Chapter 51 Show Off Your Skills (1)

This rescue mission is very important, and any medical worker must pay attention to it!

Of course, it is inevitable that some leaders will avoid it for special reasons.

Because a hospital is a complex institution after all, many people in charge of administrative work are not involved in medical events.

And although Hao Xuliang is the vice president in charge, he is also a medical backbone. It can be said that he can't be less careful. He communicates with relevant departments almost all the time, how to carry out the rescue work in an orderly manner.

A few minutes later, Hao Xuliang rushed into the rescue room, saw Li Baoshan and asked, "Baoshan, have you been found? Where is it?"

Li Baoshan pointed at Chen Cang: "This is the doctor in our department, Chen Cang, he will use a peritoneal dialysis machine."

Hao Xuliang shrank his eyes suddenly, glanced at Chen Cang, then turned to stare at Li Baoshan: "Are you sure?"

Li Baoshan glanced at Chen Cang, he knew this Chen Cang, because he was the one who recruited Chen Cang at that time, and he knew very well about Chen Cang's conduct. Play slippery, very low-key.

This time since he said he would! Li Baoshan believed that he would.

Li Baoshan nodded: "Well, I'm sure."

Hao Xuliang turned and stared at Chen Cang: "Where did you learn it?"

Chen Cang told the truth: "When I was in college, I was in the East Medical University. I went to the Sixth Hospital of Haishi for my internship. There I stayed in the peritoneal dialysis room for more than three months, where I needed to do peritoneal dialysis every day. I learned it at that time."

This is all true, but... After three months, some basic operations will be learned.

Hao Xuliang was still a little worried, and exhorted: "Young man, life is at stake, there is no room for sloppy and false, you understand?"

Chen Cang: "I understand!"

Hao Xuliang immediately made a decision: "Let's go, the abdominal dialysis room!"

Peritoneal dialysis is actually not difficult, but it is not easy to say.

It won't take long to learn this thing, so Hao Xuliang and Li Baoshan still believe it.

And this time is not your mother-in-law's time.

A group of people pushed the poisoned patient directly to the peritoneal dialysis room. This is a newly opened place in the hospital. There is no one here.

Hao Xuliang is still a little tangled at this time. What if something goes wrong?

Suddenly he remembered his old classmate, and a phone call was broadcast.

"Old Yang, I'm Hao Xuliang, I have something to ask you to help me check!"

The other party asked directly: "What's the matter?"

"There is a patient in our hospital who needs peritoneal dialysis, but no one can do it now. A little doctor in the emergency department said that he will. I am still worried. I plan to open a remote video conference to let the peritoneal dialysis experts in your hospital check it. How about it? ?"

As soon as Lao Yang heard it, he suddenly asked: "Is it the poisoned patient from the explosion in the chemical city?"

Hao Xu brightly nodded: "Well, I can't afford to delay!"

Lao Yang nodded: "Prepare for a video conference, contact me in a few minutes."

Hao Xuliang hung up the phone and his eyes lit up!

This time, it's safe. With the guidance of remote experts, Chen Cang will know a little bit. It shouldn't be a big problem, right?

Having said this, Hao Xuliang directly picked up the phone and said to the security department: "Go to the sixth floor, take down the teleconference TV on the sixth floor, and send it to the abdominal dialysis room!"

It took ten minutes and everything was ready!

The remote video conferencing TV is very large, more than two meters long, and can basically restore and change faces one-to-one. Through the camera, the other party can basically see clearly for the operation of abdominal dialysis.

The emergence of remote video conferencing is mainly to facilitate case discussions and consultations and surgical demonstrations between different hospitals.

Video link is successful!

Looking at each other, a picture of each other appeared on the TV, a man in his fifties and a woman in his forties.

Hao Xuliang said hello: "President Yang, you've worked hard! I'm sorry to trouble you."

The man smiled: "It doesn't matter, this is the deputy director of our hospital's peritoneal dialysis room, Xu Aiping, just let her guide you."

Hao Xuliang turned to Chen Cang and said, "Can we start?"

Chen Cang nodded!

