The anesthesiologist was stunned.


    Recalling the process of emergency endotracheal intubation, I did have some problems as teacher Wu said.


    But Mr. Wu smiled and said something strange, like an invisible hand on his face.


    It hurts.


    "The operation was very successful, Mr. Chen." Wu Mian looked at Chen houkun and asked with a smile.


    “……”


    If another person asks, Chen houkun must say success with his chest.


    But Wu Mian asked... There was another patient in the intensive care unit who was more seriously ill and recovered better. Chen houkun couldn''t say the word "successful operation" anyway.


    "I looked at the operation records. The process was OK. I think it should be very smooth." Wu Mian''s smile was still gentle. "I just said that the problem of anesthesiologist was not very important. After all, people were lucky and intubated successfully at one time. How can we blame the problem on anesthesia."


    "The success of one-time intubation under visual laryngoscope will not lead to serious laryngeal edema. What is the reason for the patient''s serious laryngeal edema?" Wu Mian asked.


    "Maybe... Maybe..." Chen houkun thought about it for a long time and had a certain idea in his heart.


    "The patient is prone, the neck leans forward, and the tissue is compressed for a long time, which leads to venous reflux disorder. The patient is evaluated as difficult airway before operation, and it is a long-time cervical prone operation, so it leads to postoperative laryngeal edema." Wu Mian said, "do you consider that the operation is particularly smooth, so pull out the tube in advance in order to prove your level?"


    Every word and every word pierced Chen houkun''s heart like a knife.


    Normally speaking, for the sake of safety, postoperative endotracheal intubation is required for at least 24 hours. But the operation went well. Chen houkun was also a little proud. With some careful thinking, he decided to pull out the tube.


    Unfortunately, it''s easy to pull out the tube, but it''s hard to send it back undamaged.


    "Extubation after operation is not impossible, but we must be very careful. It is suggested that the next time we extubate, we should retain a tube changer or probe to avoid the formation of an emergency airway after extubation." Wu Mian looked at Chen houkun with a low voice. He just stated one thing without any subjective idea.


    "Later, I found laryngeal edema and repeatedly tried to intubate. It was Mr. Wang who did it." Wu Mian said Chen houkun and turned his eyes to Wang Ziliang.


    "Er... Yes..."


    "You are bolder than them all." Wu Mian said faintly, "the patient has airway obstruction and respiratory depression. As a result, the mask ventilation is difficult, and oxygen and can not be maintained. When the ventilation can not be guaranteed, you even interrupt the spontaneous breathing with vecuronium 8mg. Can you ensure that the mask ventilation is not difficult after muscle relaxant is given? Or can endotracheal intubation be successful at one time?"


    "But... No muscle relaxant, more..."


    "I know." Wu Mian nodded. "The British das2015 edition of guidelines for unforeseen difficult endotracheal intubation for adults points out that muscle relaxants help to improve the effect of mask ventilation, glottic exposure and endotracheal intubation conditions, and laryngeal mask placement and ventilation conditions."


    "There is no principled error in using muscle relaxants, but what is the premise of this sentence in the das2015 guide to unforeseen difficult endotracheal intubation for adults?"


    Wu Mian looked at Wang Ziliang and asked in a deep voice.


    “……”


    "The guideline clearly states that we should try our best to ventilate with a mask on the premise of ensuring sufficient muscle relaxation, and actively prepare the invasive airway in front of the neck, such as cricothyroid incision."


    "At this time, we should explain the condition to the patient''s family members. If it is not successful at one time, we can use cricothyroid membrane puncture to send steel wire retrogradely. If not, why not do tracheotomy?" Wu Mian''s voice is a little cold, and his smile is not as gentle as it was just now.


    "The patient''s family refused..." Wang Ziliang said.


    "It''s because that''s what the gold Lord meant." Wu Mian shook his head slightly. "The gold Lord is not a doctor. It''s natural for them to take money and see a doctor. But medical treatment is not a standard service industry. In some special cases, they can''t adhere to their professional opinions and remedy their previous mistakes. It''s no use asking the doctor to listen to the opinions of the patient''s family members."


    "No one has the final say, and what happens after the patient is not serious. After all, the operation is successful, and occasionally some minor complications are normal. But the first one in Xiangjiang is the world''s top private hospital. Everything is money." Wu Guan''s side slightly glanced, and his eyes swept all the doctors sitting in the house.


    "What if you has the final say? Why don''t you let the family members of the patients themselves save lives?"


    "Zheng family is the top chaebol in Xiangjiang, but not the top doctor. Can you stick to it in your professional field?"


    "Really think of yourself as a waiter?"


    "If I can''t cook well, I''ll change another house. But if I can''t cure my illness, what if I die?"


    "OK, I''ll say that." Wu Mian scanned the people in the room again and smiled. "The patients should have no problem. The software and hardware level of the nursing and hospital are very high, which can be said to be the world''s top, no problem."


    With that, Wu Mian stood up, bowed slightly and strode away.


    Wei Dabao followed Wu Mian and took a look at many doctors here. He didn''t know any of them, but Wei Dabao could feel the smell of superior doctors emanating from these people.


    That is the pride that naturally appears under the support of technology.


    But these people were trained by section chief Wu like dogs. They bowed their heads and didn''t dare to say a word more.


    The old doctor named Prince Liang returned two words, but he was directly rejected by section chief Wu. Tut Tut, when can I be so gentle?


    Ren Haitao looks humble. He is different from Wei Dabao. He knows Prince Liang.


    I still remember when the academic meeting was held, Wang Ziliang was invited to give lectures. As a top expert in the world, the academic meeting also printed the words of inviting Professor Wang Ziliang, a famous severe disease expert in Xiangjiang, to give guidance on the brochure.


    At the meeting, Ren Haitao clearly remembered that Wang Ziliang didn''t know much about technology.


    But in front of Mr. Wu, Professor Wang Ziliang was like a student. He was pointed out countless mistakes, stupid like an intern.


    Really? Ren Haitao knows.


    What Mr. Wu said is actually right from some angles. But! They can''t argue.


    When the family did not agree to do tracheotomy, only Mr. Wu could retrograde the guide wire and then implant the endotracheal tube.


    Others can do it, others can''t, so Mr. Wu can point to his nose one by one, and others can only listen.


    Even if I want to talk back, I feel empty at the thought of the operation just now.


    In fact, they are only wrong in one place - they should not listen too much to the opinions of the patient''s family.