godfather of surgery

Chapter 469 Save one, is one.

Yang Ping didn't care about things other than saving people, that was the business of the leaders, and he just focused on performing the operation.

Saving one is one, there is no other better way.

Knowing the anatomy of the human body almost with his eyes closed, Yang Ping is very fast.

The image of the boy's CT scan was immediately converted into information directly guiding the operation in the brain.

Where is the injury, where is the bleeding, how fast is the bleeding, where is life-threatening, and where is the highest priority, naturally forming a clear order.

Open your chest without hesitation.

As skilled and easy as Qiepi.

The hemorrhage in the mediastinum was stopped, the cardiac tamponade was relieved, and the damaged lungs were repaired if they could be repaired, and those that could not be repaired were resected decisively.

Everything is for the purpose of saving lives, any other redundant things are discarded, and every operation is straightforward.

The ribs are fixed with memory alloy clips to restore the normal ribcage.

Next, the pelvic cavity is opened, which will require great risk.

If it were someone else, they would definitely not dare to open the pelvic cavity at this time. They must first consider embolization to stop bleeding, and then fix the pelvis with an external fixator. After the blood pressure stabilizes, then consider whether to open the pelvic cavity.

At this time, the pelvic cavity is opened, the closed volume space is opened, the pressure in the retroperitoneal space drops instantly, and the blood spurts stronger under the drive of the pressure difference immediately, and the wounded will die immediately due to the instantaneously increased hemorrhage.

But at this time, if the bleeding is not completely stopped immediately, the blood pressure cannot be stabilized at all, and the wounded have no hope of surviving. This is the only bridge to victory, and there is no other way.

No matter how high the risk is, the pelvic cavity must be opened, and conservative measures such as embolization should be attempted, which will only waste time.

The sound of the aspirator squeaked, the blood tide did not recede, and the tip of the vascular forceps in Yang Ping's hand had penetrated into the blood, reaching the bleeding point.

Clamping, ligation, all in one go, all actions are done in the blood.

The blood tide receded, and when a clear surgical field appeared, Yang Ping had already completed the hemostasis of several main blood vessels.

Song Zimo was at a loss. What kind of technology is this? There is blood everywhere. Before he could see clearly, he successfully ligated the blood vessels in the blood.

Yang Ping completed the vascular ligation blindly, and each ligation position was accurate.

Can his eyes see through?
Otherwise, how could there be such a powerful blind manipulation ability?
The few blood vessels ligated in the blood are all the most fatal bleeding places. Some of these broken blood vessels have retracted, which means a clear surgical field, and it is not easy to operate under direct vision.

"On the CT film, you can see the distribution of hemorrhage, and you can guess which blood vessels are damaged. If you are proficient in anatomy to a certain extent, you can find the bleeding point even with your eyes closed. After all, there are very few variations."

Yang Ping explained during the operation, so that Song Zimo would not look like a magic trick.

It’s a reasonable explanation, just like typing, if you are proficient to the extreme, you don’t need to look at the keyboard, and you don’t need to think about it. Whichever word you want to type, you will naturally press which keys.

When Song Zimo was hesitating, Yang Ping ligated several blood vessels.

With the cessation of bleeding from the venous plexus around the sacrum, the pelvic bleeding was completely controlled, and all organs were explored.

After the damaged organs were repaired, reduction and internal fixation of pelvic acetabular fractures began.

The pelvis was screwed with reconstructed steel plates in a mess, and the separated pubic symphysis was also fixed with steel plates. The shattered and deformed pelvis returned to normal.

"Blood pressure is up, 85/48mmHg." Fatty Liang reported his vital signs regularly.

Finally, the blood pressure began to rise slowly, indicating that the reversal was beginning to occur.

After lingering on the critical line for a long time, life begins to recover, and then gradually moves away from the critical line.

For bilateral femoral shaft fractures, closed reduction and interlocking intramedullary nail fixation, reduction, opening, guide wire insertion, reaming, nail insertion, and locking nail insertion are all done in one go.

The whole body trauma operation was successfully completed in one operation, and the vital signs were stable in the normal range.

"90/62mmHg—"

Fatty Liang continued to report his blood pressure.

If the follow-up blood type AB in the blood bank can keep up, the child will surely survive the danger.

The 16-year-old is in the flower season and should not be adjusted to zero!

"How about it?"

Lao Han shuttled back and forth in several operating rooms, keeping abreast of the progress of each operation.

