medical simulator

"Okay!" Zhou Cheng nodded, bid farewell to Zhou Cheng, and then walked directly to the gym.

The body is the capital of revolution...

Unexpected new addition to the Chapter 59 group

After Zhou Cheng finished exercising from the gym, he took a shower when he got home, and when he came out wiping his hair, the phone rang.

It was Luo Yun calling.

"Teacher Luo." Zhou Cheng quickly answered.

"Zhou Cheng, Director Cai just called. He said that he will have an operation tomorrow, but he hired Professor Zhong from Hunan University of Traditional Chinese Medicine who does a lot of manual resets." Luo Yun explained.

"Oh, yes, Teacher Luo." Zhou Cheng replied with a smile.

"Zhou Cheng, don't have any thoughts in your heart. Don't just think that Director Cai has adopted your plan but won't let you get started." Luo Yun continued to enlighten.

Zhou Cheng's tone and expression were completely normal: "No, Mr. Luo, where would I have any thoughts?"

"There are not many opportunities to learn from the professor!"

"If it wasn't for Director Cai to invite Professor Zhong, I wouldn't even have the chance to watch."

"And this kind of patient that even Director Yan dare not deal with, and even the professors of the Affiliated Hospital of Shonan University and the Second Affiliated Hospital are unwilling to accept patients. To be able to experience the manual reduction surgery taught by the professor of the Hospital of Traditional Chinese Medicine is also an increase in knowledge."

Zhou Cheng said cheerfully, but the meaning in the words was not the one expressed to Luo Yun.

Because Zhou Cheng really wanted to see how powerful the associate professor Cai Dongfan hired who was good at reset techniques was, and how he would compare to himself.

He just feels that he is now, probably, probably, perhaps a little better than the average professor in terms of manual reset.

"That's the best you can think of."

"The associate professor is a family heirloom of fracture manipulation, and he has solved many complicated fractures before!"

"I have also done manipulative reduction for many fracture patients who cannot be operated on." Luo Yun talked about the past achievements of the associate professor, and also wanted Zhou Cheng to understand the reason for Cai Dongfan's choice.

After chatting for a few more words, I hung up the phone.

Zhou Cheng didn't think much about it, and completely put the matter behind him, then continued to open his notebook, and began to think about the treatment plan for the special type of fractures, fractures or defects caused by other diseases.

Moreover, this time, Zhou Cheng planned to check the corresponding literature first.

The definition of a fracture is the interruption of the continuity and integrity of the bone, and the bone defect is also a fracture in the strict definition, which fully conforms to the simulated direction of the fracture copy...

Unfortunately, however, cases of bone defects are uncommon.

The treatment of bone defects is also really complicated.

In the simulated copy, Zhou Cheng spent three consecutive simulated opportunities, and the number of bone defect cases he came into contact with was less than [-].

Moreover, Zhou Cheng came into contact with more patients like this when he went to Shanghai to work.

In normal times, it is difficult to encounter such special cases.

Because there are fewer cases of contact, the progress is slower...

But it doesn't matter if the progress is slow, the three simulations only get the bone transport surgery treatment of skill bone defects (common), it doesn't matter, just take your time.

The simulation of the dungeon lies in the step-by-step process and the continuous solidification of the foundation. When the foundation is established and a breakthrough is sought, then take an unusual path.

On the contrary, this allowed Zhou Cheng to conclude the direction for different surgical simulations in the future.

The first step is to read a lot of literature, to study, to watch surgery, to be the surgeon, to acquire basic skills, whether it is entry-level or general.

In the second step, after obtaining the basic skills, perform crazy surgeries to improve the proficiency of the skills to the current world-class level.

The third step is to create new and redefine the perfect level by yourself...

The next day, in the morning.

After the on-duty nurse and the on-duty doctor Zhang Zhengquan finished their shifts, Yan Hanhan did not adjourn the meeting immediately, but asked Cai Dongfan casually: "Director Cai, I heard that you plan to do nerve block incision + technique for that patient. Reset?"

"Well! Yes, my patient and family members have communicated, and they all agree."

"Although there are certain risks to be taken, there is no other better way." Cai Dongfan nodded and replied calmly.

This is a special case, and it is normal for Yan Haihan to be concerned.

Yan Haihan's expression froze, and he emphasized: "Yes. This patient is quite special, and he must take some risks. But safety must be the top priority, and he must communicate with the patient and his family members, and explain the possibility of terminating the operation at any time. "

Yan Haihan didn't directly order Cai Dongfan not to do it. If Cai Dongfan asked him to find a way and push the patient to his own group, wouldn't it hurt?

