In medicine, there is a famous saying: We doctors can also commit crimes and accumulate virtues; we can encounter setbacks and also achieve success. The sins we commit are often unavoidable at work and of course cannot be made up for.
The reality is that medicine is not yet a precise discipline, and we are working with living, breathing, complex human beings rather than a jar containing a mixture of chemicals.
This sentence was said by an emergency department expert in the United States.
Ordinary diseases and routine diseases often cause doctors to think about it again and again.
And this kind of sudden accidental injury is even more difficult. The handling at this time is not like doing multiple-choice questions. I can discard the answers that I think are not good.
The organs of the human body are not leeks, so it is quite difficult to choose. Sometimes, being a doctor is really difficult.
To save a life, you might have to give up a kidney or part of your liver. Wanting to save lives while saving some organs is often an empty dream.
Really, after many years of medical work, the hearts of many doctors are as hard as cold stones.
This is not natural, it is created by the entire industry. He has to be tough and he has to make choices.
Operating room, one, two, three, four, five, bang! Bang! Bang, like stuffed buns, the children were sent to the operating room.
From the emergency center to the operating room, Zhang Fan almost lost his strength in the compressions. This kind of rescue, especially cardiopulmonary resuscitation, is best done by a professional from start to finish.
It doesn't matter if the doctor is tired. The worst he can do is take more rest after finishing the work. But for the patient, a slight pause may cause irreparable damage to the brain.
Therefore, you will often see a scene like this, where countless doctors gather around and watch one doctor rescuing people. This is the reason.
The patients of general surgery and general patients were separated at the door of the operating room, and everyone unanimously left the most serious patient to Zhang Fan.
In the operating room, the relatively younger children slowly woke up at this time.
Look around you at the people wearing blue hats, blue masks, and green clothes. Look at the people holding cold knives, scissors, and sharp needles.
Fright, blood, pain, strange and terrifying environment made children who had not experienced anything huddle together.
His little heart was swaying and beating fast, and with the wounds on his body, he didn't even dare to cry. He was like a cub that had escaped from the herd, looking pitifully at this group of strange people.
The circulating nurses are usually a little older. Seeing the pitiful appearance of the children, she wanted to step forward to comfort them.
As a result, before he even took two steps, the director of general surgery stopped him with a shout. "Don't worry, these bastards should be scared, otherwise big trouble will happen in the future."
Crude words, but good intentions.
On the operating table of the cardiothoracic surgery department, the director looked at the wound and wanted to say something but couldn't.
The child here is a little older. When the explosion occurred, he was standing a little further away, but the damage was considerable.
The energy of the air flow from the explosion tore his clothes to pieces like a big hand, and then the broken glass shards pierced his chest like pear blossom needles in a rainstorm.
On the small chest, there are countless bloody wounds, either dots or flakes, just like lips with red lipstick growing on the chest. As the child breathes very weakly, these lips keep spitting red. Spitting ideas.
The child's chest was as bulging as a toad about to scream.
The chest, which was originally purple from the cold, now turned purple and blue due to lack of blood.
The other two children were relatively lighter, but they had sharp glass stuck in their faces and necks.
The child on Zhang Fan's side was in the worst condition, as his stomach directly hit the first wave of the explosion.
The wound was like an inverted flower, and the meat on the wound was directly the strips of meat coming out of the meat grinder. It stuck to the stomach like rag strips, rising and falling with the blood in the stomach.
Coupled with the broken intestines, undigested food flows out.
Green vegetable leaves, chylo-like food residues, and digested yellow stool were all stained on the floating strips of meat.
Green, yellow, and gray, it's really like the mutton shabu-shabu dipped in sesame sauce and coriander.
The smell of blood and feces was really like that of a disemboweled pig in a slaughterhouse.
The child's water and electrolytes have been disturbed and he has already entered a state of shock.
There is no time now to test the extent of his body fluid deficiency. All medications are based on estimates and the doctor's experience.
Ren Li is the host of the rescue. “Inject 3% hypertonic saline and be ready to click. If atrioventricular fibrillation occurs, conduct electric shock cardioversion as soon as possible.
EKG report! "
"Arrhythmia, QT shortening, ST-T wave curvature..." The deputy director of the Department of Cardiology immediately reported the results of the electrocardiogram.
