Chapter 231 228. Surgery Case Seminar at Ormitz Fortress General Hospital [4]

Salson is the son of a capitalist. Although he is not as strict as Bergert's tutor, the resistance he encountered on the road to becoming a surgeon was consistent, and their father did not agree to choose surgery.

Two college students with the best medical grades could have easily become the ranks of internal medicine physicians, but their master's and doctoral teachers actually looked for professors of anatomy.

I didn't do a good job in internal medicine, but I actually went to work as a drill. The difference is not only my income, but my status is much lower.

If the Bergers originally hoped that he could inherit the family's political assets, the gap between internal and surgical departments would not be too large. Salson, who was born in a civilian family, was counting on the status of an internal medicine doctor to get to the upper class.

With society building bridges, there is a huge difference between internal and surgical departments.

Under such pressure, this young man in his early 20s survived and walked on the path he chose.

Unlike Bergert's admiration for Ignaz and Melen's desire to show his abilities in front of everyone, Salson's attitude towards surgery is not mixed with other factors, so it seems purer.

Just a simple love.

This purity also made him act more resolutely when choosing his own path.

In comparison, Salson's father-son relationship with his father is much sharper, far less harmonious than Bergert and Krish's performance. You can see the relationship between the two father-son pairs on the issue of joining the army.

gap.

The two fathers and sons on the Bergt held a unified opinion. Since they were heirs of titles and were unreasonable to not go to war, the insurance in the army could also raise their identities for future succession of titles.

Salson had a big fight and ran away from home. The ward is now his home. But the young man is fearless. In his eyes, family and parents are important, but what really makes him excited is that

surgical.

Interest was his motivation, and four months of training and several surgeries Yu Kawei did together became a real accelerator.

"Everyone starts with ignorance. Opportunities are equal to everyone, it depends on whether you can seize them."

Kavi showed a completely opposite side to Ignaz. He was very confident in this young man and dared to hand over power: "In the points reward system, even the emergency doctor who simply bandaged Ronalne was also

No exception. His name has been recorded as three points by me, and the third army's director of surgery is also recorded as three points.

It is not easy for doctors who are not in the Fortress General Hospital to return to the hospital. They need to consider the establishment of the military military medical department, and they cannot be changed by simply saying it.

So those doctors who cannot leave the hospital will receive a expensive bonus when leaving the army. As for how much they can give, Kavi has not set a number for the time being: "These things are not important, what is important is Ronagne

.So, do you know the method of measuring cerebrospinal fluid pressure that I just mentioned?"

From symptom judgment to simple numerical judgment (80-180mm water column height), the judgment criteria are more concrete, and the difficulty of understanding should be reduced.

But the doctors who have no research on neurosurgery in the audience have even more question marks on their foreheads.

It has always been said that the abdominal cavity is a forbidden area for surgery, but it is simply because they have been there and found that there are too many difficulties and then retreated. As for the brain, many people don’t even have the courage to open it, and the concept is not on the same level.

After all, only places where you can walk can be called forbidden zones. Places like deep seas, volcanic magma should not be

It is really not touched at all, and I don’t even understand the most basic concept: “If intracranial pressure is really the cause of death, then why should I choose to measure it in the waist? The skull cavity and lumbar spine are apart from one hundred and eight thousand miles.

Can they be connected?"

"I also find it very strange. The brain is the brain, and the spine is the spine. Even if they are called the nerve center, there should be obvious differences between them."

"Unless the brain and the spine are connected together, this can explain why intracranial pressure can be judged by the fluid pressure in the spinal cord."

"This is so ridiculous, how can it be connected?"

This is probably the difference between ordinary people and top students after studying in higher education institutions. The questions arising from a clinical examination were actually turned into an anatomical problem. Kawei was happy that they discussed it, and he could not support it by relying on himself alone.

Start this seminar.

As for whether the brain and spinal cord are connected, it was actually concluded last night.

"You probably didn't see the lumbar puncture last night, did you?"

"I didn't see it, I'm taking a break."

"I was in the operating room and went to bed after that. I only heard about it this morning."

"So too, I've been so tired these days."

"That's a pity. Lumbar puncture, the first case of lumbar puncture in the world! Who would have thought that it would be magical to penetrate the spine directly from that position with a silver needle."

The doctor spoke so vigorously, but there seemed to be not much surprise to the others in the conference room: "Well, it seems that you have seen too many 'world number one', and the word "is not much impact" is no longer enough.

Now.”

"Can a simple puncture prove that the fluid and spinal cord of the brain communicate with each other?"

"I used methylene blue yesterday," Kavey said, "The stain can explain the relationship between fluids in the spinal cord of the brain very well."

"Yes, yes, it's methylene blue! I watched the whole process of lumbar puncture in the ward yesterday, which was amazing. I simply inserted it from the skin at the 3-4 level of the lumbar spine with just a thin trocar needle.

, the depth is about 2cm. After pulling out the needle, you can see blue liquid flowing out drop by drop."

Methylene blue is inherently antibacterial and can be used as a tracer, so it is best to use it at this time.

Everyone in the audience recognized the function of the dye. Since it can pierce the blue liquid from the waist, it can basically prove that the liquid in the cranial cavity and spinal canal is common.

