After being separated from my family, I became a darling of the military region thanks to my medical

"Systolic blood pressure is 88."

The anesthesiologist quickly called out the numbers.

"Blood oxygen 91%".

Gao Yuan pulled the catheter back to a safe position.

"The medication dosage is calculated based on body weight, and the lowest effective dose is determined first."

Li Hong finished checking and handed him the syringe.

Dosage confirmation.

Gao Yuan took the syringe and slowly injected the solution through the sheath.

The blood vessels did not recover immediately.

The blood pressure on the monitor dropped another two millimeters of mercury.

Inside the observation room, Zhou Hai's hand rested on the glass.

"Should we let Xiao Ye take over?"

Liu Jianmin was also present.

"The risks of young doctors performing surgeries independently are still too high."

"If Dr. Ye doesn't take over, the spasm will spread, and eventually even the guidewire won't be able to be inserted."

Zhou Hai picked up the intercom.

Before he could press the button, Liu Xiaohe stopped him.

"Gao Yuan has already activated Plan B."

"Wait one more minute."

Liu Jianmin glanced at her.

"You've just completed one surgery, and you're already making guarantees for others?"

I won't vouch for him.

Liu Xiaohe stared at the monitoring data.

"I trust Professor Ye's arrangements."

Inside the catheterization lab, Gao Yuan re-examined the pressure curve.

The medication has taken effect, but the narrowing of the blood vessels has not been completely relieved.

Based on past experience, the dosage can be increased at this point.

The risk of increasing the dosage is that the child's blood pressure will drop further.

Gao Yuan did not rush to take the medicine.

He adjusted the fluoroscopic angle and found that the bend in the catheter was still attached to the inner wall of the blood vessel.

The medication only addresses the chemical irritation; the mechanical irritation remains.

Gao Yuan slowly rotated the tube, turning it thirty degrees counterclockwise.

The catheter bends away from the blood vessel wall.

Ten seconds later, the outline of the blood vessels began to expand.

Twenty seconds later, the pressure curve returned to normal.

"Systolic blood pressure is 98."

"Blood oxygen 93".

Li Hong relaxed her tense shoulders.

"The spasm has subsided."

Gao Yuan did not linger.

He reassessed the catheter route, reduced its curvature, and reinserted it.

Throughout the entire process, he did not ask Ye Zhen for help.

Ye Zhen, standing in the supervisor's position, spoke up at this moment.

Why wasn't more medication administered?

"The drug's onset speed is consistent with the plan, but the blood vessels are still narrowing, indicating that there is still mechanical stimulation."

Gao Yuan answered while adjusting the guidewire.

"Continuing to increase the medication will lower blood pressure; it's more appropriate to relieve the pressure on the catheter first."

"Operational basis".

"According to item nine of the Huaxia Standard Crisis Management Table, if the spasm lasts for more than 30 seconds, the catheter position must be re-examined, and insufficient drug dosage should not be assumed."

Liu Jianmin heard this through the intercom and his expression became somewhat unnatural.

Many doctors in China are accustomed to administering medication first and then observing the patient when treating vasospasm.

If Gao Yuan had followed his old experience, the child's blood pressure might have dropped below 80.

The Huaxia Standards have not made young doctors conservative.

It allows young doctors to prioritize in emergency situations.

Gao Yuan completed the measurement of ventricular septal defect.

The diameter of the defect deviated by half a millimeter from the preoperative assessment.

The 12mm occluder is still within its applicable range, but it is approaching its limit.

The scrub nurse prepares to open the package.

Gao Yuan raised his hand to stop him.

"Change to 10 millimeters."

Lin Yi was somewhat surprised.

"Twelve millimeters of coverage provides more stable protection."

"The edge of the child's aortic valve is thinner than it appears on ultrasound."

The image is projected from a high angle.

"A 12mm right disc may compress the valve after unfolding; 10mm would be sufficient to cover it."

Ye Zhen gave no hint.