It doesn't work if you don't deal with it, which is equivalent to letting the patient die.

But safety must still be emphasized.

Cai Dongfan nodded and said yes.

Because this is a special patient, and it is only an incision and exploration with local anesthesia + manual reset, if it goes well, it may be done in ten minutes!

So Yan Haihan talked with other surgery patients and asked them to give up the first surgery unit.

Because it was the director who spoke in person, and the operation time was not too long, and Cai Dongfan's relatives, that is, the patient's family members, went to meet with the other patients and their families to intercede one by one. agree.

Cai Dongfan had already communicated with the anesthesiology department in the operating room, and the head of the anesthesiology department personally managed the monitoring during the operation.

Moreover, Cai Dongfan asked Luo Yun to drive the invited Professor Zhong from Hunan Provincial Hospital of Traditional Chinese Medicine to the hospital early on. After arranging breakfast, he waited in the operating room.

After Cai Dongfan simply checked the room, he asked Zhang Zhengquan and Zhou Cheng, who were on duty yesterday, to complete the medical orders for the patients in the hospital, and immediately took Luo Yun and Du Yanjun out of the operating room.

Without Zhou Cheng.

The main reason is that Du Yanjun's surgery was ranked first and second, and this newly added minor surgery is also Du Yanjun's patient.

After Cai Dongfan took Du Yanjun away, Zhang Zhengquan stretched out his body and said, "Brother Zhou Cheng, don't you want to go to the operating room? This is an associate professor from the Hospital of Traditional Chinese Medicine who is here to do manipulation reset for rare cases!"

"If you want to go, I will handle the doctor's order for you."

Zhou Cheng smiled, shook his head and said, "Quan Zi, you can go if you want, and hand over the patients you want to deal with. I will change the medicine for you, and then you will write the doctor's orders and medical records yourself."

Look, there really isn't much to look at.

In case I went to see it and I didn't come on stage during the operation, what happened to Professor Zhong during the reset process, should I take action or not?

Moreover, if the patient has passed through someone else's hands, then if he takes over by himself, has the broken end of the fracture changed?Is the previous imaging examination useful for reference?

There is a saying in ancient times that doctors do not knock on doors.

Forget it.

Too lazy to take that risk.

Moreover, Cai Dongfan deliberately avoided himself, and he may have his own considerations in his heart. There is no need to hang around in front of him and Luo Yun without hinting, otherwise it will make him and Luo Yun feel that they are right. It seems that there are opinions on stage.

Zhou Cheng had no such idea.

Zhang Zhengquan was obviously agitated: "How dare you do that? Brother Zhou Cheng, you should go."

Zhou Cheng raised his eyebrows and said, "Do you want to go or not?"

"Cheer up!"

"Thank you Brother Zhou Cheng!" Zhang Zhengquan immediately stood up, handed the paper recording the doctor's order to Zhou Cheng, and then ran away.

Looking at Zhang Zhengquan's back, Zhou Cheng was not envious or had any other thoughts. He just felt that Gui Peisheng was really not easy, and he had to work hard to get any chance to learn.

If he hadn't owned an emulator, he would be a copy of Zhang Zhengquan, at most a little bit better than him.

Zhou Chengcheng started to get busy.

Fortunately, the doctor's order for the new patient admitted by Zhang Zhengquan was completed yesterday, and Zhang Zhengquan also changed the medicine this morning. What needs to be dealt with is the change of medicine and the adjustment of the doctor's order for the previous postoperative patients, which can be done in four to 10 minutes.

Zhou Cheng was not in a hurry, and after fulfilling the doctor's orders one by one, he pushed the medicine changing cart and piled up the medicine changing kits to change the medicine...

After about four or 10 minutes, Zhou Chengcai finally cleaned up the rubbish on the medicine changing cart.After throwing the garbage into the yellow trash can with a yellow medical waste bag, he washed his hands slowly and checked all the doctor's orders before rushing to the operating room.

When he arrived at the door of the operating room, Zhou Cheng also checked the time, and it was already [-]:[-].

After stepping on the sensor door of the operating room, he found that besides the anesthetist, Cai Dongfan, Luo Yun, Du Yanjun and Zhang Zhengquan, there were two more people in the operating room.

Zhou Cheng didn't know one person. From his appearance, he was probably an associate professor invited from outside, but the other person was Yang Yifeng who had met Zhou Cheng several times.

Yang Yifeng also put on the surgical gown at this moment and stood on the stage.

After Zhou Cheng walked in, Luo Yun glanced at him, then looked at the time displayed on the timing panel in the operating room, and said nothing.