The entire cognitive transformation process is the same as when Heinrich Quak, the first person in lumbar puncture, proved that the craniospinal connects, but the dyes chosen by the two were different. This neurologist who practiced both inside and outside the Germany used it.

Red mercury sulfide.【1】

At this time, Quak was still a 24-year-old young man. He might have just graduated from Berlin Medical College. As for whether he joined the army, it is unknown.

"Since everyone has agreed with my point of view, the increase in intracranial pressure is a problem that Ronalne must face now." Kavi sighed, "His cerebrospinal fluid pressure is twice that of an ordinary person, but unfortunately it is

, I have no choice but to do everything I can, and I can only recover slowly by himself."

"I heard that his body temperature is also rising?"

"The body temperature exceeded 39 degrees Celsius this morning, which is a normal reaction after the brain trauma surgery, and almost everyone will do this." Kawei still has no choice, "As it said, we have done our best, let's see him next

Just do it yourself.”

“We will pray for him.”

Ronalne revealed this, and what Kavi wants to talk about next is another kind of firearm injury.

"Bed 55, bed 63, bed 71, bed 94. These are all chest firearm injuries." Kawei flipped through the medical record book in his hand and said, "I saw from the medical record that the people's handling was pretty good. I sent it to you.

There are a total of 38 chest firearm injuries here, and the mortality rate is temporarily at 45%.

The number of wounded people is not large, which is not a pleasant proportion. Because the mortality rate of chest firearm injuries is no lower than that of cranial firearm injuries, those who can be transported to fortress hospitals for treatment are the lucky wounded people.

The chest cavity is not as good as the abdominal cavity. The closed chest cavity is the prerequisite for the lungs to breathe, so it cannot be opened easily unless it is absolutely necessary.

In fact, even if it is turned on, surgical technology at this stage will only increase damage, and even Kawei will not do anything too much. Moreover, there are rich nerves in the pleural cavity, which are very sensitive, and a slight stimulation will produce nerve reflexes.

, and the injured person is seriously injured in physical condition, and reflex shock may occur if he is not careful.

The bullet cannot be removed without opening the chest cavity. What the surgeon can do is simply bandage and stop bleeding, simple wound suture, and give a simple respirator, and methylene blue.

Those who died of chest firearm injuries are often caused by uncontrollable bleeding or fatal heart damage. In this case, God can only say a few words about Hallelujah with a headache, and then return to him

Stay quiet where you should go.

"These 38 chest firearm injuries have survived more than half of the number, and even a considerable number of them have stabilized. They are all attributed to your diligence and serious work." Kavey rarely praised it, but it was not enough in the audience.

Hearing his extra points, he was choked back, "Doctor Lucius, please come on stage."

"I?"

A tall and thin man stood up from the audience, wrapped in a cotton coat, his hair was messy, and his face was not energetic. It seemed that he had just started shouting from the bed, and then followed someone to the conference room for no reason.

He raised his hand in disbelief and pointed at himself, then left the seat helplessly.

Lucius felt as if he was dead, but he still wanted to resist a few words to show his dignity as a surgeon: "Doctor Kavey, if I have something wrong, I just say it straight, there is no need to make it so complicated.

.If what makes sense, I agree, and I agree with the points deducted."

"You misunderstood. I didn't say you were wrong. Don't be nervous, I'm not a mad dog that bites everyone."

Kavi did not lie this time, and his performance in these three days made Lucius a completely positive image.

Although the medical records are not as detailed as Salson, they are better than comprehensive and are good at grasping the key points. Apart from the sloppy handwriting and the recording position is unkempt, there is no disadvantage. He has nothing to be picky about in terms of surgery, at least in these two

More than a dozen main surgeons can reach the upper and lower level.

The most important thing is his judgment ability.

It is rare to catch a positive person, and Kawei has to use it, making him a typical representative of the consolidated points system: "The wounded in bed 1175 should have arrived yesterday afternoon, right?"

"Yes, yesterday afternoon." Lucius exclaimed that something was wrong when he heard the bed number, "Doctor Kavey, Dean Kavey! I really tried my best yesterday. I was concerned about his situation while operating on bed 1324. The operation was over.

After that, I stayed by his bed, it was really.”

"I understand, I understand, don't be nervous." Kawei continued to soothe his nervousness, "It's just a case discussion. Deaths are also cases, let's talk about the situation."

Lucius had no choice but to briefly introduce the wounded: "I don't know which unit he belongs to, and I didn't hear anyone talk about it when he was sent. Anyway, he was wearing an imperial uniform, he should be from a certain infantry regiment.

Soldier. He was seriously injured, and probably more than a dozen shrapnel pierced directly into his chest and abdominal cavity, causing serious bleeding.

At that time, my blood pressure was still around 80/35, and my heart rate was very fast, and I should have been above 130. I urgently asked for a blood transfusion because I knew that infusion alone could not save his life."

When Lucius said this, he paused for a moment, and Kavey looked at him and asked, "What's wrong? Why don't you continue?"

"Okay okay, I admit, I admit I hesitated at that time!" Lucius sighed, and slapped his head and paused, "If I were more determined at that time, if I pulled him right away, I would pull him right away!"

Go to the operating table and open his abdominal cavity. Maybe there is still a chance."
To be continued...