"Can you relax a little? Don't be nervous, Auntie." Liu Jingyun tried to calm the patient.
"I can't bend my waist. I can't bend my waist." The old lady kept complaining about the pain in her waist.
Liu Jingyun looked back at the clock. The surgeon might be here soon. If he saw that the patient was not anesthetized, he would probably be angry. This was a surgery at noon, and the surgeon had sacrificed his rest time to perform the surgery for the patient.
The result of the surgeon getting angry was just like the last time in the emergency department. He finally complained to the anesthesiology department: It’s just a simple spinal anesthesia, and people in your anesthesiology department can’t do it?
"Don't be nervous, take a deep breath, Auntie. Can I hold your hand first?" Liu Jingyun held the patient's hand, and in her heart she really wished she could suffer the pain instead of the patient.
Xie Wanying looked at the patient's condition and examined him from head to toe to see where the problem was.
Is the patient exaggerating his complaint? He said that the pain was so severe that he couldn't even bend his waist? Some patients get nervous when they enter the operating room, and they are so nervous that they exaggerate their pain.
The patient's heart rate on the monitor is a little fast, but the blood pressure is strange, a little low?
"Senior Sister." Xie Wanying called her Senior Sister again.
...
...
Liu Jingyun turned around and asked Junior Sister in confusion: "What's wrong?"
"I don't think I can get a spinal anesthesia."
Maybe the junior sister didn't understand that lumbar disc herniation can be treated with spinal anesthesia. Liu Jingyun was going to explain it to the junior sister.
Walking around the end of the patient's bed to the senior sister on the opposite side, Xie Wanying whispered, "Maybe we need to rule out spinal problems, such as ankylosing spondylitis?"
Something's wrong with the spine? Liu Jingyun was shocked.
"Emergency patient? How many tests did he undergo?" Xie Wanying asked.
Liu Jingyun looked back at the medical records on the treatment cart. It was definitely an emergency patient. The emergency doctor was probably worried about what might happen to the anus, so he rushed to perform the surgery.
To find out what the specific situation was, Liu Jingyun went back and picked up the medical records to check again. It turned out that the patient had an anal fistula and had undergone an anal surgery before, using local anesthesia. Local anesthesia has no risks and treats low-position anal fistulas. Later, it was found that the recurrence was serious, which may involve high-position anal fistulas. After coming in from the emergency room, this time he entered the operating room, probably wanting to do a thorough anal surgery.
If you want to have surgery, you will do some basic preoperative tests, such as electrocardiogram, which is generally normal, and blood tests, which show that blood coagulation is normal. Because of anal fistula, there must be infection, and the white blood cell count is higher, so surgery is needed.
Liu Jingyun thought again and again, why did the junior sister suspect that there was something wrong with her spine?
"It hurts so much, could it be that the spine is deformed? The last time I did the surgery under local anesthesia, I probably didn't need to bend over." Xie Wanying said, "And the patient is thin and has a high white blood cell count. They say it's caused by an anal fistula, but could there be other causes?"
The back hurts when bending over, but usually it doesn't hurt to this extent. Even the slightest bending over is not possible. The patient also complains of headaches.
If you have spinal problems, you definitely cannot have spinal anesthesia. This is a contraindication for spinal anesthesia.
It's right to be cautious, but in order to find out if this is the reason, the patient needs to be filmed and a clinical doctor needs to be contacted for consultation. If it was any other teacher, it would be fine, but today it was that instructor Zhang, and Liu Jingyun felt 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 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, obviously different from ordinary people. She felt that something was really wrong.
"Didn't you take a chest X-ray?"
"He's not an inpatient and came in from the emergency room. There's probably no time to take a picture." Xie Wanying said as she helped the senior sister look through the medical records.
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