Today, #Aier Ophthalmology A doctor beat the patient's head# on Weibo hot search.
The video was posted on December 19 by Weibo user "Emergency Sunflower Ai Fen", in which Ai Fen said: "The 82-year-old patient made a sound due to pain on the operating table, but Feng Mou, a doctor at Guangxi Guigang Aier Eye Hospital, not only did not take any way to comfort the patient, but instead slammed the patient's head with his fist, and the patient lost sight in his left eye after the operation. The doctor plans to be promoted through senior titles in the near future. 」
Video clip, source: Weibo user "Emergency Sunflower Aifen"
In the early morning of December 21, Guigang Aier Eye Hospital issued a "statement on the online information of 'doctor boxing patients on the operating table'".
The statement said that the incident occurred on December 12, 2019. Patient Qin, diagnosed with cataract in the left eye, dislocation of the lens in the left eye, preoperative vision: light perception. The patient was diagnosed and underwent left eye lens extraction (abnormal lens) + anterior segment vitrectomy.
The hospital proposed that during the operation, due to local anesthesia, the patient was intolerant to the operation, and reached up to try to touch the eyes, and the area near the eyes was a sterile area for surgery, which could cause infection once touched, and the operation was in progress.
Doctor: Local anesthesia may have a "bad effect", but the fist-swinging behavior is suspicious
Regarding Aier Ophthalmology's mention of "patient intolerance to surgery", an ophthalmologist Wang Lin (pseudonym) said that patients will feel discomfort in their eyes when local anesthesia measures are used for general eye surgery. However, due to the different sensitivities of individuals, the response to pain tolerance is also different. If the patient is highly sensitive to pain, or if the procedure is longer, the patient may be more likely to feel uncomfortable during the procedure.
Ophthalmologist Lin Li (pseudonym) believes that most eye surgeries are performed under local anesthesia, and patients are awake throughout the whole process, and "movement" is relatively rare. There are two possible consequences of the patient's movement, one is that it may contaminate the sterile area, and more importantly, the surgical instruments are shaking in the eye, which may injure the intraocular tissues and make it impossible to continue the operation.
In order to avoid such a situation, during the preoperative education, the doctor will repeatedly emphasize to the patient not to use his hands or head, and if there is discomfort, he can give a loud reminder. In the face of people with poor cooperation in the elderly or sensitive to pain, they will occasionally "tie" their hands through the waist to prevent patients from moving during the operation through soft restraint. In addition, there are also itinerant nurses in the eye surgery room who can help hold the patient down if there is an emergency.
Preoperative propaganda demonstration video, source: A public tertiary eye hospital
Wang Lin said that for non-general anesthesia surgery or other special surgeries, the ophthalmologist can complete the anesthesia operation by post-eyeball injection, without the need for an anesthesiologist. During the operation, the surgeon is usually equipped with an assistant to complete the operation. Due to the principle of aseptic operation, the surgeon can only touch the space on the surgical towel, and the doctor himself cannot touch other parts. "The knife has been opened, and at this point, if the words are not stopped, the patient can only be reminded by pressing his head. 」
Wang Lin said: "The doctor's behavior in the video is a bit irritable, and if general anesthesia is included in the preoperative evaluation, the situation in the video may not occur. However, in general, due to the short time of eye surgery and the financial situation of the patient, most patients will not choose general anesthesia surgery. 」
Regarding the doctor's behavior of "hammering" the patient's head in the video, a surgeon in the Lilac Garden community (user ID: Duche Lesch Eel Rice) left a message, "The anesthesia effect is not good, and the effect of additional anesthetic is not good", "Surgery requires aseptic operation, and sometimes the patient will subconsciously touch it with his hands when he is in pain, and generally shout at the patient to let him not move, or help press the patient's arm if there is an assistant by his side." 」
Screenshot of the Lilac Garden community
However, the doctor said that he had never seen the case of "directly slamming his fist", and if the patient really had an uncontrollable violent struggle to destroy the sterile environment, he would re-disinfect the cloth.
