Path of Medicine With a System

When Zhang Fan was in Fangdong Hospital, he sometimes listened to the bragging of the sailors in the room during the ward rounds.

"The Bohai Sea is the bathhouse!" At the beginning, Zhang Fan thought that these people were really bragging. How big is your bathhouse?

But this time, he felt that what the other party said was too true. The ocean and the sea are really different. When Hua Guo was tossing around in the Bohai Sea, he never said anything.

The navy is the navy, but when it rushed out of the Bohai Sea, it started to talk about the deep blue army. The large ships were like dumplings, and Hua Guo only started to talk about the deep blue when they dropped off one by one.

And he said it very carefully, our deep blue is not attacking, we just want to see the stars and the sea!

Kidnapping people is very particular. Especially some people who are not in the medical field, have trauma, and are far away from the hospital. They are in a hurry, and then they take a thin rope and start to strangle them desperately.

Bleeding, bleeding from small arteries and small veins, if there is no first aid item, first look for a large towel or the like, if you can't find it, the sleeve of the clothes is also a perfect tourniquet.

Don't use a thin rope to bind the limbs. You don't know if you will die from bleeding. If this kind of thin rope is ligated for a long time, the hospital doesn't need to stop the bleeding, and the limb will be amputated directly.

The organs of the human body are not sauced trotters. This thing needs blood with oxygen, and it needs to breathe.

Especially for some people with special hobbies, playing with a jacked pendant, brother die, which is full of sponge-like blood vessels inside, once it is damaged, it will be too late for you to cry at it.

After binding Zhang Fan and his assistants with a wide belly belt, Zhang Fan could feel the loveliness of Mother Earth firmly.

Injury, with the increasing number of cars in society today, there are also more and more traffic accidents. Sometimes, you must not be careless.

Zhang Fan encountered a case in the hospital. A car hit an old man. The driver got out of the car and checked quickly. Hey, hey, the other party was fine, not even scratched.

The uncle also made sense, saying it was all right, and got up and jumped on the spot. The driver felt sorry and didn't want to give the uncle a hundred yuan, saying it was compensation.

The driver then drove away. As a result, the old man fell to the ground and went into shock before he came home.

The family members were quick to send them to the hospital and call the police, but it turned out that the spleen ruptured and the old man died, so Xue Fei was rescued. After waking up, the traffic police confirmed that the driver was released, otherwise it would be an accident. escape.

The two wounded, the young fisherman looked quite serious, with a stomach full of blood donations, dripping down continuously.

People are also so weak that they are like fish jumping on the shore, breathing desperately with their mouths open, and they look quite serious. Looking at the other one, there are no other symptoms except the face is like gold leaf.

Those who are inexperienced, looking at this situation, may have made a difficult choice in their hearts, which one to save!

Preoperative considerations are quite important in such emergencies. Sometimes, this consideration is more important than surgical techniques.

Injuries caused by external mechanical energy (not to mention burns) can be roughly divided into two categories: blunt trauma and penetrating trauma.

The penetrating injury mechanism is relatively simple. During the operation, a trauma life chain is guaranteed. Those who can survive will never die. If they are really dying, they may not be able to be sent to the hospital, such as directly hitting the aorta.

The mechanism of blunt injury is more complicated than that of penetrating injury. Apart from other things, the shear moment generated by a pressure cannot be easily diagnosed by ordinary doctors.

This thing is like a missed shell, no one knows where it hits or where it hits.

Often, blunt injuries result in systemic damage to organs and organs.

If there was a shearing force, the left abdomen was originally injured, but the right kidney, thousands of miles away, was also opened, bleeding profusely, like a wronged doll.

"You take the hygienist to quickly treat the abdominal trauma, and leave the shock to me."

"Okay!" Zhang Fan's director assistant was also unambiguous.

The soldier with a face like gold leaf was carried to the chief surgeon. While taking off his clothes, the nurse opened other unopened passages, and the dark red blood transfusion bag had already been hung up.

Even the blood transfusion bags and infusion bottles are fixed on top of the wound with gauze in circles like a bandage.

When Zhang Fan was working as a nurse, he sanitized and thought at the same time. When performing an operation in a hospital, everyone seems to think that the patient enters the hospital, is lifted onto the operating table, and the doctor pulls open the stomach and cuts out the broken organs, and that's it.

In fact, it is not the case. When a patient is admitted to the hospital, the first examination is to confirm the diagnosis. Then, at the morning meeting of the department the day before the operation, everyone began to discuss the operation plan.

Whether to cut horizontally or vertically is almost always predetermined in advance. Some emergencies are even considered.

This is also why patients who undergo surgery often have a lot of lines drawn by the doctor at the place where the knife is needed. This is the scheduled incision, so don't wipe it off with your hands.

However, in such a sudden situation with poor equipment, Zhang Fan now considers two things: First, after the stomach is opened, whether the body of the wounded is strong enough to fully detect.

Second, if the condition of the wounded does not allow surgery under such conditions after the stomach is opened, will he be able to persist in fighting again in the future!

