Chapter 405

"Is it really brain herniation?!"

Hearing the doctor's roar, the nurse was like she was facing a great enemy and instantly switched to emergency mode.

Brain herniation is the most serious complication of cerebral hemorrhage. It refers to the increase in intracranial pressure caused by the compression and displacement of brain tissue out of a specific range.

Poor prognosis, high mortality rate and disability rate.

Dehydration and reducing intracranial pressure are basic measures to prevent or alleviate brain herniation.

As Xiao Chenguang said just now, the nurse here has instinctively searched for medicine in the rescue box.

"Inject 20% mannitol 250ml intravenously, and furosemide 20mg intravenously. Quick!"

The doctor also knew that the patient's condition was urgent and immediately began to give rescue medical instructions.

At the same time, he cursed in his heart.

What bad luck!

It was obviously a patient with mild cerebral infarction. How could he fall and have cerebral hemorrhage.

Now it is a direct brain herniation and urgently needs surgery.

There were no family members at the scene, and I didn't know who to ask to sign the consent form for the operation. It was still unclear whether the patient could survive.

All kinds of difficult decisions were piled up in front of the doctor.

"There must be no more problems!"

As the drug was injected into the patient's body, the doctor prayed silently in his heart.

The liquid in the Murphy's dropper flowed into the patient's body like water along with the injection made by Xiao Chenguang.

The nurse looked up at Xiao Chenguang while pushing furosemide.

"Thanks to you for using a No. 7 black needle for the patient, otherwise I would have to give another injection."

Mannitol lowers blood pressure, and the key is speed.

Whether it is to reduce intracranial pressure or to compress the spinal canal due to lumbar disc herniation, it is best to infuse all 250ml of liquid within fifteen to thirty minutes.

The fast speed, coupled with the high osmotic pressure, will stimulate blood vessels and cause pain.

Therefore, the choice of blood vessels is crucial.

"I am also doing my best under the limited conditions."

Xiao Chenguang considered these problems in advance, so he directly used a black needle to establish a venous access in the median blood vessel of the patient's forearm.

In order to allow the patient to receive better treatment.

"Awesome!"

The nurse looked at him with admiration and couldn't help but praise him.

A young doctor who came from another place for further training can not only provide first aid on the spot, but also give injections, and even choose blood vessels more accurately than these old nurses.

Really amazing.

While talking, the nurse's hands did not stop, she called Xiao Chenguang to help her take off the patient's pants.

Before, furosemide was injected, and the patient needed a catheter to evaluate his intake and output.

This is a basic operation.

Generally, male patients are catheterized by male doctors.

But now, the doctor on the car is paying attention to the changes in the patient's pupils. He keeps turning the patient's eyelids to check the light reflex.

There is no time to operate at all.

As for asking Xiao Chenguang for help, the nurse is not bold enough to do so.

Wear gloves, disinfect, hold, and insert.

The movements are smooth and the operation is fast.

The whole process does not take more than three seconds.

It is said that emergency nurses are good at both literature and martial arts, and can be called all-rounders.

"The patient's pupils have changed!"

The doctor who has been at the patient's bedside shouted again.

With the drug treatment, the pupils that were originally dilated and fixed began to shrink slightly.

This means that the intracranial pressure is decreasing.

The patient can be saved!

"Master Liu, how long will it take to get to the hospital?" The doctor only had time to ask the driver in the cab at this time.

"It's lunch time now, there is a little traffic, it will take about 8 minutes!"

There are obviously more vehicles on the roads in the provincial capital, and there are no dedicated roads for special vehicles at this time.

There are many cars lined up in front of the ambulance, and even with the alarm on, it is still impossible to get through unimpeded.

"It's okay, it's okay, eight minutes will be here soon."

The doctor muttered, still wiping the red blood that kept flowing from the corners of the patient's mouth.

However, things did not go as he expected.

He opened his eyelids again.

The originally dilated pupil was contracting, but the other normal pupil was now blood red.

The eyeball kept shaking at a very fast speed, like a broken clock, swinging left and right.

Just like in the horror movies that we often watch, humans invaded by evil spirits have weird and uneasy eyes.

"Nystagmus?!"

Xiao Chenguang had already stood up from his seat.

The monitor he had been paying attention to also began to change at this moment.

The heart rate suddenly soared, like a wave of raging waves, bright red numbers, flashing alarms, and a harsh sound in the small and cramped carriage for a while.

"Is the patient twitching?"

The nurse had just fixed the catheter and was shocked to find that the patient's waist and hips were tightly lifted, his hands and feet were straight, his body was arched, and his body was trembling slightly.

It was like a person who was frozen by the heavy snow, or a patient who was stabbed by rust and had tetanus.