"Use furosemide, quickly, push furosemide! Zhang Yuan, can the patient be given an electric shock now?"
A series of treatments are all aimed at preserving the child's heart, or in other words, all at preserving the child's circulatory system.
However, what is lost is always more than what is input.
"Yes or no?" Zhang Fan was not sure at all. Really, medical matters are often not absolute.
Without electrical cardioversion, heart failure cannot escape. However, if electrical cardioversion aggravates bleeding, it is still heart failure.
Gritting his teeth, Zhang Fan held the gauze in both hands and tried his best to stuff it into his abdominal cavity. White gauze was stuffed into the child's belly piece by piece.
The circulating nurses and equipment guards kept passing gauze around.
"Electric shock! You only have one chance, which one of you will go?" Zhang Fan was already wearing sterile gloves and sterile surgical gowns.
"I'll do it!" Ren Li still wanted to stand aside and grasp the overall situation. At this time, Naduo stood up.
"Remember, it's just one chance, there will never be a second chance!" Zhang Fan said, staring at Na Duo.
Naduo pursed her lips tightly, looked at Zhang Fan, nodded, and took a deep breath. Hold the electric shock device in both hands and place it on the child.
Bang! A lot of gauze popped out of her belly. At this time, Duo was so nervous that she could hardly breathe.
Her ears were almost standing up like Ahu's. She didn't dare to watch the ECG monitor because she was worried that an electric shock would cause more bleeding and directly lead to the child's death.
"Effective! Cardioversion!" The anesthesiologist exclaimed softly. This sentence, just this sentence, made the girl's face flush with excitement. The adrenaline hormones had really reached their peak. If she was asked to shout, she would It can definitely roar to the sky.
Zhang Fan heard it and found it effective. Then he quickly led the general surgery doctors to get started.
The white gauze filled in was taken out quickly, white, white, then half white and half red, then red, green and yellow.
Take it out piece by piece.
“Continue to correct acid-base poisoning, cut open organs, and put on a ventilator.
Adrenaline, digoxin, and injection of dobutamine to prepare for vasodilation..."
Medicine and surgery are going on at the same time, balancing, and now physicians are trying their best to create a weak and short-lived balanced environment.
Now it's time to look at Zhang Fan and the others. If the damage cannot be dealt with in a short time, then this environment will not last long. When the balance is lost, death will follow, and there will be no optional path.
For a normally healthy person, if the abdominal pain lasts for more than six hours, it is a no-brainer. This is an acute abdomen and he should be sent to the hospital immediately.
For surgeons, apart from massive postoperative bleeding, there is nothing more terrifying than gastrointestinal anastomotic leakage.
You can think about it, an anastomotic leak can make surgeons frightened, let alone this child with a full belly.
This kind of large-scale ulceration of the digestive tract, let alone the blood or the loss of intestinal juice, just the infection and poisoning caused by the bacteria in the stool permeating the abdominal cavity will make the surgeon's head explode.
This thing is not a one-point thing now, but the whole body's functions are facing collapse, right on the edge.
"Quickly, find the break and find the glass fragments involved!" Zhang Fan and the general surgeon lowered their heads and searched for the break and the fragments with great difficulty.
I dare not think too fast. This kind of trauma, especially the injury caused by a large foreign body and a sharp instrument entering the abdominal cavity, is really quite overbearing.
You have to be quick to find a breach, right? But do you dare to be quick? Don't dare!
With a belly full of intestines, there might be a piece of glass debris hidden under the duodenum. If you are a little quick or a little careless, the old opening will not be found, and a new one will appear.
"Warm salt water!" Zhang Fan no longer relied on his eyes. He relied entirely on his hands. He stuffed it into the child's abdomen like playing mahjong, slowly groping and moving it bit by bit.
With long-term exposure to the abdominal cavity, the child's body temperature also slowly drops, and even the fat on the mesentery in the abdominal cavity begins to slowly become like leftover braised pork, and begins to slowly become clear!
I didn’t dare to pour too much warm salt water, as I was afraid that too much salt water would spread the infection. I could only pour it where I felt it, and I had to suck it out as soon as possible. Really, this surgery was extremely difficult for Zhang Fan.