After a few minutes, not even more than ten minutes, Zhang Fan had to stop thinking, because everything was ready and waiting for his operation.

"Start!" Zhang Fan nodded and took a deep breath, "Knife!" Weird scene.

Just like the TV filmed by a cameraman suffering from Parkinson's, Nurse Zhang Fan and the patient lying on the operating table were shaking at the same frequency.

Zhang Fan took a knife and opened the wounded's stomach. This kind of operation can be called laparotomy in a broad sense.

The wound is directly from the xiphoid process to the pubic bone, that's it, maybe after the exploration, another crosscut on the left or right is needed.

Most people can't feel how big this kind of wound is. The feeling of this kind of incision is definitely different from that of no incision.

When pigs are slaughtered during Chinese New Year, when the pigs are hoisted up to remove their internal organs, this incision is very similar to this laparotomy.

Coupled with the forceful pull of the retractors around it, darling, let alone stuffing a human head into this abdominal incision, it is not a problem at all to put a half-old child in.

Just like you are wearing clothes, your girlfriend can't get in, you unbutton the clothes, let alone one, even two can be wrapped in it, it's so wide.

Open the stomach, the blood is mixed with half-coagulated blood clots, just like some kind of duck blood that is going to be poured into the hot pot, the soup is overflowing.

Open the peritoneum, the right side of the liver is like a laughing child's mouth, with the front teeth bared and laughing.

"Sterile glass bottle!" Zhang Fan said in one sentence. If it was in an ordinary hospital, the doctors and nurses might not understand the meaning.

In a hospital, as long as it is a regular hospital, very few doctors encounter this situation.

But the military hospital is different. In critical moments, when there is no rear, no support, and every day is not working, this kind of uncontaminated blood is the last guarantee for patients.

The assistant collected the blood in a glass bottle. Although it is still impossible to tell whether the blood has been contaminated, collecting it is better than not collecting it.

Zhang Fan held a piece of wet salt gauze in his left hand and covered the opening of the liver, and then inserted his right hand into the abdominal cavity, as if cooking a famous capital dish.

He kept stretching in and out of the intestine with his right hand. Now Zhang Fan firstly determines whether there are other organ injuries and bleeding, and secondly determines whether the blood is contaminated.

There is an iron rule in blood self-reinfusion, no matter whether it is the chest cavity or the abdominal cavity, once the hollow viscera is ulcerated, the blood cannot be recovered.

What are hollow organs, the largest hollow organs are the intestines and stomach. Zhang Fan kept churning in his intestines.

There are rules for this tumbling. Whether the intestinal tract is ruptured or not, the best examinations are abdominal CT and X-rays, and you can know the free gas in the stomach with just one scan. But now there is no such condition.

Zhang Fan's eyes were staring like cows, carefully staring at the blood in his abdominal cavity, his ears were pricked up like police dogs.

Then the right hand is like a butcher washing pig intestines. Starting from the pylorus in the stomach, Zhang Fan pushed down with his right hand little by little.

What is it doing? To put it simply, it is to see if there are any air bubbles, and to hear if the wounded will fart.

Older boys probably had the experience of repairing bicycle tires when they were young.

Take a basin of water, and then turn the tire of the bicycle over the basin little by little. Once you see air bubbles, you can determine where it is broken.

In layman's terms, Zhang Fan will do this again now. After pinching the smooth small intestine and bag after bag of large intestine, no air bubbles were seen, and the sound of exhaust came through my ears.

"It can be used, ready to filter." Zhang Fan breathed a sigh of relief. With this amount of bleeding, in this environment, it is really lucky to be able to transfuse autologous blood.

With the ability to regenerate blood automatically, the patient's chances of surviving have increased several layers.

"Yes!" The roving nurse took the recovered blood and began to filter it, and the six layers of gauze began to filter the blood little by little.

This filtering process is quite slow.

When Zhang Fan first came into contact with chemistry in the third year of junior high school, one of the experimental classes was to learn filtration. The teacher took the debris liquid mixed with sand and salt and let Zhang Fan and the others do the filtration and sedimentation.

Zhang Fan watched the turbid saline in the flask drop by drop endlessly. At that time, he didn't know what a prostate was.

It may be estimated that men are naturally very disgusted with this kind of ticking. Then, without further ado, Zhang Fan poked a hole in the filter paper with his little finger.

Men don't like the slow ticking of water by nature, but they like poking holes very much.

What kind of window paper, what kind of plastic foam, you don't believe it, look at it, for girls, girls can be transformed into cute things.

And boys definitely use their fingers to insert holes everywhere. It's not that boys like to destroy things. This thing is born with genes, and it has been practicing and previewing to prepare for the future.

When Zhang Fan pierced the filter paper with his finger, he was deeply remembered by the teacher. A chemistry teacher who is as strong as Wu Song, slaps his face, and slaps his feet.

While beating, ask, do you like poking so much? Ah, is that all you like to poke? Can this be stabbed? I let you poke! I let you poke!

