of doctors. After graduation, you can take the junior nurse exam after working for one year. After obtaining the junior nurse certificate, you can take the intermediate nurse exam after working for four years.
She said she would be able to take the mid-level nursing exam next year, which meant she had been working for at least five years.
No wonder Qiao Yu was bullied by her.
"Local anesthetic!"
Zhou Can had to remind her.
"OK!"
Tian Tian agreed with a smile, quickly prepared the anesthetic, and handed it to Zhou Can who was carefully examining the child's wound.
Because there was a lot of blood in the wound, some of which had coagulated into clots, it was impossible to see the specific condition of the wound.
Only after anesthesia and cleaning and disinfecting the wound can the best suture plan be formulated.
Zhou Can took the prepared anesthetic and injected it around the child's chin wound.
With his attending physician-level injection skills, he can probably administer local anesthetics better than most attending physicians.
Not long after the beating, the child's wound began to bleed more.
The child complained of headache, chest discomfort, and shortness of breath.
This scared Zhou Can.
Jin Mingxi was in an accident last time and is still being punished.
"Teacher, this child showed many abnormalities after receiving local anesthesia. Could it be that he is allergic to the anesthetic?"
It was the first time Zhou Can encountered such a situation and he was a little panicked.
Hurry up and ask Dr. Xu for help.
"What is the dosage of the medication?"
"About 20mg!"
Zhou Can injected the child with superficial anesthetic, reducing the dosage by at least half.
"What anesthetic was used?"
Doctor Xu looked at Tian Tian.
At this moment, Tian Tian was very calm. When something goes wrong, nurses usually don't have to bear too much responsibility, because it's the doctors who take the lead.
Unless it is found that it is the nurse's negligence or mistake, the nurse bear the primary responsibility.
The biggest risk for instrument nurses is that they fail to count consumables when cooperating with major surgeries, resulting in items such as gauze and vascular clamps being left in the patient's body.
In a minor operation like this, the chances of a nurse making a mistake are very small.
So Tian Tian acted as if it had nothing to do with her and was quite calm.
"It's tetracaine! It's diluted strictly in proportion with saline."
She replied.
As they were talking, the child's condition took a turn for the worse.
Any surgery has risks.
Once danger occurs, sometimes doctors and nurses don’t even have time to react.
The situation is extremely dangerous at the moment.
"It is almost impossible for tetracaine to cause a severe allergic reaction. Procaine requires an allergy test before use." Doctor Xu frowned.
Giving Zhou Can the authority to perform surgery independently is actually a violation of hospital regulations.
But as long as he, as a teacher, is willing to take this risk, it is acceptable from a procedural point of view. At least there is no legal risk.
Nothing will happen unless something goes wrong.
If the people do not report, the officials will not investigate.
But now the child's condition is so critical that even the experienced Dr. Xu doesn't know what the problem is.
Then there is no way to provide accurate rescue.
Time is life.
Every second of delay doubles the risk of death for the surgical patient.
Fine beads of sweat appeared on Doctor Xu's forehead. His eyes were extremely sharp as he stared at the child, observing some of his symptoms.
"Is the amount of bleeding from the wound suddenly increased? This means that the patient's heart rate has increased and his blood pressure may have risen. Measure his blood pressure immediately."
After measurement, the systolic blood pressure was 190/110 mmHg, which was frighteningly high.
Such a sudden high systolic blood pressure indicates that the heart is contracting rapidly and its pumping capacity is far beyond normal levels.
"Teacher, do you think there might be something wrong with the anesthetic?"
Zhou Can quickly calmed down from his panic.
The most important thing right now is not to think about being suspended or even sentenced after an accident.
Instead, we tried to find out the cause and save the child as quickly as possible.
Zhou Can had a strong diagnostic ability. After testing the blood pressure, he was able to associate the cause and effect. The abnormality only occurred after the anesthetic was injected.
It must be the anesthetic.
"Show me the bottle of anesthetic."
Dr. Xu is a very capable doctor and he also realized that it might be a problem with the anesthetic.
Tian Tian immediately squatted down and looked for the bottle of anesthetic.
I saw her expression change slightly.
Then he took out a medicine bottle from it.
"Here, this is the medicine bottle."
Her eyes were a little evasive and her expression was a little abnormal.
Zhou Can has been dealing with her for such a long time that he knows that this woman is a scheming bitch.
I don't quite believe what she said.
He walked around the operating table and went to the small trash can and squatted down.
A lot of medicine bottles have been thrown inside.
