Chapter 2813: with translation of chapter title

"You might not know about ophthalmology, but you've probably had a total gallbladder removal, right?" Su Yun stared at the ECG Monitor, moved a stool to the patient's left side, and chatted with Yu Zong intermittently.

"Um, the gallbladder-cardiac reflex?" Yu Zong asked.

"Yeah, what's most feared when removing the gallbladder? Cutting the cystic duct is serious, but not as serious as the gallbladder-cardiac reflex. Like the ophthalmocardiac reflex, during bile duct Shou Bing, due to traction on the gallbladder or exploration of the bile duct, the resulting bradycardia and blood pressure Decrease can, in severe cases, cause myocardial ischemia, arrhythmia, or even cardiac arrest due to reflex coronary artery spasm."

"Especially for patients being resuscitated from hemorrhagic shock, the probability keeps going Rise."

"Yu Zong was fine, after all he's the 912 Inpatient Chief. But Gu Xiao Ran's heart was pounding as he listened on the side."

"He has already started doing related Shou Bing at his hometown Hospital."

"The Hospital back home is smaller, the departments aren't that detailed, the director and Zhou Chun Yong have connections, so Gu Xiao Ran seized an Opportunity that nobody wanted and managed to get to Du Du."

"Coming to Di Du for further study has truly brought a huge change to Gu Xiao Ran's life; every day he has a new transformation. For example……today."

"Thinking back to before he usually does Gallbladder Removal Surgery and explains things to the patient's family, there was no mention of the gallbladder-cardiac reflex, and he also had no idea what the gallbladder-cardiac reflex was."

"Not to mention Gu Xiao Ran, even their director probably wouldn't know. The probability of this situation is extremely low; you might not encounter a case even after doing 1000 Shou Bing, let alone a newbie like Gu Xiao Ran."

"\"Yun Ge'er, what do we do after it occurs? \" Gu Xiao Ran asked softly."

"\"Resuscitate, you can't just watch the patient die. \" Su Yun said contemptuously: \"If you're not sure, call over the big shot from your Hospital; whoever's most capable, call them. Of course, as long as you don't cry on the Operating table, anything goes. Even contaminating the operating area isn't enough to cause trouble. \"

"Su Yun ended up teasing Gu Xiao Ran a bit."

"\"Hehe. \" Gu Xiao Ran smiled, but his smile was even stiffer than Yu Zong's."

"\"Xiao Ran, right? \" Yu Zong said, \"The gallbladder-cardiac reflex is truly rare, and urinary retention in the bladder pulling on the vagus nerve is even rarer. Otherwise, why would Zheng Lao Ban always feel something's off before surgery but couldn't recall what it was? \""

"Gu Xiao Ran glanced at Zheng Lao Ban, seeing him sitting in the corner of the Operating Room, his eyes seemingly fixed on the ECG Monitor just like Yun Ge'er's."

"Zheng Lao Ban was still worrying about the patient, and Gu Xiao Ran felt a faint strangeness in his heart. He always heard Zheng Lao Ban talk about rich clinical experience……what is rich clinical experience? This is it."

"Although Zheng Lao Ban didn't notice it first, he stepped up at the First Time, led the resuscitation successfully, and the patient should be fine."

"Thinking of this, Gu Xiao Ran glanced at the patient again."

"He opened his eyes in a daze, as if he had just woken up, still unaware of what had happened."

"\"The probabilities differ; the occurrence rate of the ophthalmocardiac reflex in ophthalmology Shou Bing is 90%, but the probability of the bladder-triggered cardiac reflex is too low. \" Su Yun said."

"\"Um… I remember, once during a Shou Bing, after opening the abdomen I saw the patient's appendix. \" Yu Zong had already finished the colostomy, and incidentally told the circulating nurse to drain the urine from the bladder in 2-3 batches: \"When I used the Retractor, whenever I applied force, the patient's heart rate would change; at the time I thought it was fun. \"

"\"That's caused by the reflex; the vagus nerve reflex in the gastrointestinal tract is also very rare, and after it happens nobody knows what's going on. \" Su Yun stood on the stool, a bit higher, and said while looking down at the ECG Monitor."

"\"Pretty much, back then I lacked experience. Yun Ge'er, this time there should be no problem, right? \""

"\"It should be fine. \" Su Yun glanced at his own Boss, seeing him sitting steadily on the stool. Although he said nothing, just sitting there gave people a sense of reassurance."

"As long as this guy is around, there definitely won't be any issues; Su Yun's heart gradually accepted this reality."

"Really rich clinical experience? Or is this guy naturally endowed with a keen sense of smell, just like Heizi?"

"Su Yun glanced at his own Boss, pondering."

"This incident, beforehand he also seemed unaware of what would happen. Only at the moment of cardiac arrest did he start leading the resuscitation. Sigh, Boss this guy, why is he so eager to steal the spotlight? Su Yun sighed deeply."

"\"A full bladder leading to cardiac arrest is not uncommon. \" Zheng Ren suddenly said."

"Huh?"

"\"But generally nobody would think it's due to a full bladder. \" Zheng Ren continued: \"Upon waking, holding urine, then suddenly emptying, the whole person collapses in the bathroom. Such examples are often seen, but they're usually sent to the cardiology department for treatment. \"

"\"... \" Yu Zong stared for a moment."

"\"When a hollow organ receives a distension stimulus, it can travel via the celiac plexus or vagus nerve to the central nervous system, excitation conducted to the lower parasympathetic center in the medulla, the dorsal vagal nucleus, releasing impulses that then travel via the left vagus nerve's parasympathetic fibers to the heart. \" Zheng Ren said, \"a very clear reflex arc. \"

"\"Um... \" Gu Xiao Ran let out a sound of astonishment, then said: \"Zheng Lao Ban, our former director once had a Shou Bing and suddenly had a myocardial infarction! Now I think it might have been from holding urine. \"

"Huh? Then what?"

"Myocardial infarction."

"\"Was he revived? \" Zheng Ren asked."

"\"Oh yeah, since it was in the Operating Room, he was revived. \" Gu Xiao Ran said, \"While administering thrombolytics and contacting the municipal hospital, the Emergency Rescue Service ambulance delivered the stent. \"

"\"You can't even place a stent there? \" Su Yun asked."

"Hmm." Gu Xiao Ran nodded, "I went along with them; the city doctor said it was just a little off. Fortunately, the onset happened in the operating room; at the time I still felt quite lucky, but now I think it might have been from holding in urine."

"Boss, do you think this counts as an occupational injury?"

"Have you heard of occupational injuries in the hospital?" Zheng Ren asked in a rare counter-question.

Seeing he hadn't finished speaking, Gu Xiao Ran changed the topic again and hurriedly asked, "Zheng Lao Ban, vagus nerve excitation—then what?"

"The result of vagus nerve excitation is—coronary blood vessel spasm, decreased sinoatrial node excitability, slowed conduction velocity of the specific conduction system, weakened myocardial contractility, Reduction in cardiac output, Decrease in blood pressure, and even cardiac arrest." Zheng Ren said.

"Impressive." Gu Xiao Ran said softly.

"Not impressive; I never thought of that before." Zheng Ren sighed, saying, "This time I have experience, so it'll be fine from now on. Su Yun, you're right."

"What the heck, you're saying I'm right?" Su Yun glanced at Zheng Ren and asked.

"Clinical experience is just a little bit of accumulation; that Korean professor is playing tricks." Zheng Ren said seriously.