godfather of surgery

The difficulties faced by the operation were perfectly resolved. Yang Ping planned to personally meet with Lu Jiangbei's family members and sign an informed consent form for the operation.

This operation is not an ordinary operation. As the chief surgeon, he must communicate face-to-face with the patient's family to let the patient's family understand the risks and details of the operation in detail. At the same time, Dr. Zhou, the doctor in charge, and Director Pan of the trauma ICU were also present.

In the consultation room of the trauma ICU, Yang Ping met Lu Jiangbei's mother, who was pushed by relatives in a wheelchair.

At that time, all three members of the family were trapped in the car. Fortunately, the mother's injuries were relatively minor and no surgery was required. However, she was also in the hospital. Now she had to serve as both a family member and a patient.

"Your husband is out of danger, but the child's injury is very serious, especially the traumatic occiput atlanto-atlantic joint dislocation combined with atlas comminuted fracture, and now there is high paraplegia. It is uncertain whether he can recover after the operation, but we will do our best Go all out."

Yang Ping's tone is very calm, and he always seems very rational when dealing with patients and their conditions. This kind of rationality sometimes makes people feel that he lacks a touch of warmth.

"Can I still take the college entrance examination?" My mother blurted out.

She knew that it was very inappropriate to talk about this issue at this time, and she should be more concerned about the child's injury, but somehow, the college entrance examination was deeply ingrained in her heart, and it seemed that she had to make way for anything. She was not indifferent, but almost instinctive This question pops up.

Over the years, all her energies have focused on a few words --- her child's college entrance examination, which has almost become her ultimate goal in life.

"Now we don't talk about this issue. Now we only talk about surgery. If he doesn't have surgery, it's still unknown whether he can survive." Yang Ping's tone was still calm.

He is a doctor, he doesn't care about the patient's life and fate, he only cares about the patient's current physical fate.

The mother was slightly hesitant. She knew that even if she could take the college entrance examination, it would waste a lot of time. Every minute in the senior year of high school is very precious and can be converted into one cent of the grade.

Thinking that her years of hard work might be in vain, she felt a lot of unwillingness in her heart.

"Doctor, he is a good student. Please help, don't waste too much study time." The mother's eyes were floating, and she was making the last effort in her heart.She herself didn't want to dwell on this issue at this time, but she just couldn't let it go.

Yang Ping had to remind her again: "My responsibility is to let the child survive and live better. Nothing is more important than living."

Yes, nothing is more important than living. Mother's eyes were a little dull and she repeated this sentence in her heart.

"Traumatic occipital atlanto-atlantic joint dislocation, atlas shattered bone, high paraplegia -- the mortality rate is very high. Most of the wounded died at the scene of the car accident. He was very lucky to be able to come to the hospital and be able to go to the operating table, so We should cherish it and try to keep him alive, understand? Only by being alive can we have everything. If we can’t live, everything is meaningless! You have to understand that this is the trauma intensive care unit, and leaving here alive is the highest priority for every patient. The goal, to be alive! Above all."

Yang Ping's words hit the mother's heart directly. She closed her distracted eyes and touched the corners of her eyes: "Yes, living is more important than anything else."

"Can we start talking now?" Yang Ping took over the medical records of the doctor in charge.

Mother nodded, trying to adjust her emotions. At this time, except life and death, everything else was as light as smoke.
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Lu Jiangbei had a fever, and her body temperature reached as high as 42 degrees Celsius!
Early the next morning, Yang Ping received a call from the trauma ICU. The call was made by Director Pan.

Sudden high fever, this is undoubtedly terrible news for the operation, and the scheduled operation had to be postponed.

Yang Ping hurried to the trauma ICU, Lu Jiangbei was lying on the bed, using physical cooling, ice packs and blankets had been used.

"I just checked the bedside chest X-ray, and there are infections in both lungs."

The doctor in charge, Dr. Zhou, looked a little anxious. He could have operated on now, but he suddenly developed a high fever, and the operation had to be postponed.

"Look at the X-rays!" Song Zimo suggested.

Dr. Zhou called up the chest radiograph on the electronic screen next to the bed, and it was obvious that both lungs were infected in a large area.

"Yesterday, I was fine during the day, but I started to have a fever in the middle of the night——I'll check the chest X-ray earlier." Dr. Zhou felt ashamed, feeling that he did not manage the patients well and caused everyone trouble.

After reading the chest X-ray, Yang Ping said: "The patient's condition changes all the time, especially for this kind of patient. It is impossible to check the chest X-ray every day."

"Do you want to send it to the CT room for further chest CT examination?"

