top student at medical school

Chapter 476 Octahedral Warrior

Emergency room cases are like the temper of a menopausal woman; you never know when they'll strike.

However, you can never completely ignore it!

Come to think of it, Fang Ziye hasn't seen any frontline emergency cases in the emergency department for a long time!

Seeing that Fang Ziye's lunchbox was almost untouched, Luo Tingzhu said apologetically, "Senior brother, are you hungry?"

Luo Tingzhu was also aware of the principle of eating whenever possible during her hospital stay.

If he hadn't been waiting for me, and if we hadn't been chatting, Fang Ziye would have already filled his stomach.

After putting down his phone, Fang Ziye quickly ate two mouthfuls, swallowing them in a daze, before walking out of the office.

Without giving a direct answer, they provided the best response through their actions.

Luo Tingzhu didn't get up to see him off. She only watched Fang Ziye leave before dividing the food in the lunchbox into two portions.

Finally, after careful consideration, I realized that my appetite was smaller than Fang Ziye's, so I divided it into one-third and two-thirds portions.

Only after seeing a fairly clear dividing line in the middle did Luo Tingzhu start moving again.

……

Emergency operating room 04.

When Fang Ziye entered, the operating room was already filled with many people, most of whom were familiar faces to him.

"Dr. Fang." Someone in the crowd recognized Fang Ziye and called out.

"Brother Qi!" Fang Ziye recognized the other person as Mi Qi and responded.

"Doctor Fang."

"Dr. Fang!"

Several other vascular surgeons also called for help and made way for Fang Ziye.

On the operating table, Liu Faming said, "President Fang, please wash your hands and come up to the operating table. This patient's condition is very complicated. He not only has an open injury to his lower limbs, but also active hematomas in the pelvis, upper retroperitoneum, and lower retroperitoneum."

Fang Ziye also examined the patient's injuries, following Liu Faming's voice.

The injuries to both lower limbs were not serious, just scratches and punctures to the soft tissue!

It's not a scratch, it's a wound from being scraped or stabbed.

However, after Wang Yuanqi, who also rushed to the operating room, examined the situation, it was found that it was not serious and that Wang Yuanqi could handle it himself.

"Ziye, the injuries to both lower limbs are non-vascular soft tissue injuries. A simple debridement will suffice, and at most, a drainage tube may be placed."

"They just called Brother Nie, and Brother Nie isn't planning to come back today."

"Moreover, Brother Nie is now our liaison in the trauma surgery department!" Wang Yuanqi gave Fang Ziye a reassuring reply.

Nie Mingxian's professional title, age, strength, and experience are all far superior to Wang Yuanqi's, so Wang Yuanqi's respect for him when he calls him Brother Nie is genuine.

It's just that he and Fang Ziye might have been fellow apprentices before, so Wang Yuanqi always called Fang Ziye "Ziye" and didn't change his address to "Brother Ye" because of Fang Ziye's excellence.

"What is the patient's blood pressure now?" Fang Ziye asked the anesthesiologist.

"78!" The anesthesiologist was so busy that he didn't even bother to mention the diastolic pressure.

"We need to perform surgery to stop the bleeding as soon as possible, otherwise all the blood transfusions will be wasted."

As the anesthesiologist was speaking, the anesthesia machine started beeping again, and the junior anesthesiologist immediately panicked: "It's 67, sir!"

"Infuse the fluid under pressure and increase the continuous pump volume of norformin."

"Draw another electrolyte." The anesthesiologist was too busy to keep up with Fang Ziye's reply and adjusted the oxygen and carbon dioxide concentrations.

The patient's blood loss was far more severe than expected.

Upon seeing this, Fang Ziye immediately went back to wash his hands. No matter what, he had to wash his hands and go on stage first in order to be able to do more things. Just standing below the stage and watching was not enough.

As Fang Ziye was leaving, he ran into Professor Deng Haibo, who was rushing to the operating room. After seeing Fang Ziye leave, Professor Deng abandoned his plan to go into the operating room to check on the situation and instead asked, "Dr. Fang, how is the patient now?"

"Low-pressure shock, the bleeding must be stopped immediately!" Fang Ziye replied simply.

Deng Haibo turned back and walked to the sink with Fang Ziye. The two of them quickly washed their hands, and the foam from their palms and arms splashed everywhere, with a lot of it splashing onto the mirror.

"Is it an active hematoma in the entire posterior peritoneum?" Deng Haibo asked with a furrowed brow.

"I heard that's how it is, Professor Deng. I haven't had a chance to watch the film either."

"Let's go up on stage and find out the details!" Fang Ziye didn't know much about the medical history either.

