859 Why is there no preoperative signature?
"Section Chief Wu..." Director Zhou had already completed the operation, but was still wearing a surgical gown and stood in front of the stage to observe Wang Chengfa's situation.
He heard the footsteps and saw that it was Wu Mian coming in, and he hurriedly said.
Wu Mian didn't say anything, first glanced at the ventilator and monitor, and saw that the value was stable and then looked at Wang Chengfa lying on the operating table.
Wang Chengfa has changed to a state of general anesthesia, and his chest is undulating with the rhythm of the ventilator.
On his lips and the corners of his mouth, you could still see the blood that had just been wiped off and was not wiped clean in the rush.
"Section Chief Wu, Director Wang is in a stable condition." Dean Zhou said embarrassedly when he knew Wu Mian was angry.
Wu Mian lifted the sterile sheet, glanced at Wang Chengfa’s abdomen, and asked, “Is it made of a supral incision?”
“Yes, yes.”
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"Director Zhou." Wu Mian said in a deep voice, "It's not that I blame you, you are also an old urology surgeon. You have had at least a few hundred prostate surgeries. How can you not even know about electroresection syndrome?"
"..." Dean Zhou looked like a child who made a mistake, lowered his head and said embarrassedly, "I usually do supraptic incisions, and the patients who open the bladder are very stable. Who knows what happened this time?"
Wu Mian sighed and said, "Tell me about the specific situation."
"Lao Wang's blood routine after admission: Hb 96g/L, renal function: creatinine urea nitrogen blood sugar 9.2mmol/L, abnormal renal function is considered to be caused by long-term renal obstruction, and the urethra catheter is retained. Re-examination of renal function: creatinine urea nitrogen preoperative diagnosis: 1. Prostate hyperplasia. 2. Chronic urinary retention. 3. Chronic renal insufficiency."
While speaking, Director Zhou looked at Wu Mian, afraid that he would not say anything right, Section Chief Wu kicked himself on the wall.
The blood splashed by the human traffickers is still vivid in my mind. Dean Zhou believes that he is in good health, but he definitely can't withstand Section Chief Wu's feet.
But after hearing these medical history, Wu Mian refused to comment, so President Zhou could only continue to talk.
"The prostate resection was performed in the suprapus incision under the suprapus. During the operation, 5% mannitol rinsing fluid was used. After about 35 minutes of the operation, Lao Wang coughed. At that time, I asked him if he had any special feelings, and Lao Wang said there was nothing uncomfortable.
During the operation, the vital signs were monitored smoothly, the operation went smoothly, and there was not much bleeding. After about 45 minutes, Lao Wang suddenly began to get restless when the operation was about to end.
He didn't speak, he was confused, and there were pink blood foams spewed out from his mouth and nose."
Wu Mian said this medical history to report... and asked, "How much salt water did you use to rinse it?"
"Uh..." Dean Zhou was stunned for a moment.
Wu Mian glanced at the tour nurse.
"Secretary Wu, 5,000ml of normal saline." The nurse was still very smart. She applied ten bottles of 500ml of normal saline, which was nothing difficult to calculate.
"How many are drawn out?" Wu Mian continued to ask.
President Zhou and the nurse were confused. Chu Zhixi hurriedly ran to the bucket of the attraction, and after calculation, he said, "Brother, take out about 3150ml."
"Director Zhou, do you know what prostate resection syndrome is?" Wu Mian asked.
"..." Dean Zhou was speechless.
Wu Mian didn't explain, moved a chair and sat next to the ventilator, saying, "Check blood and gas analysis, are you serum ions?"
"No……"
"Check, call the laboratory and let them get the results as soon as possible. Give 250ml of mannitol, and give another sodium bicarbonate. Make blood, and get the time to give 200ml of plasma." Wu Mian whispered.
The nurse on the tour just relaxed, but when she saw that Section Chief Wu looked bad, she felt a hype. She tried hard to remember the various doctor's instructions that Section Chief Wu had just said, and the person ran away and started to collect blood without touching the ground.
The venous blood was drawn out smoothly, and the needle could not enter when the arterial blood was collected.
Chu Zhixi whispered, "I'll do it."
The nurse looked at Chu Zhixi gratefully and saw that she skillfully touched the position of the femoral artery, disinfected, inserted the needle, and drew out the arterial blood, and completed it in one go.
"Xiao Chu, you are so skilled." The nurse whispered.
"Go and send blood quickly and tell the laboratory department to get the results as soon as possible." Chu Zhixi reminded.
"Oh oh oh." The nurse of the tour ran out immediately. Dean Zhou was worried and called the laboratory department to hurry up and do it.
After 20 minutes, the results were rewarded one after another.
The electrolyte blood gas analysis prompted that after a series of disposals, Wang Chengfa's consciousness recovered and he could open his eyes.
The peripheral blood oxygen saturation is maintained above 95%, and the heart rate on electrocardiogram monitoring is 97 times per minute. Respiratory 1 is maintained with a ventilator for another day." Wu Mian frowned and said, "Does any nurses understand the ventilator below?"
Dean Zhou shook his head.
"Girl, call Li Qiong and ask her to do some help." Wu Mian said.
"good."
After saying that, Wu Mian stood up, "Director Zhou, this should be over. Urethral prostate resection syndrome, also known as diluted hyponatremia.
It refers to the diluted hyponatremia and excessive blood volume caused by rapid absorption of the irrigation fluid after surgery after surgery. "
"Yes, yes, yes." Dean Zhou didn't know if he understood Wu Mian's words, so he just responded repeatedly.
"Pulmonary edema, brain edema, heart failure and consciousness disorders are the main complications, so be careful." Wu Mian thought for a while, "Girl, ask Wei Dabao what he is doing, let him come and see him for a day."
"If the re-examination results are fine tomorrow, it will be fine," Wu Mian said, "Director Zhou, have an operation..."
Wu Mian wanted to say a few words, but when he turned around, he saw Dean Zhou lowering his head, as if he was listening to his words carefully, he couldn't help but feel relieved.
He sighed.
It is inappropriate to leave at this time, and at least you have to wait for Wei Dabao and Li Qiong to arrive.
He picked up the medical records on the anesthesia flat car, turned around and sat down, and said while looking through the medical records, "Director Zhou, go back and read the book first. If you have any questions, please ask me any time."
"Yes, yes, yes, I know Section Chief Wu." President Zhou still said yes like a third grandson.
As soon as he finished speaking, Dean Zhou suddenly felt that the air around him was stagnant, and the sound of icy crackling could be heard vaguely.
This is...Director Zhou raised his head in confusion, not knowing what happened.
Wu Mian sat on a stool in the operating room, turned around, holding the medical record in his right hand, and the paper signed before the operation appeared in front of Dean Zhou.
"Director Zhou, why didn't there be pre-operative signatures?!" Wu Mian asked in a tight voice.
A thunder fell on Dean Zhou's head, making a loud noise, and blind voices were heard.
The patient had an accident without the signing of the operation. Isn’t this a sudden rain?
How could it be? It should not be possible!
President Zhou quickly recalled everything in the past.
Chapter completed!