Chapter 758: The First Patient

"The patient...should be anesthetized." Selina, who was the interpreter, said in a low voice, and the worry in her heart was self-evident.

Ling Ran said "En", but did not act immediately, but quietly observed the patient, and said: "We use the shortest possible time and as few steps as possible to treat the patient's wound, mainly to maintain life. "

He tried to explain as clearly as possible that there are not enough people in the operating room, and the assistants are even less experienced... In fact, he doesn't even have an assistant, only a nurse and a translator who has washed his hands, and he has to teach and do it at the same time .

In this case, to do a complete operation is to challenge the limit.

Ling Ran himself doesn't mind challenging the limit, but he can judge with gallstones, the patient definitely doesn't want to accept the limit challenge. Moreover, the time spent on the complete operation is also more, which is also a disadvantageous factor for the rescue of the following patients.

Therefore, although Ling Ran instinctively wanted to perform a complete operation, at this time, Huo Congjun's roar would resound in his mind: "Save lives first, then treat illnesses!"

After staying in Yunyi's emergency center for a long time, Ling Ran agrees with Huo Congjun's philosophy very much.

Ling Ran flipped the patient gently, then looked at the numbers on the monitor to judge the depth of anesthesia, and then said: "During the operation, we should also pay attention to the amount of urine. If you can notice it, report the amount of bleeding and flushing as well." .”

"How much is normal?" Selina wanted to take the job.

Ling Ran shook his head: "According to the patient's weight, the normal urine output per kilogram per hour should be 1 milliliter, but there are other factors, so you can report the number. The main thing to note is that the urine output decreases. If it increases, it is generally Not a big problem."

"Okay." Selina then asked the nurse a few times in a low voice, and then looked up, and saw Ling Ran flipping through the patients again like salted fish.

Seeing the patient's bleeding wound, Selina couldn't help but assume the identity of a doctor, and said, "Doctor Ling, why don't you start yet?"

"Wait a little longer." Ling Ran said.

"Why?"

"As far as possible to ensure the depth of anesthesia." Ling Ran replied.

Selina didn't understand the meaning, so she repeated it with some doubts: "The depth of anesthesia?"

"kindness,

Insufficient depth of anesthesia may lead to intraoperative awareness. "Ling Ran said it lightly, but actually described the greatest horror in surgery.

The so-called intraoperative awareness means that the patient wakes up during the general anesthesia operation.

Imagine that a group of people are cutting your body, and then you wake up. However, this is not the scariest part. The scariest thing is that because the current anesthesia methods are combined anesthesia, even if the patient is aware of the operation , because of the use of drugs such as muscle relaxants, he may not be able to express in any form.

In other words, at the time of awareness during the operation, the patient's consciousness is clear, and the pain is continuous, except that he cannot speak, shake his head, or even tighten his muscles to resist.

If this is not scary enough, the greater horror of intraoperative awareness lies in the fact that most patients with intraoperative awareness after waking up do not know that they have intraoperative awareness.

Because of the use of narcotics, the patient who wakes up may have forgotten the hellish pain he experienced an hour or two ago.

It is very unavoidable to know oneself during the operation. Because everyone's physique is different, and anesthetic drugs cannot be used in unlimited quantities.

For Ling Ran, the use of narcotics is even more difficult to control.

Therefore, Ling Ran needs to observe more. At the same time, it is also necessary to reduce the operation time as much as possible. As far as the current environment is concerned, this is beneficial and harmless.

In the operating room, it was a little quiet for a while.

Immediately afterwards, Ling Ran took out a scalpel and quickly opened the patient's abdominal wound.

"Intestinal injury." Ling Ran said, and then cleaned and sutured the wound, then cleaned and infused with antibiotics, placed a drainage tube, and began to close the abdomen.

Closing the abdomen is not a complete closure, but a simple suture so that the stomach is not open.

It is actually a challenge for Ling Ran to use expedient measures in the land of rights and interests.

"Now deal with the shoulders." Ling Ran explained, and began to change the patient's position.

Intestines and shoulders are actually not within the range of Ling Ran's skills. However, if you simply treat the wound, the difference between each part is not too big, especially the treatment in the emergency department has always been very rough.

Ling Ran doesn't pursue any refined operations now, just like an ordinary resident doctor in the emergency department, frivolously doing operations that he is not very good at.

It is estimated that there will be many complications. For the same patient, if he is sent to a large hospital for emergency treatment, or if he is sent to a professional hospital for surgery, the length of hospital stay will be significantly different. Not to mention the current conditions.

In fact, the patients in front of me will definitely have to enter the palace twice, and if they are unlucky, they may need to enter the palace for the third time, but they just need to survive.

Like a novice, Ling Ran cut open the shoulder with unfamiliar movements to reset the patient.

This time, there were no skills to assist him, not even the guidance of a superior doctor, so Ling Ran could only rely on his past experience and existing knowledge to operate for him.

Ling Ran did it slowly, but his movements were still proficient.

After all, it is orthopedic surgery that he is good at. Even if he has not been in contact with it, the difficulty of orthopedic surgery is not as complicated as hepatopancreas.

The most important thing is that Ling Ran has to complete this operation, otherwise, the patient's shoulder will hurt more and more, and when the painkillers are not enough, he has to scream.

Fortunately, Ling Ran knows how to do Chris' fracture, and it's a perfect Chris' fracture. The technique of anatomical reduction is not a problem for him.

He also has a lot of experience in anatomy of the upper limbs. The system has given him more than 3,000 times, and he has performed a lot of surgeries by himself.

Compared with ordinary doctors, Ling Ran may have a deeper understanding of the anatomy of the shoulder.

That is to say, the approach and steps of the operation are not very familiar.

After all, the purpose of surgery is to repair the patient's body. It cannot be like dissecting a corpse, just cut it down with a knife and put it together.

Whether it is open surgery or laparoscopic surgery, in the final analysis, it is a dojo in the shell of a snail. The doctor must treat the patient with as little trauma as possible. In this way, it is not a matter of the doctor’s convenience to operate, but a location that can avoid important nerves, blood vessels and even muscles, and can achieve surgery. Goal.

Such a position and path is the surgical approach. Generally speaking, a surgical approach is accumulated and perfected by multiple generations of clinicians. Inexperienced doctors, except for learning and memorizing such approaches Otherwise, there is basically no other choice.

To create a brand-new surgical approach without ten or eight years of clinical experience is simply a dream. Of course, more clinicians can only remember the popular approach after 20 or 30 years.

Ling Ran's memory has always been good, he took care of the fracture of his shoulder slowly, and his forehead was sweating for the second time.

"Selina wipes my sweat, Nandaman, you bandage." Ling Ran helped the nurse and began to bandage the wound.

Selina and the nurse nodded at the same time, looking at Ling Ran with distress.

"Sweating so much, I'm so tired." Selina wiped Ling Ran's sweat, and couldn't help but said, "It's actually just an arm, don't work too hard... Well, I mean, there are still many patients behind. Woolen cloth."

"Well, it makes sense to do one well before doing the next one." Ling Ran nodded.

"With Dr. Ling here, everyone will feel lucky when they encounter floods." Selina wiped off Ling Ran's sweat carefully, and put down her hands reluctantly.