Lu Jiangbei only had a bedside chest X-ray. In order to learn more about the condition of the lung infection, a chest CT scan must be performed further. In this situation, it is possible not to move it as much as possible.Yang Ping thought for a while: "Forget it, try not to move it, take sputum specimens for bacterial culture, and then do three sets of blood cultures, it seems that it is sepsis, first use antibiotics according to experience, wait for the culture results to come out and then check the drug susceptibility." test."

The operation must be postponed. Severe lung infection will lead to a decline in lung function. Although Lu Jiangbei now has a ventilator to assist breathing, it only helps the lungs to ventilate, not to help it ventilate.

The so-called ventilation is the exchange of gas between the lungs and the outside world, and ventilation is the exchange of gas between the alveoli and capillaries. Severe lung infection hurts not only ventilation, but also ventilation.

Once the lung infection gets out of control, it may cause respiratory failure, and finally rely on ECMO to support breathing. By that time, it is basically close to death.

"According to the color of the sputum, it is likely to be Staphylococcus aureus. Let's use the medicine first. As long as it is not MRSA, there is hope." Director Pan decided immediately.

As the director of the trauma ICU, he often deals with infections, and Director Pan handles it with ease, but when this happens just before the operation, Director Pan is also under pressure.

That night, Lu Jiangbei had a fever. Director Pan came to the hospital in person to investigate the cause of the fever. Most of these post-traumatic infections have several causes: wound infection, infection in the blood accumulation in the body, lung infection, urinary tract infection and so on.

After investigating these causes, it was confirmed that the infection came from the lungs.

Whether it is viral or bacterial, and if it is a bacterial infection, what kind of bacteria it is, generally requires bacterial culture, but if this takes too long, treatment will be delayed.

Therefore, before the results of bacterial culture are available, it is necessary to use empirical medication to determine what kind of microorganisms are based on the color, nature, and viscosity of sputum.

Medicine is an evidence-based science, but in the final analysis it is also an empirical science. In any case, it cannot escape its reliance on experience.

"Be more diligent in suctioning sputum and use a bronchoscope to suction sputum." Director Pan told the nurse who was suctioning sputum.

The muscle strength of Lu Jiangbei's limbs and torso is now at the first level, or slightly higher than the first level, so the respiratory muscles have no strength, and even breathing is difficult, and it is impossible to talk about coughing and expectoration.

The ventilator can only assist breathing, but not help expel sputum. The accumulation of sputum can easily lead to infection.

The operation depth of ordinary suction tube is very limited, it can only go deep into the main bronchi, while the bronchofiberscope can go deep into the 3-4 level bronchioles, or even deeper. a lot of.

Bronchoscopy is a technique in respiratory medicine, which is often operated by respiratory medicine doctors. Under the influence of comprehensive surgery, many doctors in Sanbo began to dabble in marginal and interdisciplinary specialties, forming a composite technical ability.

Dr. Zhou has almost mastered the basic techniques of various specialties, such as bronchoscopy in respiratory medicine, gastroenteroscopy in gastroenterology, dialysis in nephrology, closed chest drainage in thoracic surgery, etc.

These techniques were originally scattered in various specialties. If necessary, specialists were invited to operate in the form of consultations. Now that there is a compound doctor like Dr. Zhou, there is no need to be so troublesome. Dr. Zhou operates alone.

Dr. Zhou began to suck sputum under the fiberoptic bronchoscope, and he took a few samples and sent them to the laboratory for bacterial culture.

"Professor, are we still going to the special ICU?"

August, who had returned to general surgery, offered to do so.

Robert wished he could punch the German guy to death. Every time he turned over, August was only in charge of the head, and Robert was the one who contributed the most. He was the main force in charge of the torso. He also wore small clothes. August's clothes were in good condition. Undamaged, while Robert's underarms were cracked on both sides.

Hearing that Robert volunteered, the head nurse said happily before Yang Ping could speak, "The clothes are already prepared for you, and I have to trouble you."

During this period of time, the ICU has been full, the girls are so busy that they are dizzy, and several male nurses are too busy to hold on. If August and Robert continue to help, I wish they could.

Lu Jiangbei's nursing care is the most difficult among these patients. Turning over at random requires the cooperation of several people, and she dare not relax in the slightest.

August and Robert worked in the ICU for a few days, and the extra-large clothes were delayed. After they were delivered, the two returned to general surgery, so the extra-large clothes did not come in handy.

But I didn't expect that Lu Jiangbei would have a fever now and the operation would be postponed. These sets of extra-large clothes would finally come in handy.