Crisis and Opportunity (3)
When I entered the echocardiography room, Katarina was talking to the staff.
“Professor. I’m here.”
“It came sooner than expected?”
“By any chance, what did you call me for?”
“Since Mr. Choi doesn’t practice suturing, I’m thinking of giving him another homework.”
Katarina continued speaking with a smile on her face.
“I’m going to have you study for PCI today.”
Percutaneous Coronary Intervention (PCI).
This is called coronary intervention, and it is a procedure that treats diseases in the coronary arteries using a catheter.
“Isn’t PCI done in internal medicine?”
Choi Ki-seok tilted his head and asked.
“Usually that is the case. But at MHC, thoracic surgeons perform PCI. The internists literally just prescribe drugs. This is a place to make thoracic surgeons all-rounders.”
“….”
“For your information, pacemaker insertion is also performed by a thoracic surgeon.”
“That’s surprising.”
“I think learning internal medicine is too much, but it’s Head Chief Yasada’s decision.”
Katarina trailed off.
“Have you ever observed PCI?”
“It only happens once.”
“I was just asking just in case, but it really exists.”
“My lover in Korea works in the cardiology department. So I watched her first PCI.”
“Just like the last time I sutured, I really can’t stop Mr. Choi. First, read the patient’s chart. We’ll go into PCI in about ten minutes. I’ll use Mr. Choi as a second assistant, so I know that.”
“all right.”
Ki-Seok Choi sat on a chair and looked at the patient’s chart.
The patient’s name is Julia and she is 70 years old.
He suffered from moderate coronary artery stenosis.
The area of stenosis was the right coronary artery, where extensive stenosis of approximately 80% was observed, and occlusion occurred behind the right coronary artery.
Considering the patient’s age and condition, PCI was scheduled rather than CABG.
“Are you ready?”
“yes.”
“Then let’s go right in.”
Ki-seok Choi finished scrubbing with the staff and entered the treatment room. Procedures for checking the patient, time-out blood pressure monitor, and electrocardiogram installation. Anesthesia was completed one by one.
“I think the puncture should be done on the femoral artery. I did the Allen test, but the radial artery is not in good condition.”
“okay.”
“Then we will proceed with disinfection.”
After Ki-Seok Choi finished disinfecting, Katarina received a guiding catheter from the nurse.
“PCI is starting. Everyone is nervous.”
Suuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuu
The guiding catheter penetrated the patient’s right radial artery.
Katarina watched the ultrasound monitor and inserted the guiding catheter deeper.
The operation of inserting a catheter into a blood vessel.
This may seem easy at first glance, but it requires delicate handling.
If you make a mistake, the conduit may move to the wrong place or the blood vessel may be damaged.
A treatment room with a lot of tension.
Eventually, the catheter safely arrived at the site of the stenosis.
“First, treat the area with obstruction. Guide wire.”
“yes.”
A guide wire followed the catheter to the treatment site.
“Finished insertion of drug-eluting stent. Adjust air pressure.”
“All right.”
Ki-Seok Choi set the air pressure in the right coronary artery to 14 and the pressure in the area with the occlusion to 12 atmospheres.
The first assistant looked mesmerized by his quick treatment.
Adjusting the air pressure is essentially the job of the second assistant. However, it was surprising that Choi Ki-seok, a beginner, was able to kill him cleanly without receiving any instruction.
“Mr. Choi. Do you know the standard atmospheric pressure?”
“Oh yes. I studied it before.”
“No chatting! The balloon dilatation procedure is about to begin.”
Katarina’s treatment continued.
As the balloon inserted into the stent inflated, the narrow blood vessel gradually widened. Soon after, the right coronary artery and its occluded vascular branches returned to normal levels.
“All we have to do is remove the guide wire. Would you like Carol to do the removal?”
“Please just leave it to me.”
Carol confidently stood next to Katarina.
He took a deep breath and pulled on the guide wire.
PCI is coming to an end.
When the guide wire is removed, only the balloon and stent remain, which helps normal blood flow to the blood vessels.
“Professor… the guide wire won’t fall out.”
“A wire?
” Yes. It seems to have caught properly somewhere.”
Carol, who was at a loss as to what to do, pulled on the guide wire with all her might.
But at that very moment, the guide wire suddenly broke.
Carol’s face turned pale, and Katarina looked up at the ceiling and sighed.
” sorry. I was wondering if it might come off if I apply force…”
“It’s good to apply force, but you have to do it moderately.”
Katarina’s eyes moved to the monitor.
The end of the broken wire was stuck in the branch of the right coronary artery where the blockage was.
“It’s not surgery . Don’t take PCI lightly. They say a lot of accidents happen during PCI.”
“…Yes. There is no shame in it.”
Carol stepped away from her seat and lowered her head.
“Mr. Choi. What should I do when the guide wire gets stuck like this time?”
Katarina stared at Choi Ki-seok.
“It depends on the case. Depending on the patient’s condition or the position of the guide wire, there are cases where the wire is left alone, and there are other ways to remove it surgically or percutaneously.” “In this case?” “I think it would be better to remove it
percutaneously
. If you give me the chance, I would like to remove the wire.”
Katarina looked like a surprised rabbit at Choi Ki-seok’s answer.
She didn’t know that she would hear such a sharp answer or that she would go out of her way to remove the wire herself.
Choi Ki-seok’s behavior was within the range of her expectations. ‘It’s not like
the Deputy Director and Chief Yasada are providing care for nothing.’
Katarina muttered to herself,
“Okay. Give it a try.”
“Thank you.”
