Chapter 304 The Second Time

The church members bid farewell to Kraft who took the patient away, and offered a carriage to facilitate the transfer. They also said that they would patiently wait for the patient's family members who arrived and inform them of their whereabouts.

They were not really concerned about the follow-up. The point was that the church had handed over the treatment of the injured to a prestigious doctor.

As for what kind of treatment the patient would receive, that was the doctor's business and had nothing to do with the church.

Symbolically, they still sent a monk to ensure participation.

Brother Wadin volunteered to take up the position. He was a little worried, or very sure that others would not be willing to let the patient be taken away after knowing the treatment method to be carried out.

Even the monk who unfortunately fell off his horse during the rainy night attack and was treated by Kraft would feel a palpitation when he touched the small triangular depression on his head afterwards.

The bone was collected and a double-winged ring amulet was carved as a memorial of surviving the disaster and as a proof of being favored. He hoped that this kind of divine favor would continue to accompany his life.

Kraft did not express any objection to the patient's attribution of part of the credit to God, nor did he feel that this was a disdain for his work.

To some extent, he even agreed with this view.

Under the current instruments and sterile conditions, it is conservative to say that God blesses the craniotomy operation that can be successfully completed without infection and too much bleeding and exudation. It is entirely possible to consider competing for the selection of God, at least to pass the audition.

Therefore, as long as it is not necessary, Kraft is actually reluctant to do this kind of operation.

After special means of exploration, he excluded patients with less severe compression, active bleeding that has stopped, and stable vital signs.

This kind of patient can be kept for further observation. If all goes well, a small amount of hematoma will be slowly absorbed over the next long period of time, which may leave some sequelae, but it is better than gambling on the operating table.

The rest are patients who have to be treated.

While preparing for the operation, an informed consent form that has been prepared on weekdays has been completed, waiting for the family members to arrive, and the work will start after informing the patient of the condition and obtaining consent.

Fortunately, the family of the patient with Cheyne-Stokes arrived first.

Unfortunately, the patient's brother of similar age did not quite understand what the doctor meant.

Although Kraft used the most vivid analogy to describe the patient's current condition, the dangers, and why surgery was the best option, the family still asked in confusion when his brother would wake up.

"He may never wake up." The doctor had to take a more straightforward statement, "Even if I use my method, he will most likely die in the next few days or simply die during the treatment process. The chance is quite slim."

"You can choose to let him suffer less pain and leave in a more decent way; or gamble on the one in ten or two chances of survival."

"You said you want to open the head...but isn't that death?" This man who runs a small business doesn't know a bit of medicine, and he can see that his brother is in a bad condition, but if someone on the street jumps out and says that to him, he will definitely be beaten.

"As long as the things inside are not damaged, he is just missing a piece of his skull, and we need an opening to clear the blood clot." Kraft repeated the principle of surgery again, not hesitating to bring up bloodletting therapy.

"It's just like doctors usually drain blood to treat you, but this time it's in your brain."

"Is this the only way to treat it?" The patient's brother still had some luck.

"You can also expect a miracle to happen." To be honest, the idea of ​​"it's better to just leave it at that" has begun to appear in his mind.

This operation is currently very difficult, the benefits are relatively limited, and it is easy to be misunderstood and cause a series of troubles. It is a pure loss-making operation, but providing the plan with the greatest theoretical benefits for selection is his profession.

"Think about it, it's better to be quick." He left after saying this. The family members can think about it again, but he has to go to the back to prepare. As long as the other party signs, it can be started as soon as possible.

When Kraft washed his hands and put the last instrument in place, and felt that he might not need to do it while waiting, Kupp came to inform the family members that he agreed to sign.

Now things are much simpler, and the only thing to worry about is the operation.

The patient was carried to the stage by David and his assistant, and the range of the hematoma had already been drawn.

Compared with the first craniotomy object, this one's condition is obviously more serious, and the instability of vital signs is caused by some kind of more serious brain hernia.

Hernia can be simply understood as tissue squeezing into a place where it shouldn't go through some gaps.

This situation is not caused by direct injury, but the excessively large hematoma breaks the balance of intracranial pressure, causing the brain tissue to be compressed and displaced. If this compression is uniform, it would be fine.

