I can see the status bar

Chapter 144 Talk about Cao Cao, Cao Cao arrives

Ningyuan, the Fourth Central Hospital, was brightly lit. The patients and family members who came to see the doctor were still anxiously waiting for the doctor's treatment as usual.

"It's low again?" Liu Tangchun was so busy today that his forehead was sweating, and he had already changed three T-shirts.The No. [-] City Hospital, which is the closest to the No. [-] Central Hospital, received a suspected case of bird flu today. A staff member of a chicken farm in the suburbs of the city was unconscious with a high fever. At the same time, there were reports of a large number of poultry deaths in the chicken farm.After the Ningyuan City Center for Disease Control and Prevention sent the staff member to the fever clinic of the Emergency Department of the Second Municipal Hospital, it directly closed and isolated the emergency department of the Second Municipal Hospital.This caused the pressure on the Fourth Central Hospital to increase a lot.And "coincidentally", the Fourth Central Hospital also received many critically ill patients today.

Liu Tangchun is busy dealing with the No.3 patient with fulminant myocarditis who was delivered within today.Among the first two patients, the most critical patient has been connected to ECMO (Extracorporeal Membrane Oxygenation), while the other ECMO is working in the ICU. The ECMO that can be used immediately in the Fourth Central Hospital Machine, only the last set left.

A set of machines, and there are two patients with fulminant myocarditis in front of them.Liu Tangchun was so anxious that he almost cursed.With great difficulty, I worked with the critical care medicine department and the doctors in the heart to stabilize the condition of the two patients, but not long after I relaxed, bad news came from the emergency room—one of the patients’ heart rate dropped again .

"Are you ready to go to the capital?" Liu Tangchun picked up his white coat and was about to run to the emergency room. Before he reached the door, he saw Liu Pingchuan swaying towards him with his hands behind his back. "What are you doing here? Are you leaving get off work?"

"The next ghost." Liu Tangchun walked around Liu Pingchuan angrily, and walked quickly towards the emergency room, "Three explosive myocarditis! There is only one ECMO that can be used in the hospital. How do you tell me to get off work?" ?”

Liu Pingchuan has long been no stranger to Liu Tangchun's fiery personality.He quickly followed behind Liu Tangchun and explained, "The hospital bought a total of three ECMOs at the beginning, and two of them were assigned to your emergency department. The serious ones came to me many times, so I left them all for you. ?”

"If you don't leave the ECMO to me, is it possible to put it out of your mind?" Liu Tangchun snorted twice, "Why are you following my ass? I didn't ask you to come for a consultation."

Liu Pingchuan smiled, "Didn't I hear from Old Zhu of the Tongxie that he plans to send his students to our hospital to study..."

"What old pig? There's something about the second senior brother?" Liu Tangchun pretended to be confused, "Why don't I understand?"

After all, he wanted to poach someone from Liu Tangchun. Liu Pingchuan's attitude was unusually good, and his mentality was also extremely good, "Zhu Minhua's student, that young man named Yuan Ping'an."

Liu Tangchun faltered a few words, and almost reached the door of the emergency room, and then said directly, "Zhu Minhua has already agreed with me to let Yuan Ping'an come to our emergency department and learn a lot from Xiao Xu and Li En. By the way, Yuan Ping'an is a Ph.D. in emergency medicine, so it's not unreasonable for him to be a neurosurgeon with you."

"Yuan Ping'an planned to take my Ph.D. exam." Liu Pingchuan sighed, and explained with force, "I suddenly decided to come to Ningyuan that year. In the end, I really had no other choice, so I entrusted him to Zhu Minhua, now that they are chasing all the way from the capital to Ningyuan, it will be unreasonable to procrastinate, right?"

Liu Tangchun opened the door of the emergency room, "I don't care about this matter, anyway, he is now the chief resident of the emergency department, and he is also my person who comes to Ningyuan!" He strode into the emergency room and began to observe the patient's condition. "Tell me about the situation, who is in charge of the bed?"

