Chapter 238 234. Litokwa's personal diary [2]

Littokva comes from the outskirts of Graz. His father is an ordinary clerk in the political agency. His strong learning ability allows him to enter the Medical College of Graz University. After graduation, he entered the largest hospital in the local area and became a surgeon there.

If we look at it from the 19th century perspective, his surgical ability should be of medium to upper level.

Although not as good as Hills and Herman, he can also preside over amputations and some ordinary facial surgery. After all, Graz's medical level is one level lower than Vienna, and his teacher is not Ignaz, so his basic skills must be poor.

Go on some.

After a brief training, he failed to pass Kawei's surgical examination and has now become a doctor in the army.

Life in the Cravortex Battalion was not only monotonous but also short. He was sent to the rear hospital less than two weeks after he entered the army. However, his luck was pretty good. At least the shell on the morning of the 27th did not take away his hands and feet.

, otherwise I would have to say goodbye to medicine in this life.

This young military doctor had a great understanding of this and praised the surgical level of the Fortress General Hospital in his diary. [1]

In today's surgical atmosphere, amputation is still the first choice for limb surgery, but the Fortress General Hospital often conducts limb protection surgery, and the success rate is very high. While praising this surgical method, Litto, as a surgeon,

Kwa said it was impossible not to be surprised or moved.

Especially that night, Ronalne completely refreshed his understanding of surgery, and all of them were written into his diary:

[It was such an amazing rescue, which directly interrupted my description of the battlefield yesterday morning.

In order to accurately record the entire rescue process, I had to stop the diary of September 27 and open it directly for September 28. It is now at 11:48 pm on September 28, and Ronalne was sent in.

My ward.

The abominable Prussians directly pierced his head, his skull ruptured, and his brain was also broken.

This is almost a mortal situation. Not to mention that I have never seen such trauma, even if I have seen it, I don’t know what to do. Excerpt the broken part? Maybe there is really only one way to remove it, after all, Graz Medical College

This is how medical professors teach surgery.

But can you survive after removal? There may be only one answer, but the operating room of the Fortress General Hospital rescued this guy from the God of Death.

Now that Ronalne's head is missing, part of his brain may have been cut off, and his whole face is swollen. Just now, just now, less than an hour ago, Dr. Kavi solved it at his bedside again.

He had a tube for his blood pressure problem.

To be honest, I can't imagine why a puncture tube was placed on the waist when the brain trauma was used. However, this operation lowered his blood pressure very well. The heroic soldier who charged for the empire survived. Although he had not woken up yet,

I know his heart is still beating.

I have never seen such a surgical procedure, and I don’t know what made him survive?

Is it his strong and unyielding will to survive?

No, I have seen some trauma in the brain. Even if it is just ordinary trauma, it is difficult to survive. The head has always been the deadliest part of human beings.

Are they the new medicines in the medicine box? Or are they superb surgical procedures?

I asked the nurse who was in charge, but said I didn't know. I asked the ward assistant here, and they also said I didn't know. The doctors who could go on stage to see the whole process of the operation are either sleeping or busy now, and no one can answer

I!

Damn it! It's really hateful!

Why didn’t I pass that assessment? If I pass the assessment, I might have learned it now. No, I shouldn’t be so arrogant, at least I can see this operation!

I really want to go into the operating room and take a look and see how Dr. Kavey and his assistants operate!]

This is the text written by Litokva at 0:35 on September 29.

At that time, Ronalne's craniotomy and debridement surgery had only been around for a while, causing severe cerebral edema, and his blood pressure rose from 140/84 to 155/98. If nothing unexpected happened, Ronalne would definitely die of cerebral edema that night.

Like brain hernia, it is like other wounded people with craniocerebral trauma.

However, Kawei temporarily solved this problem with lumbar puncture and lumbar pool drainage.

At that time, Litokva could not see clearly the situation on Ronalne's bed, and there were doctors and nurses around him. Even if he finally stood on his bed, he could only barely see the bow posture of Ronalne's sleeping side and Kavey.

back.

As for how he did lumbar puncture and drainage, Litokwa couldn't see it at all.

Close the diary, his first midnight was quite difficult, and his mind was repeatedly scrolling through Kawei's teaching content to the doctors around him:

[The exposed position requires the side lying position with "hugging the head and bent the knees", and the waist should be perpendicular to the bed]

[Maintaining the patient's body posture is very important, which will affect the success rate of the operation. For example, Ronalne just lying on the flat side without a pillow. Now when doing a puncture, he must give him a pillow to prevent his head from affecting his body posture when he is facing downward]

[You must pay attention to the scope of disinfection. The scope should be large to prevent one gap from entering. You can use another gap]

[Please pay attention to the sliding of the skin when entering the needle, and fix the fingers well. If the soft tissue of the skin is not fixed, the tip of the needle will go wrong. It is not that your needle entry posture is crooked, but that the internal structure is crooked, remember!]

