"Can you relax a little? Don't be nervous, Auntie." Liu Jingyun tried to calm the patient's emotions.
"I can't bend my waist, I can't bend my waist." The aunt kept complaining that her back hurt.
Liu Jingyun looked back at the clock. The surgeon might be coming soon. If he saw that the patient was not well under anesthesia, he would probably be angry. This was an operation at noon, and the surgeon originally sacrificed his rest time to do it urgently for the patient.
The surgeon was angry, just like the last time he went to the emergency department, and finally complained to the anesthesiology department: It was just a simple spinal anesthesia, and the people in your anesthesiology department couldn't do it well?
"Don't be nervous, take a deep breath, auntie. Can I hold your hand first?" Liu Jingyun held the patient's hand, wishing that she could bear the pain instead of the patient.
Xie Wanying looked at the patient's condition and looked at the patient from head to toe to see where the problem was.
Lumbar disc herniation, so low back pain? Is the patient's complaint exaggerated? Is it so painful that he can't bend a little? Some patients are nervous when they enter the surgery room, and they are too nervous and amplify their pain.
The patient's heart rate on the monitor is a little fast, but his blood pressure is strange and a little low?
"Senior Sister." Xie Wanying called her Senior Sister again.
Liu Jingyun turned around and asked her junior sister in confusion: "What's wrong?"
"It shouldn't be possible to get spinal anesthesia."
Maybe the younger sister doesn’t understand that spinal anesthesia can be used for lumbar disc herniation. Liu Jingyun is going to explain it to the younger sister.
Walking around the end of the patient's bed and walking to the senior sister on the opposite side, Xie Wanying whispered: "Maybe we need to rule out spinal problems, such as ankylosing spondylitis?"
Is there something wrong with the spine? Liu Jingyun was shocked.
"Emergency patients? How many examinations have been done?" Xie Wanying asked.
Liu Jingyun looked back at the medical records on the treatment cart. She was an emergency patient. Maybe the emergency doctor was afraid of what would happen to the anus and rushed to perform the surgery.
What was the specific situation? Liu Jingyun walked back, picked up the medical records and checked again. It turned out that the patient had an anal fistula. He had had an anal surgery before, and local anesthesia was used at that time. There is no risk in local anesthesia, and it was a low-level anal fistula. Later, it was found that it recurred.
It was serious and may involve a high anal fistula. I came from the emergency room and entered the operating room this time. I probably wanted to do a thorough anal surgery.
If you want to have surgery, you will basically do some preoperative tests, such as an electrocardiogram, which is generally fine, and a blood test, which shows that coagulation is fine. Because of anal fistula, there must be infection, and the white blood cells are high, so surgery is needed.
Liu Jingyun thought about it again and again, why did the junior sister suspect that there was something wrong with her spine?
"If it hurts like this, could it be spinal deformity? The local anesthesia surgery last time may not require bending." Xie Wanying said, "And the patient is thin and has high white blood cells. It is said to be caused by anal fistula, but is there anything else?
What’s the cause?”
When bending over, the pain is usually not severe enough. Even if the patient cannot bend over even a little bit, the patient will complain that his head hurts as well.
If there is a problem with the spine, spinal anesthesia cannot be performed. This is a contraindication for spinal anesthesia.
It is right to be cautious, but in order to find out whether this is the reason, the patient needs to be taken for an X-ray, and a clinician must be contacted for consultation. If the other teachers are okay, it is the instructor Zhang today, and Liu Jingyun gets a headache just thinking about it.
Putting down the medical records, Liu Jingyun walked back to the patient's bedside and reached out to touch the patient's back to check the condition of the patient's spine. This was a positioning action she had to do before anesthesia. After touching carefully, she found that the patient's back muscles were very stiff and obviously abnormal.
For ordinary people, it feels like something is really wrong.
"Didn't you take a chest X-ray?"
"Non-hospitalized patients came in from the emergency room and didn't have time to take pictures." Xie Wanying said as she helped the senior sister look through the medical records.