medical simulator

For the first surgery, Cai Dongfan brought Zhou Cheng and others down at 08:21!

After the operation, the time for the patient to leave the operating room is 08:27!

The Department of Anesthesiology and the tour completed the operation turnaround of sending and receiving patients and anesthesia in 27 minutes, and they are already stepping on the hot wheels in the dark.

Little sister An Ruo felt that the soles of her feet were a little hot, and her wrists were also a little hot.

This is a precursor signal of lactic acid accumulation during short-term overload exercise.

After the anesthesia was finished, he leaned back on the chair used by his teacher to rest a bit suspiciously, while Zeng Yi stood up and went to the operating table to watch Zhou Cheng's operation.

Under the timing panel in the operating room, Wang Yongjin, Zeng Yi, Dou Chengpeng, and Yan Hanhan No. [-] Middle School were sitting there holding a clipboard, as if they were going to evaluate the second operation very seriously.

Yan Haihan, who knew the operation situation best, quickly explained: "Director Wang, Director Zeng, Section Chief Dou, this second operation is a fracture of the lateral malleolus. From the professional point of view of our orthopedics department, this operation is strictly open surgery."

"The alternative to the surgery is the second one, which is to put a locking plate on the outside."

"This time, these scoring rules can be used."

Wang Yongjin also said: "This operation is a routine orthopedic operation, more routine than the previous one, and it is already one of the very mature surgical methods."

Dou Chengpeng breathed a sigh of relief.

But because of the lessons learned just now.

He still flipped left and right, and then looked at the detailed surgery scoring rules, but there was no surgical plan like the one with a few simple ones for the previous surgery, which made him breathe a little.

He replied calmly: "Well, in fact, it is mainly based on the four majors of Director Wang, Director Zeng, and Director Yan."

"I'm an outsider."

Dou Chengpeng began to show weakness with lingering fear.So as not to die again.

After watching Cai Dongfan and the others, Zeng Yi did not expose his calf like the first one, but took a few steps back after applying a sterile film: "An Ruo, this time it must be an operation. Look, the sterile drape for surgery has been done."

Zeng Yi knew that two anesthesia machines in a row would consume a lot of physical strength for the anesthesiologist.

Anesthesiologist is a professional technical job, even if Zhou Cheng forced her to do physical work, it was hard enough for a female student like herself.

An Ruo nodded, not daring to think about anything, just stood up, gave up his seat to Zeng Yi, then sat on his small round stool, nodded and said, "Yes."

Very well-behaved, very sensible.

Because she found that if she doesn't complain, she will actually feel much more comfortable, and complaining will not reduce her workload.

In fact, it is a matter of resignation.

Cai Dongfan didn't have the business of welcoming people, so he participated in the whole operation, including disinfecting the towels.

Finally, everything is pending.

Cai Dongfan stood in the first assistant position and said to Wang Yongjin and others: "Director Wang, Section Chief Dou, we are starting the operation."

Wang Yongjin and others saw that Zhou Cheng had already raised the round knife, so they stood up quickly.

Then they walked slowly to the operating table one by one.

Zeng Yi wiped his forehead with the back of his hand.

Anyway, you took a scalpel, unlike the first one, which said it was surgery, but didn't even mention the scalpel, but it was ready. Isn't this a waste of resources and a burden on the patient.

Of course, I just think so in my heart, I don't know how many patients expect and desire such a 'burden'!

The operation can be completed without using a knife, and then it only costs a few extra dollars for the scalpel, which cannot be done elsewhere.

Do you think he would be happy?

An Ruo also settled down, patted her chest, took a long breath, and then began to rest.

"Start the operation!" Seeing Zeng Yi and others approaching, Cai Dongfan immediately ordered Zhou Cheng.

Zhou Cheng had already prepared, and Luo Yun and Cai Dongfan had already exposed the patient's lateral ankle, which was just right for the direction and position of Zhou Cheng's knife.

However, after Zhou Cheng lifted the knife, he put down the round knife again, and after thinking about the type of fracture for a while.

