Chapter 314: Chapter 315: The First Surgery
Hearing Meng Xiâs words, Ge Huai was startled!
He thought Meng Xi was joking!
Unexpectedly⦠she was serious.
Heart sac puncture, huh?
This is not the same as a thoracic puncture.
He had only been there for a few days, hadnât operated once, and now he was being asked to perform a heart sac puncture, which was clearly a bit tooâ¦
However, Ge Huai suddenly thought that Meng Xi was just asking.
Chen Cang might not even know how!
Even if he did, Ge Huai estimated that Chen Cang wouldnât dare, after allâ¦
âI can do it.â
A plain and indifferent remark from Chen Cang directly interrupted Ge Huaiâs conjecture.
Ge Huai was frightened so much he shuddered.
What the fuck?
You can do it again!
If this was the expression on Ge Huaiâs face.
Then, Wu Peng beside him was utterly confused.
He glanced at Chen Cangâs clothing, which was clearly the white coat worn by resident trainees, this wasnât a joke.
With this in mind, Wu Peng awkwardly said, âDirector Meng, this is no joke, emergency surgery is serious, and Iâm the first to disagree with letting this student do it.â
It wasnât that Wu Peng looked down on Chen Cang, but in the end, it was about being responsible for the patient.
So, no matter how you look at it, no matter the stance or approach, it was correct!
But Meng Xi was silent for a moment, looked at the ultrasound machineâs screen, and said to Wu Peng, âHmm, I understand Dr. Wuâs concerns, but⦠the patient likely has acute bacterial pericarditis, staying in emergency is pointless, transfer to cardiothoracic.â
After hearing this, Wu Peng was momentarily stunned, it seemed⦠there wasnât a problem.
This patient was no longer his responsibility.
âAlright, alright, then Iâll leave the trouble and hard work to Director Meng and Dr. Ge, take good care.â
Meng Xi turned and glanced at Ge Huai, âDr. Ge, you go with Dr. Wu to handle the paperwork, make it quick, Iâm going up with Chen Cang right away for the puncture!â
Ge Huai was even more dumbfounded, werenât the students supposed to do the paperwork?
Wasnât the doctor supposed to do the puncture?
Whatâs going on here⦠how is this mixed up?
But there was no way out, Director Meng was his direct BOSS, it was best to just obey.
Ge Huai hurriedly began to handle the transfer with Wu Peng.
Patient transfers from the emergency department were quite straightforward and fast, unlike the hassle it was with other departments.
There wasnât much difference in the treatment process, the only change being that the patient and the ultrasound doctor had changed locations, while Chen Cang officially performed the heart sac puncture.
Ge Huai ran back and forth, busily finishing the task, then hurried to the ward to watch Chen Cang perform the puncture.
Just as he entered, he heard Chen Cang say, âPerfect, Teacher Ge, help me with the aspiration later, I appreciate it.â
Upon hearing this, Ge Huaiâs face changed instantlyâ¦
Fuck⦠who exactly is the student and who is the teacher!
But if he didnât help, was he going to let Director Meng do the aspiration?
With that thought, Ge Huai couldnât help but sigh.
Forget it, forget it!
Iâll endure it!
The grown-up doesnât dwell on petty grievances.
This time, due to real-time echocardiographic positioning and cardiac monitoring, the safety factor was significantly increased.
In the training space, Chen Cang had practiced this procedure countless times under such conditions, it was basically routine for him.
However, to avoid vagal-induced hypotensive reactions, Chen Cang looked at Ge Huai and said, âAtropine.â
Ge Huai blinked.
Chen Cang: âAtropine.â
Just as Ge Huai was about to ask why, his expression suddenly changed, and he immediately realized.
This Chen Cang⦠not bad at all, quite skilled!
Chen Cang began the standard procedure of laying out the drapes⦠disinfecting⦠anesthetizingâ¦
Chen Cang held the puncture needle, and at the exact point where the xiphoid process meets the left costal margin, he aimed the needle upwards, hugging the backside of the sternum, and slowly advanced.
The needle advanced slowly, and Chen Cang felt the sensation!
Itâs in place!
