Chapter 130

When Lin Gaoyang heard that the nurse was cutting the bag without gas, his heart skipped a beat.

Unable to intubate the trachea, without a tracheotomy bag, and unable to open the airway for a long time, what awaits the wounded is endless despair and death.

"Help...me."

The strong desire to survive suddenly woke up the wounded who were originally unconscious.

The man's expression was ferocious and terrifying, and his eyes still showed the desire for life.

As long as he had a breath left, he would fight tooth and nail to survive.

For the sake of his elderly parents, and for the sake of his wife and daughter, as the mainstay of the family, he must not die.

At this time, a firm voice sounded in his ears, and vaguely, under the dazzling sunlight, a motionless figure stood in front of him.

"Don't panic, help me prepare a syringe, saline, guide wire..."

Xiao Chenguang remained calm in the face of danger, commanding the nurses on board to prepare relevant supplies.

The moment he saw Xiao Chenguang taking out the puncture needle, Lin Gaoyang beside him suddenly thought of a possibility.

Cricothyroidotomy.

This is a puncture method chosen for emergency upper respiratory tract obstruction in order to open the airway as quickly as possible.

The new version of the textbook is clearly written, but in actual operation, there are many difficulties.

Positioning, materials, and operations are all indispensable.

As for these items, from Lin Gaoyang's perspective, it seems that Shengli Hospital has not yet introduced relevant technologies and equipment.

For a surgeon, no matter how skilled he is, if he doesn't have the right tools, everything will be in vain.

"Boss, are you going to do cricothyroidotomy?"

Lin Gaoyang asked uncertainly.

"That's right!"

Xiao Chenguang put on gloves and quickly disinfected the skin of the injured person's neck.

"Since there is no incision bag, we can use cricothyroid membrane puncture technique instead. As long as it can relieve the casualty's airway obstruction, any method can be tried."

One of the indications for cricothyroidotomy is that it is used in emergency situations when conditions for tracheotomy are not available at the scene.

However, this technology requires a special cricothyroid membrane puncture kit to be convenient to use.

But in this era, the popularity of hospital-specific kits is far from meeting requirements.

So Xiao Chenguang's idea is also very simple.

If there are no conditions, create conditions. The necessary items are obtained from local materials and used for whatever they have.

"Director Xiao, the salt water is pumped."

The nurse prepared all the items according to Xiao Chenguang's request.

Although she didn't know what cricothyroid membrane puncture was and how difficult it was to perform.

But if it was Xiao Chenguang who did it, there would be no problem.

"Okay, you can use iodophor to sterilize these items and keep them for later."

After Xiao Chenguang finished his instructions, he turned sideways and looked at Lin Gaoyang.

"Gao Yang, put the patient in a supine position, put a pillow under the shoulder blades, and tilt the head back as much as possible to fully expose the trachea."

"clear."

Lin Gaoyang didn't dare to delay. He found a pillow, held the back of the wounded man's neck with one hand, and lifted it hard.

The powerful explosive force almost lifted the wounded man's entire upper body.

A body weighing nearly 200 kilograms could be lifted at will, with one hand. This made Xiao Chenguang's eyelids jump.

"Take it easy, take it easy, okay, okay, that's all, keep some strength."

Xiao Chenguang supported the wounded man and positioned himself with Lin Gaoyang.

I have to say, strength really works.

Originally, depending on the condition of the injured, the operation of placing a pillow under the shoulders required at least two or three people to work together.

But at this moment, Lin Gaoyang could do it alone. Not only was he fast, but the angle and position of the pillow were also just right.

This allowed Xiao Chenguang to quickly carry out the next operation.

Press your index finger on the injured person's Adam's apple and slide it up and down to locate the puncture point.

"Boss, his neck is so swollen, can he still feel the thyroid cartilage and cricoid cartilage?"

As a cardiothoracic surgeon, Lin Gaoyang has a much better understanding of airway structure than other doctors.

Generally, cricothyroid membrane puncture is performed on the membrane between thyroid cartilage and cricoid cartilage.

