Chapter 51: Show Off Skills (Part 1)
Translator: 549690339
This rescue mission is of utmost importance, and every medical worker must be fully alert and attentive!
Of course, inevitably, some leaders will avoid participating due to special reasons.
After all, a hospital is a complex institution, and many who are responsible for administrative work do not get involved in medical events.
Although Hao Xuliang is a deputy director in charge, he is also a medical backbone. He cannot afford to be less attentive, almost constantly communicating with relevant departments on how to carry out rescue operations in an orderly manner.
A few minutes later, Hao Xuliang rushed into the resuscitation room and asked Li Baoshan, “Baoshan, have you found the person? Where are they?”
Li Baoshan pointed at Chen Cang, “This is our department’s doctor, Chen Cang. He knows how to use the peritoneal dialysis machine.”
Hao Xuliang’s eyes narrowed instantly as he glanced at Chen Cang, then turned to stare at Li Baoshan, “Are you sure?”
Li Baoshan looked at Chen Cang. He knew Chen Cang because he was the one who recruited him. He was very knowledgeable about Chen Gang’s character. This person was very reliable. In over two years of work, he had made zero mistakes, never slacked off or cut corners, and was always low-key.
Since he said he could do it, Li Baoshan trusted that he could.
Li Baoshan nodded, “Yes, I’m sure.”
Hao Xuliang turned to Chen Cang, “Where did you learn it?”
Chen Cang answered honestly, “I learned it during my university days at the Eastern Medical University. I interned at the Sixth Hospital of the Sea City, where I spent over three months in the peritoneal dialysis room. They needed to do peritoneal dialysis every day, and that’s where I learned it.”
It was all true, but… staying there for three months meant he only knew some basic operations.
Hao Xuliang was still somewhat uneasy and cautioned, “Young man, human life is of paramount importance; there is no room for carelessness or falsehood, do you understand?”
Chen Cang, “I understand!”
Hao Xuliang immediately gave the order, “Let’s go, to the dialysis room!”
Peritoneal dialysis is neither very difficult nor very easy. It’s really not difficult for those who have experience, but it’s definitely going to be a problem for those who haven’t done it before if they attempt it rashly.
Learning this doesn’t take long, so Hao Xuliang and Li Baoshan still believed him.
Moreover, this was not the time to be indecisive.
The group pushed the poisoned patient straight to the dialysis room, which was a newly opened area in the hospital with no one around.
At this point, Hao Xuliang was still somewhat conflicted, what if something went wrong?
Suddenly he remembered an old classmate and immediately made a phone call.
“Old Yang, it’s Hao Xuliang here. I’ve got a situation that I need you to oversee and help with!”
The other party asked directly, “What’s the matter?”
“We have a patient in our hospital who needs peritoneal dialysis, but there’s no one available who knows how. An ER doctor claims to know, but I’m still not at ease. I’m planning to set up a remote video conference so your hospital’s peritoneal dialysis specialist can supervise it, what do you think?”
Upon hearing this, Old Yang suddenly asked, “Is it a poisoning patient from the chemical city explosion?”
Hao Xuliang nodded, “Yes, we can’t delay!”
Old Yang agreed, “Prepare the video conference, we’ll connect in a few minutes.”
Hao Xuliang hung up, his eyes suddenly brightening!
With remote expert guidance, and Chen Cang already knowing a bit, there shouldn’t be a big problem, right?
At this point, Hao Xuliang immediately picked up the phone and spoke to the security department, “Go to the sixth floor and bring down the remote conference TV from there, send it to the dialysis room!”
After fifteen minutes or so, everything was ready!
The remote video conference TV was quite large, over two meters long, and could essentially replicate the scene at a one-to-one scale. Through the camera, the peritoneal dialysis operation could be seen quite clearly by the other party.
The emergence of remote video conferencing is mainly to facilitate case discussions, consultations, and surgical demonstrations between different hospitals.
The video link was successful!
Face to face, the figure of a man in his fifties and a woman in her forties appeared on the TV.
Hao Xuliang greeted them, “Director Yang, thank you for your efforts! We appreciate your assistance.”
The man smiled warmly, “No problem, this is Xu Aiping, the deputy director of our hospital’s peritoneal dialysis room. Let her guide you.”
