novelraw Chapter 346 - 182: All Small Fries—A Perfect Training Opportunity (2)
Chapter 346 - 182: All Small Fries—A Perfect Training Opportunity (2)
Mainly it’s about respiratory parameters, blood pressure, heart rate, and blood oxygen.
If problems arise during surgery, the equipment will emit different alarm sounds.
No medical staff wants to hear the alarms go off.
But all surgeries carry risks, which cannot be fully controlled by doctors and nurses.
What can be done is to make the pre-operative preparation and check as thorough as possible, minimizing the risks.
"The patient’s vital signs are stable, and the anesthetic state is good. Surgery can proceed."
"Let’s begin!"
The nurse had long prepared the skin on the hands and marked the incision sites.
Let’s talk about the importance of marking the incision site before surgery.
A patient was set to undergo knee tumor surgery.
Pre-operative incision marking was required, but the patient was adamantly opposed, heaping insults on the medical staff and being extremely uncooperative.
There was no choice but to send the patient into the operating room after disinfection.
It turned out the surgeon had a very high caseload that day, being extremely busy and frazzled. Without inquiring upon the patient’s entry, the surgery was originally supposed to be on the right knee but was performed on the left knee.
After searching for a long time without finding the tumor, the doctor was quite puzzled.
However, such situations do occur occasionally.
Sometimes it could be due to issues with inspection equipment, or diagnostic errors by doctors, leading some results of low-density or high-density shadows to be misdiagnosed as tumors.
Of course, such errors are relatively rare.
Clinically, any tumor less than 1cm is usually suggested for observation. If there is immense concern, procedures like biopsy are recommended.
Among these risks, there’s consideration that tumors too small might not be found after the incision.
This patient who refused incision marking paid the price for her obstinacy.
The surgery doctor couldn’t find the tumor and could only help her suture up the incision.
As a result, after emerging from the operation room and waking up from full anesthesia, she discovered the incision was in the wrong place and created a great fuss in the hospital.
The surgical doctor, having experienced misfortune, faced disciplinary action, and had to perform the surgery again on her.
However, there was no remedy for the extra incision she endured.
Thus, for pre-operative skin preparation and incision marking, patients must cooperate with the medical staff.
Sometimes throwing a tantrum incurs a particularly heavy price.
At this moment, the patient was under general anesthesia.
For hand surgeries, if minor, usually brachial plexus nerve block is employed.
If the surgery is relatively major and takes a longer time, general anesthesia will be prioritized.
The specific anesthetic plan is determined by the anesthesiologist.
He will devise the optimal anesthesia plan for the patient.
"I won’t elaborate on selecting incision sites in detail; the key is choosing the most advantageous entryway. The principle is to expose the lesion area quickly upon incision while avoiding major blood vessels and important nerves. If a secondary surgery is applicable, prefer the original incision."
Professor Wu patiently imparted surgical experience to the younger doctors.
Given the number of young and inexperienced doctors, it’s necessary to teach them from the basics.
"When making the incision, don’t cut corners; incise layer by layer and control the angle of the knife as much as possible. Qin Fei, you need to change your bad habit of dragging the knife."
"I’ve been working hard to correct it. Recently I practice with pigskin at home every day."
Qin Fei quickly responded.
Dragging the knife and hand tremors are common issues faced by novice doctors.
When operating on a patient, inner tension is an inevitable phenomenon. Only veteran doctors who have gone through numerous battles can remain calm and steady during incisions.
Dragging the knife when cutting the epidermis might not be a big issue — it may only result in a slightly longer incision.
If it happens when cutting important tissues or when removing lesions in the thoracic or abdominal cavity, dragging the knife would invariably lead to an accident.
Dr. Qin’s family is well-off, and practicing diligently with pigskin is sure to greatly enhance his surgical skills.
But compared to Li Jingsheng’s attribute panel, the discrepancy is not negligible.
Even if Dr. Qin buys a ton of pigskin to practice at home for a year, it may still not compare to Li Jingsheng gaining 100 proficiency points in dermal incision directly.
Professor Wu would discover a ’new world’ when bringing Li Jingsheng into the operating room.
"Huang Xiaoren, watch closely how I cut into the subcutaneous tissue. Your incisions look as if they’ve been gnawed by a dog. This instability in knife handling when opening the skin is due to poor hand control. You can practice drawing straight lines with a pencil at home to enhance hand control."
"I understand. After you mentioned it last time, I’ve been practicing drawing straight lines every day. I’m confident you’ll notice my significant improvement in some time."
The reply came from a young doctor around twenty-eight or twenty-nine years old, possessing an ordinary-looking face.
His face bore the pitted scars left from healed acne.
This Dr. Huang seemed not very talkative, a relatively introverted person.
At this moment, he was able to stand at the operating table and was second only to Qin Fei in Group Two.
Li Jingsheng had more or less gained an initial understanding of the members of Group Two.
Poor hand control is a major problem, indicating a lack of surgical aptitude. It not only manifests in this crucial basic skill of incision but also in suturing, inserting, and knotting, appearing ’clumsy’.
However, if one has immense perseverance and can consistently hone surgical skills, there are many examples of late bloomers.
Li Jingsheng knew of such examples, like the Chief Physician of General Surgery at the First Hospital, Luo Zhenggang. His surgical talent was notoriously poor. At thirty, although he had been promoted, his surgical skills were not even on par with trainees.
He was disliked by various senior doctors.
Eventually, through hard work and diligent practice, he became a renowned surgeon in Lijiang City by fifty.
He is often invited by Class Three Grade A hospitals for freelance operations, and it’s said that his fee for a single operation ranges from 5,000 to 10,000 yuan at least.