Chapter 2882: 2788.2680 Different Ways, Different Rewards

2788.2680 Different Ways, Different Rewards

"What are you saying?" Chang Yue asked in surprise.

"Ugh..." Lao He scratched his head, knowing Chang Yue didn't do surgeries and only wrote medical records, "Appendectomy surgery, when performing continuous epidural anesthesia, the epidural catheter broke; it's said it should be left inside about 6 cm or more."

Zheng Ren Gang was about to speak when a "ding-dong~" sound suddenly came from beside his ear.

This sound had been long absent; since receiving the Nobel Prize, Big Pig Trotter had stopped issuing missions, so Zheng Ren could only rely on the continuous mission 【Best Surgeon】 to gain trivial skill points and experience points.

【Emergency Mission: One in a Million.

Mission Content: Remove one fractured epidural catheter.

Mission Reward: System data calculation in progress; different removal methods yield different rewards.

Mission Time: 24 hours.】

Zheng Ren really had some complaints about Big Pig Trotter, issuing a mission while the reward was still being calculated? This is too unrigorous.

Moreover, the focus lies on these six words: 'different removal methods'.

Originally Zheng Ren's first thought was to surgically remove the fractured epidural catheter, but after seeing these six characters, Zheng Ren hesitated a bit. Since Big Pig Trotter gave a hint, trying an interventional surgery approach wasn't impossible.

Zheng Ren entered the System Operating Room without hesitation, clicked to purchase surgical training. The System Operating Room rose up from the ground, and he strode in. To be honest, Zheng Ren also had a bit of interest in anesthesia mishaps; after experiencing such things, if he encountered them himself, he wouldn't be at a loss.

"Anesthesia catheter? It can break like that? Is it made of paper?" Chang Yue was especially surprised.

Not only ordinary people; for an internal medicine doctor, it's unimaginable that an epidural anesthesia catheter would break.

What on earth is this, how can it be so flimsy! It's utterly fantastical.

"Little Chang, this situation of catheter breakage isn't particularly rare..." Lao He hesitated a moment, then spoke frankly: "According to domestic statistics, the incidence rate is 0.06%～0.2%; abroad, it's 0.0017%～0.04%."

"How can the difference be so great?" Chang Yue asked in surprise.

"Look at your clueless expression." Su Yun said disdainfully, as if she had already forgotten that not long ago she herself had drunk to the point of blacking out and been carried home, "Different materials, different ways of avoiding certain positions during anesthesia, can lead to similar incidents."

"Well, one recent case I heard about from others: a trainee pulled out the tube, used force incorrectly, and the catheter snapped inside." Lao He said somewhat seriously: "If we examine it closely, there are many possibilities."

Speaking, he put down his phone and began to crack his fingers.

"The causes of epidural catheter breakage during surgical anesthesia are complex, mostly related to anesthesiologist operation, pathological or physiological changes in the puncture area, and catheter factors."

"For example, the main cause of catheter breakage during insertion is inserting the catheter too deep; generally, if it's more than 5 cm, breakage may occur."

Speaking, he pressed his right hand onto his left thumb, indicating this was the first possibility.

"Moreover, when encountering resistance during catheter insertion, the anesthesiologist may panic, exert excessive force, retract the catheter, adjust, but if the Tuohy needle isn't moved accordingly during operation, the angle twists and the catheter breaks."

Speaking, he pressed down his second finger as well.

Su Yun suddenly said: "Older brother Yang, do you know why Boss and I have been praising you all along?"

Professor Yang had a black line; really anything could be linked to himself. Speaking of that day, he directly activated Peerless, and it seemed he had activated it correctly… He hoped he could always activate Peerless anytime, anywhere.

"Well, Professor Yang's approach that day was correct; whether in surgery or anesthesia, brute force is truly unsuitable." Lao He said, "Moreover, improper placement of the Tuohy needle in the epidural space, with the catheter located between the needle tip and the bony surface or lodged in the intervertebral joint or bony fissure, etc., is also a factor. This requires considerable anesthesia experience and is also a place where mistakes are easily made."

The third finger was pressed down.

"The causes of catheter breakage during removal relate to excessive force and repeated attempts to pull out a knotted catheter or one entangled with surrounding tissue when encountering resistance during removal."

"Moreover, patient-specific pathological and physiological factors such as spinal stenosis, bone overgrowth, pregnancy, epidural space connective tissue hyperplasia, and positional changes are also important causes of epidural catheter breakage during insertion or removal."

"Consumables also play a role." Zheng Ren suddenly said.

"Surely, the domestic incidence rate is much higher than abroad; one reason is the quality of consumables." Su Yun said.

"The material and model of the epidural catheter… I recall literature reporting that nylon or polyurethane catheters are more sturdy than Teflon or polyethylene ones, and 19G catheters tend to break at a fixed point near the tip." Zheng Ren finished speaking, wiped his mouth, and looked at Lao He.

Lao He immediately became solemn.

Boss Zheng's meaning was quite clear, but Lao He felt he couldn't guess; it would be better to listen to Boss Zheng's opinion.

"Lao He, what does that side mean?" Zheng Ren asked.

"I saw the WeChat message; the person involved is a director of the anesthesiology department of a lower-level city county, and the content looks like a mass broadcast." Lao He said, "No greeting at the start, no thanks at the end; that side is probably flustered and doesn't know how to handle it."

Just a single sentence, a single inquiry, and Lao He could see many things.

"What does he mean?" Zheng Ren asked.

"Boss Zheng, please check the WeChat." Lao He held his phone, bent at the waist, and trotted over to Zheng Ren.

【May I ask if you have ever experienced an epidural catheter breakage? Besides conservative treatment, what other solutions are there?】

It's a very simple message; the sender is truly flustered, not even expressing basic thanks.

It looks a bit vulgar, but when encountering emergencies, many people are flustered. Just like the first time going to the province, encountering Wang Hai performing a cerebral angiography and pushing the catheter forward—same situation.

At that time, Dr. Wang seemed completely dazed; Liu Zewei and Gao Shaojie took turns trying to retrieve the guidewire, and after failing he didn't say a word. I myself pulled out the guidewire, he held my hand, also not knowing what to say.

So Zheng Ren understood and could guess what the sender meant.

"Lao He, ask if he needs a hand." Zheng Ren said, "Also, clarify where the person is."

"Sure." Lao He readily agreed.

Although it's a thankless task, Lao He still had no complaints and hurried to make contact.

"Boss, you really do any kind of work." Su Yun had long guessed that the boss would get itchy hands, but when he said that, she couldn't help but complain in her heart and directly blurted out a sentence.