On social media platforms, some doctors also said: This incident also reminded me that unless life and death are at stake, think more about whether there is no need to be so "urgent" in some of my words and actions under "urgency".
Screenshot of Weibo, authorized has been obtained
Aier responded that "it has been reconciled", and the staff of the Health Commission: It is being investigated and verified
Regarding the cause of the "thrashing", Lin Li believes that "whether the patient tried to touch the surgical area" in this incident cannot be directly judged based on the video, and the possibility that "the patient's head or eyes moved, causing the operation to not proceed".
In addition, in response to the postoperative patient's left eye blindness mentioned by Weibo user "Emergency Sunflower Aifen", many ophthalmologists believe that the beating action may not be related to the patient's blindness outcome, but may be related to the patient's prognosis.
In the "Statement on the Online Information of 'Doctor Operating Table Boxing Patient's Head'" issued by Guigang Aier Eye Hospital in the early morning of the 21st, Aier Ophthalmology said: "This incident occurred on December 12, 2019, and after the operation, the patient had a misunderstanding, and after the doctor explained to the patient and the family, the two parties have eliminated the misunderstanding and reached an understanding. 」
According to relevant media reports, the staff of the Guigang Municipal Health Commission responded that they have paid attention to the relevant situation and are investigating and verifying, and the details are not convenient to disclose to the media for the time being.
In response to the problem of standardized operation in ophthalmic surgery, Aier Ophthalmology replied to Ding Xiangyuan:
"In conventional eye local anesthesia surgery, the patient is always awake, so patient cooperation is very important during eye surgery. In order to ensure that the patient can cooperate, we will teach the patient how to cooperate with the doctor during the operation many times before the operation, and under normal circumstances, the patient can cooperate with the doctor to complete the operation smoothly, because most of the ophthalmic surgery time for local anesthesia is short, and local anesthesia can make the patient almost no unbearable pain, but it is inevitable that some patients will not cooperate because of excessive tension, or are particularly insensitive to local anesthetic drugs. It is rare for the patient to suddenly move in the video, this patient is older, his hearing is not good, he does not understand the requirements of the medical staff, and the degree of cooperation is slightly worse. Poor patient cooperation often increases the difficulty of local anesthesia surgery, making simple surgery complicated or even difficult to manage. Before the surgery, the medical staff will routinely educate the patient and their family about the precautions during the operation, and it is important to cooperate with the doctor to complete the operation smoothly. During the operation, when the patient cannot cooperate with the surgical area and the operator's hands that have been disinfected, the surgeon cannot use his hands to stop the patient's range except for the eye area, because those ranges are bacterial compared to the surgical field, which is also to ensure the safety of the operation. For patients who cannot move during the operation, we will immobilize the patient's hand at the side of the operating bed with the patient's consent, and if they cannot cooperate, they will need to change to general anesthesia. For the elderly, general anesthesia is also risky, so it is more appropriate to choose local anesthesia surgery or general anesthesia surgery after a comprehensive evaluation. Therefore, for ophthalmologists, the success of local anesthesia eye surgery is due to the doctor's credit and the patient's credit, and during the surgical process, the patient's inability to move and cooperate may cause very serious consequences, including the loss of the eyeball, which is an unacceptable consequence for both the doctor and the patient. For skilled ophthalmologists, most local anesthetic eye surgeries can be completed alone, and nurses with instruments can make the operation faster, and surgical assistants will be brought when there is a need for teaching, but the medical staff on the operating table need to complete the surgical hand disinfection, and they cannot stop the movement of the patient's limbs on the table. ”
In addition, the relevant person in charge of Aier Ophthalmology said that the group level will issue an official statement tonight.
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Information sources: Weibo users "Emergency Sunflower Aifen", Guigang Aier Eye Hospital, Qilu Evening News
Source: Lilac Garden (O31)