Choi Ki-seok stood in the position of the surgeon and released his wrists.
If it were Korea, there is a high possibility that Shin Gyu would have been scolded for speaking out, but this is America.
If you speak up for yourself, you can have many opportunities. “ Then
, shall we start by learning how to remove the wire?”
“I plan to put in a few new wires and then twist them to make a noose. “I plan to use this snare to remove the embedded wire.”
“This is the standard for percutaneous removal. good. Please give it a try.”
“Let’s begin.”
Choi Ki-seok inserted a guide wire through the catheter.
His eyes were fixed on the monitor and his hand movements were cautious. He was nervous
because it was his first PCI, but the effect of a frozen heart drove away his fear. .
Eventually, the first wire safely arrived at the place in question.
The second wire also settled in.
Choi Ki-seok manipulated the two wires and brought them into close contact with the wire stuck in the blood vessel. Then, he twisted them into a twist and wrapped them around the stuck wire. Hard
. After making the vine, he carefully pulled the wire.
He applied a moderate amount of force, but the embedded wire did not seem to come off. He
groaned several times, but the result was the same.
Sweat was beading on his forehead.
“Mr. Choi. Don’t pull it straight, but pull it out in a circular motion. That would be better.”
“Yes.”
Ki-seok Choi followed Katarina’s advice and set out to remove the guide wire stuck in the blood vessel. When he pulled in a circular motion, the guide wire that had not budged began to move slowly. After several operations, the wire was freed
. It came out.
Tung!
Choi Ki-seok smiled as he looked at the wire falling on the curved board.
A sense of pride came over him.
He had completed his first medical treatment cleanly.
I wonder if Jeong Seol-hwa in the past felt this way too.
“Good job. It’s pretty good?”
“Thank you. “I did it thanks to the professor’s trust and advice.”
“Mr. Choi’s skills were good. There is bleeding in the area where the wire was stuck, so let’s deal with that first.” As
Katarina finished the rest of the treatment, the PCI was completed successfully.
[The brave doctor takes over the treatment. You have completed a hidden achievement.
You will receive 500 A.P. as a reward. .]
[A new item jelly has been opened in the store. Jelly
can be purchased with A.P.]
[You have formed a rapport with Katarina.]
NEW [Rapor Stage 2 – Faith]
Notifications ringing in succession.
Choi Ki-seok confirms the new reward. I sat down in the break room with my colleagues.
“Honestly, I didn’t expect Mr. Choi to be at this level.”
Katarina sighed after drinking a can of drink.
“I think at this level, I can go straight to the actual battle next time?”
“That’s too much praise.”
“These are not empty words. As long as wire removal is possible, general PCI should be considered no problem. Other unexpected situations will also be dealt with to some extent.”
“….”
“I will soon pick a patient and hand it over, so do your best.”
“Yes.”
“Don’t be too sullen, too.”
Katarina’s eyes stayed on Carol.
“It’s not your fault that the wire broke. I have some responsibility.”
“Professor’s responsibility?”
“Why is it your responsibility?”
Ki-Seok Choi and Carol asked at the same time.
“Now that I think about it, the end of the guide wire we used was hydrophilic. It is mainly used when there are multiple lesions, but it has the disadvantage of breaking easily. If I had told you in advance, you wouldn’t have pulled Carol with all your might.”
“….”
“So, don’t be too discouraged, okay?”
“Yes. I’ll keep that in mind.”
Carol’s expression brightened.
The conversation continued on topics such as a review of the PCI that had just been completed and other PCI methods.
Choi Ki-seok could tell that Katarina was a warm worker who was skilled and knew how to take care of those under her command. .
The surgical field is crowded with men.
It can’t be a coincidence that she came up from that jungle to where she is now.
“I’ll get up first, so you two can rest a little more and then come up.”
“It’s time for us to go up too…”
” Take a good rest when you can. Resting well is also a necessary virtue for a soldier.”
Katarina winked and left the lounge.
Choi Ki-seok talked with Carol some more and then headed to the thoracic surgery ward. When he
opened the status window and entered the store, a new item, jelly, caught his eye. .
[If you purchase jelly and apply it to a regular item, the effect will be activated.]
[Jelly (rare): Charisma +2] / 100 A.
Can be purchased for P.
[Jelly (rare): Humor +2] / 100 A .
Can be purchased for P.
[Jelly (rare): Luck +2] / 100 A.
Can be purchased for P. [Jelly (rare)
: Movement Speed +3]
Can be purchased for
100 A. P.
. .
.
Choi Ki-seok is on the list After examining it, I scratched my cheek.
Contrary to what I expected, the jelly had nothing to do with the treatment.
‘Well, it’s still better than nothing.’
He bought movement speed jelly, humor jelly from Crocs, charm jelly for his gown, and applied it to his call phone.
“Dr. Choi. Hello.”
The nurse I met at the station greeted me first.
“Nice to meet you. Anna. You look much prettier today than yesterday, right? If I keep doing this, sooner or later I will become a real princess.”
“You too, my teacher.”
Anna covered her mouth and laughed at the joke parodying Summer Kingdom. Who would have thought that she, who has a reputation for being blunt, would show herself like this. The effect of
humor jelly . was surprising.
“By the way, let’s go to the conference room now.”
“Why the conference room? Is something going on all of a sudden?”
“I’ll find out when I go.”
Ki-Seok Choi put his doubts aside and headed towards the conference room.
Grumbling.
When he went inside, the conference room looked unfamiliar. It was crowded with people,
including the cast and staff of ABD Channel’s new medical drama.
