Chapter 274: Two chief physicians failed to clear the blockage, a god-like operation
While they were discussing, the child's condition worsened again.
His body hunched up, his hands began to scratch and his feet kicked. His face had turned dark purple, his lips had turned dark purple, and his nails, even his fingertips, had turned dark purple.
This is a sign of severe hypoxia.
There is no time left for consultation with the doctor.
"I can perform emergency treatment after tracheotomy, but I don't have much clinical experience in this area. The patient's condition can't wait any longer, so open the trachea immediately!"
Director Dai is one of the youngest chief physicians in Tuya Hospital. He has strong comprehensive strength, but also has some shortcomings.
For example, rescuing children with blocked airways.
This is not as simple as just being able to operate an endoscope or having a certain level of surgical skills.
The younger the child, the more dangerous the operation.
Doctors need to have extremely rich surgical and rescue experience, as well as strong enough adaptability to ensure the success of the rescue.
Director Dai saw that the child's condition was critical and had no choice but to go ahead with the treatment.
At this moment, it was obviously too late to request reinforcements from Tuya Hospital. The golden rescue time for the sick child was only three to five minutes.
"Doctor Chen, please go and get Director Zhang Bihua over here right away."
Director Dai Shan was worried that something might happen, so she decided to ask Director Zhang Bihua from the Obstetrics and Gynecology Department to come and help.
Director Zhang Bihua has extensive clinical experience in rescuing infants.
The patient is only one and a half years old and is as fragile as a baby.
"Forget it, I'll just call her and tell her!"
Director Dai may have taken into consideration that there were many family members and patients surrounding the expert's desk in the outpatient hall, and direct face-to-face communication would cause unnecessary panic and negative impact.
Even if the child died, the hospital is not responsible from a legal perspective.
Because the hospital has fulfilled its obligation to rescue.
But other patients and their families would not think so after hearing this.
The first thing they thought of was that Xinxiang Women's and Children's Hospital had just killed a pregnant woman last year, and many patients had reported that there were various problems with the hospital.
Now another young child has died due to this treatment. Who would dare to come to a hospital that specializes in killing people?
Therefore, reputation is extremely important for any hospital.
If you have had a major accident, it is like being sentenced to prison. After you are released, you will also have a historical stain. It is almost like a lifetime of black mark.
When a theft occurs in the jurisdiction, the first people to be investigated are those with a history of theft in the area.
Once an accident occurs in a hospital, its reputation becomes extremely fragile. Even a normal death due to ineffective rescue may be magnified thousands of times.
Director Dai called Director Zhang Bihua who was seeing patients in the outpatient hall on the spot.
In fact, from the moment the nurse from Xinxiang Maternity and Child Health Hospital ran to the outpatient hall to ask Director Dai to come over to participate in the rescue, Director Zhang Bihua had been secretly paying attention to the progress of the matter.
She personally led the expert outpatient activities to support Xinxiang Maternal and Child Health Hospital.
She is the person in charge.
If something went wrong, she would lose face, and she also had the obligation to ensure that this expert clinic activity achieved a certain positive effect, rather than creating a negative impact on Xinxiang Women's and Children's Hospital.
"I'll be right there!"
After listening to Director Dai’s report, Director Zhang Bihua acted decisively and calmly.
He only said five words lightly, but it gave Director Dai a reassurance.
Zhang Bihua first apologized to the patients and their families who were waiting in line to see her. "Dear patients and families, I'm sorry, I have to rush to the operating room to complete an emergency operation and can't continue to treat you. Now other experts from our Tuya Hospital will continue to provide outpatient services for you."
After saying that, she stood up and looked at Deputy Director Shi.
"Director Shi, I need to borrow Dr. Zhou from you temporarily. We need him to help in the operating room. Is that okay?"
At this time, she did not rush to the endoscopy room to participate in the rescue, but first asked Deputy Director Shi to borrow Zhou Can as a rescuer, which was enough to make Zhou Can famous again.
Zhou Can was bored to death, and when he heard Director Zhang ask him to help in the operating room, he was more than happy to do so.
