In most parts of the world, chest trauma is the domain of cardiothoracic surgeons, head trauma is the province of neurosurgery, and bones and joints are the province of orthopedic surgeons.
Gone are the days when a capable doctor could treat a patient from head to toe. This may be the result of the development of medical technology.
Or maybe modern people can no longer bear loneliness, loneliness, life without money, and are unwilling to settle down.
Back then, if Zhang Fan didn't have cloth patches in his pockets and had no way out, he would probably have walked slower than he does now even if he had a system, and he wouldn't have achieved the results he does now.
People are sometimes fragile. A bite of steamed buns may choke a person to death. Even a word from others can make a person lose confidence in life and go to extremes.
But sometimes it is quite resilient. Ups and downs, just don’t admit defeat.
I don't believe in this fate. It's hard to say whether it will succeed or not, but once you seize an opportunity, a person who is as tough as a small strong man must not be underestimated.
Zhang Fan looks quite impressive in regional hospitals and even some provincial hospitals, because there are so few doctors who work from head to toe. Every one of them has either become a dean or has retired.
In field hospitals, there are too many such doctors. Are they more talented? No, those who are forced often end up alone at some point with no way out.
When there is no team and no rear area, you cannot be multi-purpose, and you can only watch the wounded sacrifice.
In the operating room, Mr. Wu was the first assistant, the director of the field hospital was the second assistant, and the director of the XXX Hospital was the third assistant.
Among them, the only one who is really hesitant is Mr. Wu. In addition, Zhang Fan is registered in orthopedics. He is the director of the field hospital, and the director of XXX Hospital is a gastrointestinal surgeon. He can be considered to have some influence.
Four people, four majors, jointly performed a liver surgery. This kind of situation can only be seen in field hospitals.
"Damage control! Dr. Zhang is too courageous!" The director of the field hospital came up to the stage and saw that the wounded patient's liver was covered with gauze. He was in disbelief and said to Zhang Fan in surprise.
Liver, long time ago, a doctor used the packing stop method to treat liver damage.
What does it mean? To put it simply, the liver was damaged by a big puncture, and the blood burst out like fireworks.
He did not choose liver resection or continual repair. Instead, fill it with gauze and wait for the liver to repair itself.
His achievements were not recognized at the time. After four operations, three died and one survived, but the liver that survived was intact.
His technique was considered cowardly surgery at the time. Because the chance of failure is too high.
One hundred years later, the US military once again proposed this surgical method. However, the risk is still quite huge, and there are only a handful of doctors in the US military who can do this kind of surgery.
The director of the field hospital is a man who has seen the world. When he saw this method, it was impossible not to be surprised. To be honest, no one in their hospital dared to do this operation yet.
"Yes!" Zhang Fan nodded and carefully observed the condition of the gauze.
During surgical operations, when measuring bleeding, there is a standard. It is clear how much blood is in the aspirator, because the drainage bottle has a measurement number.
How to calculate other bleeding, just count the gauze, count the gauze soaked with blood, 200ml of gauze.
"Has Dr. Zhang ever performed this kind of surgery?" Although the field doctor asked Zhang Fan again, he looked at Mr. Wu.
Zhang Fan was busy observing the gauze carefully, and did not immediately say that he wanted to confirm whether the patient's bleeding had been stopped, or how much the bleeding was now.
Mr. Wu didn't say anything, but shook his head.
"I have never done this kind of surgery, but this is the only way he can save his liver."
"Are you sure?"
"have!"
"Comrade, this is no child's play. I understand your feelings, but we have to put survival first, right?"
The director of the field hospital said to Zhang Fan a little regretfully. He admired Zhang Fan's courage to perform stop-loss surgery, but he did not agree with a doctor who had no experience in this type of surgery rashly performing stop-loss surgery.
Of course, this kind of disapproval is not just verbal disapproval, it will be reflected in the subsequent medical records and reports.
This is not the behavior of a villain. Instead, it is the most basic professional ethics of a doctor. He does not cover up, and what is one is one, and what is two is two. Everything is based on the facts seen with one's own eyes.
Mr. Wu was not familiar with this kind of stop-loss operation that was used only as a last resort. There were too many variable conditions for this kind of operation, and it was impossible to use data to form a rule.
"I now need eye surgery instruments, a doctor who can create a TEG, and a nurse who reminds me every fifteen minutes. Fast."
Zhang Fan did not explain or argue with the dean. He was not trying to convince others, but to save his liver.
"Hi! Okay, I'll ask the doctor from the hospital's hematology department to come over right now. Nurse Chen, your current task is to remind Dr. Zhang every fifteen minutes."
"Yes!" The traveling head nurse saluted and started counting.
