Chapter 788 Golden Time and Damage Control
"No problem, I agree to this condition." Xu Qiu hung up the report call from Wang Shengde and made the final decision.
Academician Su and Academician Cui were both delighted.
In this way, Tiantan has another high-quality source of students, the Linda Medical College.
In the future, Tiantan can also select talents from the Linda Medical College to be trained by the Neurosurgery Center, and the two hospitals will develop together!
Xu Qiu signed his name on the cooperation agreement that Academician Su had already drafted. At this point, the two major hospitals officially established a cooperative relationship.
…
In the afternoon, Xu Qiu held an academic lecture on the treatment and nursing of total pelvic amputation.
Department directors of Tiantan and doctors from Union Hospital came to attend the lecture.
Two hours later, after the academic lecture ended, the director of the emergency department of Union Hospital was about to leave, and suddenly found that the people from Tiantan had no intention of moving.
"Anything else?" The director of the emergency department of Union Hospital was surprised.
The director of the orthopedics department of Union Hospital also sat down again, hugging his arms and looking forward to it.
At this time, the director of Tiantan Emergency came over trotting, stood in front of the two directors and said apologetically: "Lao Lin, Lao Lei, we have an internal meeting next..."
"Can this be an internal meeting?!" The director of Union Emergency saw that Xu Qiu did not move, and immediately understood something.
Tiantan had bewitched Xu Qiu, and a lot of more confidential content was coming!
The director of orthopedics also guessed it, and said mysteriously: "What else does Academician Xu have to say, how to perform the total pelvic amputation surgery?"
"No comment!"
"You don't leave two seats for us, and we stand in the corner to listen?"
"Internal secrets, please don't embarrass me." The director of Tiantan Emergency shook his head repeatedly.
It seems that it really cost a lot...
The two Union directors understood, and no longer entangled, and left with people.
As soon as he left the Tiantan gate, the director of Union Emergency quickly called the dean: "Dean, Tiantan Hospital is suspected to be about to master the total pelvic amputation surgery!"
...
At this time, in the Tiantan auditorium, after the Union doctors left, Xu Qiu also started the lecture.
This time, we are sharing all the experience of total pelvic separation, and the importance is self-evident.
The director of Tiantan present widened his eyes, fearing that he would miss the key information.
"Before talking about total pelvic separation, I have to set two concepts first."
Everyone immediately pricked up their ears.
Xu Qiu continued:
"The first is the golden time.
"For patients with severe multiple injuries, they are often in a state of physiological function exhaustion when they are admitted to the hospital, which is manifested by a special triad, including a body temperature below 35 degrees, coagulation disorder, and metabolic acidosis.
"These three are mutually causal and vicious cycles. If the three items are not solved at the same time, it is impossible to reverse the state of physiological function exhaustion.
"Therefore, compared to saving physiological exhaustion, it is actually more important to prevent it from occurring.
"This is related to a concept: golden time.
"The golden time I judged is one hour after the injury. As long as on-site rescue and rapid pre-hospital transfer are carried out within one hour, and the emergency department is handled in the right way, and even emergency surgery can be started within one hour... The patient's rescue success rate will exceed 70%! ”
The people present were shocked.
70%?
For a patient whose lower body was crushed, the success rate of rescue was 70%... It was incredible!
Xu Qiu ignored the astonishment of the people below the stage and continued:
"What needs to be done within the golden time is to quickly and effectively stop bleeding by compressing the large blood vessels to prevent the patient from bleeding and dying in a short period of time.
"The second step is to open the superficial and deep vein channels, quickly transfuse blood and fluids, and complete tracheal intubation.
"Of course, it is difficult to achieve a 70% success rate with only these two steps.
"This involves the second concept, damage control!"
So that's it... Everyone nodded repeatedly.
If you can achieve a 70% success rate just by completing all the steps within the golden time, it would be incredible.
The director of the emergency department, the director of the orthopedics department and others did not speak, and looked at the stage intently.
Click--
The PPT also entered the next page at this time, and the four big words "damage control" jumped out.
Xu Qiu narrated calmly:
"After a serious trauma, the patient will inevitably be in a state of severe stress due to mental factors such as hospitalization, fear, and physiological blood loss and severe pain. All systems will inevitably experience functional and internal environment disorders.
"In addition, during the rescue process, the patient receives a large amount of blood and fluid below body temperature, which increases the body's heat dissipation and reduces heat production, making hypothermia more likely to occur.
"Hypothermia can control platelet function, resulting in damage to the coagulation mechanism, which in turn increases fibrin activity and causes coagulation dysfunction.
"In addition, when a large amount of blood is lost, the patient's tissue perfusion decreases, ischemia and hypoxia lead to metabolic acidosis... This is the mechanism of the special triad, which is almost impossible to correct once it occurs.
"The introduction of injury theory can avoid this to the greatest extent. The so-called damage control is to use the fastest and simplest operation to control the further deterioration of the injury. In short, it can be summed up in six words: save lives first, then treat injuries!
"Previous surgeries all required complex and complete surgeries to be performed early. But damage control does not require this. It requires curbing the injury in the shortest possible time, retaining the opportunity for further treatment, giving the patient a chance to recover, and performing staged surgery!
“If the patient had been treated according to conventional procedures, the operation would have taken at least eight hours to complete, but it only took me five hours…
“What I did was to discard some injuries that were not life-threatening and give priority to treating fatal injuries. During the operation, I ligated the internal and external iliac arteries and veins, completed the removal of necrotic tissue and digestive tract, urinary tract reconstruction and drainage, etc. After reducing the abdominal cavity volume, I used the residual skin flap to cover the lower abdominal cavity..."
Everyone looked at Xu Qiu on the stage in amazement.
Damage control... This theory can not only be used on Dai Kai, but also extend to all multiple injuries!
As long as it is a similar critically ill patient, with the help of golden time and damage control theory, you can win a chance to survive!
The only problem is... What is damage control suitable for and when should it be used?
Not all trauma patients are suitable for damage control surgery. If it is not within the indications and the condition is delayed, it will be extremely harmful.
Moreover, if the timing of choosing damage control is wrong, it will also have a counterproductive effect.
What's more, real clinical practice cannot be summarized as "fatal injury" or "non-fatal injury". Fatal injuries include severe liver damage, rupture of large blood vessels, and different types of injuries will be handled differently after applying damage control theory...
If you are not careful, using the treatment method of conventional surgery in damage control surgery may lose the conditions for staged surgery!
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