My Medical Skills Give Me Experience Points-Chapter 1252 - 493: The Skill Gap Between Director and Deputy Director, Interventional Angiography to Resolve It_3
Zhou Can proposed a better solution.
Perform abdominal artery angiography, with precise timing being crucial.
If during the examination, the patient’s bleeding happens to have temporarily stopped, it would be very difficult to locate the bleeding point.
At this time, Zhou Can’s Level 6 Hemostasis Skill comes into play.
By simply observing the patient’s skin color, facial complexion, appearance, and physical condition, he can basically determine whether the patient is currently in a bleeding phase.
Moreover, the patient had just passed liquid blood in stool twice recently, indicating a significant bleeding state.
Opportunities missed will not return.
Zhou Can decisively instructed Ali to report to Deputy Director Han and then contacted the intervention room for an emergency selective abdominal artery angiography for the patient.
The doctors in the intervention room, seeing the patient’s poor condition, were worried that the patient might pass away during the procedure, and they hesitantly invited Zhou Can over to assist.
Zhou Can is quite well-known by now, and many doctors at Tuya Hospital know his skills in endoscopic surgery and interventional procedures.
Occasionally, people invite him to lend a hand.
In this case, the intervention room invited him over, ostensibly to help, but actually to avoid taking on responsibility.
Zhou Can didn’t expose this, and went over directly.
Proposing an abdominal artery angiography for the patient was his idea to begin with.
Someone has to shoulder the responsibility of safeguarding the patient’s life.
Of course, the consent form that needs to be signed by the family must be signed.
He’s fine with saving lives diligently, but he cannot take on all the risks himself.
If the family wants to save the patient but is unwilling to bear any risk, and instead wishes the doctor to take all the responsibility, that’s not going to work. Zhou Can has never been a saint, and when it’s necessary, he must be ruthless.
Fortunately, the patient’s parents were reasonable and signed the form quickly.
In the intervention room, Zhou Can donned heavy lead clothing and carefully guided the angiographic catheter into the patient’s femoral artery, then into the abdominal aorta, and then further into the primary branches, namely the celiac trunk, superior mesenteric artery, and inferior mesenteric artery.
Throughout the procedure, he appeared particularly focused.
The celiac trunk and the branches of the inferior mesenteric artery were opacified and recorded on video, with no abnormalities found.
His heart sank.
Could the timing for the angiographic examination have been incorrect?
Through the video, the superior mesenteric artery’s diameter appeared generally narrowed, and at the distal end of the ileocolic artery, contrast extravasation was observed. 𝘧𝓇𝑒𝑒𝑤ℯ𝑏𝓃𝘰𝑣ℯ𝘭.𝘤ℴ𝘮
Zhou Can was overjoyed.
He finally located the source of the bleeding.
"Quick, quick, it’s this location."
Zhou Can swiftly indicated the position of the bleeding source on the patient.
The extravasated contrast at the distal end of the celiac artery branch was visible, forming a concentrated ball.
After pinpointing the bleeding, 20U of pituitary posterior hormone was slowly administered through the catheter, followed by withdrawal of the catheter.
It turned out to be active bleeding from the ileocolic artery, no wonder the bleeding volume was so large.
Almost any significant arterial bleeding is terrifying.
And it’s very difficult for it to stop on its own.
Finally understood why using two different hemostatic drugs together still couldn’t stop the bleeding.
"This patient needs emergency surgical hemostasis immediately, push them back first! I’m going to discuss with Dr. Xu to see if we can perform this surgery directly in the ER."
Zhou Can already had a surgical plan in mind.
However, this matter needed to be discussed with Dr. Xu first.
After all, while it’s Zhou Can performing the surgery, Dr. Xu is the one bearing the responsibility.
After discussion, Dr. Xu reviewed the angiography footage and agreed to take on this surgery.
For Zhou Can, this is a very good training opportunity.