"That's fine with me, as long as Dr. Zhou agrees."
Deputy Director Shi doesn't dare to make decisions for Zhou Can.
It seems that there is several levels of difference in professional title between him and Zhou Can. On the surface, Zhou Can is his subordinate doctor and has to listen to him.
In fact, when he was in the Department of Gastroenterology, Deputy Director Shi often asked Zhou Can for help.
Zhou Can saved him many times.
Therefore, he had special respect for Zhou Can.
"Doctor Zhou, what's your opinion?"
Director Zhang looked at Zhou Can.
"I am ready to receive Director Zhang's orders and instructions at any time."
Zhou Can's half-joking compliments made Zhang Bihua very happy. She also found Zhou Can more pleasing to the eye.
Zhang Bihua took Zhou Can and Yang Chan and quickly rushed to the endoscopic operating room.
The patient's trachea had been cut open, but his symptoms had not changed much.
The atmosphere in the operating room was tense and solemn.
The medical staff were busy.
Director Dai had sweat on his forehead as he was trying to find a way to suck out the sticky, purulent secretions in the sick child's trachea.
But this sticky purulent secretion is not easy to suck out.
Moreover, the children are very young, and their organs and tissues are very delicate, making the operation even more difficult.
Chen Jiaojiao stood by and couldn't help at all. She could only watch Director Dai operate anxiously.
"Director Zhang is here!"
Someone shouted with joy.
Zhang Bihua is very famous in the field of obstetrics and gynecology. She is not only a living signboard of Tuya Hospital, but also well-known in other hospitals. There are countless obstetricians and gynecologists who have asked her for help or studied under her.
Her students are spread across hospitals large and small across the province, all working in obstetrics and gynecology.
The essence of Xinxiang Maternity and Child Health Hospital is actually a combination of obstetrics and gynecology and pediatrics.
Specialized medical services include pregnancy, gynecology, infertility and pediatrics.
Therefore, there are many doctors in this hospital who know Zhang Bihua.
"How is the patient?"
Zhang Bihua nodded cordially to the doctors involved in the rescue, and then her eyes fell on the sick child.
"The situation is very bad. I have almost stopped breathing, my heartbeat is weakening, and my blood pressure is also dropping..."
This is a sign of suffocation to death.
The time is often very short, maybe only three to five minutes, and the person will be completely gone.
“Can’t the purulent mucus be sucked out?”
Zhang Bihua watched Director Dai suctioning the bronchial secretions with worry in her eyes.
To be honest, Director Dai's operation was not particularly good, it could only be considered average.
"The secretions in the trachea are too viscous and the amount is too large to be sucked out."
Director Dai looked distressed.
"Director Zhang, you are familiar with this kind of operation. Can you do it?"
She probably wanted to resign a long time ago.
I had no choice but to help the sick child clear his bronchi.
"Okay, let me give it a try!"
Director Zhang did not refuse.
After she took over the operation, she was worthy of being called a living signboard of Tuya Hospital. Her aura was much stronger than Director Dai, and her operations in all aspects were much more proficient.
"It looks like there's a scab in there, no wonder it's so blocked!"
After Director Zhang sucked out some purulent secretions, he could not suck out any more.
Upon closer inspection, I found a scab inside.
She tried many methods, but nothing worked.
Seeing that the child's vital signs were getting worse and worse, many signs such as blood pressure, breathing, and heart rate sounded the alarm.
This also means that the god of death has arrived and is about to take the child's life.
"A large amount of sticky purulent secretions adhere to the glottis, bronchial walls, etc., and stubborn scabs are firmly wedged on them like nails and cannot be sucked out. This is really fatal!"
Director Zhang Bihua began to become more and more anxious.
The formation of scabs is actually the result of purulent secretions not being discharged in time, which gradually dry up and form scabs.
This phenomenon rarely occurs in adults because when adults feel discomfort in their throats, they will cough hard or use other methods to spit out the purulent secretions in the bronchial tubes.
Young children do not know how difficult it is to master these self-clearing techniques and are most likely to develop scabs.
This can also further block the airway.