Gao Yuan adjusted the projection angle to confirm the edge of the defect again.

"Use ten millimeters."

The scrub nurse removed the spare occluder.

Gao Yuan inserted the plug into the sheath.

The left plate unfolds.

Pull back and adhere.

Release the right-hand drive.

After the contrast agent was injected, there was no residual shunt at the edge of the occluder, and the aortic valve activity was not affected.

The tensile test was passed.

Gao Yuan achieved liberation.

The operation is over.

The spasm lasted for one minute and fifty-three seconds from its onset to its relief.

The entire procedure, from puncture to sheath removal, took twenty-seven minutes.

When the child was taken out of the catheterization lab, Gao Yuan leaned against the wall, took off his mask, and took a few deep breaths.

Liu Xiaohe handed him a glass of warm water.

Why didn't you ask Teacher Ye for help just now?

Gao Yuan took a sip.

"And then?"

"If this one can get through, what about the next one?"

Liu Xiaohe remained silent for a moment.

"You made the right choice with 10 millimeters."

"It's not bad if you retract the guidewire by two millimeters."

The two looked at each other for a moment, then laughed at the same time.

Ye Zhen came out of the catheterization lab and handed them two surgical records.

"What are you laughing at?"

The two immediately stood up straight.

"It's nothing."

Ye Zhen looked at Liu Xiaohe.

"Qin Le's blood flow record half an hour after surgery".

Liu Xiaohe answered immediately.

"Skin temperature is normal, nail bed filling time is one second, dorsalis pedis artery pulsation is clear, and there is no bleeding at the puncture site."

"Next patrol time."

"4:20"

Ye Zhen then looked at Gao Yuan.

"If the spasm persists even after adjusting the catheter angle, what is the next step?"

"Stop the procedure, remove the catheter, maintain circulatory stability, and reassess the risks of continuing the intervention."

What if blood pressure drops below 80?

"Increase blood volume, administer low-dose vasopressors, continuously monitor ECG changes, and immediately initiate crisis procedures if malignant arrhythmias occur."

Ye Zhen opened the record.

She checked the guidewire path, occluder selection, drug dosage, and the timing of each procedure.

Liu Xiaohe and Gao Yuan stood to the side, their bodies tensing up again after just relaxing.

Zhou Hai and Liu Jianmin also rushed over from the observation room.

"How is it?"

Zhou Hai was eager to see the results.

Ye Zhen did not answer, but picked up a red pen and signed her name on the last page of Liu Xiaohe's surgical record.

Then, she opened Gao Yuan's records and signed them.

"From today onwards, Liu Xiaohe and Gao Yuan are qualified to independently perform interventional surgeries with risk levels of level 2 or below."

Zhou Hai paused for a moment, then patted Gao Yuan's shoulder forcefully.

"Okay, at least I can share the burden with your teacher, Mr. Ye."

Gao Yuan staggered forward half a step after being hit, but he couldn't hide the joy on his face.

Liu Xiaohe held the surgical record and looked down at the signature.

"Professor Ye, am I really ready to perform surgeries independently?"

Ye Zhen covered the red pen.

"You performed the surgery yourself just now."

"The patient's imaging results are right there; who else do you need to vouch for you?"

Liu Xiaohe's throat tightened.

She has come a long way from the first time she worked on an interventional procedure, when she would even mispronounce the names of the instruments, to today when she can independently complete an entire interventional surgery.

That qualification certificate came without a medal or applause.

But she couldn't bear to put down the surgical records.

Liu Jianmin took the two records and checked them item by item.

He examined it for a full ten minutes but couldn't find any obvious flaws.

"I originally thought that the quality of surgery would decline after Dr. Ye left Huaxia Heart."

Liu Jianmin closed the record.

"These two surgeries today have changed my perspective."

Ye Zhen looked at him.

"A team cannot rely on one person to always be in the lead surgery position."

"The value of standards is that they enable fully trained doctors to make correct judgments when faced with variables."