The Godfather of Surgery

Huang Jiacai's brothers and sisters do not lose the chain at critical times. This set of equipment is truly unique in the city. Because it was customized by Huang Jiacai, the connecting rod between the guide and the steel plate has been lengthened, which is suitable for particularly obese patients. He also customized some other more exotic instruments, such as extended plate screws, in case of emergency.

After fracture reduction, the plate was successfully placed, and a locking screw was placed under the guidance of the guide. With long plates, high spans, stress is dispersed and fractures are bridged.

How come people have equipment, but yours doesn't? Do you want to dismantle?

Director Ouyang was disfigured and embarrassed on the stage, and he lost his temper at the equipment dealer and the stage.

I just asked him to dig three feet in the ground to get the equipment, but he still didn't get it. Several bigger companies have asked, who has a whole set of equipment for 400-pound patients, and it's useless to scold people to death . But Yang Ping's equipment dealer had it, and it was delivered. Director Ouyang had reason to suspect that the equipment dealer didn't care.

If it hadn't been for Yang Ping's rescue, or if it wasn't for Yang Ping's powerful equipment dealers, this operation would have really failed.

I'm sorry, I'm sorry, I'm sorry, our work is not in place, our manager will be here soon and come over to apologize in person. The equipment dealer who followed the stage did not dare to refute a word.

Director Ouyang is pretty good. If you meet Director Bai and the equipment falls in front of you, you can only nod your head and smile.

At this point, no matter if it is wrong, it can only be like this, until Director Ouyang is in good spirits. Now the equipment dealer is a punching bag, a sandbag who is beaten, and he does not have the ability to pretend to be a grandson. Difficulty, the equipment is not easy to use, and the scolding is inevitable.

After screwing, the C-arm X-ray machine saw no problem. Dr. Jin used the electrocautery line to measure the alignment of the lower limbs, the anterior superior iliac spine, the center of the patella, and the middle of the first and second toes. Just like shooting a gun, three points and one line ,normal.

This kind of surgery is an innovative result of fracture treatment technology. It is called biological fixation and is suitable for long bone fractures of the extremities. Of course, this cannot be done for ulna and radius fractures. Because of its precise rotational function, the ulna and radius are treated as intra-articular fractures, requiring anatomical reduction and strengthening. fixed.

And this kind of femoral shaft fracture does not need anatomical reduction, does not need to return to the original state, as long as the length and line of force are restored to normal, even if the goal is achieved, the messy bones in the middle can be ignored. After treatment, in fact, the blood supply is protected, and finally it grows into one piece, and the human body shapes it again. In the future, the femur will not be different from the normal shape, and it will not have any effect on the function.

This is the progress of medicine, the innovation of ideas, the innovation of surgical methods and instruments, and finally the improvement of treatment effects.

What kind of rubbish, don't bring this gadget in the future. Director Ouyang fiddled with the original guide a few times and threw it directly into the trash can, so that his anger would be relieved.

The manager of the equipment dealer said that he was really coming, hurried to the operating room, and kept hunched over: Director Ouyang, our service didn't keep up, we've caused you trouble, look, give me a chance, and get off work together. Juju, let me apologize to the brothers?

Being scolded like a grandson, asking the director to ease his anger, and then inviting him to eat and drink, is indispensable, and the quality of this meal cannot be low.

Everything is comfortable, and the business has to be done. After all, this is not a subjective error, but it is true that there is no such equipment, and I have transferred goods to a brother company, but there is none.

The manager whispered to the attendant to learn about the situation, and only then did he know the equipment sent by a small company. Responding to Director Ouyang's urgency, the manager glanced at Huang Jiahui, a girl who was not familiar with the world.

Looking at the special guide on the instrument table, I couldn't understand how there is such a strange guide. I have been immersed in the industry for so many years, and I can be regarded as an equipment expert.

Director Ouyang took off his surgical gown, the manager hurriedly went up and smiled, helped untie the ties, moved the stool with the stage, and adjusted the height. Director Ouyang did not go to sit, but went to the reading light to watch the film, and Yang Ping stood there.

Lao Jin, explain to the family clearly that these bone fragments do not need to be reset and will not affect their function. Director Ouyang explained to Dr. Jin.

The most difficult part of this kind of operation is the family members. The family members do not understand, and when they see the X-rays after the re-examination, they think that the doctor's level is too poor, the operation is not done well, and the bones are in a mess.

The doctor explained a lot of medical principles, but the family did not understand anything. The last sentence: the bone fragments seen on the X-ray were similar to those before the operation.

