Chapter 246 242. "Preparation" of surgery

Oluke's treatment is mixed, but at least fasting is a good choice. Generally, cholecystitis will slowly return to normal. However, the patient's condition is not optimistic. Judging from the records of the medical records, he has had a high fever and abdominal pain for three days.

There is no sign of relief.

Now the diagnosis of cholecystitis can be basically clear, almost the same as the degree of the disease. What remains is the problem of the degree of the disease.

The course of cholecystitis directly affects the choice of treatment methods. It is both conservative, surgery, or conservative first and then surgery.

The acute cholecystitis has not yet been relieved on the third day, and basically you have to go to the operating table. Of course, the prerequisite is to do a good job of diagnosis, that is, imaging examination. There is no imaging examination now, and the operating room of the temporary rescue center does not meet the standards.

It takes a lot of time to transfer backwards, and changes may occur halfway.

Everything can only be judged by Kawei's experience.

He touched the patient's right upper abdomen again and clarified that the location of the lesion was in the gallbladder: "Are you sure you want to have surgery now?"

"I'm sure." The patient nodded repeatedly, then tightened his muscles, turned sideways and forced himself to avoid Kawei's palpation, "Don't press it! I really can't stand it!"

"All right."

Oluke is a very typical 19th century internal medicine doctor. The advantages and disadvantages of doctors in their eyes are basically judged by the speed of diagnosis and treatment measures. In particular, the diagnosis speed can best reflect the experience of a doctor.

A doctor who quickly judges the condition may not be excellent, but a quack doctor must be the one who hesitates for a long time and cannot get a diagnosis.

Although Kawei used quite a lot of palpation and directly contacted the patient's body, and was also a dirty surgeon, his diagnosis speed was excellent, even among the senior experts of the Association of Internal Medicine, who had rapid diagnosis.

Rank to the forefront.

There are many suspicions of pretending to understand, but after the stitching just now, Oluke still believes that Kavi has really made the correct diagnosis.

It’s just that the word “cholecystitis” seemed particularly strange in his mind.

"What does cholecystitis mean?"

"The most common reason for inflammation in the gallbladder is that there are stones in the gallbladder," Kavey explained. "From his body temperature and abdominal symptoms, it can be seen that the inflammation is very serious, and it does require immediate surgery."

Oluke didn't know surgery, but he couldn't help asking: "How to remove inflammation in the surgery?"

Kawei made a simple cutting action and said: "The principle followed by surgery is to cut off wherever it is not good for the body. If there is inflammation in the appendix, cut off the appendix, and if there is inflammation in the gallbladder, cut off the gallbladder."

"There is no effect on the body after the cholecystectomy?"

"There is, there is, but not big," Kavey said. "Cutting off the gallbladder does not affect normal life, it only has a little impact on digestion. I personally think that this effect should not cause him to refuse surgery."

"It's okay, it's not a big deal!" The patient said, covering his stomach, "I'm so painful now that I want to use a knife to cut my stomach open. Let's take the surgery quickly, I can't stand it!!!"

"I need to make some preparations," Kavey glanced at Oluke again, "Does the deployment work in the surgical room are not under the jurisdiction of Doctor Oluke?"

Oluke nodded: "I am only responsible for the logistics and internal medicine treatment of the ambulance center, and I have no right to interfere in the surgical department."

"It's okay, the resistance to intervention in surgery is much smaller." Kawei looked back at the captain behind him, "Go to find Teacher Ignaz and told him that I need an operating room, and I hope the surgeons here can cooperate.

.”

"Dr. Ignaz should have gone to the center of Gabrunz."

Kawei was stunned and nodded slightly: "I forgot about this, it seems that Lucius has followed him, right?"

"Yes, there are more patients there, except for your own first trauma team and two nurses, everyone else followed."

"Okay, let Herman negotiate, Damilgaon and Begate prepare as soon as possible according to the most basic abdominal surgery." Kavey said, "and Amore, the operation time is 1-2 hours, let the

He took the initiative to do it himself. Then he asked the nurse to open the vein for the patient and first hung a bottle of saline."

"I see."

The captain of the guard left the internal medicine tent, while Kavey took advantage of the others' preparations and followed Oluke back to his office.

As the chief physician of the internal medicine department of the Sixth Army, Oluke has a separate farmhouse as a lounge, and the treatment is much better than that of officers of the same level. Just leaving the smelly internal medicine ward and stepping into it, it is like crossing the human world directly

, from hell to heaven.

This place is not as spacious as the Laming Command Post, but it is a little delicate under Oluke's own arrangement, so it is hard to believe that there was an ordinary farmhouse two days ago.

"Doctor Oluke seems to like art very much." Kavey looked at the small portrait on the wall, then glanced at the frame along the corner and said, "Is this Mr. Hans's painting?"

"Yes, when I went to Vienna for a meeting two years ago, I took time to commission him to draw it." Oluk changed out of his military uniform and hat and wore a more comfortable coat. "What? Doctor Kavey also likes Mr. Hans' works?

”

"It's okay, I'm a friend of Mr. Hans." Kavey found a chair and sat down. "But I've never seen him paint such a small portrait. Today is an eye-opener."