The skin was as hot as charcoal fire.

High fever, convulsions, craniocerebral injury with brain hernia, plus arrhythmia.

The doctor on the car felt that an invisible big hand pinched his neck, and he couldn't make any sound from his mouth.

He had seen and treated many seriously ill patients, but it was rare for the patient in front of him to develop so quickly.

A moment of hesitation made the patient's condition more serious.

Muscle tension leads to respiratory muscle paralysis, the patient's breathing becomes slower and slower, and the blood oxygen saturation on the monitor drops precipitously.

"Is there diazepam in the rescue kit? 5mg IV push."

"Prepare the bite, bandage, laryngoscope, endotracheal tube..."

"Set the defibrillator to standby mode."

Xiao Chenguang's voice broke the deadlock.

"Yes, yes, I'll get it!"

The doctor came back to his senses and saw that Xiao Chenguang was calm as usual, and instinctively followed his instructions and began to act.

The nurse took out diazepam from the rescue box, broke open the ampoule, sucked out the liquid medicine, and quickly pushed it on the patient.

The drug was administered intravenously, and the effect spread throughout the body in a few minutes.

The patient's muscle stiffness was relieved, and the doctor on the car had found the intubation items.

"Help me open the airway."

The faint voice sounded, without any emotion.

This look of not changing color in the face of a mountain collapse made the doctor start to assist Xiao Chenguang in rescuing the patient without thinking.

The patient had a forehead injury, and the doctor did not use the traditional EC technique, but placed the thumbs of both hands on the patient's cheekbones on both sides.

The index finger, middle finger, and ring finger clasped the left and right mandibular angles and lifted them up with force.

It not only ensured the opening of the airway, but also prevented the patient from causing secondary injuries.

The action was done in one go and was very skillful.

Seeing this scene, Xiao Chenguang nodded. It seemed that the doctor's hesitation just now was just because he was shocked by the sudden change of the condition.

"The patient's forehead and face were injured, the structure was unclear, and there was a lot of blood in the mouth. I asked the nurse to shine a flashlight for you, otherwise it would be difficult to find the glottis."

The doctor reminded him, but Xiao Chenguang's voice rang in his ears.

"Come on, pull out the guide wire."

Xiao Chenguang came to the bedside, holding a laryngoscope in his hand, facing the doctor's instructions, directly picked up the patient's epiglottis cartilage, and inserted the tracheal tube with his right hand.

The technique was very easy.

The airflow was exhaled along the tube, forming a mist on the inner wall.

It proved that the tracheal intubation was in the middle, right in the lungs.

"!!!"

The doctor who was still opening the airway did not react, and Xiao Chenguang's tracheal intubation was completed.

The operation was completed in less than 10 seconds.

It was still a patient with forehead and face injuries and difficult intubation.

At this speed, even their emergency director might not be able to do it to this extent.

"Isn't he a doctor who came to the hospital for further training?"

The doctor who pulled out the guide wire and fixed the tracheal tube according to Xiao Chenguang's request looked at Xiao Chenguang suspiciously.

The latter had no time to pay attention to him. He took the stethoscope and put it on the patient's chest, staring at the value on the monitor.

"Open the oxygen directly to 10L/min, one bottle of luminal sodium, intramuscular injection."

"Okay!"

The nurse was also shocked by Xiao Chenguang's tracheal intubation.

She didn't dare to say more, and immediately fixed the oxygen tube, and then began to inject drugs according to Xiao Chenguang's doctor's instructions.

At this time, the patient's condition was completely improved.

The blood oxygen saturation rose to more than 90%, and the problem of arrhythmia was also alleviated.

The people who saw this scene finally breathed a sigh of relief. They looked at the defibrillator that was flashing on the side and secretly rejoiced.

Thank goodness this thing didn't come in handy, otherwise it's hard to say whether this patient can hold on until returning to the hospital.

"Master Liu!" The doctor shouted.

"We're almost there!"

The ambulance was driving on a crowded road, and the towering inpatient building not far away came into view.

Master Liu saw that the patient was being rescued, so he picked up the horn and began to loudly ask the vehicles in front of him to move out of the way.

The irritable roar, coupled with the alarm that resounded through the sky, everyone knew that the situation was urgent and began to move out of the way.

120 soon arrived at the emergency door of the Second Hospital. The medical staff who heard the sound pushed the flatbed and waited anxiously.

The car stopped and the door opened.

The patient was pushed off the ambulance, and everyone lifted him onto the flatbed and quickly ran to the emergency room.

Xiao Chenguang, who followed, was carrying a box. As soon as he entered the hall, a cry of surprise rang out.

"Director Xiao, why are you here?"