Normal people touch their throat and can press down on the soft tissue that causes nausea and coughing, which is usually the cricothyroid membrane.

But the injured person in front of him had a short neck, and the skin was burned and swollen, and his original physiological structure was covered.

It is very difficult to locate accurately.

Faced with Lin Gaoyang's worries, Xiao Chenguang said nothing. The touch from his fingers made him realize that ordinary positioning methods would not work for the wounded in front of him.

Xiao Chenguang immediately raised his palms upright, closed the tips of his hands, and quickly found the suprasternal fossa of the wounded man with his little finger.

and the depressed point where the lower edge of the clavicle connects with the upper part of the manubrium of the sternum.

With gentle pressure, the area pointed by the adjacent index finger at this moment is the cricothyroid membrane.

"What kind of positioning method is this?"

Lin Gaoyang on the side was stunned. He had never seen the positioning method used by Xiao Chenguang in the textbook.

"Syringe, blade, ready to puncture."

Xiao Chenguang reminded him that the empty needle handed over by the nurse was now filled with sterile saline.

Pull out the needle cap and insert the needle at a 45° angle according to the positioning point.

The steel needle pierced the skin, passed through the tissue, and went all the way down. When the needle was halfway into the neck, blisters suddenly began to appear in the lumen filled with sterile saline.

The tiny blisters gradually grow bigger and bigger, forming a white mist just like boiling hot water.

"Gao Yang, give me the catheter."

After verifying the puncture result and confirming that it was inside the trachea, Xiao Chenguang picked up the blade and gradually incised and expanded the skin according to the positioning needle.

Scarlet blood began to flow down his neck.

Everyone on the scene dared not look directly at it, and they were terrified.

Only Xiao Chenguang was confident, and the tip of the knife quickly separated the swollen tissue around the cricothyroid membrane.

"Catheter!"

"Okay."

After the cricothyroid membrane area was cleaned, Xiao Chenguang took the tracheal tube from Lin Gaoyang's hand and directly inserted it into the main trachea of ​​the injured person through the cricothyroid membrane.

Seeing this, Lin Gaoyang, who was assisting at the side, connected the breathing bag that had been prepared long ago to the catheter exposed at the neck.

The nurse next to him grabbed the bag, squeezed and loosened it with her fingers.

Suddenly, a stream of clear water flowed into the injured person's lungs that were about to burn out.

Whoosh!

The cool gas was quickly exchanged in the lungs, and the injured person, who had a ferocious expression, suddenly felt like he was reborn.

He opened his mouth, took big gulps, and greedily sucked in the fresh air.

His dark face also had a little red light.

"Director Xiao, the patient's blood oxygen saturation has increased!"

The nurse on the vehicle, who was holding the ball and observing the vital signs of the injured, excitedly reported the situation.

The blood oxygen saturation, which was originally at a critical value, has climbed to more than 90% in just a blink of an eye.

Lin Gaoyang, who was standing by, was even more shocked.

Precise positioning and blind puncture techniques, as well as the intact thyroid cartilage and cricoid cartilage above and below the catheter.

The boss is worthy of being the boss, with sufficient experience and high medical skills.

In this kind of "lack of food and clothing" on-site treatment, he can still maintain such superb skills.

Lin Gaoyang knew in his heart that even if the injured was hospitalized with a tube, it would not affect his speaking in the future.

After solving the problem of airway obstruction, Xiao Chenguang found that the skin temperature of the injured was very hot, and raised his head and shouted to Gong Liang not far away.

"Gong Liang, can't the ambulance come in?"

"It can't come in. Both sides of the road are blocked by small stalls. I searched for a long time, but couldn't get through."

"Director Xiao, it really doesn't work. We can only ask the driver to take a detour."

Gong Liang seemed very anxious.

When treating the patient, Xiao Chenguang assigned Gong Liang a task to help clear the passage so that the ambulance could come in to pick up the patient.

But the narrow streets in the shantytown were full of debris. Gong Liang tried his best and almost shouted himself hoarse, but it was still useless.

"It's too late to take a detour. Forget it. Go find a water pipe. The injured need to be cooled down urgently."