Chapter 170 Mastering another skill, can’t you do good things?

"It is most convenient when more than two people are needed to operate. One person can fix the patient's fracture site and keep it stable, and then put on the splint. If the patient is younger or the cooperation is not high, then this method cannot be used and holes must be drilled.

Directly perform invasive external fixation.”

Dr. Xu's words scared the patient as well as a kindergarten baby.

After all, no one wants to have a doctor drill holes in their legs.

After treating the patient, carefully lift the patient directly to the flat bed.

Just transfer to the inpatient ward for care.

"You should remember that patients with severe fractures like this must find ways to prevent sterile inflammation even if they are successfully reduced by manipulation. If it is severe, it can directly lead to bone necrosis and joint degeneration."

"OK!"

Li Jingsheng and Dr. Chen nodded to express their understanding.

Aseptic inflammation often occurs in bones and joints and is extremely harmful.

"The strong young man outside should be able to receive local anesthesia. Lao Yu, since you are here, let's give him a brachial plexus anesthesia before leaving! His muscles are stronger than a gorilla, and the dosage and depth of injection are probably only yours.

Only such an experienced anesthetist can be precise."

Doctor Xu looked at Lao Yu who had packed his treasure box and was about to leave.

"You are the only one who has a lot of things to do! Well, why do we have any friendship at all?"

Lao Yu happily agreed.

"Also, I am an anesthesiologist, not an anesthesiologist, not an anesthesiologist!"

This statement made several people laugh.

Anesthesiologists hate being called anesthesiologists because it makes them sound like technicians.

In fact, they are serious doctors, and they are well versed in emergency medicine, critical care medicine, anesthesiology, and also have certain knowledge of general medicine.

Being a surgeon, curing diseases, anesthetizing and saving lives is not something you get in vain.

In the early days of critical care medicine departments, many of them were critical care medical teams formed by excellent anesthesiologists and excellent medical nurses drawn from various departments.

In particular, the medical care in the two departments of respiratory medicine and cardiothoracic medicine has made a huge contribution.

So far, the critical care medicine department still focuses on the two major signs of respiration and heartbeat when rescuing patients.

The establishment of the two major circulatory systems is basically based on these two physical signs.

Lao Yu carried the suitcase and went out.

"Xiao Li, let him operate it, and I will guide you."

Dr. Xu really "takes care" of his apprentice.

I just handed over a difficult case to my apprentice, and another more challenging one came.

"Teacher, you also saw that man's fist. It's bigger than a bowl. I'm afraid I didn't catch him properly, and then his fist would hit my face."

Li Jingsheng said with a grimace.

The patient just now was of high quality and good-tempered. Li Jingsheng treated him for a long time, and he never said a single bad word.

But the strong man outside had a temper that was not easy to offend.

The risk of getting beaten increases exponentially.

"As long as you follow my instructions, you'll be fine. You should first remember the technique of folding top and turning!"

Li Jingsheng had already been taught the operating techniques and skills of the folding top slalom.

It's just that practice and theory are completely different things.

Li Jingsheng tried hard to remember the key points of the slalom operation.

"During the operation, the thumbs of both hands are pressed against one end of the protruding fracture, and the other four fingers overlap and surround the other end of the sunken fracture. Under traction, the thumbs of both hands are pressed downwards on the protruding fracture end to increase the angular deformity of the fracture. Rely on the thumbs

The feeling, predicting that the distal and proximal bone cortices of the fracture have reached each other, suddenly reflected..."

The following key steps are based on the basic bone-touching technique, which is not very difficult.

At least he was completely confident in detecting changes in the patient's bone position.

The rotation technique is similar to the rotation technique in rotation, flexion and extension, but the specific operations are different.

When we came outside, Dr. Xu was already chatting with the patient.

"Young man, your muscles are very developed, and it takes a lot of strength to perform manual reduction on you. This can only be done by our young doctors. The young doctors are less experienced, so please be more careful when doing it. In case the manual reduction fails,

Then there is no other way, you can only consider surgical reduction."

After hearing this, the strong man didn't think twice and readily agreed, "No problem, just give me the treatment. If it doesn't work well, I won't blame you, don't worry!"

Since the patients have agreed, there is nothing more to say.

Lao Yu personally gave the patient local anesthesia, and then Li Jingsheng reset him.

This person's arms are really too thick.

Fortunately, the local anesthetic has a good muscle relaxation effect and provides the necessary foundation for manual reduction.

Just now Lao Yu was preparing a local anesthetic, but Li Jingsheng didn't see it.

It feels like there is definitely more than one kind of lidocaine.

He memorized all the injection points for brachial plexus anesthesia on the patient.

"Xiao Li, please check the patient again."

Dr. Xu asked Li Jingsheng to touch the patient's bones again.

"It seems like there is soft tissue embedded in the fracture site."

After the muscles were effectively relaxed, Li Jingsheng felt the bones more smoothly this time.

Not only can the bone image and bone position be clearly felt, but the surrounding soft tissue can also be felt more clearly.

"First use the roundabout maneuver to completely free the embedded soft tissue. You first determine the path of dorsal displacement of the fractured end."

After Li Jingsheng nodded to confirm that it was OK, Dr. Xu continued, "When rotating, perform the operation in the opposite direction of the fracture displacement. During traction, you can boldly increase the force."

Li Jingsheng did as he was told.

"Yes, that's it. Rotate in the opposite direction of the original fracture displacement so that the broken ends face each other. You can carefully listen to the bone fricative sounds at the broken ends until you are sure that the soft tissue is completely freed."

The teacher taught him step by step, and Li Jingsheng had a good foundation.

The operation process was quite smooth.

"Both hands must hold the two fracture ends so that the broken bone cortices are close to each other to avoid increasing soft tissue damage..."

"Yes, yes, very well done!"

Dr. Xu can judge the progress of reduction just by listening to the bone fricative sounds.

After Li Jingsheng finished, he touched it and said, "Just implement the folding method to reset it. You already know the other techniques, so I don't need to teach you anything."

The patient turned his head the whole time, not knowing whether he didn't dare to look or didn't want to look.

Releasing the embedded soft tissue is only the first step.

He began to use the roof-folding technique to reset the patient's position.

After two consecutive operations, the reset was not successful, but his seventh advanced bone-setting technique reached the entry level.

This is simply like giving a pillow when you feel sleepy.

Li Jingsheng secretly upgraded his newly mastered top-folding maneuver to a proficient level before the patient became angry.

This time my confidence increased greatly.

Try again.

Still failed.

The patient's muscles are too developed, which makes the reduction exponentially more difficult.

"Damn it, I can't even reset the Master level. It seems I can only upgrade to the Xiao Cheng level."

It only takes 100 health points to upgrade to master level, and 500 to upgrade to minor level.

Fortunately, he has accumulated a lot of health points now.

It took another 400 health points to upgrade the top-folding maneuver to the minor level.

If it doesn't work this time, there's nothing we can do.

Try again.

Once it was done, the whole process went smoothly beyond imagination.

Xiaocheng-level bone-setting techniques can help him more fully feel the resistance from muscles and soft tissues. During reset, he can even use part of the resistance to move.

"alright!"
To be continued...