Zhou Cheng approached Zhang Zhengquan and asked, "Have you done the manual reset?"

"It hasn't started yet. It was reset once before. The patient was in too much pain, so it was forced to stop."

"Director Zeng of the Department of Anesthesiology said that with simple femoral nerve combined with sciatic nerve block, the anesthetized segment will not reach the fracture site!"

"So Yang Yifeng is performing a branch cutaneous nerve block on the patient..."

Branch cutaneous nerve block?

Zhou Cheng was stunned. He had rarely heard of this term. It required a very solid foundation of anatomy and bedside color Doppler ultrasound experience to be able to do it.

This is a very cutting-edge technology in anesthesiology.

Zhou Cheng looked inside, and sure enough, he saw Yang Yifeng was lowering his head, meticulously using a puncture needle to give the patient block anesthesia under the monitoring of color Doppler ultrasound.

This Yang Yifeng is really not simple.

Chapter 60 Dead Bird!

股神经阻滞适应症：1.膝关节镜检查术。2.大腿前部的浅表手术。3.股四头肌肌腱修复手术。4.髌骨骨折手术。5.髋关节和膝关节置换术的术后镇痛。

The range of anesthesia for femoral nerve block is actually at the intersection with the range of surgery for this patient.

If the strength and direction are not selected correctly during reduction, the muscles in the non-anesthetized area will be cut.

It is equivalent to operating on the patient without anesthesia.

Even if the sciatic nerve block is combined, it only temporarily paralyzes the sensation and touch below the knee joint, and the sensation and touch above the knee joint can only be said to be uncertain.

Cutaneous nerve branch block is a better supplement to sciatic nerve and femoral nerve block combined with anesthesia.

It's just that this kind of cutaneous nerve branch block is extremely difficult to control, it is a sophisticated operation, and its applicability is not strong, so not many anesthesiologists will study in this direction.

Zhou Cheng was quite surprised that Yang Yifeng could perform such an anesthesia, but considering that Yang Yifeng is a graduate student in orthopedics, he has a relatively deep understanding of basic anatomical knowledge, and if he can use bedside color Doppler ultrasound, it is not impossible. .

At least, Zhou Chengcheng would not be able to do such a nerve block. He is only an orthopedic surgeon, not an anesthesiologist.

When Zhou Cheng arrived, the block was almost over.

Yang Yifeng then lightly poked the skin near the patient's thigh with the tip of the needle, and asked, "Does it still hurt?"

"No more pain, no more feeling!"

"Ouch, it's much more comfortable."

"It doesn't hurt at all, thank you, doctor." The patient's breathing gradually calmed down.

For him, as long as it doesn't hurt, the feeling is simply wonderful.

Yang Yifeng pulled out the blocking needle and said: "When the patient's fracture end is just inserted into the muscle, the injured muscle is deformed, and there is a certain torque tension. If any force is applied at this time Lateral stress will generate greater cutting force and severe pain."

"The pain receptors in our muscles are extremely sensitive to the force of the cut."

"So if you add the respective blocks of the branches of the cutaneous nerve, you can avoid this situation to the greatest extent."

"However, this is only a short-term block. I estimate that it can only last for about 30 minutes at most. Teacher Cai, Professor Zhong, is this enough time?"

Hearing Yang Yifeng's words, the director of the anesthesiology department, Director Zeng, said with a smile: "Enough is enough, it must be enough."

"Today I have gained a lot of knowledge. I heard people talk about this kind of branch cutaneous nerve block at the academic exchange meeting before. Very few people know it. I didn't expect that Xiao Yang, you can do such a block operation. .”

"I really hope you can come to our anesthesiology department!"

Cai Dongfan probably felt that the big problem of anesthesia for patients has been solved now, so he joked: "Director Zeng, Xiao Yang is Professor Ding's precious student, if you fool him into the anesthesiology department."

"I guess Professor Ding would not mind letting you see the fists of the old professor of orthopedics."

The corner of Director Zeng's mouth twitched, remembering that he couldn't even beat Cai Dongfan in a one-on-one fight, let alone one-on-one with Professor Ding and a large group of disciples and grandchildren...

Just shook his head: "I was just joking."

After Yang Yifeng finished the anesthesia, he said, "Teacher Cai, Professor Zhong, I'm done with the anesthesia, so I'll step down first."

After speaking, Yang Yifeng was about to take off his clothes.

"Xiao Yang, don't step down. The manipulation of the femoral bone reset requires a lot of strength, and one more person will add more strength." Cai Dongfan was a little stunned.