Hao Xuliang turned to Chen Cang and said, “Are you ready to begin?”
Chen Cang nodded!
The peritoneal dialysis began!
Peritoneal dialysis is a method that uses the body’s own peritoneum as the dialysis membrane.
By flowing dialysis fluid into the peritoneal cavity, it exchanges solutes and water with the blood plasma in the capillaries on the other side of the peritoneum, thus removing retained metabolic products and excess fluid from the body, while also replenishing substances essential to the body through the dialysis fluid.
At this time, the patient was already suffering from kidney failure and needed a metabolic substitute for the kidneys. This was achieved by continuously renewing the peritoneal dialysis fluid, achieving the purpose of renal replacement or supportive therapy.
During peritoneal dialysis treatment, the peritoneal dialysis catheter is used to infuse the peritoneal dialysis fluid into the abdominal cavity. On one side of the peritoneum in the abdominal cavity is the blood, filled with waste and excess water, while on the other side is the peritoneal dialysis fluid. The waste and excess water from the blood pass through the peritoneum into the dialysis fluid.
After a period, the peritoneal dialysis fluid containing waste and excess fluid is drained from the abdominal cavity, and new peritoneal dialysis fluid is infused, thus continuing the cycle.
Operating a peritoneal dialysis machine is not troublesome; the main thing is the first step—catheter insertion!
Catheter insertion is the most important and crucial step in peritoneal dialysis!
It directly affects the success rate of peritoneal dialysis, and an excellent catheter insertion procedure can significantly reduce adverse reactions of peritoneal dialysis surgery.
There are two common methods for peritoneal catheterization: laparoscopic and open surgical placement.
And now, Chen Cang had only one option before him, which was the open surgical catheter placement.
It wasn’t because he didn’t know how to perform laparoscopic catheter insertion, but because there was no laparoscope available at the moment!
As Hao Xuliang said, since this facility had not yet been fully developed, all the laparoscopes were in the operating rooms and had not yet been allocated to this area!
In reality, catheter insertion is also a type of minor surgical procedure.
On the video call, Xu Aiping seemed to realize that Chen Cang was going to use surgical catheter placement and said, “This traditional open surgical method requires the operator to have solid basic surgical skills! And… skilled catheter insertion technique! There must not be any errors!”
“Because any mistake during catheter insertion can affect the patient’s recovery and may even cause very serious adverse reactions, such as… peritonitis…”
Chen Cang turned a deaf ear!
He opened the catheter package, prepared the surgical instruments, and began the operation!
The catheter room next to the peritoneal dialysis room was not very different from an operating room; it had everything needed!
Make the incision!
Chen Cang chose to make an incision of about 3 centimeters to the left of the navel.
After making the markings, extensive disinfection was needed!
The area involved in peritoneal dialysis was too large; essentially from below the chest to above the groin had to be disinfected, and even more so to the midaxillary lines on both sides.
Anesthesia!
Local anesthesia!
Since there was no one else, Chen Cang had to do all the work by himself!
He carefully cut through the skin and separated the subcutaneous fat to reach the anterior sheath!
At this moment, Chen Cang held his breath and lifted the anterior sheath.
At this time, all abdominal muscles were exposed!
Bluntly separate the muscles!
Next, Chen Cang took a deep breath, lifted the peritoneum, and at that moment, Xu Aiping on the video screen held her breath too.
She dared not disturb!
Because at this moment it was essential to be careful, absolutely not to damage the greater omentum or the intestines.
Any injury could easily lead to infection!
The most important aspect of peritoneal dialysis is the control of details. Xu Aiping, in her forties, now used mainly laparoscopic catheter insertion because it carries less risk, whereas open surgical catheter placement demands high surgical skill from the operator, is more prone to infection, causes larger incisions, and is not conducive to recovery, among many other factors.
But!
It is undeniable that an excellent surgeon prefers open surgical catheter placement because it is precise!
What does this mean?
If laparoscopic and traditional surgeries were scored, open surgical catheter placement would have a perfect score of too, while laparoscopic catheter placement could only achieve 70 at best. Traditional surgery can be perfect, while laparoscopic surgery is fundamentally judged on passing the bar!
ps: There’s more to come, keep flipping through the pages, yes, that’s right!