The doctors at Xinxiang Maternity and Child Health Hospital were even more anxious. The child could not die.
Once a death occurs, it will be like adding insult to injury for Xinxiang Maternity and Child Health Hospital.
Many ignorant patients think that fish bones stuck in the throat, diphtheria, and acute bronchitis can be saved by cutting the trachea. This is too naive.
From the throat to the trachea, there is an elastic tube, which is very tough and has the same strong elasticity as a rubber tube. Ordinary compression or minor problems cannot cause them to be blocked.
This can also effectively protect patients from easily dying from airway suffocation.
However, when this trachea, which is not easy to deform or be blocked, becomes diseased, it becomes extremely difficult to clear it, and it is full of uncertainties.
Also, the structure of the bronchi is actually tree-shaped.
The main air intake duct is thick, and then when it leads to the lungs, it first splits into two, leading to the left lung and the right lung.
After splitting into two, it spreads out like branches into many small and large tracheae after entering the lungs. Then it becomes thinner and wider layer by layer until it spreads throughout the lungs.
Let’s talk about the breathing principle of the lungs.
It is composed of countless alveoli, like balloons, which expand when you inhale and shrink when you exhale, thus completing the gas exchange.
The only passage to the outside world during gas exchange is the bronchi.
It's like a highway system.
Countless rural roads connect to county roads, which then converge onto provincial roads, and finally provincial roads converge onto national roads, forming a highway transportation system that reaches across the country.
Problems with the main bronchial trunk or the secondary "provincial trunk" can cause serious damage to the patient's lung function or even respiratory arrest.
At this moment, the patient's main and secondary bronchial arteries were severely blocked, causing his breathing to almost completely stop.
The body cannot exchange oxygen, fresh oxygen cannot enter the body, and waste gas cannot be discharged. The patient's major organs will quickly shut down. The heart and brain are the first to be affected, and the symptoms are extremely obvious.
If the airway cannot be cleared quickly and the patient cannot be helped to breathe again, the heart will stop beating due to lack of oxygen . The whole body will stop functioning due to lack of oxygen and the patient will die quickly.
Precisely because they knew the danger involved, Director Zhang Bihua and the doctors at Xinxiang Women's and Children's Hospital were as anxious as ants on a hot pan.
At this time, Director Tian also heard the news and rushed to the operating room with his men.
Looking at the sick child whose life was hanging by a thread, Dean Tian almost collapsed.
By mobilizing all available personal connections and spending huge amounts of money and energy, we were able to finally invite experts from Tuya Hospital.
I thought I could use the fame and superb medical skills of these experts to restore the reputation of Xinxiang Women's and Children's Hospital.
I never dreamed that something like this would happen on the experts’ first day of consultation.
Dean Tian couldn't even imagine the consequences of the sick child's death.
In short, she will become the eternal sinner of Xinxiang Women and Children's Hospital. It was during her time in charge that she destroyed this specialty hospital with a 70-year history.
"Director Zhang, this child cannot die! The efforts and hard work of several generations of Xinxiang Women's and Children's Hospital's hundreds of employees depend on this child. Once he dies, this hospital will completely collapse and it will be difficult for it to stand up again. Please give us a chance to breathe."
Dean Tian was almost begging.
Although she also saw the situation at hand, she was afraid that it would be difficult to save the sick child.
"I'll do my best!"
Director Zhang Bihua could only answer this way. Everyone could hear that her tone was full of insecurity and uncertainty.
Just when everyone thought that the worst result was about to happen, Zhou Can, who had been standing by and watching for a long time, stood up.
"Director Zhang, Dean Tian, can you let me try? I have just seen the patient's condition. If we want to remove the scab in the trachea in the shortest time, clamping is the best way."
Zhou Can’s grasping skills are currently at level four, which is the middle level for attending physicians.
Removing scabs from a young child's airway is a challenge.
The main reason was that time was of the essence, and the organ had to be removed successfully in one or two minutes at most. Otherwise, the child would have died immediately.
"I'll give you twenty seconds to try. If you can successfully remove a scab, you will be in charge of the rescue work."
