A hospital is actually a small society, each operating under certain rules and regulations.

The main purpose of these systems is to serve patients, but in some cases, they have become a way for doctors to avoid risks!

1. First-diagnosis responsibility system; 2. Third-level physician ward rounding system; 3. Difficult case discussion system; 4. Consultation system; 5. Critical patient rescue system; 6. Operation hierarchical management system; 7. Preoperative discussion system; 8

, Checking system; 9. Shift handover system; 10. Clinical blood management system;

11. Death case discussion system; 12. Basic norms and management system for medical record writing; 13. Hierarchical nursing system; 14. Medical technology access system; 15. Doctor-patient communication system; 16. Transfer system to hospital and department; 17. Special diagnosis and treatment system

Treatment notification system; 18. Surgery safety verification system!

Why does Zeng Dewei want Chen Bing to come to power? Isn't it just that he wants to take responsibility together?

The patient's blood pressure has been dropping. When the peripheral blood pressure drops, there are only two problems to look for: blood supply and bleeding. Cardiac function testing. Naturally, when the cardiology department is in the ICU, he has been called for several rounds without any indication.

Symptoms indicate that when cardiac function is impaired, cardiotonic drugs cannot be used rashly to increase blood pressure.

Unless you are coming to raise your blood pressure when you are close to death, the anesthesiologist at this moment has already prepared these two drugs, whether they are intramuscular injections or pumped, they are always ready, and even dopamine has started to slow down.

The pump was on because I was afraid that the blood pressure would be too low and cause shock on the spot!

Qin Yuanwu can't escape. He is the director of vascular surgery, so he will definitely come up to find out the blood spots. Chen Bing is only the director of orthopedics. If there is no problem in orthopedics, Chen Bing will not be impulsive to go on stage.

Take up space on the operating table.

The matter of finding blood spots actually has little to do with technology. On the contrary, only those who know the condition best and participated in the operation for the first time know what hidden injuries may have been ignored in previous operations.

Zhang Yuewei and Fu Yu were obviously the last to arrive at the operating room, so even if they went up, they could only touch their eyes.

But even so, Zeng Dewei still hoped to get some help and guidance from Zhang Yuewei and Fu Yu, so he said: "Professor Zhang, Professor Fu, the patient was pushed directly to the operating room from the emergency department. At that time, the right lower abdomen, left lower quadrant and lower abdomen were

There are obvious traumas on the abdomen.”

"The most serious ones are the rupture of the intestines, slight contusion of the spleen, and many bleeding points in the liver!"

"During the operation, I only made an enlarged incision from the original wound, and then the door frame of the lower abdomen was inserted a little deep."

"After hearing that the blood pressure was unstable, I immediately opened my abdomen again and performed debridement and exploration. The first thing I looked for was to explore the spleen. I suspected delayed splenic rupture, but there was no bleeding in the right upper quadrant, and...

I couldn't find any bleeding point in my abdomen."

"So do you think this could be bleeding in the liver?"

Zeng Dewei looked at the two of them for help.

But almost as soon as Zeng Dewei put forward this suggestion, Zhang Yuewei shook his head and said: "Intrahepatic hematoma is possible, but intrahepatic hematoma is usually localized. Even if it is not localized, the blood that oozes out will always be

There has to be a place to go.”

"Unless it passes through the diaphragm and pleura and goes directly into the chest cavity."

Having said this, Zhang Yuewei immediately said: "Anesthesiologist, please listen to the breathing sounds!"

If there is blood oozing and accumulation in the chest, you will definitely be able to hear solid sounds. If it is a special situation, closed chest drainage may be required.

Zeng Dewei's expression immediately changed, and he immediately reacted: "Make a round, call the thoracic surgery department. Anesthesiologist, please take the trouble to pay attention to the patient's pupils, and be sure to pay attention to the head injury."

Intracranial injuries are usually treated first. A CT scan is done immediately before coming here, and a CT scan is also done before entering the ICU.

This is to avoid intracranial hematoma or delayed intracranial hemorrhage.

When Zeng Dewei shouted this, he was still feeling faintly happy in his heart. Well, there is one more person here, and he has one more strength.

There was also a very low voice saying that there was another person to shoulder the pressure.

At this time, Lu Cheng was also looking at Yue Nanji with his brows furrowed and his eyes tightly closed. He had now discovered the flaws of these medical equipment.

The glasses he wore were special glasses for orthopedics. He could only see the blood vessels in the limbs, but not the whole body. Therefore, at this moment, Lu Cheng could only confirm that the patient's bleeding point was not within the scope of orthopedic anatomy!

Moreover, the most uncomfortable thing is that Lu Cheng's current understanding of anatomy is mainly based on the anatomy in the field of orthopedics. In other subjects, he has always felt that he has no need for it, so he has not studied too much.

First, the field of orthopedics is vast, and Lu Cheng still feels that there are too many things to learn, and it is difficult to divide them.

Second, there is no need for clinical assistance from other departments.

Now Lu Chengke somewhat understands what Min Hong said to him. When you encounter a problem in your own subject, you may have to look for answers from other majors or even other disciplines.

A person is a whole, and any problem in any part of it may kill him.

But even so, Lu Cheng still lowered his voice and said to Chen Bing: "Director Chen, how about I come on stage to help?"

There are reasons why Lu Cheng said this. First, he wanted to get in close contact with the patient. Although the effect of his equipment was limited and he could not directly see the blood flow in other places, he had the passive skill Dexterity Touch.

, so Lu Cheng hopes to feel it and help him.

Moreover, Lu Cheng is a junior doctor now, so it is impossible for him to be a chief surgeon, but as a junior doctor, it is still okay to suggest it.

