2613 Accumulated clinical experience little by little
“You might not know about Ophthalmology, but you’ve always had cholecystectomy, right?” Su Yun’s eyes were fixed on the ECG monitor. She moved a stool to the left of the patient and chatted with Vice President Yu.
“Uh, is it the gallantry reflection?” President Yu asked.
“Yeah, what’s the worst thing about cholecystectomy? Severing the common bile duct was very serious, but it was not as serious as the gallheart reflex. Just like the Oculus-cardiac reflex, the heart rate will slow down and the blood pressure will drop when the gallbladder is involved in biliary tract surgery or when the biliary tract is explored. In serious cases, it can lead to myocardial infarction, arrhythmia, and even cardiac arrest due to reflex coronary artery spasm. “
“This is especially true for patients with hemorrhagic shock. The probability of success will increase exponentially.”
President Yu was still fine. After all, he was the chief resident of Room 912. But Gu Xiaoran’s heart was beating fast as she listened.
He had already started the relevant surgery at the hospital in his hometown.
The hospital on the other side of her home was smaller, and the Department was not so detailed. The director and Zhou chunyong were in contact, so Gu Xiaoran took the opportunity when no one was willing to come to the capital.
Coming to the imperial capital to study this time had really made a huge change in Gu Xiaoran’s life. Every day, he had a new change. For example … Today.
He remembered that he usually told the patient’s family members before he performed cholecystectomy that there was no choledochocartic reflex at all, and he did not know what it was at all.
Not to mention Gu Xiaoran, even their director probably didn’t know. The probability of this happening was extremely low. It might not even happen once in 1000 surgeries, let alone a rookie like Gu Xiaoran.
“Brother Yun, what do we do after they appear?” Gu Xiaoran asked softly.
“Emergency treatment. Can you just watch the patient die?” “If you can’t figure it out, call your hospital’s big name over and call whoever’s the best,” Su Yun said in disdain. Of course, as long as you don’t cry on the operating table, you can do whatever you want. If we pollute the surgical area, we’ll cause more trouble. “
Su Yun even laughed at Gu Xiaoran at the end.
“Hehe.” Gu Xiaoran smiled, but his smile was stiffer than President Yu ‘s.
“Xiao ran, right?” President Yu said,”the gallbladder-heart reflex is really rare. It’s even rarer to see urinary octopuses in the bladder that pull the vacuous nerve. Otherwise, why would boss Zheng always feel that something was wrong before the surgery, but he can’t remember what it was?”
Gu Xiaoran glanced at boss Zheng and saw that he was sitting in the corner of the operating room, staring at the electrocardiogram like Brother Yun.
Boss Zheng was still worried about the patient, and Gu Xiaoran felt a little strange. He always heard boss Zheng talk about his rich clinical experience … What was rich clinical experience? This was it.
Although boss Zheng didn’t discover it at the beginning, he stepped forward at the first moment and presided over the successful rescue. The patient should be fine.
At the thought of this, Gu Xiaoran took another look at the patient.
He opened his eyes in a daze, as if he had just fallen asleep and did not know what had happened.
“The probability is different. In Ophthalmology, there’s a 90% chance of cardiac reflex happening, but the probability of bladder triggering a cardiac reflex is too low.” Su Yun said.
“Um … I remember now. There was once when I saw the patient’s Appendix after laparotomy during an operation.” President Yu had already finished fistulation, and he also told the circulating nurse to discharge the urine in the bladder in two to three times.”When I operated the retractor, as long as I exerted force, the patient’s heart rate would change. I thought it was fun.”
“It’s caused by reflex. Vacuous reflex in the gastrointestinal tract is also very rare, and no one knows what happens after it happens.” Su Yun said as she stood on the footstool, which was a little taller, and looked down at the electrocardiogram from a bird’s eye view.
“More or less. I didn’t have any experience back then. Big brother Yun, it should be fine now, right?”
“He should be fine now.” Su Yun glanced at her boss and saw him sitting steadily on the stool. Although he didn’t say a word, he gave people a sense of security even just sitting there.
As long as this fellow was around, he would definitely be fine. Su Yun’s heart gradually accepted this reality.
Did he really have rich clinical experience? Or did this guy have a naturally sharp sense of smell, just like Blackie?
Su Yun glanced at her boss and pondered.
He didn’t seem to know what would happen in this accident. However, the moment her heart stopped, he started to take charge of the rescue. Sigh, why is the boss so willing to steal the limelight? Su Yun sighed deeply in her heart.
“It’s not uncommon to have a full bladder that leads to cardiac arrest. ” Zheng Ren suddenly said.
“What?”
“But generally speaking, they wouldn’t think that it’s caused by a full bladder.” Zheng Ren continued,”I had to hold my pee in the morning. Suddenly, my bladder was emptied. I fell into the bathroom.” Such cases are common, but they’re usually sent to the cardiology department for treatment. “
“…” President Yu was stunned.
“When the empty organs are stimulated by expansion, they can be transmitted to the center through the abdominal nerve cluster or the vacuous nerve. The excitement can be transmitted to the low-level motonel sub-sympathetic Center and the vacuous nerve nucleus. The release of the impulse can then reach the heart through the left vacuous nerve sub-sympathetic fiber.” Zheng Ren said,”a very clear reflex arc.”
“Uh …” Gu Xiaoran suddenly made a startled sound and then said,””Boss Zheng, our old Department Director had a sudden heart attack while he was performing surgery! Now that I think about it, it’s probably because he’s holding his pee. “
“Eh? What happened after that?”
“My heart is hurting.”
“Have you been saved?” Zheng Ren asked.
“Oh, oh. He was in the operating theater after all. He was saved.” Gu Xiaoran said,”contact the City Hospital to get the stent sent over by the 120 ambulance while you carry out thrombosis.”
“You can’t even set up a stent there?” Su Yun asked.
“Yes.” Gu Xiaoran nodded.”I went with him. The doctor in the city said that it was almost there. Fortunately, it happened in the operating room. At that time, I thought I was lucky, but now I think it might be because I was holding my pee. “
“Boss, do you think this is a work injury?”
“You’ve heard of work-related injuries in the hospital?” Zheng Ren asked in a rare tone.
Seeing that she hadn’t finished, Gu Xiaoran changed the topic and asked quickly,””Boss Zheng, the vascal nerve is excited, and then?”
“The result of the vacuous nerve stimulation is a seizure of the Xuanji coronary artery, a decrease in the excitability of the sinus node, a decrease in the transmission speed of the specific guidance system, a decrease in cardiac contraction force, a decrease in cardiac output, a decrease in blood pressure, and even a cardiac arrest. Zheng Ren said.
“He’s so powerful. ” Gu Xiaoran whispered.
“Not at all. I’ve never thought of it before.” Zheng Ren sighed and said,”it’ll be better in the future with the experience this time.” Su Yun, you’re right. “
“What do you mean by I’m right?” Su Yun looked at Zheng Ren and asked.
“Clinical experience is accumulated bit by bit. That Korea professor is just a hooligan.” Zheng Ren said seriously.