"It should be pulled back." Yang Ping looked up.

Lao Han felt a little relieved, saving one was one.

"Let the ICU pay attention to fat embolism, pulmonary embolism!"

Yang Ping explained a few words, took off the surgical gown, he didn't rest, and immediately ran to the next door to participate in the rescue of the female driver.

Director Ouyang took Dr. Jin and two deputy chief physicians from the general surgery department and the thoracic surgery department. They were operating nervously. The female driver's heart stopped beating just after the chest was opened.

The life of the female driver is currently maintained by an artificial heart-lung machine.

They were undergoing intrathoracic heart compressions. The thoracic surgeon held the heart in his hand, squeezed it rhythmically, and then injected epinephrine into the heart with a syringe, but there was still no response.

The heart was in his hand, like a mass of dead flesh, without any sign of beating.

When this woman was so drunk that she rushed the Maserati into the crowd, she wondered if she had thought about what would happen to her.

-

In the emergency room, the female driver's father, a man in his 50s, was constantly calling to find someone. He didn't know if he was looking for someone to save his daughter, or to find someone to help settle the accident.

The jeweled woman, the mother of the female driver, looked anxious, knocking hard on the door of the emergency operating room from time to time.

Surrounding them were a few entourages in suits and leather shoes, as well as a lawyer who rushed over with a briefcase.

The door of the operating room opened, Director Han, Director Sun, and Director Zhao came out and stood at the door without calling their names.

The woman rushed up, "How is my daughter?"

"The heartbeat and breathing have stopped, and the rescue is underway. There is little hope." Director Zhao said with a sigh.

The woman immediately grabbed Director Zhao's chest and wailed loudly, asking how and why it happened like this.

The man put down his mobile phone and grabbed the woman's hand. The security guard also rushed up and separated the woman. Director Zhao straightened his collar.

"The injury is too serious. We are doing our best and we must be mentally prepared."

Medicine is as cold as iron, so Director Zhao can only report his condition objectively.

As a father, the man felt dizzy for a while. This precious daughter, how many disasters he had caused, could be dealt with by himself. Now he felt scared for the first time, really scared.

Heartbeat stops, which means—dead.

The man shuddered, touched his forehead, tried hard to calm down, and almost dropped the hot phone he was holding.

"Please, doctor, save her, she is still young." The man begged.

"We are doing our best, but the injury is too serious." Director Zhao was very calm.

With many years of experience as the director of the medical department, this kind of scene is commonplace.

The boy who had just been rescued by Yang Ping was pushed out and sent to the trauma ICU.

Before his family members arrived, the principal and teacher followed up: "How is it?"

"The operation was successful. The vital signs are stable now, but he is not out of danger now. He will be sent to the intensive care unit for further monitoring and treatment." Xiao Wu and Zhang Lin escorted the patient.

Another student was pushed out of the operating room. His right calf was damaged and had to be amputated.

As the flat car rolled out, looking at the empty limbs, the student's mother cried out heartbreakingly, while his father hugged her and comforted her constantly.

They were fine a few hours ago, but now they are missing a leg due to a sudden accident. No matter what, they couldn't face it.

Compared with the student who died at the scene due to craniocerebral injury, he was much luckier, at least he was able to live.

The students who are still undergoing surgery, their family members and teachers are anxiously staring at the gate, uneasy.

The third student pushed it out, and this one underwent splenectomy, partial liver resection, and partial intestinal resection.

At the entrance of the emergency operating room, there was a mess, and the government staff responsible for appeasing kept comforting the family members.

The female driver's parents sat back on the blue plastic chair. Her father picked up the phone a few times, but at this time he didn't know who to call, and he was confused.

These students were pushed out one by one, and the female driver's parents didn't even raise their eyelids, let alone go up to find out about the illness, as if the whole incident had nothing to do with them.

Knowing that they were the parents of the female driver, the mother of the amputee student lost control and rushed to ask for an explanation, crying.

At a distance of three meters, the staff pulled the grieving mother back.

The lady got up subconsciously, took two steps back, and pulled her clothes in disgust, for fear that the people who rushed up would mess up her clothes.

The disdain and contempt on his face are enough to make anyone angry.

-

Yang Ping has already taken over the operation of the female driver, and Song Zimo has also taken the position of first assistant.

Director Ouyang, Dr. Jin, and the deputy chief physicians of the General Surgery Department and the Thoracic Surgery Department automatically stepped aside.