Chen Bing also considered that there were not many people on the table now, so he nodded and said: "Xiao Lu, please work hard and help Dean Zeng and Director Qin pull the hook."

Chen Bing knew that Lu Cheng wanted to come to power, but he also pointed out that you were just there to help. Don't be brave. At this time, if you violate the medical system, Zeng Dewei and the others will not shoulder the burden for you.

.

This is a matter of life and death, and everyone will immediately become extremely realistic at this time.

Zeng Dewei smiled bitterly. What he actually hoped for most was that Zhang Yuewei and Fu Yu would come to the stage. Lu Cheng, a young doctor, probably only knows about orthopedics. At most, he would know a little more about the interdisciplinary subjects of orthopedics. If there are really problems in this regard, Chen

Bing has already come up, why do you need him?

It's just that Zhang Yuewei and Fu Yu don't have this intention now, and they probably don't know what to do, so they don't want to or dare to go on stage rashly and steal the chief surgeon's position.

There is no way for Zeng Dewei to let go.

After listening for a while, the anesthesiologist frowned and said, "I heard that the sound of the lungs was still very good twenty minutes ago, but now it seems that there is solid sound, which is also strange."

"Logically speaking, if there is a contusion in the lungs, there will be a real sound immediately!"

The anesthesiologist then said: "Dean Zeng, can you open the chest?"

Of course Zeng Dewei couldn't, but Zeng Dewei immediately said: "I am not a thoracic surgeon, but Qin Yuanwu is. In the past, the thoracic and vascular surgeries in our hospital were not separated, Director Qin, Director Qin!"

At this time, Qin Yuanwu stepped on the door and walked in, staggering away from Lu Cheng who had gone out to wash his hands.

After seeing Qin Yuanwu, the anesthesiologist and Zeng Dewei immediately told him about the thoracotomy. Qin Yuanwu, who had done thoracic surgery before, shook his head and said: "If you just do closed chest drainage, there is no way to stop the bleeding."

The purpose.”

"And if a full chest opening is required, the patient's lungs have no contusion, and CT does not support the diagnosis of thoracotomy. If it is just to find blood spots, is it a bit too much to just open the whole chest?"

Zeng Dewei urged: "Director Qin, when did this happen? This is to save your life. If your life is not saved, what else does it matter?"

Qin Yuanwu was complaining in his heart at the moment. No matter how life-saving it is, you still have to look at the indications for surgery. What if the blood from the abdomen seeps into the chest? What should we do then?

I opened a large circle on my chest but still couldn't find the bleeding point. Who should bear the responsibility?

No matter how urgent the situation is, the indications for surgery must be clearly understood. If a thoracotomy is performed just on suspicion, what is the difference between today's thoracic surgery and that of 50 years ago?

The progress of medicine lies in precision and systematization, not roughness.

Otherwise, are the indications for surgery just for fun?

Qin Yuanwu frowned and said: "Dean Zeng, why don't you wait for Director Xue? I think we should be more cautious when opening the chest now. I haven't done thoracic surgery for many years. Director Xue must be more judgmental than me."

Be clear."

Qin Yuanwu should not be fooled by Zeng De's position.

Director Xue is the director of thoracic surgery. Although Qin Yuanwu is also a thoracic surgeon, he is now the director of vascular surgery. If he doesn’t open the chest, he will be held responsible if anything happens. If nothing happens, he won’t get the credit. Only a fool would do this.

matter.

Zeng Dewei mentally scolded Qin Yuanwu for procrastinating, but he did not dare to make the decision without permission. He was the dean. He could give emergency authorization on behalf of the general manager. If he repeatedly requested, Qin Yuanwu could overstep his authority and perform the operation, and the responsibility would be his.

.

He originally wanted to push some responsibility away, so how could he still take responsibility for himself?

"I'd better check the branches of the femoral artery and abdominal aorta first to see if there are any bleeding points." Qin Yuanwu said and started his professional work.

I don't care about the chest for now, but I still have to do what I need to do about the abdominal aorta, renal arteries, and iliac arteries.

Professional people do professional things, which is also the origin of the consultation system.

After a while, Lu Chengcheng arrived on the stage and saw Zeng Dewei and Qin Yuanwu respectively finding blood spots, while Chen Bing and Zhang Yuewei were watching the operation seriously in the audience without blinking.

He just went to help Qin Yuanwu pull the hook, and then his right hand began to feel restlessly in various places.

It's just that the structure of the abdomen is too complicated. Lu Cheng's dexterous touch still feels very difficult to sense. It seems that he can only feel where the arterial pulses have weakened or disappeared bit by bit.

Arteries are continuous, and arterial pulses can be conducted. If there are bleeding points, the local arterial pulses must have weakened or disappeared.

This is not a special function of any skill, but an attempt by Lu Cheng to use his existing skills and common sense.

In the abdomen, there were no bleeding points, at least there were no obvious bleeding points and the location of stopping and stopping.

Lu Cheng could only explore his chest.

The chest was covered with surgical cloth, which made it more difficult for Lu Cheng to find the bleeding point.

However, I don’t know whether it was Lu Cheng’s luck or Yue Nanji’s. Just when Lu Cheng touched the fourth intercostal space on his left chest, he suddenly felt something about two centimeters to the left from his chest.

, the pulse of the supracostal artery seems to have disappeared by a segment.

When he touched this point, Lu Cheng then descended another segment, and also found the pulse of the arteries in the next intercostal space, which weakened slightly. Then when he went further to the chest, there was no fluctuation of the intercostal arteries.
To be continued...