Just like a boxer, he can obviously beat his opponent, but his hands are tied together with a rope, and then he keeps hitting his opponent's face with crackling left hooks and right hooks.
Bang, bang, bang, glass particles like pearls and diamonds were fished out from the child's abdomen by Zhang Fan and others.
Really, you can only touch glass with your hands. If it were an iron object, it could be irradiated directly by the C-arm. Zhang Fan could quickly find the iron object even if he struggled to take the rays. However, glass would not develop under the C-arm, so he could only rely on his hands. I can only rely on the feeling of my hands.
Really, Zhang Fan was breaking out in cold sweat, and even the inside of his slippers were wet.
Just then, Ren Li kept urging anxiously, "Zhang Yuan, the blood potassium is obviously abnormal, and 1000cc of blood has been transfused."
Zhang Fan really wanted to shut Ren Li's mouth, but he still had to listen to people reporting the patient's physical signs to him at any time.
Disaster! ~
Touch, touch, touch. It was really like washing pig intestines at home. Zhang Fan didn't dare to be careless at any point from beginning to end, from top to bottom.
Once you touch something, you often have to go back and touch it again. Not to mention the intestines, a place full of grease and mucus.
Even if a needle accidentally sticks into the fat layer of the human body, don't even think about it and rush to the radiology department. It will never stay in one place, waiting for you to find it.
Therefore, due to the peristalsis of the intestines and the lubrication, the glass ballast is like a naughty child, constantly playing hide and seek with the doctors.
"Zhang Yuan, this is no longer possible, we can't hold on any longer!" Ren Li's voice changed to emphasize.
Really, sometimes, when rescuing someone, you just watch a life that is about to be rescued.
In the end, all of a sudden, like the King of Hell becoming angry and unhappy, the defense that the doctor had finally built up was overthrown and crushed in an instant.
Outside the operating room, the owner of the chemical plant seemed to have lost his soul, staring blankly at the fluorescent lights in the aisle.
Parents whose children have entered the operating room are on pins and needles, unable to sit or stand. Whenever a nurse or doctor comes out, their anxious eyes are really pitiful.
In the morgue, parents who had lost their children cried heartbreakingly while holding their children in their arms.
When several of the children with the most severe injuries were sent to the hospital, there was no need for resuscitation and they had already lost their lives.
At this time, parents are really like using a blunt knife to cut into the apex of their hearts.
There was even a mother of a child who was crying and suddenly wanted to hit the wall.
The women gathered around were thankful that their children were fine and shedding tears of sympathy.
He clung tightly to the mother who wanted to commit suicide.
"He has not been rescued, and my soldiers have not been rescued. Even if they cannot be rescued, I will feel better.
God, God, you are blind, my soldier. "
The people around me can't even persuade him. They can say anything. It's useless to say anything now. It's too late.
The county security leader stood in Ouyang's office with a livid face, speechless, staring at the phone on Ouyang's desk, staring at Ouyang's phone.
Before he came to the hospital, he had been scolded by his superiors, who asked him to deal with the follow-up in the hospital first, and then talk about it after it was over. Really, he was really exhausted mentally and physically.
He is also aggrieved, he is too aggrieved. Originally, there was not even a flour mill for grinding flour in their county, so where was the industry? In the past, I only managed a few blacksmiths who forged iron and made knives.
As a result, it seemed like overnight, all the factories in the county were built up. He felt that it was not a good thing at the time. As a result, the good did not come, but the bad came.
"Zhang Yuan..." Ren Li's voice began to sound helpless.
Zhang Fan gritted his teeth and said, "Start, start the operation, quickly!"
"Zhang Yuan, I still can't guarantee the glass inside my body..."
"If something goes wrong, I'll be responsible. Hurry, do the surgery!"
Zhang Fan rudely interrupted the surgical assistant's speech.
There is no way, there is really no way, I can only gamble, bet that all the glass in the child's belly will be cleaned.
If you try hard, what else can you do? If you delay it any longer, you won't even have the chance for surgery.
Now for surgery, it is better to have an accident than to have no chance of surgery. Human life is at stake. Zhang Fan gritted his teeth. Even if something happened, he would rather take responsibility than let this child lose his life.
