Chapter 34: The Third Advanced Medical Skill

Tuya Hospital's Emergency Department is always so busy, and before eight o'clock, the hallways are already crowded with patients seeking consultation.

Many patients who should have registered for a specialist outpatient department, in order to see a doctor earlier, or because the specialist appointments for the day are fully booked, flock to the Emergency Department instead.

This further exacerbates the staffing shortage in the Emergency Department.

"Dr. Zhou, hurry to the operating room to help, a car accident victim needs emergency surgery."

Ye Tingting saw Zhou Can and immediately called him to support the operating room.

By intuition, her professional title must not be low.

Definitely not at the level of a junior nurse, at least she is a junior nurse practitioner.

She seems to have a special liking for Zhou Can. She took good care of him in the operating room yesterday.

Jin Mingxi, who entered the Emergency Department with Zhou Can, did not receive this kind of treatment.

"Okay, I'll be right there!"

As soon as Zhou Can heard there was a surgery to be done, he immediately perked up.

After changing into surgical scrubs, he entered the operating room and saw.

Dr. Xu, an unfamiliar resident doctor, an anesthesiologist, and Tang Ling, the instrument nurse, four people in total, were preparing the patient for surgery.

"Good morning, Dr. Xu! Good morning to all of you!"

Zhou Can took the initiative to greet the four people.

The patient's legs were a mess of blood and flesh. The bloodied trousers had been cut off.

Perhaps due to lack of manpower, the instrument nurse was multitasking, disinfecting the area to be operated on the patient.

Though in the eyes of doctors, there is no distinction between male and female.

But when she disinfected the patient's perineal area, she was obviously embarrassed.

"Let me do it!"

Zhou Can took over the forceps from her hand, and disinfected the patient with a cotton swab.

"Thank you!"

Tang Ling gave him a grateful smile.

"Don't mention it!"

When Zhou Can was an intern doctor, he had done this kind of thing a lot. Now, he operated with great proficiency.

And soon it was done.

"Catheterize the patient."

Dr. Xu ordered.

This task is usually done by nurses. Holding the catheter, Tang Ling looked at Zhou Can for help.

"If I'm present, you can leave this kind of task to me."

Zhou Can took the initiative to take the catheter without her asking and skillfully inserted the urinary catheter into the patient.

For a patient with serious injuries like this, catheterization has multiple purposes.

For example, obtaining urine samples for testing, and monitoring whether the patient urinates normally after surgery, among others.

[Congratulations, you have acquired the implantation technique, current experience points, Level 3 1/1000. You can place special materials or medications such as vascular stents, bone nails, springs, etc., into the corresponding tissue parts of the patient.]

Zhou Can was stunned for a moment, then overwhelmed with joy.

Implantation technique belongs to Advanced Medical Skill.

Its practice is extremely difficult.

But it is widely used in various high-difficulty precision surgeries, such as cardiac stent placement, vascular balloon implantation, etc.

Directly at Level 3, equivalent to a lower level of a resident doctor's standard, this made Zhou Can very satisfied.

If he mastered this medical technique, when he returns to surgery one day, he will surely shock everyone.

The fact that he earned the implantation skill just by inserting a catheter truly surprised him.

It seems that in the future, he can also eagerly take on these seemingly insignificant tasks.

Inserting a single catheter and getting 1 point of implantation experience is incredibly thrilling.

It's as exciting as picking up a hundred-dollar bill on the street.

Currently, he has acquired three advanced medical skills; if he can improve them all to the Chief Level, he would then have the capability to undertake some high-difficulty surgical work.

"The patient's legs have already suffered severe fractures. We in the Emergency Department can only do preliminary treatment of the injuries, ensure the patient's life is safe, make our best effort to save his legs, and then transfer him to surgery."

Dr. Xu set the tone for the operation.

The Emergency Department simply does not have the conditions to perform all of the surgeries for such patients.

Its job is to rescue critically ill patients and do its utmost to save lives.

"Dr. Lin's suturing and ligation skills are much better than Xiao Zhou's, so Dr. Lin will be my first assistant, Xiao Zhou will assist, and also take on the duties of a circulating nurse."

After Dr. Xu assigned the tasks, everyone took their positions.

"Ouyang, how are the patient's vital signs?"

"Surgery is viable."

Before surgery, it is necessary to hear the anesthesiologist's opinion.

The patient's blood pressure was obviously low, and the heart rate was too fast. This indicates excessive blood loss.

The thigh area contains the Femoral Artery, which can lead to rapid blood loss and death.

Currently, it is very likely that the Femoral Artery has been ruptured.

Many people may not realize how high the risk factor of a ruptured Femoral Artery is. Everyone knows that if the neck is cut, it is easy to die.

In fact, if the trachea is cut in the neck, one does not die immediately.

But if the carotid artery is cut, blood will immediately spurt out.

The Femoral Artery, like the carotid artery, is directly connected to the coronary artery.

Such severe bleeding is very frightening.

Only next to being stabbed in the heart with a sharp object.

On the contrary, wrist-slashing suicides often seen in TV dramas are not as terrifying in terms of bleeding. In some cases, with strong clotting function or in cold temperatures, bleeding may automatically stop.

Dr. Xu carefully debrided the patient's crushed leg area.

A gush of fresh blood spurted out like a fountain.

"Hemostatic forceps!"

Before Dr. Xu could finish speaking, Zhou Can had already clamped the proximal end of the bleeding vessel with the hemostatic forceps.

The Intermediate level Hemostasis Skill of a resident doctor is not given for free.

The first assistant, Doctor Lin, looked at Zhou Can with a slightly surprised glance.

"I heard that two strong recruits came to the Emergency Department, and I didn't quite believe it. Having witnessed Dr. Zhou's hemostasis skill, now I am convinced."