Zhang Bihua appeared very decisive at this critical moment.
She brought Zhou Can here because she knew he was very good at surgery. Many chief physicians had told her that Zhou Can was not only good at traditional surgery, but also very good at endoscopic surgery.
Before coming to help rescue the sick child, she was considering that if endoscopic surgery was needed, Zhou Can might be able to help.
That's why Zhou Can was specially seconded here.
Since she had never seen Zhou Can's specific surgical skills, and the tracheal scab removal of the patient in front of her was extremely difficult and risky, and required very high technical skills from the operator, she did not take the initiative to ask Zhou Can for help.
Now that Zhou Can had volunteered, his demeanor and tone revealed a strong sense of confidence, she couldn't help but have higher expectations for him.
"Is this... a bit risky?"
Dean Tian is worried that if he tries all kinds of medical treatments in a hurry, it will cause even bigger trouble.
Even if the sick child cannot be saved now, the hospital will not be sued because everything is done strictly in accordance with the rules and regulations. The hospital and the doctor are not at fault, at most they killed the patient and their reputation is bad.
If this ridiculously young doctor had performed the operation, and if he had punctured the child's trachea, the child would have died, and the family would have asked the higher authorities to investigate. That would have been a huge problem.
If yellow mud falls into your crotch, it will become shit.
Even if Dean Tian had eight mouths, he couldn't explain it.
"Don't worry, Dean Tian. Dr. Zhou Can is the youngest and most promising resident in our Tuya Hospital."
Zhang Bihua's words of comfort not only failed to reassure Dean Tian, but almost scared him to death.
"What... He, he's just a live-in student, how can he be allowed to operate it?"
If Dean Tian hadn't seen Zhang Bihua's noble status, she would have wanted to curse.
Director Zhang was really ridiculous. The child was already dying and in critical condition. In this case, even a general chief physician would have to think twice before operating. But she actually let a resident trainee operate the core rescue project.
So irresponsible.
Zhou Can ignored Dean Tian's doubts and saved the patient like putting out a fire. After getting Director Zhang Bihua's approval, he took the specially made long-arm forceps, carefully inserted it into the patient's airway, aimed at the largest scab, firmly clamped a force point on it, and after a lot of effort, he finally clamped it out of the trachea.
The surface of this scab is covered with extremely sticky, viscous, purulent secretions.
It sticks to whatever it touches.
This is not the hardest part.
It is not a hard scab as imagined, but more like rice paste.
If you squeeze it a little harder, it will break into two pieces. If you squeeze it too lightly, it will break as well.
The gripping technique must be extremely precise in order to peel it off the airway.
In addition to the difficulties mentioned above, it is also necessary to ensure that the forceps do not damage the airway in the curved and narrow airway, and at the same time ensure that the scab does not adhere to or touch the inner wall of the airway.
All the difficulties added together are absolutely hellish.
"Director Zhang, a scab has been clipped out."
Zhou Can's entire operation took eleven seconds, nine seconds shorter than the twenty seconds Director Zhang gave him. And the scab he removed was the largest one.
“Ah… so fast!”
Director Zhang Bihua had just been talking to Dean Tian. Unexpectedly, in the time it took to say a word, Zhou Can had successfully clipped out a scab.
When she took another closer look at the scab that Zhou Can had pinched out, she suddenly became a little uneasy.
"This, this... which scab is this? Why is it so big?"
"The child's breathing seems to have recovered a little, and his blood oxygen index is also rising."
Director Dai shouted in great surprise.
As the chief physician of pediatrics, she witnessed with her own eyes today what a godly operation is.
In the time it took to catch her breath, Zhou Can had completed the operation that neither she nor Director Zhang Bihua had been able to perform, clipping out a very large scab from the patient's airway.
The patient's airway, which was almost completely blocked, was cleared, resulting in such a big turn for the better.
"Oh my God, it took you just over ten seconds to remove the largest scab that was blocking the bronchus. How did you do it?" Director Zhang Bihua, who was usually as steady as a rock, was startled and exclaimed from time to time.
