Chapter 230
"Anesthesia, urgently check the arterial blood gas and send it to the laboratory to check for acid respiration combined with electrolyte imbalance."
"Call the blood transfusion department, ask for plasma, and do a coagulation test to check the risk of DIC."
"Instruments, re-sterilize and prepare the table, and drape the surgery."
Xiao Chenguang's medical orders were like a tornado, creating a whirlwind in the operating room.
The other people were rescued vigorously and resolutely by the three people on the stage, and they were so shocked that they couldn't say a word.
In their view, cardiopulmonary embolism is a fatal situation. Not to mention the treatment plan, life and death are matters of an instant.
For some patients with mild embolism symptoms who are discovered in time, a miracle may happen if they are intubated and put on a ventilator for a few days.
Most patients have one foot on the coffin board and the other foot stepping inside.
But now, the patient has been rescued and even has vital signs. In their opinion, it is more miraculous than a miracle.
Injecting acupuncture, drawing blood, and sending for examination, everyone had the rescue experience just now, and this time Xiao Chenguang's doctor's orders were quickly implemented.
"Director Xiao, do you still need the adrenaline?"
Seeing that the heart rate came back, Anesthesia asked.
"No need to push, switch to hydroxylamine to increase blood pressure."
"Continue to use inotropes, and adjust the speed according to blood pressure fluctuations."
Xiao Chenguang's calm and calm voice still echoed at the scene. In the eyes of others, this disease may be an emergency that eats people without spitting out their bones.
But here, with his rich rescue experience and on-the-spot adaptability, he can carve out a hope of life out of a certain death situation.
Monitor, the patient's vital signs become increasingly stable.
Has the patient been rescued?
Anesthesia looked at the messy glass ampoules on the operating table, feeling that everything was not real.
Xianyou has not yet recovered from the life-and-death rescue situation.
The nurse who witnessed the entire rescue process watched Gong Liang continuously slap and tap on the patient's chest.
I was curious and surprised.
Cardiopulmonary embolism can still be rescued in this way?
She had heard before that she encountered a patient with air embolism on the stage. At that time, a deep vein was used to remove the air from the heart, and the patient was able to survive.
It was incredible at the time. She didn’t expect that cardiopulmonary embolism could be rescued in this way, without deep veins. This was even more beyond her imagination.
"Director Xiao, the test report is out."
Soon, the staff of the laboratory department took the test results and hurried to the operating room.
Arterial blood gas analysis showed that the patient's partial pressure of oxygen and partial pressure of carbon dioxide tended to be normal.
Lactate is five points higher than normal, which is related to cardiac arrest. This will automatically decrease as the patient recovers.
As for the blood routine and coagulation issues, they were also included in the plasma and platelets urgently sent by the blood transfusion department, and were no longer critical.
"Observe for another half hour to ensure that the patient's physical condition is stable."
Xiao Chenguang has experienced many times of on-stage rescue, most of which were emergency and critical patients.
Elective surgeries like this are generally rare, so be more cautious.
The patient's heart rate was beating in an orderly manner on the monitor. Lin Gaoyang on the stage had stopped pressing, leaving only Gong Liang who was still tapping on the precordial area of the chest.
"Liang, stop."
Hearing this, Gong Liang stopped tapping and shook his red and swollen palms.
This tapping was very real. He followed the method Xiao Chenguang taught him and did not dare to slack off.
Xiao Chenguang pulled off the stethoscope from the anesthetist's neck and placed it on the patient's heart and lung area.
The previous gurgling sound like water boiling disappeared, replaced by even breathing and noiseless heartbeat.
Yes, the effect is really good.
Xiao Chenguang was very satisfied with the way he handled it just now.
"Boss, during the rescue operation, you kept asking Gong Liang to tap the precardial area. Why?"
Lin Gaoyang still understands special circumstances and non-standard chest compressions.
But it is really puzzling to have Gong Liang keep tapping on the heart area.
Not only did he have questions, but the operator himself, Gong Liang, was also curious.
The technique of invigorating the lungs and phlegm discharge by turning over and buckling the back is obviously used in the rescue of cardiopulmonary embolism this time.
"This patient has a typical embolism caused by the establishment of pneumoperitoneum."
The patient on the stage was in good condition, and Xiao Chenguang also explained a few words.
"Stopping pneumoperitoneum and preventing further injuries is the primary purpose. This is the same principle as carbon monoxide poisoning, where the injured are first removed from the danger area."
"Change the body position to prevent embolism from further aggravating the burden on the heart, lungs and brain, hit the precordium area, and use inotropes to strengthen the heart, mainly to crush large bubbles, accelerate circulation, and expel gas from the body."
"Of course, the best and most effective way is to perform deep venous puncture, insert the catheter into the patient's right atrium, and extract the air and thrombus. However, such technology requires special materials."
Unlike pericardial, thoracic, and abdominal puncture, deep veins can only be operated with special catheters due to their anatomical structure.
However, because the operating room lacked kit, he was very passive during this rescue.
"I'll have someone fix it right away. This will never happen again."
I had just been immersed in the ocean of learning new knowledge, but when I was suddenly called on, I felt ashamed and quickly said that the supplier was already on the way.
After the matter was over, he suggested to the director of anesthesia that patients undergoing on-stage surgery in the future should at least prepare a deep vein puncture kit in case of emergency.
"When we encounter patients like this in the future, we still need to..."
Xiao Chenguang spoke very quickly, listing dozens of rescue measures, which made everyone burst into tears.
Otherwise, Xiao Chenguang could be the director of general surgery. Rescue only takes a moment, and the reaction time may be only a few seconds.
Director Xiao can not only make accurate judgments, but also has so many countermeasures in his mind.
Even if the young man lies in the coffin, he can be pulled out by Xiao Chenguang.
It's really... too awesome.
Just as everyone was recalling the thrilling rescue just now, a hoarse and low voice sounded in the operating room.
"Xiao Xiao... Is the patient okay?"
As soon as he opened his mouth, Wang Jingang found that his voice was hoarse and unpleasant with a little trembling, and his whole body was nervous and anxious, and even his tone changed.
Although he did not participate in the rescue just now, he saw everything that happened on the stage.
The patient was rescued without any signs, just like the laparoscopy he had just started a year ago.
The patient came on the stage, and before the operation began, his heart stopped, and there was no chance of rescue.
The incident was a big deal, with apologies, compensation, and suspension.
The laparoscopic technology that had just been developed was all stopped, and even the general surgery department was facing disbandment because of this incident.
All the past events, like a tide, poured into Wang Jingang's mind again, like a knife cutting and burning, destroying his heart.
"Director, it's okay."
Seeing Wang Jingang like this, Xiao Chenguang seemed very silent.
He didn't know how to comfort the director at this moment.
He had heard about this incident before. After the incident, Wang Jingang felt so guilty that he locked himself in the office for several days and nights, without eating or drinking, as if punishing himself.
In fact, Xiao Chenguang understood the director's mood very well.
The development of new medical technologies is to open up a road to overcome difficulties and seek hope for life for future generations.
There will definitely be countless things happening in it.
Xiao Chenguang can stand on the shoulders of giants, come back here and use experience and technology to avoid risks, develop business, and seek benefits for patients.
He can do it, but Wang Jingang can't.
Once something goes wrong, the pressure will be enough to crush a giant, not to mention Wang Jingang who was walking alone before.
"Xiao Xiao, thanks to you this time, otherwise, I really don't know what to do."
Wang Jingang's eyes were red. He had been strong all his life, but at this moment he had to admit that he was indeed old in the face of new technology.