Chapter 232 229. Surgery Case Seminar at Ormitz Fortress General Hospital [5]

Medical puncture technology has appeared very early, and the devices used are similar, except that the purpose and effect of puncture in the 19th century and modern medicine are completely different.

The former is a helpless move that cannot be handled by surgery. They use blind penetration that cannot be seen directly, and often return without success, and may even cause iatrogenic secondary damage due to the puncture of the needle.

The latter is different.

Under complete imaging positioning, puncture has become the best way to invasive diagnosis due to its small damage, simple operation and short time. For those emptying of fluid in the body, puncture can also play its role well.

Even without imaging assistance, blind wearing of modern medicine will become much safer due to the operator's solid anatomical knowledge.

Lucius' puncture was indeed a helpless move at that time, because the injured person was injured too much and there was no room for treatment. Seeing his breathing frequency decreased and the blood transfusion did not work, his first reaction was that his lungs were active.

Sexual bleeding.

The chest cavity where the lungs are located is a closed chamber because the pressure provided by the closed chamber is required to regulate the contraction and expansion of the lungs.

The pressure during bleeding of the chest blood vessels can easily exceed the pressure of lung expansion. When the blood begins to squeeze the expanded space of the lungs, breathing will naturally become difficult. Lucius' judgment lies in this, since the blood squeezes the lungs.

, Surgery cannot open the chest surgery, so using a puncture needle to draw blood is definitely a good way. [1]

"I chose the base of the lung, which is between the seventh and eighth ribs, for a puncture." Lucius said, "The puncture result was good, a lot of blood was leaking, and the wounded's breathing quickly recovered.

only"

"It's just that he was too seriously injured and died not long after." Kavey suddenly asked, "Do you know the cause of death?"

Lucius shook his head: "This requires an autopsy before confirming it, but now we don't have time to do this. In order to make room for the ward, the dead wounded soldiers will be moved away and buried as soon as possible."

"I remember many of you went to the military doctor just to dissect the body. Why didn't you dissect it now?" Kawei felt a little regretful, "That's such a good material."

"We doctors who are the surgeons are so busy that we sometimes don't even have to eat."

"What do you mean sometimes? I haven't eaten in a fixed order these days, and the food I sent when I recovered was cold."

"So, I didn't even sit from morning to night."

"Doctor Kavey, you just came yesterday and don't know what's going on here. That is, there are fewer carriages in the morning, and in two or three hours, when it is approaching noon, you will send a group of wounded soldiers to the carriage.

Basically everyone has to go into the operating room to wait."

Since Kawei started talking, the audience simply complained about his workload. The sudden excess workload made them very uncomfortable. After all, it might take two or three days to do a surgery in the original hospital, so it doesn't need to be that way at all.

Try hard.

"Be patient, the doctor reserves in the fortress hospitals are much better than those in the Battlefield Central Hospital in Italy on the southern line." Kavey explained, "As for autopsy, I personally hope you can do it, which will also increase your corpses.

Of course, I will not force you to let your assistant do it if you don’t have time.”

Let the assistant do it? Isn’t this called forcing?

This light and pleasing sentence sounds like nothing wrong. It is normal for the assistant to fill the vacant work that the main surgeon does not do. This is what they have always done.

But if you think about it carefully, something is wrong, because although the dissection is tiring, it is not a miscellaneous task and is the main method for them to improve their surgical techniques in daily life.

In these three days alone, nearly 1,000 wounded soldiers died in the Fortress General Hospital. If the fatal injuries on their bodies and limb defects in a certain part are eliminated, the quality of the corpse is actually not bad at all. They are all strong young people.

Soldiers, they are usually the source of corpses stolen by major hospitals.

If all these anatomy work is given to the assistant, wouldn’t their skills be improved?

It is naturally a good thing to improve assistant technology, which can provide a lot of convenience for surgery, but now is an extraordinary period, and the competition brought by the points system cannot withstand such technological improvements.

"Doctor Kavey, we really don't have time."

"Yes, I'm really exhausted after a day!"

Kawei just said it casually, but he really didn't expect this level. After hearing their endless complaints, he was a little confused: "Didn't I say that the assistant can do it for him, I just want to know the cause of their death. This is not only

It is just for the development of military medicine and also to increase your clinical experience. Why not do it?"

Some people's answers are subtle:

"Don't all those assistants go for autopsy at that time, no one will take care of the surgery."

"It's right. After all, the work of the hospital is more important. We must prevent this kind of putting the cart before the horse."

Some people say it very bluntly:

"We're busy with surgery, are they busy with dissection of the body and adding technology?"

"Mad! I don't want someone to take the lead in the swordsmanship!"

When they violate their core interests, they will burst into a more positive side.

However, after considering their workload and rest time, Kawei pressed the pause button for them: "I didn't consider this, and the assistant was indeed a bit hasty in charge of the autopsy. The autopsy must be done.

The cause of death is diagnosed. As for who will do it, I will discuss it with you later.”

It was rare that Kavi was willing to understand their hard work, and everyone breathed a sigh of relief.

