Chapter 130 Crazy emergency department, crazy patients
"Do you want to increase the dose of anesthesia?" the director of anesthesia asked in confusion.
Xu Qiu shook his head: "Give some pressor drugs to raise the blood pressure to about 150 systolic."
Everyone was stunned.
What is this for?
The director of carotid surgery, vascular surgery and anesthesia widened their eyes at the same time.
They certainly guessed what was going to happen.
Xu Qiu was going to raise the blood pressure, and after blocking the carotid artery, let the contralateral carotid artery perform the communicating branch compensation!
But...
Such a dangerous operation, can Xu Qiu really grasp it?
Ordinary endarterectomy alone is dangerous enough, and it actually actively raises blood pressure!
"Okay..."
However, the director of anesthesia only hesitated for a moment and executed it immediately.
Who dares to question the decision of a person who can even remove pheochromocytoma!
Soon, the supplementary anesthesia was completed.
The patient's systolic blood pressure gradually climbed to about 150.
Beside the ordinary flat bed, Xu Qiu moved the muscles of his hands.
The experience of master-level endarterectomy seemed to be embedded in every muscle fiber.
At this moment, he felt like he was in control of the whole situation.
"Heparin 40mg."
"Vascular clamp..."
"20-gauge injection needle to measure reflux pressure..."
The next moment, the assistant on the opposite side reported the value: "43mmHg!"
Xu Qiu nodded.
More than 40 means that there is enough intracranial collateral circulation.
He immediately blocked the internal carotid artery.
After that,
longitudinally cut along the outer side of the common carotid artery...
Place a bypass tube at the proximal and distal ends of the carotid artery sclerosis plaque...
After fully eliminating blood clots, bubbles and debris, establish a bypass...
"Javid clamp."
After fixing the bypass tube, Xu Qiu selected the endarterectomy level in the middle layer of the artery.
Before everyone could react, he reached out his hand.
The instrument nurse almost didn't react, and was stunned for a moment before quickly handing over the nasal septum stripper.
Watching Xu Qiu start blunt separation of the endometrium the next moment, the instrument nurse slowly exhaled, with a look of shock on her face.
This is too fast...
...
Fifteen minutes later.
The plaque was removed, and a complete, continuous, and smooth arterial wall appeared in front of everyone.
Then, the lumen was flushed with heparin saline, and the two ends of the carotid artery incision were sutured continuously with 6-0 non-damaging sutures...
When the suture was to the last centimeter,
the shunt tube was removed, the air was removed again, and then the final anastomosis was completed.
The subsequent cortical suture was handed over to the director of the cervical surgery department who served as the first assistant.
"The operation is over."
Five minutes later, the voice of the director of the cervical surgery department sounded.
Everyone looked at Xu Qiu at the same time.
Doubt, shock, envy, all kinds of complex emotions intertwined... and finally merged into one sentence.
"Doctor Xu... Awesome!"
Xu Qiu's expression was still calm.
As if everything had nothing to do with him.
He glanced at the patient on the flat bed and said, "Although he survived, he lost too much blood and his hemoglobin is very low. He won't wake up so quickly - transfer him to the ICU."
"In addition, on the basis of the original, low molecular weight heparin is injected subcutaneously, one bottle each time."
"Mannitol 125ml intravenously, twice a day, maintain for three days first, and then adjust according to the patient's condition..."
A series of medical instructions made the expert director of neck surgery a little stunned.
This arrangement is too detailed and too strict!
It is impeccable and impeccable!
The director of neck surgery subconsciously looked at Wang Ping.
Wang Ping stretched his neck and shouted, "Why are you looking at me? Such a simple thing can be handled by our emergency department residents!"
"You are so stubborn." The director of neck surgery looked at Wang Ping and couldn't help cursing.
The others laughed.
In addition to the doctors in the neck surgery department, only Xu Qiu in the emergency department can give a postoperative plan for such professional nursing measures!
...
After the operation.
