Chapter 187 Finally got it, one-on-one training
"The surgery is going on so soon! Even if we go through the green channel of the chest pain center, it won't be this fast, right?"
A nurse asked in surprise.
Larger hospitals all have chest pain centers, which are generally multidisciplinary collaborations including emergency department, cardiology department, imaging department, cardiac surgery department, thoracic surgery department, gastroenterology department, respiratory medicine department, etc., to establish a regional collaborative treatment system to provide rapid and accurate diagnosis for patients with acute chest pain.
Patients with chest pain do not need to queue up to see a doctor or get examined.
The original intention of building
These diseases are all critical and severe.
Every minute of delay increases the patient's risk of death.
Therefore, you must seek medical attention as soon as possible, and then have an experienced doctor quickly diagnose and determine the next treatment plan.
"I thought that since it was within the territory of cardiothoracic surgery, there was no need to go to the emergency chest pain center. So I went directly to Director Xue for diagnosis." Zhou Can explained.
"wise!"
"Director Hu has been very kind to us and is the mentor of the entire cardiothoracic surgery department. Now that he is ill, I believe that every doctor in the cardiothoracic surgery department wants to do their best to save his life."
"Xiao Zhou, well done!"
When several leading doctors heard that Zhou Can had directly asked Director Xue to jump the queue to treat Director Hu Kan, they strongly agreed with Zhou Can's approach.
When encountering such a situation, we must do everything we can to save people first.
If you are pedantic and stick to the so-called rules and dare not overstep the boundaries, then you are really stupid.
Zhou Can's approach is very much to the liking of people like them.
"Director Hu's safety has been taken care of, so everyone can proceed with the surgery with peace of mind! Performing this operation beautifully is the best consolation we can give to Director Hu."
Director Le said to everyone.
It’s true, this method of boosting morale is quite effective.
The morale, which had been somewhat low, quickly became high.
Each of them is as excited as if they had been injected with chicken blood.
This is enough to show that Director Hu holds a very high position in their minds.
"The patient's condition is very bad. At this rate of surgery, the situation is not optimistic."
Doctor Feng poured cold water on this group of people.
This operation was full of twists and turns, and many things went wrong.
Now, the shortcoming of slow surgical speed of the doctors in Director Hu's department was infinitely magnified in this operation.
"Even after establishing extracorporeal circulation, the patient's vital signs still cannot be controlled?" Director Le asked in despair.
"According to the speed at which you are operating, it is basically equivalent to sentencing him to death." Doctor Feng spoke without beating around the bush. This made Director Le feel very uncomfortable.
"Director Le, can you let me give it a try? My separation speed is fast, and maybe I can shorten the operation time a lot." Zhou Can just stepped forward and volunteered with the idea of giving it a try.
I don’t think Director Le will agree.
"I have seen Dr. Zhou's separation, and it is not only fast, but also of a very high standard. At least not lower than the attending physician's level."
The nurse on duty actually spoke up for Zhou Can at this time.
Zhou Can had some impression of her. She had performed a thoracotomy and hemostasis surgery with Dr. Long, and it seemed that this nurse was also a patrol nurse.
Zhou Can performed extremely well in that operation.
All the medical staff were impressed.
Since that operation, Dr. Long has been polite to Zhou Can.
"How do you know his level of separation is very high?" Director Le asked, staring at the nurse.
"Once Dr. Long was performing a thoracotomy to stop bleeding, and Dr. Zhou showed off his superb surgical skills, which even Dr. Long felt inferior to. I believe you have witnessed with your own eyes how skilled Dr. Zhou is at suturing, ligation, and various catheterization techniques."
The nurse replied neither humbly nor arrogantly.
She spoke up for Zhou Can at this time, which made Zhou Can very grateful.
Their eyes met and she blinked at Zhou Can.
"Come here and try it!"
After a lot of struggle between himself and himself, Director Le finally decided to boldly use Zhou Can in the battle.
Because Zhou Can's leather sewing skills are indeed very high.
They are on par with him, the chief physician.
Director Le decided to first see Zhou Can's separation level.
"Isolate this small blood vessel."
