Both Kavi and Ignatz are busy people in the surgery department. They work almost every day, either in the ward or in the theater, or in the autopsy room cutting up corpses. Kawei also has one more place to go than Ignatz, and that is two laboratories used for oxytocin experiments.
Count Morazo was getting married today, and the two busy people were away, leaving the Department of Surgery at the Municipal General Hospital an empty shell.
Except for the unremarkable sebaceous cyst removal in the morning, all other operations were postponed for a day. Hermann, Mellen, and Sarson completed the operation and checked the ward, and then stayed in the ward doing nothing.
Normally, they would follow Ignatz's surgery, even if they didn't go on stage, they would just stand on the sidelines and watch. If there was no surgery, I would spend time in the anatomy room with Ignatz. Anyway, there would always be something to do.
But corpses are precious, and dissection has always been led by Ignatz. Indiscriminate cutting that destroys the anatomical position is equivalent to destroying a corpse. In his absence, no one dared to touch the body, not even the key to the door to the autopsy room.
There is one word hanging above the heads of the three of them: boring.
"Teacher Heman, why don't we both go back first."
The three of them didn't have enough fun last night. Today, Sarson and Mellen got into fun again. They planned to have lunch and then go to the concert hall to enjoy the opera. But before leaving, you still have to say hello to Herman to avoid being accused of leaving early.
"Is everything done?"
"It's all done."
It was rare for Herman to be the boss, and he felt deeply responsible for the great responsibility. Of course, he did not have the aura of a boss, and he did not want to embarrass these juniors. It was really no fun to stay in a boring ward in a daze. However, for safety reasons, Heman still has to ask a few more questions so that he can make a report tomorrow morning:
"How is Ben Li doing in the postoperative ward?"
"The temperature has dropped."
"How much blood is oozing from the incision?"
"fine."
Herman nodded: "What about the three women who are about to have cesarean sections?"
"Things are all stable."
"There is placenta previa inside. How is the bleeding these days?"
"The bleeding in the past few days has been very small, and the fetal movement and heart rate are normal."
Herman compared these answers with those in his mind one by one. When he didn't see the problem, he waved his hand: "Okay, if you feel bored, just get off work."
"Thank you, Teacher Heman~~~"
However, things did not develop in the direction planned by the two of them. The fun time in the afternoon was cut off at the gate of the ward before it even started. As soon as the two stepped out, two nurses came outside, pushing a flatbed cart with an eight or nine-year-old child lying on the cart, followed by a pair of anxious parents.
"Come on, come on, pick up the patient soon."
"Patient?" Sarson looked at the child who looked a little pale and asked quickly, "What happened?"
"I fell into the river more than half an hour ago and was just fished out of the water."
The nurse didn't know the specific process, but only got a general idea from the driver and the child's parents. The two of them found it strange that they were sent to the surgery after drowning: "Did the child's hands and feet break? Or did he bump into something?"
"No, he's fine." The nurse said, "Let's send him to the postoperative ward quickly."
Not to mention that the postoperative ward is a place where surgical patients recover after the operation. Since there was no trauma due to drowning and the person was still awake, he had to be sent home if he wanted to.
Both Sarson and Mellen have learned about drowning. The treatment process in the textbook is based on awakening. As long as the person wakes up, he is alive. There is no need for further treatment: "Go home, we have nothing to treat here." .”
When the parents heard this, they became anxious and said, "It was Dr. Kawei who said he was going to send it back."
"Kavi?"
Everyone is friends, and with Kawei's current status, the two of them don't dare to mess around. However, even if they were obedient and sent the person to the postoperative ward, they still didn't know what to do next, so why should they just leave the person in the room and do nothing?
The child's condition was not bad. He seemed to be breathing a little fast, coughing occasionally, and a trace of severe cyanosis could be seen between the lips. But these are typical symptoms of surviving a drowning rescue. You should be able to recover as long as you go home and rest for two days.
"It's just a should, not an absolute!"
Then Herman came over.
He has several years more clinical experience than the two of them, and is more aware of the horror of drowning: "I think Mr. Kawei should have considered post-drowning pneumonia. Many people will contract very serious pneumonia after being rescued from drowning. I think it is Inflammation caused by water irritating the lungs."