Zhou Cheng shouted to Liu Yan, the itinerant nurse: "Sister Yan, please give me a Kirschner wire electric drill first."

Liu Yan was taken aback when she heard this.

For this operation, what Cai Dongfan told her was to cut it open first, then temporarily fix it with Kirschner wires, and then put on the steel plate?

Liu Yan looked at Cai Dongfan.

Cai Dongfan's small eyes rolled around: "Electric drill with Kirschner wire."

On the side, Wang Yongjin also noticed a slight change in the operation procedure, so he quickly explained to Zeng Yi and others: "Xiao Zhou changed the operation strategy a little bit, first fixed it temporarily with Kirschner wires, and then followed the progress of the Kirschner wires. Needle-point incision can be more precise."

"It can also reduce the incision for patients to place the steel plate."

Wang Yongjin used to have surgery on the toes from the atlas, so he knows more about fractures of the lower limbs than Zeng Yi, who assigned the lower limbs to the second department of orthopedics several years ago.

Dou Chengpeng glanced at the sixth item of the operation procedure, and he found this out.

Immediately nodded secretly, said: "In order to reduce the length of the surgical incision for the patient, this is a good thing. But it won't affect the patient's recovery, right?"

Wang Yongjin shook his head: "No, and the inner ankle is also protruding, even blind typing is quite troublesome."

"That's fine, that's fine."

Dou Chengpeng nodded hurriedly: "After all, quality is the priority."

After Wang Yongjin said so, Liu Yan could only temporarily pass the Kirschner wire to Zhou Cheng.

Then Zhou Cheng inserted the Kirschner wire in one direction, from outside to inside, without much hesitation.

Immediately afterwards, Zhou Cheng said again: "Sister Yan, give me the other Kirschner wire too!"

Liu Yan was not suspicious, so she gave the Kirschner wire over.

But this behavior made Cai Dongfan a little confused, why are you giving so many Kirschner needles?

The more Kirschner wires, the better.

"Zhou Cheng, the fracture of the medial malleolus is too large, and the fixation effect of the Kirschner wire is inaccurate." Cai Dongfan hastily reminded.

"I know, Teacher Cai." Zhou Cheng had already stood in the chief knife position at this moment, so he naturally knew about this.

However, he already has his own surgical plan.

Class II surgery, immobilization of the medial malleolus.

Just as he was talking, Zhou Cheng made another Kirschner wire form a certain angle with the first one, and sent the Kirschner wire in.

After finishing these, Zhou Chengcai said: "Sharp knife!"

Cai Dongfan wasn't suspicious, instead he let out a sigh of relief.

Fortunately, Zhou Cheng didn't yell, "Teacher on the tour, push down the C-arm machine, otherwise, he will really hit someone on the operating table."

Liu Yan handed over the sharp knife.

Zhou Cheng took the sharp knife, and then made an opening of about 0.6cm at the insertion point of the first Kirschner wire, which directly penetrated into the bone end.

Cai Dongfan frowned immediately after reading it, and Luo Yun reminded: "It's better to peel it slowly with a sharp knife."

"There are no nerves or blood vessels at the protrusion of the outer ankle, Mr. Luo." Zhou Cheng replied.

The sharp knife was pulled out, and then a second parallel opening was made again at the place where the second Kirschner wire was inserted.

Seeing this, Cai Dongfan's expression changed drastically!

People are stupid.

what are you doing?

The principle of surgery is that if one incision can solve the problem, never make a second incision.

You can even extend it up and down, and do not make parallel incisions. Parallel incisions will be used unless they are used for tension-reducing sutures.

But now?

Cai Dongfan's scalp was slightly numb.

Zhou Cheng has already fallen, and it is impossible to turn back. It is impossible for Cai Dongfan to dismantle Zhou Cheng's platform on this one, but he is secretly thinking about how to deal with it, how to explain this to Dou Chengpeng later. The mouth is good.