"I spent a lot of money at that time." Oluke picked up the rag beside him and carefully wiped the picture frame. "Only this size can you carry it with you, otherwise you can only keep it at home."

"I think you should consider using a camera."

"Although photography is amazing, the photos taken are not artistic at all." Oluke said, "I still like the lines drawn by painters with brushes. What do you want to drink?"

"Oh, no need to worry." Kavi quickly returned to the topic, "I came here mainly for the ward cleaning."

After hearing this, Oluke recovered. The man in front of him was not only a surgeon, but also a deputy inspector of the Military Medical Department, responsible for the supervision of the military hospital and the military ambulance center.

Theoretically, there will be a deputy inspector in each group army, and the work of medical staff is unified. The Osa coalition and the Sixth Army are no exception. Unfortunately, the deputy inspector who was originally on the Western Front has disappeared for no reason, and now his position is vacant.

It would be reasonable for Wei to hold Grand Duke Brecht's telegram to fill the vacancy.

But Oluke still wanted to struggle: "Deputy Marshal Laming took over the position of deputy inspector. If there is any problem, you can find him."

After hearing this, Kawei felt helpless: "I have looked for it, but I can't fight him. So now I am not ordering me as the deputy inspector, but as an equal-level doctor, I want to discuss the issue of ward cleaning with you.

”

Oluk knew that the tent environment was poor, but there was nothing we could do about it. The military conditions were like this, so he could only try to overcome it: "You have also seen that there are no decent houses in our resident place. We can only rely on tents to centrally manage those

The injured and sick soldiers would have taken half a day to go rounds alone.”

Unlike urban centers, farmhouses are very scattered, which greatly limits the efficiency of farmhouses used in temporary rescue.

"But this is not the reason why the tent is not clean," Kavey said. "Rats, bugs, fleas and lice on the body of soldiers should be removed."

"Of course I like cleanliness too. Please believe me, no one likes these things." Oluke explained. "Especially fleas and lice, we don't have enough human hands, and they are not dust on the ground, so it's not so easy to remove."

"That's why typhus is there," Kawei murmured.

"What did you say?"

"I said that the latest research has found that typhus may be related to fleas and lice," Kavey said. "I strictly control rats and insects at the Ormitz Fortress Hospital on the Northern Line. I have only seen seven cases of typhus so far

, and there is no sign of spread."

"But we are in the wild here, and the conditions are limited." Oluke was a little excited, "I don't have to light a bunch of straw to fumigate the entire ward, right?"

"I know it is not easy to eliminate fleas and lice in outdoor environments, but spraying carbolic acid, kerosene, creosodium oil, and concentrated salt water can all work." Kawei said, "At the same time, we can also start with the patient's body.

.Wash your body with diluted aqueous carbolic acid solution and soap every week, and change clothes and bedding frequently."

"There is no creosodium oil, and kerosene is not much used for lighting. Carbonic acid is a special thing for surgery." Oluke said, "I'm trying concentrated salt water, I don't know if it works."

“It’s important to clean your body and clothes with soap.”

"I'll try."

The two had a lot of discussions on the patient's high fever and body temperature, and they had completely opposite ideas in terms of cooling.

Kawei obviously prefers salicylic acid. Although it has quite annoying side effects, it can still be used by doctors as long as the dose is controlled. Oluke still insists on putting salicylic acid on the shelf. He is more important than this dangerous drug.

I like my own method: "If the hen's blood cannot reduce the fever, I will choose to use aniline."

"Aniline.What is aniline???"

"A friend of pharmacist recommended it to me, saying it is useful for fever reduction."

Kawei couldn't react for a moment: "Have you been experimenting?"

"It must have been tried, otherwise he wouldn't be so confident."

Kawei felt something was strange, but just as he was about to say something, he was interrupted by the knock on the door outside the house. The captain of the guard who had just gone out to pass the message: "Doctor Kawei, the news has been brought, but"

"Just what?"

“There are only two farmhouses that serve as operating rooms, all full.”

Kavi had already been ready to wait: "It doesn't matter, trauma soldiers are more important, I can wait."

"But they said the operation has been scheduled until noon tomorrow, so if you want to use it, you have to wait for more than twenty hours."

Kawei frowned, not because the other party was deliberately targeting him, but because he was considering whether the soldier could hold on until that time: "No, he couldn't stand it for so long, and he would have to operate tonight at the latest."

"But."

Kavey stood up: "What is the doctor in charge of the surgeon? Where is it now?"

"I'm going to have surgery now."

Donelson opposed not only the right to use the operating room, but also the surgical procedure mentioned by Kawei. After Kawei found him, the two of them developed the operation room, the diagnosis, surgical method and treatment rights of the operating room."

Fierce discussion.

"You saw it too, the operating room is very busy." Donelson only stared at the operating table, without even looking at Kawei.

"The operating room is built temporarily, I can find a place to operate." What Kawei really wants is the medicine and equipment here. "I have brought all the first aid medicines, and the stock of ether is enough, mainly because I want to Use some carbolic acid for disinfection.”

"The amount of carbolic acid is very small and I can't give it to you."
To be continued...