He pointed to a very thin vein on the gland and asked Zhou Can to separate it.
Even if a vein is ruptured, it is easy to stop bleeding.
With such small veins, the risk is completely controllable.
Director Le was extremely cautious when he asked Zhou Can to try his hand.
Zhou Can put on sterile gloves, stood at the operating position, and without any nonsense, he easily separated the vein in a few seconds.
"It's fast enough!"
Director Le carefully examined the vein and the tissue on the thymus.
In fact, the thymus of an adult is mostly covered with fat.
After the examination, Director Le's eyes lit up and he couldn't help but marvel at it.
"This separation level is really good. You must be extremely careful when separating the thymus. If you come across a part you are not sure about, stop immediately. Do you understand?"
After reviewing the case, Director Le decided to take some risks and let Zhou Can complete the remaining separation surgery.
Because the patient's condition was deteriorating, the operation had to be expedited.
At the moment, I'm afraid only Zhou Can can be competent for this task.
Another way is to seek help from other departments.
However, for something like this, I really can't save my face unless I have no other choice.
And even if we invite people over, the speed may not be much faster.
In the entire Tuya Hospital, the person who performs surgery the fastest is Dr. Xu.
Zhou Can is the successor of Dr. Xu. He has already mastered the essence of the quick knife technique and should be the second fastest person in surgical operation.
"clear!"
After Zhou Can gained Director Le's initial trust, he was about to perform the operation.
Ersuke and other doctors are still full of concerns.
"Director Le, isn't it too risky to let a resident intern perform such a dangerous operation?"
If something goes wrong, Director Le is not the only one responsible.
They will also suffer the consequences.
"Trust people when you employ them, and don't employ them if you don't trust them. As far as I know, he has already participated in many high-risk surgeries in orthopedics and neurosurgery, including several level 4 major surgeries. I believe he will not joke with the lives of patients."
Director Le ignored the opposition and insisted on letting Zhou Can complete the most difficult separation task.
From his words, we can tell that he has some understanding of Zhou Can's past.
This is a very normal thing.
The circle is so small that many of the chief doctors at Tuya Hospital have established friendships across departments.
What's more, neurosurgery, orthopedics and cardiothoracic surgery are all general surgery.
It's like a big family.
It is very common for the bosses from different departments to have private contact and chat occasionally.
This is also the reason why Zhou Can never dares to lie.
As soon as someone asked a casual question, the secret was immediately exposed.
Lying is basically equivalent to destroying your future.
"Xiao Zhou, let's start!"
"good!"
Zhou Can began to quickly separate the thymic tumor.
The reason why separation is difficult is mainly because of the adhesion of connective tissue, a lot of fat around it, and its close proximity to the heart.
Director Le really trusts him greatly by letting him take charge of the operation.
Swish, swish, swish!
The quick knife technique and separation technique are integrated into one. His separation speed, efficiency and accuracy are all amazing.
Time passes by every second.
Every minute and every second was thrilling for the doctors present.
Zhou Can's surgical speed completely refreshed their cognition.
I never thought that someone could separate so quickly.
Director Le and the second assistant were not too surprised because they had seen Dr. Xu's knife skills.
There is a big gap between Zhou Can and Dr. Xu.
Dr. Xu's sharp knife skills during his prime left an indelible impression on everyone who saw him. It can only be described as stunning.
"alright!"
Zhou Can looked up at the time and saw that it took 23 minutes.
This was the longest time he had spent separating a tissue. Normally, it would take at most ten minutes to complete. There were also times when it could be completed in just a few seconds.
This thymoma is extremely difficult to separate.
"Is this all?"
The second assistant was a little inarticulate in speaking.
He had thought about what to do if Zhou Can ruptured a large blood vessel with one cut, and he had thought about Zhou Can leaving after separating a small part. However, he did not expect that Zhou Can completely separated the thymus including the thymoma in less than half an hour.
"Director Le, can you let me remove the entire thymus and the tumor at the same time?"
Zhou Can became more and more aggressive.
Trying desperately to get the chance for surgery.
He had just separated the entire thymus including the thymoma, and earned a lot of separation experience points.