Upon entering, he only had time to ask about blood pressure; he didn't ask any other questions.

They didn't even have time to ask Michi how his recovery was going!
After the two rushed to the operating table, Fang Ziye discovered that Professor Deng Haibo and others had prepared a one-way valve for treating retroperitoneal hematomas before the operation.

Furthermore, at this moment, Chief Resident Liu Faming is being guided by Associate Professor Chen Minghao to form this one-way valve.

Looking at the arteries and veins at the retroperitoneal hematoma site in the patient's pelvis, they have all been temporarily clamped!
These methods are no different from the thinking that Fang Ziye used in the past.

Fang Ziye's mood suddenly cleared up after reading this, and he sighed inwardly that Zhongnan Hospital was indeed full of talented people. His original hemostasis idea had only been demonstrated a few times, but it had been flexibly applied by the vascular surgery department.

After Professor Fang Ziye and Professor Deng Haibo had both put on sterile surgical gowns, Associate Professor Chen Minghao reported to Deng Haibo: "Professor Deng, there is also a hematoma in the retroperitoneum, but we dare not place the one-way valve again."

"Dr. Nie is not here today, so I can only ask you and Dr. Fang to come in person."

Deng Haibo nodded: "That's good. We'll do our best to do what we can. If we have to be reckless, we'll be cautious. Don't be afraid to ask others for advice."

Then, Deng Haibo turned to Dr. Fang and said, "Dr. Fang, ever since you innovated the treatment approach for that retroperitoneal hematoma last time, we have repeated it several times with Dr. Nie."

"I think this treatment approach is excellent, and it expands the application scope of the one-way valve in blood vessels."

"Furthermore, in the period that followed, our team also..."

Professor Deng Haibo and Professor Deng Yong have a history. Previously, Fang Ziye was assigned by Deng Yong to collaborate with Professor Deng Haibo several times on the hemostasis techniques he had performed.

However, during the collaboration, Nie Mingxian discovered that it was related to his "professional field," and after only seeing it once, he "borrowed" the idea for stopping the bleeding.

For a long time afterward, Fang Ziye did not receive any urgent consultation invitations related to vascular surgery.

until today.

While listening to Professor Deng Haibo speak, Fang Ziye's hands were not idle; instead, he carefully examined the blood flow rate inside the patient's abdomen with both hands.

In such an emergency, things like reviewing medical records are all "fancy" and "unnecessary." Instead, the most direct and forceful method is to use sensory perception to examine blood flow and identify any suspected ruptured blood vessels…

Fang Ziye had already demonstrated this to the vascular surgeons before, so he wasn't afraid of scaring them.

Even though this was the second time they had seen it, Professor Deng Haibo and Chen Minghao could only stare at each other in disbelief.

Fang Ziye's current physical examination technology is something that not only surgeons envy, but even highly professional internists would envy.

But you can't have it all!

Physical examination is the first medical-related technique that medical students encounter. It is very basic, but its role is relatively limited. Most people know a little about it and are only slightly proficient in it.

There are almost no people like Fang Ziye who directly reached level 4.

Who has so much energy to devote to basic physical examinations? Every doctor performs physical examinations, and every inpatient and outpatient undergoes a physical examination, but the improvement is still slow.

This shows how difficult it is to dedicate specific training to improving this basic skill of physical examination!

"Hemostats!" Fang Ziye clamped one of the blood vessels with the hemostats in his hand and asked the scrub nurse for more.

The scrub nurse gave Fang Ziye four or five scrubbers in a row.

Fang Ziye inserted them all into the patient's abdomen, and instructed: "I inserted a total of six, four in the upper abdomen and two in the lower abdomen."

"Professor Chen, how many rounds did you fire before?" Fang Ziye asked.

The quantity of these instruments must be accurate, and they must be counted before leaving the patient's abdomen, otherwise they will remain inside the patient's abdomen.

"Drip drip!"

"Blood pressure is up, 79!" The anesthesiology resident shouted to the anesthesiologist who was preparing the medication after seeing the new blood pressure data.

"Understood." Associate Professor Ma Zi was unsurprised, but he only glanced sideways at Fang Ziye on the operating table.

Hearing this, Deng Haibo could only smile wryly and say, "Ziye, you really are fed by the patriarch."

Putting everything else aside, just this one move...

Who would have thought that a physical examination could be used in this way during surgery?

This alone is enough to make Fang Ziye a special medical worker, belonging to the category of "special skill" holders.

Fang Ziye smiled slightly upon hearing this and said, "Professor Deng, thank you for the compliment. Let's first check the condition inside the abdomen and deal with any small bleeding foci."