"Okay, let's continue talking about other patients."

As soon as he got here, a knock on the door came from the door. After opening the door, a doctor in his 30s walked into: "I'm afraid the front line will start fighting again, and two vehicles of wounded soldiers came, a total of 12 people."

"Lucius, Foster, Fred, you three bring your surgical assistants to deal with it." Kavey pointed out and called Lucius, "Let Delvoe serve you as a helper."

, look at him and report to me truthfully his work attitude."

Lucius didn't like this kind of surveillance work, but he couldn't refuse Kawei's orders, so he could only nod and respond: "Okay."

It is a very frustrating thing to be demoted from a principal surgeon to an assistant. With Delvo's personality and way of doing things, it is very likely that he will choose to lie down and dispose of it. If everyone does this same as him, then this hospital will not have it.

The method continues to work.

Therefore, monitoring and a one-to-one assessment system are very necessary.

"I repeat again that downgrade is not only a punishment for making mistakes, but also allows the person who makes mistakes to change the environment and re-examine the wards and wounded in their jurisdiction. But this is based on normal work." Kavey sighed, "If

There is no need to stay here if you don’t even have the enthusiasm to continue working.”

The content does not seem to be that serious, but the environment at this time is not the hospital where they are, but the military doctor.

If they are judged as passive slacking in the fortress general hospital, then what awaits them is not as simple as being kicked out of the army, but a more severe punishment.

After warning everyone, Kawei looked at Salson sitting in the front row and said, "You are now a surgeon, so go with me and go to the stage with your favorite surgical assistant. But you have experience now.

Not enough, only simple amputation can be done.”

"good!"

"Please pay attention to the indication of amputation. As long as the distal limb is intact and the blood vessels are well pulsating, there is a need to preserve the limb." Kavey emphasized, "Also, pay attention to debridement!"

"I see!"

The four left the conference room, and Kawei clapped his hands and pulled the others back to their attention: "It's just a small episode, let's continue to discuss the case."

The seminar was held for half an hour, and the biggest winner now is Salson. It is never easy to complete the class leap in three days.

For him, the work of the surgery was full of challenges, but more excited. Being able to preside over an amputation alone had already made Salson tremble with excitement, which was basically impossible in the Municipal General Hospital.

Although surgery mainly involves amputations, the number of amputations in peacetime is not large. In addition, Ignaz's strict orders for fresh graduates' probation period, Salson and others have no chance to practice surgery at all, and even the dissection has to be seen.

Only a person's face can do it.

However, the battlefield general hospital is full of such wounded soldiers. Of course, Kawei's attitude towards amputation is much stricter than other military doctors.

After leaving the conference room, the four of them saw the wounded people who were carried off the carriage at the entrance of the hospital.

Lucius became the on-site commander directly. Looking at the injured list sent by the injured, he started to assign the injured: "Abdominal injury, blood pressure is unstable, send it to Operating Room No. 1, Fred, come. Chest and neck

Partial injury, operating room No. 2, I will come; left arm + left shoulder, blood pressure is not bad, I will send it to operating room No. 2, Salson, you will do an amputation first, and leave the rest to me; brain injury and neck injury, I will give you one

No., Forsto, you deal with it first.”

Salson immediately got the opportunity to operate and found Goram, who is still working as an assistant, to be his own help: "Teacher Goram, please trouble you."

"It's okay, it's okay, learn from each other."

Goram looked calm on the surface, but he had already started to complain in his heart. When he really walked onto the operating table and started to deal with the residual limbs, he realized that Kavi's decision was not unreasonable.

The birth of surgical amputation is not to treat pain, but to remove useless limb tissues, and to prevent damaged tissue ulceration and infection. By retrieving irreparable parts, the remaining healthy limbs can be recovered as soon as possible.

Therefore, it is very important to grasp the removal site. If you cut too much, you will affect your function, and if you cut less, you will not work.

This is the concept proposed by Kavey at the beginning, which makes senior seniors who are used to being a one-size-fits-all surgeon and are not used to it. But young doctors do not have this problem and are exposed to new knowledge much faster.

Salson was even more experienced in the Municipal General Hospital a few months ago and has long since removed the childishness of a fresh graduate. His operation is not as clumsy as other new chief surgeons, and he can feel experience and technology in his techniques.

It's like an old man who has already mastered amputation.

"Your technique is pretty good."

Although Goram felt uncomfortable, he was better because he was in a good state of mind and was not stingy with his praise: "In Grants, young people like you don't have that delicate knife skills, and amputations are always rough and rough.

of."

"It was Dr. Kavi who taught it well."

Salson also mentioned this kind of appreciation, without much feeling, and did not show much happiness on his face, but Goram knew in his heart that there was no surgical technique that could be achieved overnight. (Except Kavey, of course)

"It seems that you have made sufficient preparations for today."

"Because the new chief surgery must start with amputation, after the Vienna military doctor was eliminated, I kept the relevant surgical indications and operation requirements for amputation in my mind, and took them out to review when I had time." Salson
To be continued...