Abdominal dialysis begins!

Peritoneal dialysis is a dialysis method that uses the body's own peritoneum as a dialysis membrane.

The solute and water are exchanged between the dialysate poured into the peritoneal cavity and the plasma components in the capillaries on the other side of the peritoneum to remove the metabolites and excess water retained in the body, and at the same time, the necessary substances are supplemented by the dialysate.

At this time, the patient has renal failure, and there must be a metabolism that replaces the kidney, and the purpose of renal replacement or supportive treatment is achieved through continuous renewal of peritoneal dialysis fluid.

During peritoneal dialysis treatment, peritoneal dialysis fluid is instilled into the abdominal cavity through a peritoneal dialysis catheter. One side of the peritoneum in the abdominal cavity is the blood containing waste and excess water in the peritoneal capillaries, and the other side is the peritoneal dialysis fluid. The waste and excess water in the blood pass through the peritoneum into the peritoneal dialysis fluid.

After a period of time, the peritoneal dialysis fluid containing waste and excess water is drained from the abdominal cavity, and new peritoneal dialysis fluid is poured in, which is continuously circulated.

It is not troublesome to use the peritoneal dialysis machine, the main thing is the first step, the tube!

Intubation is the most important part of peritoneal dialysis, and it is the most critical part!

It is directly related to the success rate of peritoneal dialysis, and an excellent catheter can greatly reduce the adverse reactions of peritoneal dialysis.

There are two commonly used methods for peritoneal catheterization, one is laparoscopic catheterization, and the other is anatomical catheterization.

And now, there is only one type in front of Chen Cang, and that is anatomical catheterization.

It's not because he doesn't know how to place endoscopic tubes, but because there is no endoscopy here at this time!

As Hao Xuliang said, because it has not been fully developed here, the laparoscopes in the hospital are all in the operating room, and they have not been equipped here!

Catheterization is actually a minor surgical procedure.

On the opposite side of the video, Xu Aiping seemed to see that Chen Cang was going to use surgical catheter placement, and said, "This traditional anatomical catheter placement method requires the operator to have solid basic surgical skills! And... you must also have skilled catheter placement techniques! There must be no mistakes!"

"Because any mistakes during catheter placement will affect the patient's recovery, and even cause very serious adverse reactions, such as... peritonitis..."

Chen Cang turned a deaf ear!

Open the tube pack, get your surgical instruments ready, and get started!

The catheterization room next to the peritoneal dialysis room is actually not very different from the operating room, and it has everything!

incision!

Chen Cang chose to open about 3 cm on the left side of the navel.

Doing a good job of marking requires extensive disinfection!

The scope of peritoneal dialysis is too large. Basically, it must be sterilized from below the chest to above the groin, and on both sides to the mid-axillary line on both sides.

anaesthetization!

Local anesthesia!

Because there is no one, all the work needs to be done by Chen Cang alone!

Carefully cut the skin and separate the subcutaneous fat to reach the anterior sheath!

Chen Cang held his breath at this time and lifted the front sheath.

At this time, all abdominal muscles are exposed!

Blunt muscle separation!

Next, Chen Cang took a deep breath and lifted the peritoneum. At this time, Xu Aiping in the video held her breath.

Don't bother!

Because at this time we must pay attention, we must not accidentally injure the greater omentum and bowel.

Once accidentally injured, it is easy to cause infection!

The most important thing in peritoneal dialysis is to grasp the details. Xu Aiping, who is in her 40s, basically uses endoscopic tube placement, because the risk is small, and the anatomical tube placement method requires too much of the surgeon's surgical level. Moreover, it is more susceptible to infection, the wound is larger, and it is not conducive to recovery and many other factors.

but!

It is undeniable that an excellent surgeon prefers anatomical catheter placement because of its precision!

What's the meaning?

If you score laparoscopy and general surgery, the upper limit of anatomical tube placement is 100 points, while the upper limit of endoscopic tube placement is only 70 points. There is perfection in ordinary surgery, and endoscopy is basically based on qualifications!

ps: There is more in the back, turn back, that's right!