Chapter 35: Good Teachers Produce Good Students
As Zhou Can loosened the hemostatic clamp little by little, the originally shrunken blood vessels began to fill up. Then, the patient's right lower limb began to regain color little by little. It was no longer so pale.
"The blood flow is smooth and the anastomosis is very successful."
A smile appeared on everyone's face.
For a doctor, the happiest thing is to see the patient's condition improve.
Restoring blood flow to the lower limbs also means that the patient's chances of saving the leg are greatly increased. From a medical point of view, if blood flow to the limbs is blocked, death may occur within 20-30 minutes.
If it is cerebral ischemia, it is even more terrifying.
Brain death can occur in just four or five minutes.
Even if he is saved in the end, there is a high probability that he will become a vegetable or mentally retarded.
"Doctor Lin, is the anastomosis almost finished?"
Dr. Xu asked.
"Almost there, about another five or six minutes."
Dr. Lin is concentrating on repairing the broken artery.
"Given the patient's current condition, it is not advisable to move him. Please ask the surgeon to come for a consultation! Let's see if the operation can be completed here."
What the emergency department can do is the initial rescue work.
Once the patient's vital signs stabilize, he or she will be transferred to a specialist for further treatment.
After a long wait, Dr. Lin finally completed the vascular repair.
"Let's do a blood test!"
After Dr. Lin finished talking to Zhou Can , he looked at the repaired blood vessels and the patient's left lower limb with anticipation.
Zhou Can continued to loosen the hemostat little by little.
You can see the shrunken blood vessels slowly being propped up by the blood flowing in. However, the skin color of the lower limbs is still pale.
After watching for dozens of seconds, Dr. Lin looked at Dr. Xu nervously.
"Don't worry, I think the blood circulation is still smooth. The blood return to the left lower limb is slow for two reasons. First, the repaired blood vessels have become narrower, resulting in a decrease in blood supply to the left lower limb. Second, the patient lost too much blood after the injury and had low blood pressure, resulting in insufficient blood supply to the extremities."
Doctor Xu seemed very calm.
Not panicking at all.
Senior doctors can perform more advanced surgeries not only because they have more sophisticated medical skills, but also because they have stronger psychological qualities to deal with crises. In addition, they have more experience and can give correct solutions in a shorter time when dealing with some emergencies.
In short, it is very difficult to grow as a doctor.
Including academics, medical skills, experience, psychological quality... many aspects.
"Xiao Zhou, what did you gain from watching us perform vascular anastomosis?"
Dr. Xu asked him questions individually.
The other doctors and nurses looked at him with envy. Even a fool could see that Dr. Xu was particularly fond of this new intern.
"I learned a lot. For example, in the final stage of anastomosis, the air that may be in the blood vessels must be exhausted. I also learned to what extent the blood vessels must be damaged before they need to be removed, and how to remove the great saphenous vein. In addition to medical skills, your calmness in the face of crisis also benefited me a lot."
Zhou Can briefly shared his gains.
"Haha, you can even learn the psychological qualities of a senior doctor. I admire you."
Dr. Xu, who is usually strict, rarely smiles.
"If you were to repair the femoral artery that Dr. Lin just repaired, what would you do?"
Just now, Dr. Xu taught him a lot of experience when he was anastomosing the blood vessels.
Did Zhou Can really listen carefully?
Can you put what you have learned into practice?
This is what Dr. Xu is most concerned about.
He really dislikes those pretentious people.
"If I were to repair it, I would probably do a triangular anastomosis repair. There are two reasons for this. The circular anastomosis is not that strong, while the triangular anastomosis is stronger. Secondly, the triangular anastomosis can perfectly avoid the small piece of damaged blood vessel wall and remove it. This can minimize the narrowing of the blood vessel lumen and even prevent a secondary rupture."
Zhou Can gave his own insights.
Doctor Lin felt ashamed after hearing this.
Although his suturing skills are better than Zhou Can's, he is obviously not as flexible as Zhou Can in the application of surgical plans.
"Not bad. My teaching was not in vain. I guess it will take a while for the surgeon to arrive. You will be the one to anastomose these two small veins."
This was obviously an opportunity for Zhou Can to practice.
Even if you screw up, there's not much risk.
Doctor Xu is watching from the side.
You can wipe his butt anytime.
Zhou Can couldn't help but be overjoyed. He liked any chance to gain experience points.
I have just learned a lot of vascular anastomosis techniques and key points, and now I can practice them on patients. This is definitely the dream of every low-qualified doctor.
Because this method of combining learning and practice allows learners to achieve twice the result with half the effort.
Many people only know that good teachers produce good students.
But I don’t know why the disciples taught by famous teachers are so powerful.