"Electrical defibrillation!"

Defibrillation of the heart directly into the chest cavity.

Stimulated by the current, the heart finally began to beat weakly, and there was a sound of rapid friction between the wheels of the cart and the ground in the corridor, and the follow-up urgently raised type AB blood was finally in place.

As long as the pulse can be restored, there is still a glimmer of life, this is the last chance.

The trolley rushed into the operating room, and the nurse who delivered the blood was panting. The itinerant nurse immediately checked the blood type, hung the blood bag on the infusion stand, and the blood transfusion set with a heating and pressurizing device quickly injected the suspended red blood cells into the human body.

Surgery continues!Must go on!
From the chest cavity to the abdominal cavity, and then to the pelvic fracture, the femoral head inserted into the pelvic cavity was pulled back into place, and finally the limbs were fractured.

Methodical, step by step.

Trauma should be dealt with step by step, saving lives first, limbs second, and functions last.

According to conventional principles, for this kind of patients, after the chest, abdomen and pelvic injuries have been treated, life threats are relieved, and the comminuted fractures of the limbs can be left for future operations.

But this is a principle set for ordinary people, Yang Ping has his own principles.

With Yang Ping's speed, it doesn't take much time to break limbs, and it can be done by the way, and these comminuted fractures have active bleeding, and the amount of bleeding is very large.

The bleeding volume of pelvic fractures is generally 500 to 5000 ml, and the bleeding volume of one femoral shaft is 200 to 2000 ml.

For comminuted fractures caused by such high energy, the value of blood loss is close to the upper limit.

血液占体重7%-8%，一个50-60千克体重的成年人，全身的血液不过4000到5000毫升。

Severe pelvic fractures can deplete the body's blood if not replenished by blood transfusions.

Acute bleeding reaches 30% of the total blood volume, which has reached the limit of human body compensation, thus threatening life.

30%, that is, 1200ml to 1500ml, if the rescue is not timely, it will cause death.

If the operation speed allows, of course it is best to solve all these fractures, any one is a leak of blood.

Step by step, because the speed of the operation of ordinary people cannot meet the requirements of one-time completion.

Yang Ping did not take steps, but completed the operation in one go.

The two deputy chief physicians of the Department of Thoracic Surgery and General Surgery stood on the stage, just observing with admiration.

They just watched silently. This young man with interdisciplinary surgery has far surpassed himself in thoracic and abdominal trauma surgery. He had only heard about or watched the surgery before, and had never really performed on the same stage.

Now I have surgery on the same stage, I have seen it with my own eyes, I am close at hand, I am convinced, I can only worship.

The replenished blood of the same type carries oxygen and circulates throughout the body, rejuvenating the cells, but some cells die due to lack of oxygen.

Even if this patient is revived, there will be serious sequelae, such as brain dysfunction.

Professor Huang Zhong from the Department of Traumatology and Orthopedics of the First Attached Hospital took the directors of Thoracic Surgery and General Surgery to Sanbo Hospital by helicopter, and they rushed to the emergency department.

The female driver's father finally saw his savior: "Professor Huang, thank you for your hard work, please, I'm afraid they won't be able to handle it."

Professor Huang waved his hand, signaling not to disturb him.

Director Han came out to greet him and said, "Is Xiao Yang busy inside?"

Huang Zhong was very respectful to Director Han, shook hands with Director Han, turned to the family of the female driver and said, "Dr. Yang represents the highest level of surgery in the medical field. I am here to observe and study."

The tone was sincere, without any casualness.

"Professor Huang—?" The female driver's father wanted to say something.

Huang Zhong waved his hand again: "If Dr. Yang can't be rescued, then he must accept his fate."

Huang Zhong is so frank and direct.

After the lady listened to it, she fell back with her head up, but fortunately there were two people beside her to support her.

The female driver's heart still keeps beating weakly, it has already unloaded all the work.

The artificial heart-lung machine next to her, ECMO, has been running to replace the functions of her heart and lungs.

"The heart beat is weak, continue to use ECMO."

The last vascular clamp was thrown on the bend.

On the monitor, the curve symbolizing life has been maintained.

Save one, be one.

This one was saved for the time being.

"How about it?"

Director Han came over again.

"It should be pulled back!"

Yang Ping stared at the data on the monitor.

Then he turned to Song Zimo and said, "Close your chest!"

Just now I dare not close my chest, fearing that my heart will stop beating again.

(End of this chapter)