Mellen was puzzled: "Shouldn't pneumonia be sent to the internal medicine department? We have nothing to treat here."
"Actually, pneumonia is not difficult to treat, and it doesn't matter whether you send him to the internal medicine department or not." Herman was also familiar with the process and wrote a few medical instructions for the child, "First, 50ml of blood is given, once a day; then routine enema is used for bowel movement, once a day; three meals a day Reduce it to one meal a day, just give it at noon, and reduce the heart rate and congestion level..." [1]
Hearing the treatment plan coming to his ears, the father who was standing by his child remembered something and hurriedly took out a note from his pocket and handed it over: "Oh, I almost forgot, that doctor Please tell me to give you a message, saying that you should treat it according to the above method."
"The note..."【2】
The reason why drowning became the leading cause of accidental death in the 19th century can be attributed in part to the lack of post-drowning supportive care, in addition to poor on-site first aid measures.
Compared with the golden treatment interval, the pathophysiological changes caused by drowning to the whole body are a process of rapid and slow development. Often, after being out of danger for the first time, it takes at least a week of treatment to fully recover.
The systemic hypoxia caused by some severe drownings can cause lesions involving multiple organs throughout the body, which is very dangerous.
The first is the damage to the alveolar walls and capillaries caused by hypoxia, plus acute pulmonary edema caused by water entering the lungs. Secondly, inhaling a large amount of fresh water will cause alveolar perfusion, surfactant will be washed away, and at the same time, a large amount of fresh water will enter the blood, and the blood volume will increase. In severe cases, it can cause acute cardiac insufficiency. 【3】
Although this is related to water entering the lungs, it is still not advisable to control water upside down during first aid.
Because water will be absorbed as soon as it enters the lungs, only water from the digestive tract will come out. If you do this during the prime time of rescue, you will undoubtedly lose the watermelon and not be able to pick up the sesame seeds. Moreover, the spilled digestive tract contents will cause aspiration and aggravate the lung disease.
For the first two symptoms after drowning, modern hospitals generally use scopolamine to combat pulmonary edema, and diuretics to combat the increase in blood volume.
After stabilizing the two waves of attacks, the patient will develop varying degrees of infection on the second and third days after drowning. There are a large number of bacteria and fungi in the water inhaled into the lungs, and they will colonize in the lungs. Antibiotics are generally used routinely from the time of admission to fight the infection in advance.
Only after the three axes have been swung, the drowning treatment is concluded and the patient can be said to be completely cured.
There was so much supportive care in the 19th century, and the vague misconceptions of doctors, it would have helped a lot without adding to the problem.
In such an environment where you don't need to worry about him after you wake up, it is impossible for Kawei to leave the king and the earl to care for a child who has already woken up. So he could only take care of the child's parents first, send the child to the hospital first, and then attached the note with the treatment plan written on it.
Ignatz had no interest in patients outside of surgery, and Herman had almost obeyed Kawei. Even if there is any doubt, he will do it.
Kawei's first aid operation just now established a good image in the hearts of his parents. Since it was the request of the savior, they would naturally follow it.
Heman looked at the strange treatment method on the note and felt an indescribable feeling in his heart.
But when he thought of Kawei's superb surgical operations before, he himself was not a physician, so he could only do what he wanted: "You guys look after the children, I'll go to the internal medicine ward first."
"Why go to the internal medicine department?"
"Get the medicine."
...
Morasso and Carvey's rescue from drowning became the biggest talking point at the wedding lunch.
Needless to say, the Count, for such a brave act of kindness, this report might appear in the evening paper. Coupled with the new marriage and the headlines, Morazo is undoubtedly the well-deserved protagonist today.
In comparison, Kawei's rescue was not so eye-catching.
He was surrounded by a group of passers-by. Except for the Count, Ignatz, and Bergt who stood beside him, not many people would prioritize his rescue. After all, if the person is not rescued ashore, even if there is indeed the hand of God, he cannot do anything to the child.
Kawei was very calm: "Mr. Laszlo is joking, my job is to save people, and most rescues do not receive applause. If I am always thinking about other people's applause, how can I work well."
"..." Laszlo lost his temper because of his professional outlook, "Are you really 17 years old?"
"Replacement guaranteed."
"It would be nice if Naya was half as mature as you, and I would be able to worry less."