Liu Tangchun was dealing with the situation urgently, even if Liu Pingchuan had an important matter, he could only hold back his words first.There happened to be two patients with suspected spinal cord concussion in the emergency room. Since Liu Pingchuan appeared in the emergency room, the doctors in the emergency department just brought the vice president to come for a consultation—since there was no time to call the doctor from Shenwai They came to help, Xu Yourong is not in the hospital now.Holding the mentality of "no use for nothing", Cao Yanhua, the attending doctor in charge of the two patients, simply put the newly released CT scan into Liu Pingchuan's hands, "Dean Liu, please show me this..."

Liu Pingchuan frowned and looked at the CT. After watching the first film, the structure on the film was normal without any abnormalities.He just agreed and supported the diagnosis of spinal cord concussion.Liu Tangchun's side became chaotic.Liu Tangchun directed the doctors to start the rescue of a patient receiving IABP (intra-aortic balloon pump) circulatory support for a sudden myocardial infarction.

"Charging, 150 joules, get out of the way!" Nurse Zhong Yu rushed over with the defibrillation pads, and placed the two electrode pads on the patient's right front chest and left lower rib. After confirming that everyone pushed away enough, Nurse Zhong pressed the defibrillation button.

"It's still ventricular fibrillation, intubate first! Bring 150 amiodarone, give an intravenous injection according to the flow rate of one hour, and inject 50 mg of lidocaine intravenously!" Liu Tangchun threw away the white coat in his hand, and the whole body The man knelt by the bed and started CPR, his gray hair rising and falling with the pressure of his body.

"It's plugged in!" Cao Yanhua rushed over when Zhong Yu was defibrillating.When Liu Tangchun was doing cardiopulmonary resuscitation, Cao Yanhua was already intubating the trachea with a laryngoscope.When Liu Tangchun pressed No. 12 times, Cao Yanhua had already completed the endotracheal intubation.And the endotracheal tube was withdrawn, and the tube was connected to the ventilator.

"Second defibrillation, charge 180J, get out of the way!" Zhong Yu started the second defibrillation.But the effect is still not ideal.The patient's ventricular fibrillation disappeared for only about 20 seconds, and then fell into ventricular fibrillation again.

It was a young child who fell into ventricular fibrillation on the bed.His name is Zhang Kai, he is 16 years old, and he is a freshman in Ningyuan No. [-] Senior Middle School.When it snowed heavily in Ningyuan two days ago, after class, Zhang Kai and a group of classmates played wildly on the playground all afternoon.By the time I got home, my clothes and shoes were all soaked.After being scolded severely by the parents, he took a shower and changed into clean clothes.Unexpectedly, Zhang Kai developed a fever that night. At first, the parents thought it was just the child who had caught a cold, and didn't pay much attention to it.Unexpectedly, a weekend passed, but Zhang Kai's condition became worse and worse.On Monday, he was ordered by his parents to go to school with a mask, and as soon as school was over in the afternoon, Zhang Kai was sent to the ambulance by the school teachers - he passed out.

In the Fourth Central Hospital, Zhang Kai was diagnosed with fulminant myocarditis.And what worried Liu Tangchun all the time was the condition of this young patient.Blood tests showed that Zhang Kai's creatine kinase index was as high as 1179U/L, and the creatine kinase isoenzyme was 150U/L.Coupled with the fact that Zhang Kai's urine output was less than 100ml within one day of admission, Liu Tangchun determined that the child may have acute kidney injury.So I went to CRRT (Continuous Renal Replacement Therapy).

But the situation was still deteriorating, and Zhang Kai fell into ventricular fibrillation again.The third defibrillation, the fourth defibrillation, the fifth defibrillation, and finally, on the sixth defibrillation, his heart returned to regular beating.However, his blood pressure was shockingly low, 45mm Hg systolic and 30mm Hg diastolic.Heart rate is about 90 beats/minute.

"The pupils on both sides are dilated, with a diameter of 7 mm." Cao Yanhua checked Zhang Kai's pupils and shook his head, "Director Liu, this patient... is in trouble."