Almost all of them are bottles of local anesthetic.
One of the bottles was buried under the other bottles, but it could still be seen that it was slightly different from the other anesthetic bottles.
Zhou Can felt that something was fishy and was about to dig it out.
Tian Tian said with concern, "Doctor Zhou, those glass bottles are broken, be careful not to prick your hands."
Zhou Can didn't say anything, but used a bottle to pick up the bottles on top, and then turned out the medicine bottle that was pressed underneath.
At this moment, Tian Tian's face turned a little pale.
But still pretending to be calm.
"Isoproterenol!"
When Zhou Can saw the name of the medicine on the bottle, he suddenly understood. He wanted to curse Tian Tian's ancestors.
What is a vicious woman?
That’s Tian Tian.
"I didn't use isoproterenol in my surgery today. Where did this bottle come from?"
Zhou Can questioned Tian Tian coldly.
Dr. Xu has a lot of experience and has seen all kinds of tricks, gimmicks, monsters and demons.
He stared at Tian Tian with extremely cold eyes.
"I don't know about this! Maybe it was left !"
Tian Tian is still trying to argue.
If Zhou Can hadn't seen that she was a woman, he would have wanted to slap her to death.
It's already this time and you're still lying here.
She was only worried about being punished after admitting her mistake, but ignored the danger of the patient and the possibility of death at any time.
I can't believe there are such vicious and stupid women in the world.
That pretty face makes people sick just looking at it now.
"Isoproterenol can enhance myocardial contractility, increase heart rate, and dilate peripheral blood vessels and smooth muscles. It is clinically used to treat bronchial asthma, cardiac arrest, and shock. It is a rescue drug commonly used in operating rooms."
Zhou Can explained to her the purpose of this medicine with a cold face.
In fact, there is no need for popular science explanation. She is also a professional and must know the purpose of this medicine.
Otherwise, when she squatted down to look for the medicine bottle in the trash can just now, she would not have deliberately buried this medicine bottle under so many bottles.
Dr. Xu has almost understood the cause of the accident.
There are many things that cannot be said in front of patients.
He quickly took Zhou Can and Tian Tian into the locker room outside.
"Tian Tian, ​​human life is at stake. Did you mistake this medicine for an anesthetic?"
Doctor Xu's face was so gloomy that water could drip out of it.
The look in his eyes was also extremely scary.
"I, I don't know, maybe that's possible."
Even at this point, she is still hiding it.
This woman is so stupid and evil.
If a medical student has moral problems, it will be a disaster for both the patients and the hospital .
They are like a time bomb that may explode at any time.
"I'll ask you one last time, is this true or not?"
Doctor Xu rarely yells at female nurses like this.
I was extremely angry at this moment.
This stupid woman didn't know how serious the consequences of this incident would be. It was very likely that both Dr. Xu and Zhou Canquan would be harmed.
The child's life will also be at stake.
Of course, the child may not die, but how can we explain this to the parents?
It's just a superficial wound, and you made my child like this.
I'm afraid no parent would agree.
Tian Tian wasn't sure if she had taken the wrong medicine, so they could only draw blood for testing and then determine the rescue plan.
By then, the daylily will be cold.
"Yes! I made a mistake. I was chatting with Li Shishi and the others just now, and Doctor Zhou suddenly urged me. I was careless and took the wrong thing." Facing Doctor Xu's ferocious eyes, she finally dared not to evade the issue anymore.
"You, what can I say about you?"
Emergency medicines and anesthetics are stored separately.
I really don't know where her mind was that made her make such a serious and stupid mistake.
"Use 100 mg of alpha-blocker immediately to reduce drug damage!"
After finding out why the child was in danger, Dr. Xu immediately tried to find a way to rescue him.
Alpha blockers are very effective against isoproterenol, but some patients naturally have this blocker in their bodies, which can make isoproterenol ineffective.
After a series of rescue measures, the child's condition finally improved.
Doctor Xu also breathed a sigh of relief.
This matter must not be concealed and must be reported to superiors in accordance with regulations.
"Xiao Zhou, continue to sew up his wounds, and I will report."
Doctor Xu is only the attending physician. This matter needs to be reported to Director Lou first, and then Director Lou will report it to the relevant departments of the hospital.
Fortunately, no serious consequences were caused. If the case had been reported to the medical department, it would have been put to rest.
There will naturally be an experienced doctor to explain to the child’s parents.
Sometimes, it is a good thing that family members and patients do not understand medicine.
For an emergency situation like this child, parents will generally accept it as long as the explanation is reasonable and the child is not seriously injured.