Zhang Fan was beaten from the head to the end of the classroom. Now the chemistry teacher probably won't hit someone when he meets a student like Zhang Fan, because he has reached the age of prostate rebellion now.

The roving nurse dripped anticoagulant into it while collecting the blood, and there was no need to shake it on board, the glass bottle had its own rhythm! Hold the bottle in your hand and it will move by itself.

After Zhang Fan turned over his intestines, his left hand was still pressing on the opening of the liver, thanks to Zhang Fan's skillful hand.

A greasy intestine is like a fish with mucus on its body. It is quite slippery. This kind of inspection should not be light or heavy. If it is light, the intestine will slide away accidentally. If it is too heavy, it may cause intestinal damage.

After palpating the intestinal tract, the spleen was palpated. Among the closed abdominal injuries, rupture of the spleen ranked first. According to a set of data, the mortality rate of simple spleen rupture is 10%, and if there are multiple injuries, the mortality rate can directly soar to 50%.

So don't take it lightly when you've been slammed into the belly. Go to the hospital for a checkup, it won't be too much trouble.

Why don't these non-cavity organs hurt after being broken, and why don't they go into shock immediately.

Very simple, these organs are wearing coats. These coats, like the more expensive apples bought in supermarkets, are covered with a layer of plastic film.

At the beginning, when the bleeding overflowed from the wounds of the organs, this layer of film blocked the blood. Although the organs were ruptured, the clothes were not, and the brain thought that this thing was complete.

Then, like water in a condom, it got bigger and bigger, and then there was a bang.

When the cover is broken, the brain and blood pressure are in a hurry. It is like a roller coaster, and the blood pressure can drop from 200 to undetectable.

The blood pressure dropped sharply. This is a person who was obviously healthy. He was hit and said he was fine. After half an hour, he suddenly lay on the ground and touched the carotid artery. It was over, the person had died!

With blunt impact, the probability of damage to hollow organs is particularly small, such as the intestinal tract, such as the stomach.

This thing is born with its own buffer. The gastrointestinal tract contains a lot of gas, not only the gas itself, but also the food mixed with various digestive juices. During the digestion process, this is directly the gas production tank.

Some people have bad breath, they brush their teeth eight times a day, and the teeth are all brushed off, but the bad breath can still make their girlfriend spit out.

This is a problem with the digestive tract, try eating some hawthorn pills, don't keep staring at the toothpaste and making trouble.

But the actual organs are not good enough. Such as spleen, kidney, liver. Among these organs, the spleen is the most vulnerable to injury.

Because this organ is not taken seriously in the human body. You just say that the kidneys have no air buffer, but people have cotton jackets.

Men love to eat big kidneys, even if there are two big kidneys and a bottle of beer on the barbecue stand, they will not exchange them for gods. In fact, what they like to eat is not kidneys, but the padded jacket outside the kidneys.

If the fat near the kidney evolves, it is estimated that it can evolve into a tendon. You can imagine the toughness of this fat.

But the spleen is not treated so well, not to mention the impact, sometimes the hiccups are severe, involving the ligament of the stomach, the stomach is fine, and the spleen is torn open.

After turning over the intestinal tract, Zhang Fan immediately checked the spleen. "Hey, the spleen is also ruptured!"

After checking the spleen, Zhang Fan asked directly, "Is the urine coming out?"

"Come out, come out!"

"Is there blood?"

"No! No obvious blood."

"It's good to replenish potassium, directly clamp the spleen blood vessels!"

Before the 1980s, as long as the spleen was slightly damaged, it was generally not repaired, but cut directly. The doctors at that time knew that this thing was useless after adulthood.

In fact, the spleen has many functions. The simplest and most useful function is to filter bacteria in the blood, which is quite awesome.

The spleen is a foodie, it eats red blood cells, white blood cells, and bacteria! So, people, you can't eat too much, or you will be discarded one day, just like the spleen.

"Can't keep it?"

"I can't help it, the hole is too big." Zhang Fan shook his head, cruel, really cruel, but medical treatment is like this, sometimes cruelty is to make patients survive longer.

"Vascular forceps!" Click, click. Just like a crocodile snapping its mouth, the vascular clamp directly clamps the access to and exiting blood vessels of the spleen.

"Repair the liver!" The organ that has already been given up is not in a hurry now.

Zhang Fan took off the gauze on his left hand and took a deep breath.

At the beginning, in order to detect the surgical injury as soon as possible, Zhang Fan did not check the liver carefully.

Looking back at the liver at this time, Zhang Fan's face felt as uncomfortable as thousands of ants marching.

This feeling is not numbness, but the feeling of goosebumps standing on end. It's trembling!

The injured man's liver wound was not big, at most it was as big as the mouth of a three-year-old child, but when Zhang Fan gently separated it with his index finger and middle finger, yes! This action, um, men should understand. .

Soft, quite soft, crisp like the liver of a green apple slowly falling apart.

The shadowless lamp penetrated into the wound...