Laszlo glanced at his daughter, who was sitting far away and playing with the lame cat, and couldn't help but sigh. When he looked at Kavi again, his eyes became different: "Forget it, we're still Let’s talk about business.”
The real thing he talked about was naturally building a factory.
Kawe hopes to mass-produce oxytocin first. No matter how troublesome the process is, it will at least be better than doing it alone. The second step is to build a surgical instrument factory that can be used by him, so that relatively high-end hardware instruments can be provided for the backward housing environment, and the difficulty of the surgery will also rise to a higher level.
After all, he was an old director who had experienced level 4 surgeries. He couldn't get very motivated by going back and forth to perform primary surgeries.
"The young man's tone is quite serious."
Although Laszlo regarded him as a benefactor, when it came to his own field of work, his tone became extremely harsh: "The oxytocin you mentioned, if the effect is true, can indeed have a very broad market. Don't say anything about it. If you open a pharmaceutical factory, you won’t lose money even if you open ten. But a device factory..."
"I have drawn some simple design drawings." Kawei took out a notebook from the box, "The drawings in it are definitely better than the current surgical instruments."
Laszlo shook his head: "The quality of the equipment is secondary, and no one cares. The key is that you have no evidence. Who will believe it without evidence? How can you make money if no one believes it?"
Different from the mature model of modern medical device manufacturers who conduct research, design, research and development, experiment, provide data and promote themselves, the medical device industry in the 19th century was completely blank. Kawei did not change his mind for a while, and his ideas were indeed a bit ahead of his time.
"If the equipment factory can't do it, then..." Kawei abandoned the car to save the handsome man, "I hope Mr. Laszlo can contact the steel factory to help me make a set of samples first."
"Do you really need this set of instruments?" Laszlo felt strange. "I think the pliers and scalpel in your box are pretty good."
"It is very necessary." Kawei explained, "When doing fine anatomy, some special structures on the instruments can bring a completely different experience to the surgeon."
"All right."
Kawei put away the notebook: "The drawings are not accurate enough. Once Mr. Laszlo has contacted the manufacturer, I will come and talk to them in person."
"no problem."
Now that Laszlo has denied the equipment factory, the production lines that Kawi had previously thought about, such as thermometers, blood pressure monitors, stethoscopes, and artificial prostheses, need to be put aside. Anyway, these things are very expensive for today’s medical system and are considered useless in the eyes of many hospitals.
Kawei knew that he could not become fat after eating at one go, so he couldn't rush: "I mainly talk about these two things. The oxytocin experimental report will be sent over in a few days, and I am also rushing to work on the paper. In addition, I I still have three cesarean sections on hand, two are expected to be performed at the end of this month, and the other one is more troublesome and I estimate it will be done in the middle of the month."
"Hopefully, the powerful effects of oxytocin will be demonstrated again during surgery."
"You won't be disappointed."
Laszlo poured a sip of wine into his mouth. Seeing that Kawei was about to leave the table to get close to Franz, he quickly stood up and grabbed his sleeve: "Young man, you left too hastily."
"Oh." Kawei thought he was being sincere because he didn't have an empty glass. He quickly turned around and drank up the wine, "Happy cooperation!"
"It's a pleasure to cooperate, I have other things to do!"
Laszlo pulled him to sit next to him and whispered: "I told you before that I wanted you to come over and be my personal doctor, but you said you were not available."
"Yes." Kawei nodded and explained, "I still hope to learn more things when I am young."
study?
Do you still need to study?
Laszlo, a bystander, didn't know how to complain about the word "study": "I am now an old friend with you, and I have taken an order from your pharmaceutical factory. My friend is in trouble now, do you have to help me? ?”
Kawei looked sad, knowing that this was not a good job, but thinking of the mass-produced oxytocin and brand-new surgical equipment, he still responded with a heart: "No problem, as long as it is within my ability, I will definitely help."
"I'm sure I can do my best!"
Laszlo smiled particularly happily, pointed to his daughter holding the lame cat in the distance, and said: "You also know Naya's temper, and she is too curious. Last time I saw you doing Qi Qie, she seemed to be interested. I just hope I can learn anatomy. If you have time, come and teach for an hour at a time. The price will satisfy you."