Of course, when explaining, I definitely won’t be silly and say something like the wrong medication was given.
Tian Tian was immediately stopped from performing surgeries.
Li Shishi was temporarily called over to serve as Zhou Can's nurse, and Dr. Lu stopped performing the surgery independently.
…
The child's wound healed well after being sutured.
After taking the wrong medicine, everything is fine.
The final result was pretty good.
This is the only thing to be thankful and thankful for.
This matter is not over yet.
Someone came out to explain and communicate with the family, and the family accepted the hospital's explanation and took the child home.
In the emergency department office, Director Lou had a gloomy face, and Doctor Xu also had an unpleasant expression.
Zhou Can was cautious.
Tian Tian lowered her head and fiddled with the corner of her clothes.
Soon, the head nurse in charge of Tian Tian and the head nurse of the emergency department's nurse station also came in.
"The medical accident that happened today should not have happened. Due to the negligence and carelessness of the instrument nurse Tian Tian, ​​it almost caused irreversible serious consequences. Our emergency department operating room was originally planning to compete for excellence this month. Now that this has happened, let alone being evaluated for excellence, we will definitely be criticized and punished by our superiors."
Director Lou has a rather impatient personality.
Such a big thing happened, he slammed the table in anger.
"Director Lou, calm down. It is really wrong for Tian Tian to make such a serious mistake. I will definitely strengthen her education." The head nurse
He still protects his nurses very much.
Doctors are pretty much the same.
Many people do this to protect their children.
Doctors and nurses are two professions where the chance of making mistakes is extremely high.
Without the care of senior doctors and nurses, the number of people who could survive would probably be less than one in ten.
Whether it was Director Lou, Director Tan of the Internal Medicine Department, or Doctor Xu... every one of these hospital department leaders had made mistakes. No one could remember exactly how many times they had made mistakes.
Because there are too many.
It is a good thing that interns and resident doctors are sometimes scolded.
Only by being scolded can you learn your lesson.
"This incident is worthy of vigilance for every nurse. I will convene a nurse safety meeting at this station as soon as possible. I will make this incident a typical example and educate all nurses to strictly abide by relevant regulations and put safety first during operations."
The head nurse was sitting while she spoke.
From this point, we can also see that her status is quite high.
Basically, if you can become a head nurse, you are already at the level of a chief nurse. You have a very high level in nursing expertise and management.
Director Lou's expression eased slightly.
"Niu Lan, what do you think we should do with Tian Tian?" Director Lou was giving face to the head nurse and showing her respect.
"Deduct your monthly bonus, cancel your annual performance evaluation qualification, and write a profound self-reflection letter. Do you think this is okay?"
Head Nurse Niu’s name is really unique.
Ordinary parents would never come up with such a name. After all, it sounds the same as "Niulan" and it is easy to be misunderstood.
She speaks very steadily, neither hurriedly nor slowly, calmly and calmly, modestly yet independently.
"Well, I think these punishments are enough to make her remember them deeply."
Director Lou affirmed her decision.
This matter has basically come to an end and we can go home now.
The person responsible has been identified and is Tian Tian alone.
"If there's nothing else, go ahead and get busy!" Director Lou said to everyone.
Zhou Can deeply felt the art of being a leader.
Not long ago, he was banging the table with a rage. Now, he lifted it high and put it down gently, and the clouds and rain stopped.
Maybe it's just a knock on the emergency department nursing department.
So as to avoid causing trouble next time.
"Please stay, Head Nurse Niu. There is something I would like to discuss with you in front of Director Lou and Doctor Xu."
Zhou Can waited for so long, and the opportunity finally came.
Originally, he thought it might take two or three months, until he had learned most of the first and second level surgeries, before he would have a chance to bring this up.
I didn't expect Tian Tian to bring such a big disaster upon herself.
It really is true what the saying goes, if God wants you to die, he will make you crazy.
Tian Tian was probably very happy because she had dealt with Qiao Yu yesterday and established her position. In a good mood, she went to chat with Li Shishi, Dr. Lu and others.
We happened to talk about taking the intermediate nursing exam this year. She felt that her future was bright and everything was going smoothly.
Being carried away by success.
End up making a stupid mistake that is easily overlooked.
Zhou Can was still a little worried that she would have to go back to the operating room, and then she would have to be an assistant again, which would be even more painful.
It would be better to seize this opportunity and help Qiao Yu up.
Although it seemed like he was taking advantage of someone's misfortune, he didn't care.