But the problem is that the brain is not a homogeneous slime. It is actually an interconnected chamber separated by the tentorium cerebelli and the falx cerebri structure, which can be imagined as a room divided into several small compartments by partitions.

Under the action of pressure, things in one compartment are squeezed to another compartment. Due to the limited size of the exit, only part of the tissue is squeezed through, and this small piece of stuff just bulges out and presses on other parts.

When luck is bad, this part will be the medulla oblongata that controls life activities, and the manifestation of respiratory depression is Cheyne-Stokes respiration.

In order to achieve a better decompression effect, in addition to removing the hematoma, this time a larger surgical range is required to remove a larger bone flap, which of course means a greater chance of infection.

Thanks to the clinic's regular replenishment of ether reserves even if it is not often used in large quantities, there is enough ether to support the operation under general anesthesia.

Kupp watched the blade cut an elliptical arc on the smooth scalp, like cutting through the strong fur covering the back of a bowl. This thing should be very tough, because you can see the metacarpal bones on the back of Kraft's hand.

Then it is literally to lift up this flap of skin together with the thin muscle underneath.

Thanks to the improvement of the equipment of the Xiguo family, it is now possible to use a small flat-headed clamp to press the cut edge of the scalp and press the superficial temporal artery to stop bleeding, instead of crudely burning the bleeding point with a heated thick needle.

The hand for pressing to stop bleeding was kindly provided by David, and Kupp was responsible for holding the vascular clamp that clamped the scalp, and the other hand provided lighting for Kraft to hold the reflector high.

Then there are some aseptic operation versions of woodworking. In the absence of a surgical electric drill, it is too time-consuming to knock off a large piece of skull with a small chisel. It requires boldness, carefulness, quickness and stability.

Practice makes perfect. With the experience from last time, Kraft felt that he was quite used to this operation and found a sense of rhythm in the banging sound.

Of course, it would be even better if a genius could make a drill in the era without electricity. In the early days of dentistry, there were pedal-powered dental drills. Sacrificing the brain cells of the craftsmen, perhaps this was not an insurmountable technical difficulty.

After about half an hour of operation, he had chiseled out two-thirds of the expected opening circumference. If nothing unexpected happened, he should be able to proceed to the decompression and blood congestion cleaning steps within ten minutes and close the wound as soon as possible.

David seemed to be numb. The most blood his eyes had seen in more than 30 years was the bleeding from the puncture hole in the chest. Now he was hesitating whether to turn his head away. Such a rare opportunity to visit was too rare.

Despite the compression to stop the bleeding, a small amount of red still seeped from the edge to the exposed white bone shell surface, which needed to be wiped off repeatedly with cotton balls. The shocking scene made him start to shake unconsciously.

Kraft didn't pay much attention to this at first, until he found that the surgical field suddenly began to shake. He raised his head slightly to let Kupp and David, who had better arm strength, switch hands.

However, before he could say anything, he found that it seemed that it was not just the small area in front of him that was shaking.

The flat objects were not very obvious, but the taller glass bottles seemed to be swinging left and right with a slight amplitude. Kupp next to him increased the strength of his arms to stabilize. It seemed that he also felt the change, but thought that he didn't hold it firmly.

"Don't move!" Kraft suddenly stopped his work and quickly pulled a piece of sterilized cotton cloth to block the surgical area. "Don't panic, we only have two floors, it won't collapse!"

The two were confused, and they felt obvious dizziness and shaking vision.

Long bottles, high shelves, and even wooden pillars were shaking, and the sound of utensils falling and smashing outside and delayed screams came, followed by chaotic footsteps and more screams from the crowd.

"Don't move!" Kraft's roar overwhelmed the noise and brought the frightened consciousness back to the stage.

He held the cotton cloth in both hands to cover the dust that was floating down from above during the vibration until the power from the ground subsided.

"Call another person to hold up the cloth, and we'll continue."

Recommended book "The Old Objects I Repaired Became Spirits", a new book by the author of "It's Not That Hard to Open a Hospital in Another World"!

In addition: The May Day holiday is coming, please pay attention to your physical condition and eat properly when you go out to play, and I hope I won't see you in the emergency room.