[If the first needle penetration is not successful, you must not try it repeatedly around. There are other tissues and blood vessels around it, so it is very easy to cause damage. The correct way is to exit the needle under the skin and then accurately locate it.

, Insert needle]

[There is a sense of breakthrough after inserting the needle, but it cannot be entirely based on a sense of breakthrough, because some patients and wounded give people a different feeling. Sometimes.]

Kavi said a lot during the operation, from preparation to injection to the final drainage, he said everything. However, because Ronalne's condition is different from that of ordinary patients, and the doctors around him are also asking questions, so

There is not much that really allows Litokva to record.

These are just a small part of them, and they are very detailed, but what Litokva really wants to know is not these details.

It cannot be said that these details are not important. It can be seen from Kawei's wording and expression that details are very important for lumbar puncture. But before pursuing details, he wanted to know one thing, that is, where is the puncture worn?

Is it going through the ligament and entering the spinal canal?

Litokwa heard the cerebrospinal fluid and also heard the doctor beside the bed after the puncture:

[Sprayed out, cerebrospinal fluid sprayed out!]

[It's so amazing that it can actually spray out, and the pressure is the same as the blood in the blood vessels!]

[This pressure is probably more than 300mmHO. After some release, I will make a simple measurement.]【2】

Litokwa knows cerebrospinal fluid, a medical term that has been identified in the 19th century [3]. The medical school’s anatomy course also taught the relationship between the brain and cerebrospinal fluid, but after the understatement, the medical students who can record it

Not many.

After all, brain anatomy cannot affect craniocerebral surgery, and no one will cut the brain and study the cerebrospinal fluid of living people.

And the most critical thing is that Litokva can't understand why cerebrospinal fluid is released from the waist? He doesn't understand why blood pressure drops after cerebrospinal fluid is released? Why does Kavi say that Ronalne is safe now

And Ronalne is indeed as safe as he said

Why???

There is also a measurement method similar to a blood pressure meter. Can the pressure of cerebrospinal fluid really show the severity of the brain trauma?

Although Litokva wrote down all these contents, it did not affect the pile of question marks in his mind. After experiencing the toss and turns in the first half of the night and the mental destruction left by repeated thinking, he reluctantly fell asleep.

past.

However, after six hours of sleep, when he woke up, the pile of question marks did not get any explanation, but instead became more.

Because Rogerini, who had just undergone surgery, was sent in by the nurses.

Originally, his bed number should be further backward, but because the bed was tight, a minor wounded man in this ward was allowed to be discharged, so he was able to be admitted.

The injured part was transferred from the craniocerebral to the chest cavity and heart, another place that made the surgeon unable to start. Littokva still vaguely remembered how the director of the surgery department in his hospital handled heart trauma, "Just do a simple bandage."

, try to stop bleeding, and wait for the heart to heal itself, if it really wants to."

This inherent processing model is universal worldwide, at least in Europe.

He has never heard of any surgeon who dares to open the chest cavity, nor has he heard of any surgeon who dares to repair the heart. Can the heart really be repaired? The heart that beats more than 100 times a minute, every second

How to do it if you want to jump twice?

Litokva hadn't even seen his heart beat. He could not imagine the scene of the operation. He could only comment on a piece of bread on the table with his eyes, and use his simple body to quickly move up and down to simulate the scene he might see.

No, my mind is even more confused!

"What the hell are you asking?" Goram was in charge of this ward, and Rogerini and Ronalne were both the targets of his focus.

Littokwa was originally a military doctor, with a rank that was not much different from Golam, but when asked, he was very careful: "Can you tell me how Dr. Kavi handled Ronalne's brain trauma?"

"have no idea."

Goram wrote the medical record carefully and answered very simply: "Without the arrangement of the principal surgery, I couldn't enter the operating room at all. I didn't even see the lumbar puncture that night. I still want to ask someone else."

"So." Litokva looked at Rogerini, who had not yet awakened, "What about him? How did he do his heart repair?"

"It's just to open the chest cavity, then find the pericardium, and cut it open." Golam pointed to his left chest, and said it very simply, "and then find the crack in the heart and sew it with a suture."

"You're on the operating table?"

"Yes, I'm here." Golam was a little proud. "I'm really happy to be an assistant by Dr. Kavi."

Littokwa was very curious about how great a young surgeon who could praise 30-year-old Golam was: "How do you evaluate his operating skills?"

"The technology is amazing, I definitely can't compare, even Dr. Bill Rott, the vice president of the Academy of Surgery, cannot compare." Golam said very bluntly, "but I think he and us.

The difference is not only on the technical level.”

"Oh? What level is it?"

"Surgery thinking." Golam said while writing medical records, "Dr. Kawi's surgical thinking is different from ordinary people and is not bound by traditional surgery and anatomy at all."
To be continued...