"Then what can we do?" Liu Tangchun, who was wet with another T-shirt, was in a bad mood. "He is only 16 years old. If our measures can be followed, he can survive this test and live like ordinary people in the future. "Resist, if you can't resist, you have to resist. As long as we can bear it, he has hope."

Taking advantage of Liu Tangchun's rest time, Liu Pingchuan came over again, "Old Liu, please save face. At least you let Yuan Pingan come to my place and learn for a while."

Liu Tangchun snorted through his nose, "You also saw that there are so many things in my emergency room, and every patient is fatal. I gave him to you, where can I find such a vacancy?"

Liu Pingchuan was in a hurry, "Your surname is Liu, don't put your nose on your face! You Rong was abducted by you to work in the emergency room..."

"Then it will be an exchange." Liu Tangchun quickly stood up and patted Liu Pingchuan on the shoulder. "As long as Yuan Pingan is willing, I have no objection to letting him study with you. In exchange, you can let Xu Yourong work here with peace of mind during this time." He smiled and pushed Liu Pingchuan out, "You also know , Takeda wants to donate a diagnostic center, let You Rong take the lead! Well, I have something to do here, so let’s stop here first.” As soon as he finished speaking, he pushed Liu Pingchuan out of the emergency room and closed it by the way. Steel electromagnetic door.

Liu Tangchun was about to laugh a few times triumphantly, but he heard the alarm sound of the heart and lung monitor behind him.Turning around, Zhang Kai had another ventricular fibrillation.

"Oh, I'll fuck it..." Rao the well-informed Liu Tangchun, seeing this situation, still couldn't help but swear.

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The emergency rescue started again, and the doctors performing chest compressions had changed three times. Everyone was so tired that they didn't even have the energy to speak.Even Xiao Guo, a male nurse, did a set of chest compressions, and the results were neither good nor too bad—although the patient still hadn't recovered his ventricular tachycardia, at least he didn't break Zhang Kai's ribs.

"Go to AutoPluse, it's not the way to go on like this." Liu Tangchun wiped the sweat from his brow, and he took another look at the condition of another myocarditis patient. Although it was not good, it was still stable.The rescue has been carried out for 10 minutes, and Zhang Kai recovered eight heartbeats, but each time did not exceed 2 minutes.If this continues, you can only use the ECMO system.But if the last set of ECMO is used, it means that once another patient has the same situation, it will be completely impossible to save.

Liu Tangchun subconsciously opened his mouth and called out to Zhou Jun, and then realized that his lover was resting at home—the incident of Zhou Xiufang hit Zhou Jun hard.Liu Tangchun made the arrangement for Zhou Jun's holiday.He froze for a moment, then called out "Lien!" Then he suddenly shook his head and smiled wryly. Sun Lien was visiting the difficult operation in the capital. Calculating the time, he might just get on the high-speed rail now...

"Director Liu, did you call me?" The door of the emergency room was pushed open, and Sun Lien appeared in the emergency room, wearing a new down jacket, carrying an old backpack, and with two dark circles on his face.He looked at Liu Tangchun curiously, and pointed to the door of the first-aid room behind him, "I just heard you call me from outside... I came in."

　Atlantoaxial replacement is currently the most difficult operation in the field of orthopedic surgery - it can almost be taken out alone, and liver transplantation, radical resection of cancer of the head of the pancreas, decompression of the third and fourth ventricle, type A aorta Dissection and inversion of the great artery are called "five-star difficult surgery".It can be regarded as the brightest diamond on the crown of orthopedic surgery.

　　It's a pity... this kind of operation is not very interesting, but rather boring.In order to ensure the fluency of everyone's reading, Sanguan decided to skip the operation part of the posterior approach. If you are interested, you may list it separately later.

　　I've been really tired these past few days, and I've kept in mind the thing about breaking my promise at midnight, and I have to make up for it slowly.

　　19/03/19 22:24 修改了两处错误，应该是脊髓震荡而不是脊椎震荡。

　　
　
(End of this chapter)