The patient's injury was an open wound, but he also suffered a blunt force injury. However, the open wound itself was not serious; the vibration from the blunt force impact was the most dangerous.

Therefore, his intestines and other solid organs were not damaged much, except for some defects in the ileum.

"Sew it up, sew it up quickly..." Deng Haibo said to the chief resident of the gastrointestinal surgery department as the blood flowed down to the ileum.

I didn't care before, but now that the blood has been completely sucked out by the negative pressure suction device, the remaining smell is so intense it's almost unbearable!
It's important to know that emergency patients do not receive an enema before surgery.

Chen Hongxing, a gastrointestinal surgeon, immediately came forward to assess the situation. After confirming that the injury was not serious, he made an incision and immediately began suturing.

He wanted to leave as soon as possible too!
The patient's condition was not related to gastrointestinal surgery; it was just that the patient's vital signs were very unstable, so he could only stand there.

Once the incision here is treated, he will be relatively free, and the rest can be left to the vascular surgeon.

While Chen Hongxing continued his operations, the process of suctioning out the remaining blood continued.

Then, Chen Minghao and Professor Deng Haibo and others saw that Fang Ziye had also clamped down on two relatively healthy blood vessels without bevels.

Seeing this, Liu Faming glanced at Fang Ziye and said with a smile, "Let's put these two hemostats back for now, since they haven't caused any bleeding."

Liu Faming's hand had just been extended when Deng Haibo slapped it away.

"Keep your hook up and be a good assistant to me!" Deng Haibo roared.

Are you kidding me? What if you take away the forceps that Fang Ziye used to clamp the blood vessel?
Liu Faming's skills are still not good enough, and his experience is not deep enough.

Fang Ziye's hemostasis not only stopped open vascular damage, but also vascular damage within the hematoma, which Fang Ziye also effectively addressed.

It was precisely because the distal ends of these two relatively large arteries were damaged that the patient's blood pressure dropped drastically!
By taking this approach, Fang Ziye has, to a certain extent, resolved the biggest source of bleeding from the hematoma at its root.

While Deng Haibo was still in awe of the theoretical accumulation and foundation required for Fang Ziye to make such a correct judgment in such a short time, Liu Faming was about to get the hemostat.

Liu Faming immediately withdrew his hand in a huff, and when he saw that his older brother Chen Minghao was also glaring at him, Liu Faming realized that he had done something wrong.

The only possible reason for making a mistake at this point is a lack of understanding on one's part.

Medicine is a vast field; let's be honest!

After Professor Deng Haibo had sorted out his thoughts, he only asked the key question: "Dr. Fang, do you think that the treatment principle of the one-way valve of the blood vessels for the retroperitoneal hematoma should be compared with that for the retroperitoneal hematoma?"

What would be a suitable location to choose?

"Is it the superior mesenteric vein?" Deng Haibo earnestly consulted Fang Ziye.

Fang Ziye shook his head upon hearing this: "Professor Deng, in my personal opinion, once a retroperitoneal hematoma forms, in addition to vascular damage, it will often be accompanied by damage to solid organs. After all, it is retroperitoneal, and its anatomical structure is different from that of the pelvis and retroperitoneum."

"Therefore, at this point, don't think about any tricks. After blocking the key blood supply artery, just slowly explore!"

Not all surgeries can be improved immediately.

Not everyone can immediately adapt to these tips!
"Okay, Dr. Fang, I'll do as you say."

"Circulation, bring another set of plasma electrosurgical units on stage!" Professor Deng Haibo immediately ordered.

Fang Ziye refused outright: "Professor Deng, this part is almost finished, and the bleeding shouldn't be too much afterward. I'll go back to my specialty: surgery!"

Non-orthopedic consultations can save lives, but non-orthopedic consultations can treat illnesses, for the time being.

We each have our own specialties, and treating patients is the task of each specialty. Saving lives is the responsibility that hospitals and society entrust to medical workers.

Deng Haibo glanced at Fang Ziye, pondered for a moment, and then said, "Then go ahead, Dr. Fang!"

At that moment, Deng Haibo was thinking that Fang Ziye was not Nie Mingxian after all; Fang Ziye did not have the kind of 'empathy' for vascular surgery that Nie Mingxian possessed.

Of course, similarly, Deng Haibo's current thinking shows a lack of empathy for orthopedics.

Fang Ziye took a few steps back, took off his sterile surgical gown and gloves, and went out again to wash and disinfect his hands!
After donning his full gear once more, Fang Ziye approached Wang Yuanqi and said, "Brother Qi, go back and rest. Leave this to me."

No matter how much of an octahedron warrior Fang Ziye is, he is ultimately a trauma surgeon!

(End of this chapter)