In addition to the high level of the famous teachers themselves, the most important point is that they can provide their apprentices with various practical opportunities.
For example, as for the current venous anastomosis, it is wishful thinking for ordinary trainees to get it.
…
About twenty minutes later, an orthopedic surgeon came over.
"Lao Xu, is this the patient?"
He nodded to Dr. Xu as a greeting.
His eyes then fell on the patient.
"Well! The victim's legs were crushed very badly by the car. The femoral artery has been temporarily connected, and the rest of the operation will probably have to be completed by your surgery department. I personally suggest that you ask your surgical specialist to complete the operation on the patient here and then transfer him to the ward?"
Dr. Xu gave a brief introduction to the situation.
Zhou Can was still concentrating on anastomosing the veins.
He was extremely fast and had successfully anastomosed one.
The one being stitched in my hand is more complicated, and I need to cut off the damaged section and then stitch it again.
"Your operating room is rather crude. Bone reconnection and repair are very complicated. I'm afraid they can only be done in our orthopedic operating room. Also, I see that the patient's thigh muscles and bones are extremely damaged. It's hard to say whether these two legs can be saved. You are the first doctor to see the patient. You must communicate this with the family. In addition, the cost of treatment will not be low. The family must make it clear whether they want to save the legs or amputate them."
This type of crushing injury can easily lead to necrosis of the leg muscles and skin.
It's hard to see with the naked eye.
The final conclusion can only be drawn after a few days of observation after the operation.
"Okay then. After we communicate with the family, we will transfer him to your orthopedic surgery department for further treatment."
Dr. Xu didn't say anything more.
He is just an attending physician in the emergency department, with limited abilities. Many things are beyond his control.
Before leaving, the orthopedic surgeon glanced at Zhou Can who was doing the suture.
"Is Lao Xu preparing to train a successor?"
"What's so good about my shift? Attending is where I end up."
There was a hint of loneliness in Dr. Xu's tone .
"Lao Xu, let me tell you something you may not like to hear. The environment and conditions of the emergency department are simply not conducive to the cultivation of high-end talents. You might as well let go of some of your obsessions and focus on emergency and critical care. With your talent, you may be able to achieve something."
The attending physician in the orthopedic surgery department also seemed to know about Dr. Xu's past.
Zhou Can couldn't help but become even more curious. Dr. Xu's medical skills were obviously not bad, so why was he placed as the attending physician in the emergency department, the worst department?
What exactly happened back then?
"What talent do I have? I've already become a useless person."
Doctor Xu smiled self-deprecatingly.
"Please don't say that. At least in the minds of many of our surgical doctors, you are still the legendary Xu Yidao. I won't say any more. I'm leaving now!"
The attending physician of orthopedics waved his hand and left quickly.
Orthopedic surgeons are probably one of the busiest clinicians in the department.
At this time, Zhou Can finally completed the anastomosis of the second vein.
[Suture experience +1, ligation experience +1, anastomosis experience +1. ]
Now earning experience points is simply a flying speed.
By anastomosing two veins, I earned 30 suture experience points, 4 ligation experience points, and 2 anastomosis experience points.
The attending physician of orthopedics said that the emergency department could not train highly skilled doctors, but Zhou Can disagreed.
According to the current rate of progress, I am afraid that within three years, a master-level surgeon will be born in the emergency department.
After the anastomosis was completed, Zhou Can tried to clear the blood.
not bad.
At least they all matched successfully.
Doctor Xu carefully checked it for a while, and then said, "The anastomosis method is fine, but the suturing level needs to be improved. For example, here, it is because your suturing level is not high enough that the lumen of the blood vessel becomes narrower. And here, you should choose it as the starting point of the suturing. You must pay attention to these details in the future."
Zhou Can benefited greatly from having Dr. Xu point out the problems in suture one by one.
Those who are involved are often confused, while those who are not involved can see things more clearly.
Many problems are difficult to discover on your own, but having a wise teacher point them out directly can help you avoid taking detours.
"Doctor Lin, go and communicate with the family. Tell them that the bleeding in the patient's legs has been controlled and that they need to be transferred to the orthopedic surgery department for further treatment. We need to prepare at least 200,000 yuan for limb salvage, and there is a possibility that the surgery will fail. After we understand the family's wishes, we will proceed with the next step of treatment."
Doctors can only give diagnosis and treatment recommendations.
As for the final choice made by the patient and his family, the doctor has no right to interfere.
Zhou Can has seen family members who simply chose to give up the treatment because of the 20,000 yuan medical fee.
The injured man is about 50 years old. Judging from his clothes, tanned skin and rough hands, his family is not well off. It is hard to say whether his family is willing to spend hundreds of thousands of dollars to save his limb.
Everyone waited patiently for Dr. Lin's communication results.