As soon as a master makes a move, one knows if they have it or not.

Zhou Can showed off his Hemostasis Skill and immediately won the respect of Doctor Lin.

Surgery isn't like writing papers. Many chief physicians spend money on buying papers or even projects in order to push for a sub-senior professional title or find various other means to lower the difficulty of obtaining it.

Eventually, even if they do get the title, you can imagine the level of their actual skills.

They only get an empty reputation while their actual expertise is shallow.

However, you can't fake surgical skills.

If you're competent, you're competent; if not, it becomes apparent immediately.

"I dare not accept the title of a master. I hope for Doctor Lin's continued support in the future."

Zhou Can lowered his posture as much as possible.

For newcomers, the lower the profile the better.

As long as you silently accumulate Experience Points, it won't take long before you can leave opponents like Doctor Lin and Jin Mingxi far behind.

"Now that we've found the source of bleeding here, Doctor Lin, you clean up the wound over there. Xiao Zhou, maintain the hemostasis posture, and I'll do the vascular anastomosis."

This is a Femoral Artery anastomosis, and although it is not too difficult, it's quite a test of the doctor's anastomosis level.

Dr. Xu didn't feel entirely comfortable letting Doctor Lin handle it.

He chose to do the anastomosis himself.

Zhou Can looked on enviously, but unfortunately, his current anastomosis skill was only at the lower level for resident doctors. If he could improve to an outstanding level for resident doctors, he should be capable of performing the Femoral Artery anastomosis.

The patient's other leg had muscles and bones destroyed from within, but the epidermis was still connected.

Doctor Lin carefully incised the epidermis.

Only to see that the muscles underneath were already rotten.

There were hematomas and contusions everywhere.

Even some bone fragments.

It was terrible.

The victim must have been run over by the rear wheel of a large truck directly over both legs.

On the other side, there was a hole in the Femoral Artery.

It was spurting out blood.

Zhou Can had to use his mind for two purposes at once, freeing his left hand to hold the hemostatic forceps and control the bleeding point.

"Thank you!"

Without Zhou Can's help, Doctor Lin wouldn't have been able to operate by himself.

The ruptured Femoral Artery needed to be repaired.

"Dr. Xu, the Femoral Artery over here is also ruptured. The situation is still okay. Could you let me handle the repair?"

By asking this, Doctor Lin more or less revealed his suturing skill level to Zhou Can.

At best, it wouldn't exceed the outstanding level of a resident doctor.

It seemed that the gap between him and Doctor Lin wasn't that big.

Currently, Zhou Can's suturing skill level was at the lower level for a resident doctor. With just a month or so in the operating room, it might be possible to surpass Doctor Lin.

While others took a step-by-step approach to improving their medical skills, which was slow going,

Most surgical resident doctors would need at least five years to elevate their suturing skills from a lower to an outstanding level.

And that is under the condition of having sufficient surgical volume.

If they only get a chance to stitch once every three or four days and are not diligent in practicing privately, they might not reach the outstanding level even after seven or eight years.

So in comparison, Zhou Can's advantage was quite significant.

"You can give it a try. Keep the suturing intervals tight and consider the arterial pressure."

Dr. Xu agreed.

On one hand, he was really too busy.

On the other, he tended to delegate authority for anything that wasn't particularly high risk to his subordinates to help them grow rapidly.

"Understood."

Doctor Lin nodded and quickly began to repair the ruptured Femoral Artery vessel.

It was also fortunate that the skin was intact, protecting the vessel and preventing it from being too badly damaged.

Otherwise, repairing the blood vessel alone would be very troublesome.

"Doctor Lin's suturing level should be at the intermediate level for a resident doctor."

After watching Doctor Lin's vessel repair, Zhou Can felt assured.

It seemed that it wouldn't take too long to surpass Doctor Lin in suturing skills.

With a bit of proactivity, maybe even ten days to half a month would be sufficient.

"Xiao Zhou, for a large arterial anastomosis, apart from ensuring the suturing intervals are fine, you also need to ascertain whether the vessel has been damaged. Like this one; it must be cut out. If after cutting, the two segments of the vessel are too far apart with too much tension, you must not force an anastomosis. You can take a segment of the great saphenous vein or use an artificial vessel instead."

"Generally, it's best to consider using the patient's own vessels. Although the artificial vessel technology is very mature, it's still a risk. Especially when operating on young patients, you have to consider that they have many more decades of life ahead. Whenever replacing any organs or tissues with artificial counterparts, utmost caution is required."

While operating, Dr. Xu meticulously passed on his valuable surgical experience to him.

"Got it."

Zhou Can nodded, his attitude was extremely sincere.

Being eager to learn was one of his major strengths.

Meanwhile, in the operating room, Jin Mingxi and Dr. Lu had entered one after another.

It was time for the shift change.

Doctor Lin was on night duty, while Dr. Xu and Tang Ling had been called by the hospital and came to help out.

About twenty minutes later, Dr. Xu had successfully completed the anastomosis of the severed Femoral Artery.

Doctor Lin was still busy.

Differences in skill level are reflected in the speed of the surgery.

Skillful surgeons not only complete surgeries quickly but also provide notably high quality.

"Xiao Zhou, release the hemostatic forceps on this side to test the blood flow."

Zhou Can slowly relaxed the hemostatic forceps.

Instead of rashly letting go immediately.

From this detail, one can tell that his hemostasis skill level was quite good. True expertise is not only shown through superb artistic proficiency but also requires careful attention to many other details.

With such a major artery, just after successful anastomosis, suddenly releasing the hemostatic forceps.

It's equivalent to opening all the gates at once during a floodgate release.

It could easily lead to adverse consequences.