"What, the bleeding hasn't stopped yet?" Upon hearing this, Mr. Wu knew that the wounded man's bleeding situation was not optimistic.
"There is still some bleeding, uncle, we still need to wait for two hours."
After Zhang Fan checked the gauze, he looked up at Mr. Wu.
Mr. Wu was also torn in his heart. On the one hand, he should completely preserve the wounded man's liver, but on the other hand, he should sacrifice it.
Really, at this time, doctors are just like standing in front of the God of Death, slapping their thighs and cursing to provoke Death, come on, come on, come on if you have the ability.
The God of Death is like a Tibetan Mastiff, baring its teeth and roaring.
Sometimes even if the patient coughs, the iron chain holding the god of death will break, and then there will be devastating consequences.
Difficulty, often in medical treatment, we will face this dilemma many, many times.
"I don't agree. He is still very young, Mr. Wu. We are gambling with his life. If we do the resection now, even if half of the liver is cut out, his life can still go on."
The director of the field hospital was also anxious. He and Zhang Fan had never met before. He was definitely not targeting Zhang Fan. He was also doing it for the wounded.
This is the difference in philosophy and age. Older people tend to be more conservative, while younger people tend to be more radical.
Who is right and who is wrong? It's hard to say.
Mr. Wu looked at Zhang Fan. Zhang Fan straightened his body and looked at Mr. Wu with firm eyes without saying a word. With the tacit understanding cultivated between the two men, at this glance, Mr. Wu knew that Zhang Fan was sure of him.
"There is still time, let's ask someone to do the drawings first. We are all doctors, and we are all doctors responsible for the wounded. I support Zhang Fan, Director Li, what about you?"
Mr. Wu's choice of Zhang Fan at this time was a real recognition of Zhang Fan's skills and a real recognition of Zhang Fan's character. He did not think Zhang Fan would be willful in this matter.
"I object!" The director of the field hospital insisted.
Three people and six pairs of eyes looked at the director of XXX Naval Hospital. The director closed his eyes at this time.
He was not escaping. At this moment, his mind was filled with scenes of Zhang Fan performing surgery at sea, just like a movie.
One stroke after another, accurately, quickly and decisively! At the age of forty, he kept recalling Zhang Fan's surgery.
He slowly opened his eyes, but there was a flash in his eyes, "I support Dr. Zhang!"
Saying this is not something that can be done by opening and closing the upper lip and the lower lip. At this time, every word and every punctuation mark is recorded by the nurse. Then archive it and not destroy it for twenty years!
When you speak at this time, you need to be responsible!
He did not choose the more stable half-liver surgery, and he did not consider whether he would be responsible for today's words in the future.
However, he chose to support Zhang Fan today just to make the injured's quality of life more comfortable in the future. I just want him to live in this world like a normal person, without needing other people's pity or other people's...
"Hi! They are young, Mr. Wu, you, hi, I will contact the backup staff now." Although no one supported him, the director of the field hospital also began to actively prepare.
This is the disciplined force.
This is the medical force that is the final guarantee of our country’s medical care.
Time passed little by little, and the TEG diagram began to be described. With reminders again and again, 2 hours passed.
"Start!" Zhang Fan spoke after watching TEG.
In the operating room, only the sound of the waves was quiet.
So clear!
The gauze stuffed inside the liver, Zhang Fan pressed it gently with both hands. Zhang Fan could clearly feel the feeling coming from the gauze. How much of the gauze was dry and how much was wet.
This is his ability, this is the super sensitive perception he has developed in the system.
Dare to go to Daliangshan without three points?
joke!
Just like rolling a dice to reveal a treasure, a piece of gauze was gently taken out, but there was no bleeding.
Although Zhang Fan could feel how much bleeding there was, he didn't know where it was. It was like buying a lottery ticket. He knew that one of them would definitely win, but he didn't know which one would win.
Therefore, he treated every piece of gauze as if it were bleeding gauze, facing it slowly and gently, with all his muscles tense.
"Saline water, ice salt water!" When the gauze covering the top surface was taken off, he finally saw the blood-stained gauze.
Almost all people who have been injured have had the experience of changing dressings. The larger the wound, the more painful the dressing change will be.
If you meet an impatient doctor, changing the dressing can turn into killing a pig.
The gauze covering the wound surface was soaked in blood, dried over time, and pasted on the newly grown tender granulation.
When changing the dressing, the anxious doctor pulled the gauze away. Really, there was no way to describe the pain.
It was like the flesh that had been wrapped in the skin was suddenly pulled out one day, and then scratched up and down on the denim. It hurt, it was an unforgettable pain, and after the pain was over, there were still burning and continuous thorns. It hurts, really. People who can feel the pain would like to hold this piece of meat in their mouths.