In fact, doing this is better than cutting and piecing the bones together, and the fracture heals faster and better.

Joint fractures cannot be operated through this procedure. Joint fractures must be put together piece by piece, honestly, so that they can be reunited.

Director Ouyang came over and planned to ask Yang Ping how to achieve a successful prying and reset, but the equipment manager was next to him, and it was difficult to speak out of face.

Yang Ping does not have the urge to lecture, so naturally he will not take the initiative to explain, some people like to learn, some people don't like to learn, everyone is free, if you want to know more, you can ask him directly, he will explain, if you don't ask, he will not take the initiative to give. You said, except for Song Zimo.

After the operation is over, the patient's bed transfer is also full of challenges.

When entering the operating room, the width of the flat car is not enough, and the bed is directly propelled. Now that the bed is crossed, the horizontal width of the bed sheet is not enough. The nurse has thought of a way to use a few bed sheets to lay it horizontally, so that it can work.

Six people, three on one side, pull hard on one side and send on the other side, until the lumbar intervertebral disc is almost pulled out, and the patient moves a little bit.

We had to add two more boys, and five people pulled together to pull the patient to the bed.

The equipment dealer manager and the attendants also participated and worked very hard. At this time, they had to prove their efforts to Director Ouyang.

The patient is under general anesthesia with endotracheal intubation. The commonly used anesthesia for this operation is sciatic nerve and femoral nerve block, or combined spinal-epidural anesthesia, but no matter which one, because the fat is too thick, positioning is extremely difficult.

In combined spinal-epidural anesthesia, the anesthetic is injected into the spinal canal. The anesthesiologist's conventional lumbar puncture needle probably cannot reach the spinal canal at all. The puncture path is too thick, and the conventional puncture needle is relatively short.

Wei Danian, wake up! The anesthesiologist slapped the patient's face, hoping to wake him up through stimulation, ready to extubate.

Dr. Jin reminded the anesthesiologist: Another way, not long ago, in the emergency department of a hospital, an old lady's heart and breathing stopped. The doctor used the fist hammer method to convert the rhythm, and slammed it down with one punch. The old lady and son were two. Slap, you bastard, people are like this, you still beat people, and you still beat me in front of my face, so bullying people, bullying me stupid.

The anesthesiologist was so frightened that he stopped. This is a bad habit, so he kept his mouth shut. He raised his throat and shouted to the patient, Wei Danian, wake up, the operation is over.

The patient was in a daze, opened his eyes as a response, then closed his eyes again, opened his eyes, had spontaneous breathing, and could be extubated. The anesthesiologist used a suction device to remove the secretions from the respiratory tract again, and the endotracheal intubation was successfully pulled out.

Blood pressure down!

Dr. Jin kept staring at the monitor, his blood pressure dropped to 76/35mmHg, his breathing became deep and big, and the patient inhaled and exhaled violently.

Ketoacidosis?

The patient had diabetes, took deep breaths, and had a drop in blood pressure. The anesthesiologist immediately thought of ketoacidosis.

Re-intubation! The anesthesiologist quickly reinserted the tracheal tube.

Glucose meter to check fingertip blood sugar, blood to check blood routine, biochemistry, liver and kidney function, blood gas analysis--- the anesthesiologist reported a series of oral medical orders.

He was experienced and took deep breaths. This was acidosis. The patient had diabetes. When he was admitted to the hospital, his blood sugar was 38mmol/l, and he dared to operate only when he was satisfied with insulin.

In the operating room, the anesthesiologist is responsible for the safety of the patient's life, so the anesthesiologist is naturally nervous.

Blood sugar 6.2mmol/l The nurse looked at the data on the blood glucose meter.

Not high? What's going on? The anesthesiologist wondered.

Director Ouyang and Dr. Jin were also nervous. They suspected that fat embolism caused pulmonary embolism, but the blood oxygen was not low.

Check blood lactate! Yang Ping suggested.

Well, check blood lactate. The anesthesiologist instructed the nurse.

Emergency specimen delivery does not require manual delivery. The hospital has a dedicated automated logistics system. The nurse only needs to label the specimen, scan it into the computer, and then put it into the logistics tube, and it will automatically be sent to the laboratory through the transportation pipeline.

The results came out soon, bicarbonate ion 8mmol/l, pH value 7.14, blood lactate concentration 2.8mmol/l.

Acidosis is right, it's lactic acidosis, not ketoacidosis!

Lactic acidosis has a critical prognosis and high mortality.