Luo Yun was also taken aback, his glutes pinched with tension, and his hands twitched a little, but he didn't speak.

Yan Haihan inadvertently said: "Uh."

Immediately, Wang Yongjin and Zeng Yi glanced at Yan Hanhan, and each squeezed their throats.

Uh-huh.

It was as if the collective had suffered from pharyngitis at the same time.

Signal him to shut up.

Dou Chengpeng doesn't understand majors, so don't demolish your own platform.

Only then did Yan Haihan come to his senses and did not speak.

Zhou Cheng put down the sharp knife, and saw Cai Dongfan kept giving him eyes, almost bursting into flames, asking him what he was doing.

However, when Zhou Cheng returned the sharp knife to Liu Yan, he patted Cai Dongfan's hand lightly, and said in a low voice, "Teacher Cai, don't worry, I have the bottom of my heart."

"Sister Yan, give me two headless compression screws, one 5.5 and one 4.5!"

After hearing Zhou Cheng's words, everyone's brains went down at that time.

Only Luo Yun suddenly looked up at Zhou Cheng in amazement, as if he understood Zhou Cheng's intention.

The headless compression screw is a single fixation screw used in posterior malleolus fractures. It has a very strong fixation force. It is also feasible to use two screws to fix the lateral malleolus.

What Zhou Cheng has to do is to make the incision as small as possible to minimize the trauma...

But he is also too courageous! ! !

Liu Yan handed the headless compression screw to Zhou Cheng, only to find that the eyes of Cai Dongfan, Zeng Yi and others were a bit strange.

But he didn't say anything to stop her, and he didn't intend to take over the operation, so he had to listen to the surgeon first.

After Zhou Cheng took the screw, he put pressure on it and began to screw it in.

This twisting process is neither fast nor slow, it is a laborious work.

……

While Zhou Cheng was doing all this, Luo Yun appeared next to Cai Dongfan's ear and explained in a low voice: "Director Cai, what Xiao Zhou is doing now is to use headless compression screws to fix the medial ankle. This is infinitely repeated." Shrunk the incision."

"This method, currently in trauma surgery, is a cutting-edge small incision surgery."

"Madou and Kyoto have already started to do it."

Cai Dongfan immediately felt struck by lightning.

Looking at Zhou Cheng, he continued to push the screws into it with a calm expression, and suddenly felt that Zhou Cheng seemed to have driven the nails into his heart, constantly pressing and blocking his coronary arteries, feeling uncomfortable like being squeezed .

Cai Dongfan was not stupid, so he understood Luo Yun's words.

But the word frontier made his scalp numb.

Cursing in my heart, Zhou Cheng, Zhou Cheng, don't fucking hurt me, I gave you a military order in front of Zeng Yi, frontier surgery?

You call this a class II operation?

……

Luo Yun then took a few steps back, pulled Zeng Yi, Wang Yongjin and others aside, and explained again: "Director Wang, what Zhou Cheng is doing this week is the cutting-edge small incision for fractures that has great potential in trauma surgery. Reduction and internal fixation."

"His process and choice are correct. In the posterior ankle fracture, many doctors have performed closed reduction."

It's okay if Luo Yun didn't say anything, but when it was clear, the four of Wang Yongjin became at a loss.

You look at me, I look at yours.

Then, it was Dou Chengpeng who looked through the grading rules prepared for him by the Orthopedics Department, and asked, "Then how do you score this?"

"It's not written on it either?"

"Director Wang, then I will score with you?"

Dou Chengpeng's words made Wang Yongjin's eyes and upper body twitch slightly.

After pondering for a full five seconds, Wang Yongjin tilted his head slightly, and said apologetically to Dou Chengpeng: "Well, Section Chief Dou, I can't rate it, and I don't know how to do this kind of surgery."

Dou Chengpeng looked at Zeng Yi and Yan Haihan.

Zeng Yi and Yan Haihan could only bite the bullet and learn from Teacher Wang Yongjin, and stood closely behind Teacher Wang Yongjin.