The entire process was quick; after all, he had done it countless times, so his movements were fluent and smooth, leaving even the ultrasound doctor beside him agape with astonishment.
Afterward, he said, âTeacher Ge, itâs ready.â
Ge Huai seemed to have not yet reacted, after all, how many seconds had passed since the last sentence? Is it done already?
Young man, can you not be so rash? In medical work, can you not be a bit more serious?
âThat quick?â
Chen Cang nodded, âStart drawing.â
As Ge Huai began to draw out the fluid, he immediately sensed it.
It has to be said that compared to the ambulance driver, Old Liu, Doctor Ge was much more professional, withdrawing the liquid slowly and methodically.
It wasnât long before the fluid extraction was complete.
Then he seamlessly injected some antibiotics into the pericardial cavity.
Soon after, the patientâs symptoms mostly stabilized.
However, this didnât mean the surgery was over.
They had only alleviated the patientâs symptoms, ensuring his vital signs were stable; the next steps were the important part.
Identify the nature of the pericardial effusion and complete the surgery as soon as possible.
After all, the pathological changes of acute pericarditis early on manifest as inflammatory responses in both the visceral and parietal layers of the pericardium, with the presence of a viscous liquid composed of fibrin deposition and polymorphonuclear leukocyte accumulation, known as fibrinous or dry pericarditis.
The inflammatory response often extends to the myocardium beneath the pericardium, and in a few severe cases, it may affect the deeper myocardium, known as myopericarditis.
After pericarditis heals, small plaques may remain, or there may be varying degrees of adhesions. If the inflammation spreads to the outer surface of the parietal layer of the pericardium, adhesions can form between the heart and the nearby tissuesâpleura, mediastinum, and diaphragm.
Therefore, the treatment of this kind of acute pericarditis should be conducted promptly.
And once bacterial pericarditis is diagnosed, the general procedure is to initiate surgery as quickly as possible.
Now blood cultures are needed, as well as an analysis of the fluidâs characteristics.
That can only wait until tomorrow.
Meng Xi said, âHmm, well extracted! Do you do this often?â
Chen Cang nodded with a smile, âYes, often in emergency cases.
Meng Xi suddenly commented thoughtfully, âThen can you perform a pericardiotomy?â
[Ding! You have completed Meng Xiâs mentorship challenge, the second step, earning a favorability increase of +5 and triggering the third stage task, perform a pericardiotomy.]
Chen Cang hesitated, after all, like that pericardiocentesis, he was skilled, even at a master level, which is why he said it was possible.
But pericardiotomy⦠he was far from confident about that.
He wasnât sure.
Could he do it?
Perhaps he could.
With the aid of the system and Director Tao Ziâs explanations, Chen Cang had acquired the theoretical knowledge for pericardiotomy.
But what he lacked was practice.
And the previous task, to complete five pericardial surgeries, would allow him to advance his skill level to advanced.
Thus, Chen Cang bit the bullet and candidly said, âTeacher Meng, Iâd like to try, but⦠I canât guarantee the surgery will go smoothly since Iâve never attempted one, although Iâve observed many.â
Meng Xi was caught off guard for a moment but then smiled and nodded, âGood, youâll lead the operation tomorrow.â
After speaking, Meng Xi skillfully took off his white coat, tidying up as he said, âIâll watch you perform it.â
Upon hearing this, Chen Cang suddenly felt a warmth in his heart.
Actually, Teacher Meng was quite good to him.
Ge Huai on the side wanted to speak but held back.
Observing the interaction between the two, he suddenly had a realization and understood!
Right!
Opposing Chen Cang was just inviting trouble for himself, wasnât it?
After all, Chen Cang was the disciple of his boss, the chief disciple at that, and such a relationship between mentor and protégé was very profound.
Meng Xi would certainly focus on nurturing Chen Cang.
To put it plainly, they were on the same side, and challenging Chen Cang was essentially challenging Director Meng, and it was possible that both would team up against him.
Having thought it through, Ge Huai suddenly felt that he should be more open-minded and magnanimous, behaving more like a teacher.
â¦
PS: Posting three updates first, thank you everyone, there will be an additional stand-alone chapter later.