The patient was immediately transferred to the intensive care unit.
His hemoglobin was only 6g, and more than 2,000 milliliters of blood were added during the operation, but in the end it was only about 12g.
The normal value for men is around 120~160...
Therefore, it can be seen how dangerous this operation is.
Even if the operation goes smoothly, his recovery time is still not optimistic, and it may take at least four or five days.
During this period, the doctors in the cardiac ICU need to adjust the treatment plan at any time and monitor closely.
"This is the most dangerous patient I have ever rescued, no one else..."
After leaving the emergency room, the director of the cervical surgery department was still a little frightened.
When exploring, it was discovered that the large arteries and veins in the neck were bleeding at the same time.
In this case, human life is as fragile as paper.
But Xu Qiu actually saved it with his own hands!
The directors present all looked at Xu Qiu's palm at the same time.
Gulp——
Many people swallowed subconsciously.
So envious!
Suddenly, Wang Ping took a step across and stood behind Xu Qiu.
He said with a smile: "Don't look at it. I'll be angry with anyone who wants to take advantage of him!"
"Mr. Wang, don't be too greedy..."
"Resident doctors still have to rotate!"
"Can you lend him to the doctors in our department to teach and help us train a few experts in human hemostats and human ultrasound machines..."
Wang Ping waved his hand, called the nurse, and said: "This emergency room will be sealed first. Clean it up quickly and resume use before the afternoon."
"Got it!"
Several nurses and a group of cleaning staff came and began to clean up the messy emergency room.
Wang Ping pulled away the director who was still ruthless and pushed them out of the emergency department.
"You bastard, we'll kick you when you're done!"
The directors went back to their respective departments with dark faces and cursed.
...
Xu Qiu finished the operation, and there was still some time before noon.
He had an outpatient clinic in the morning, but later because of the operation, another doctor from the same department took his place.
The other person's name was Fan Lei, a young doctor who came in a few years ago. He had some background in his family, so he didn't suffer the torture of working consecutive night and day shifts during his residency, and he was quickly promoted to attending physician.
Now that the operation was over, Xu Qiu also planned to return to the outpatient clinic.
As soon as he pushed open the door of the clinic, the old man who was seeing the patient looked back, and his eyes immediately lit up, "Doctor Xu, Doctor Xu, I'm here to see you!"
Fan Lei's face turned black on the seat.
As a result, as the old man shouted, the outside of the clinic suddenly became lively.
"Doctor Xu is here!"
"Quick, come and line up!"
"Hey, I don't think Doctor Xu is here to see patients. I didn't even go in when the number was called. I was just waiting for Doctor Xu!"
Noisy footsteps sounded outside the corridor. Apparently, the patients started lining up again.
Fan Lei pressed the pen and stepped back. The chair scratched the ground with an unpleasant sound.
He stood up, glanced at Xu Qiu, and rushed out without saying a word.
A few seconds later.
Fan Lei's legs were hanging in the air, and he was squeezed in by the swarm of patients.
At this moment, he experienced the despair of being squeezed into the subway...
Facing the situation that was about to get out of control, Chen Qiao took a step forward, put her hands on her waist and shouted crisply: "Line up! Stand outside the clinic. Doctor Xu won't see those who don't line up!"
Swish!
In an instant, the chaotic crowd returned to order.
Fan Lei tidied up his wrinkled white coat and left angrily.
Xu Qiu shook his head.
Although the young attending physician had a bad temper, he still had to thank him for helping him see several patients.
"How many are left?" Xu Qiu asked casually as he sat down.
Chen Qiao lowered her head: "When patients come in and see that it's not you, they don't want to see a doctor. This is Dr. Fan's first patient..."
Xu Qiu's eyebrows twitched.
"Okay, see the patient first."
He took the opportunity to replenish some water and glanced at the old man's medical records.
But soon, he paused in drinking water, turned his head and looked in the direction where Fan Lei left, frowning slightly.