The same goes for the liver. Whether it hurts or not, there is anesthesia. The most difficult thing is secondary bleeding.
The protein in the blood coagulated and stuck to the blood vessels, but it also stuck to the gauze.
At this time, the gauze is not in contact with the small area where you are changing the dressing, but the whole piece is adhering.
Once you are not careful, all your previous efforts will be wasted.
The salt water is dripping, the dripping is low, and the gauze is covered with coagulated blood, and it doesn't absorb much water at all.
This is also one of the difficulties that is difficult to solve with this kind of surgery. It is not only necessary to prevent unclosed bleeding, but also to prevent secondary bleeding after adhesion, which is very difficult.
"Doctor Zhang, fifteen minutes have passed!"
"Yes!" Zhang Fan nodded. The wound was exposed for longer and longer, and the chance of infection was also increasing.
"Tweezers!" Zhang Fan took the tweezers, and everyone in the operating room held their breath.
Tick tock, tick tock.
Qing Qing, at this time, others can't help Zhang Fan at all. Even if they can help, they can only pray in their hearts.
too difficult.
The hands should not tremble at all. After holding the gauze with tweezers, once it trembles, no one can guarantee that the invisible adhesion may be an artery.
Slowly, my heart started to rise. When I opened my mouth, my heart was beating in my throat.
People with bad mental qualities can be scared to death here.
One moment after another, Zhang Fan took out a piece of gauze intact.
Just like a crumpled pink letterhead, Zhang Fan made a clanking sound when he threw it into the curved plate.
You can think about how advanced Zhang Fan's skills must be to completely remove the gauze from such a hard gauze without causing the liver to bleed in all directions.
After Zhang Fan took out the gauze, the director of the field hospital became more and more confident in Zhang Fan.
Just when everyone can breathe a little easier, phew! He was bleeding, and Zhang Fan, who was almost leaning on his liver, had blood sprayed all over his face.
"Quick, I can't see!" At the critical moment, blood entered Zhang Fan's eyes. It’s really adding insult to injury.
The warm blood was just like a beautiful woman's tongue, warm and viscous. Zhang Fan tried desperately to open his eyes, but his eyelids were so stuck that he couldn't open them.
This wound can only be seen by the surgeon, because the area is too small, and others cannot see the specific wound inside.
Zhang Fan's eyes were covered with blood again. The roving head nurse, like a leopard, was two or three meters away in the blink of an eye.
She held the back of Zhang Fan's head, straightened her chest, and fixed Zhang Fan's head on her chest.
Then the other hand held the new Jieermien gauze and touched it directly on Zhang Fan's eyes.
As for Zhang Fan, after he shouted, he was like a big rooster with its head chopped off.
He didn't feel his head being pressed against his chest, nor did he feel his eyes being touched by Jie'ermie. It was as if the head was not his own, and there was no resistance at all.
But his body and hands did not stop. At the moment when blood came out, Zhang Fan's eyes didn't even have time to react, but his hands had already taken action.
The pliers were like the most accurate missiles fired at the blood vessels that spurted blood.
In just a few breaths, Zhang Fan immediately asked: "Uncle, look quickly, look quickly, is there any bleeding?"
His heart was hanging, he couldn't see, he didn't know if the clamps had caught the bleeding in the first place. He was panicking, as panicked as thousands of wild dogs chasing him who was shaking an elephant with his bare butt.
"Stop, stop, don't move, don't move!" The uncle's voice began to tremble.
Blood vessels, blood vessels that can bleed, cannot escape, they are definitely arteries, and arteries are like earthworms that spit out when hiding in a cave. If they are slightly loosened, he can definitely take them back.
Once it is taken back, the only option is to cut the liver.
The hand, holding the blood vessel clamp, rested on the wound surface of the liver.
The eyes finally saw it, "How is it, do you see it?"
"Can!"
Then, Zhang Fan didn't dare to move. He didn't know what his current position was.
Gently, the head nurse gently pushed Zhang Fan's head away with her hands and pushed it to the normal position.
Zhang Fan blinked, "Hemostatic forceps!"
Piece by piece, there was no danger, really there was no danger. Slowly, all the gauze was taken out.
The wound surface of the liver was as clean as a bowl licked by Erha.
"Shh!" Mr. Wu let out a long breath.
"sharp!"
"Place the drainage tube and close the abdomen!"
…
Cool! It was so refreshing. Zhang Fan looked at the young wounded man, breathing smoothly, and the color slowly returned to his face.
Although there were many dangers along the way, he felt so happy. Especially this kind of exhilarating feeling of losing strength, it's like all the pores in the body are opened and the muscles all over the body are trembling slightly.
It was a feeling that was so good that Zhang Fan could scream, and so good that Zhang Fan couldn't bear to leave.