Not to mention anything else, the extra 100 separation experience points he received as a reward for separating extremely difficult organ tissues for the first time were enough to make him extremely happy.
He hadn't experienced such a satisfying surgery in the past five months.
In the critical care department, needless to say, opportunities for surgery are extremely rare.
The only decent surgery I've performed in the cardiothoracic surgery department was the thoracotomy and hemostasis surgery I performed with Dr. Long.
"OK!"
Director Le has more confidence in him.
Zhou Can even successfully completed the most difficult separation of the thymus and tumor. Resections are more than ten times simpler than this, so what else is there to say?
Decisively let Zhou Can take charge.
Zhou Can first freed the thymic vein, and then demonstrated his deputy director-level ligation skills.
After ligating and cutting the vein, he carefully removed the thymus and the entire tumor.
The operation is not over yet.
Only the most core part of the operation has been completed.
After cleaning the surrounding tissues, there were no hidden dangers. Zhou Can looked at the ruptured artery.
"Director Le..."
"If you are confident, do it. The separation and removal of the thymus and tumor, which carries the highest risk, have been assigned to you. Is the repair of this blood vessel still a problem?" Director Le watched the operation go smoothly and made great progress, destroying the main force of the 'enemy'.
He was really happy in his heart.
It was like the emperor appointed a young general, and it turned out that this young general named Huo Qubing was a military god. He defeated the Xiongnu in no time, and the Xiongnu fled far away to the area beyond the desert. From then on, there was no king's court in the desert, and the Xiongnu rebellion was completely quelled.
Director Le boldly employed Zhou Can, and his decision was as successful as Emperor Wu’s employment of Huo Qubing.
Zhou Can first separated the broken ends of the blood vessels, then trimmed them and then anastomosed them.
It’s really cool to perform suturing and ligation at the deputy director level.
Although his anastomosis skills were only at the lower level of a chief physician, he was able to achieve results that were not inferior to those of a deputy director.
[Congratulations on your first successful anastomosis of a large heart artery. You will be rewarded with 100 suture experience points, 100 ligation experience points, and 100 anastomosis experience points.]
Zhou Can was awarded a total of 300 experience points at once, which made him so happy that he couldn't stop smiling.
After suturing and ligation are upgraded to level 5, if you want to upgrade further, you will need 100,000 experience points.
If you want to accumulate so many experience points, earning only 1 point at a time, it will probably take more than ten years to reach level 6. I can only say that it is too difficult to reach the director level.
No wonder some surgeons remain associate chief physicians until retirement.
If Zhou Can think of a way to specifically challenge some difficult surgical tasks like he is doing now, he can get 100 experience points as a reward each time and be promoted to the director level, maybe in two or three years.
After completing the anastomosis of the arterial vessels, Zhou Can cleaned the wound in the chest cavity and stopped the bleeding.
Then there is no problem, test whether the blood circulation is smooth.
"It's amazing. The artery was successfully anastomosed in just one use."
Some people couldn't help but marvel.
What made them even more envious was Zhou Can's astonishingly fast surgical speed.
In the past, in their perception, only slowness can lead to stability and slow work produces fine work.
After watching Zhou Can perform surgery, their perceptions were overturned. It turns out that surgery can be done quickly and effectively.
"Shut up!"
Director Le was very satisfied with the results of the operation.
Zhou Can had never completed a chest closure independently, especially a large open-chest surgery like this.
I have watched it many times.
Since Director Le didn't say to replace him, he wouldn't be polite.
I took the stainless steel wire from the nurse and sutured the sternum.
A drain is then placed behind the sternum.
"Director Le, please check it. If there is no problem, I will sew up the incision layer by layer."
Zhou Can has watched so many operations and taken so many notes that he knows every step by heart.
It finally came in handy today.
At least everything is done well and above standard.
For him personally, it was also a very important growth experience.
"Excellent! Keep going!"
Director Le and the doctors present today have fully witnessed Zhou Can's surgical skills.
The nurse who spoke for Zhou Can smiled smugly.
It was because of her recommendation that the operation took a major turn for the better.
Half an hour later, Zhou Can finished the suturing. The patient's vital signs had already begun to steadily recover after he completed closing the chest cavity.
At this moment, the operation is over and the patient is completely safe.
"Doctor Feng, you can give the patient anesthesia now. Because of his special condition, he will be transferred to the intensive care unit for observation for a day. When the patient's vital signs are completely stable, he will be transferred to the general ward for care."
Director Le made safe arrangements after the operation.
"Xiao Zhou, you did very well today. I can give you more opportunities to practice when you do surgeries in the future."
"Thank you! Thank you!"
Zhou Can finally found the right opportunity and turned the situation around.
In the cardiothoracic surgery department which is full of experts, it is really difficult for him, a trainee, to get important surgical training opportunities.
The main reason is that cardiothoracic surgery is basically level three or four major surgery. Not to mention him, even those senior residents basically help with pulling retractors, suturing skin, inserting tubes and so on.
The most high-risk practical operation they have ever done is probably chest puncture.
After the operation, Zhou Can found that it was already 6:47 in the evening.
Today's situation is considered good.
If Director Le insisted on not letting him perform the operation, and they continued the operation at a snail's pace, it would be normal for the operation to end at midnight.
Surgeons earn high incomes, but they often have to work day and night, and all hard-earned.
When Zhou Can returned to the doctor's office, he thought Director Xue must have left work long ago.
I didn't expect she was still in the office.
"Doctor Zhou, did your operation go smoothly?"
She seemed to be waiting for Zhou Can to get off work.
Zhou Can wasn't quite sure either.
After all, his status and position are extremely high, and there is no certainty as to when Zhou Can will undergo the surgery.
"The operation went smoothly. How is Director Hu?"
Zhou Can was still thinking about this matter.
Director Hu Kan's broad-mindedness and selfless teaching to junior doctors make people respect and like him from the bottom of their hearts.
Now that something has happened, everyone is concerned about his safety.
"An interventional surgery has been performed and a vascular stent has been placed. He is still in the ICU. But the overall situation is still optimistic." Director Xue introduced the general situation.
After hearing this, Zhou Can showed a happy smile on his face.
"As long as you're safe!"
He was truly happy for Director Hu.
The mortality rate of acute myocardial infarction is quite high. If treatment is not timely, even if the patient is rescued, the patient will basically be ruined.
Many people only know that nerve cells cannot regenerate, but they don’t know that cardiomyocytes cannot regenerate either.
Therefore, myocardial cells are extremely precious, and if one dies, there is one less.
Therefore, for patients with acute myocardial infarction, early vascular opening is crucial. The earlier the blood vessels are opened, the more myocardial cells are saved, and the heart will not undergo obvious remodeling.
For patients suffering from myocardial infarction, time is myocardium.
Zhou Can discovered Director Hu Kan’s abnormal condition in time and carried him around for examinations, winning precious time for rescue. His contribution was very great.
I believe that when Director Hu wakes up, he will be very grateful to him.
"Dr. Zhou wanted to ask me about the comprehensive medical examination, didn't he? If there is nothing else important right now, let's talk!"
Director Xue was really waiting for him.
Zhou Can didn't say anything, but he was deeply moved.
I quickly sat down and humbly asked Director Xue for advice.
"I have selected thirty test questions here. Just answer them. If you don't know how to answer them, you can leave them blank."
Director Xue moved the chair away and asked Zhou Can to sit in front of her work computer to answer the questions.
Such treatment made the doctors who stayed on duty in the office very envious.
Being able to receive such meticulous one-on-one training from Director Xue, I believe that as long as my foundation is not too poor, I will definitely be able to pass the comprehensive medical examination.
Zhou Can found that these test questions were very targeted.
The knowledge involved is extremely broad.
It turned out that she had been operating the computer, selecting test questions for him.
The woman is very meticulous, and this is fully reflected in her.
Zhou Can answered every question carefully, and she just watched from the side.
This method should be used to find out Zhou Can's knowledge gaps in the shortest possible time, and then help Zhou Can develop a short-term study plan in a targeted manner.
