I can see the status bar

Chapter 443
Rescue was ineffective.

Sun Li'en was leaning against the wall beside him, sweating profusely, feeling as if his legs had been completely hollowed out by something - there seemed to be no bones inside.

The status bar is still faithfully carrying out his duties, but this time is different from the past. On Huang Bingxian’s status bar, the number of prompts followed by the status of "ventricular fibrillation" is (How long is it before the defibrillation is successfully lifted??? ?Second-rate).

Continuous chest compressions and shock defibrillation had been performed over three 10 minutes, with 30 mg of epinephrine, atropine and continuous chest compressions.Even lidocaine was given almost 30ml.

But the number of reminders still maintained the state of "????", without any wavering at all.

But the rescue that lasted for half an hour still did not stop. Sun Lien gave instructions to use amiodarone 2 minutes after Huang Bingxian's ventricular fibrillation. After 150 mg of amiodarone was injected intravenously, the theoretical onset time was about 30 minutes. .

If amiodarone isn't working, there's really nothing you can do.

During the rescue process, the use of large doses of adrenaline is originally a negative indicator.The more adrenaline used in the rescue, the worse the patient's prognosis.But it is obviously impossible not to use epinephrine—as a first-line rescue drug for dilating blood vessels and reducing peripheral vascular resistance, epinephrine plays a very important role in the rescue of ventricular fibrillation.

However, it is also adrenaline, but norepinephrine and isoproterenol have completely different effects from adrenaline... Well, this is estimated to be tested when practicing medicine.Sun Lien was a little surprised that he could still consider the difference between these three drugs.He slumped on the ground with extremely complicated emotions, watching Yuan Ping'an and Brunn continue to rescue.

Norepinephrine is generally used to strongly constrict blood vessels, rapidly raising blood pressure and reducing blood flow to vital organs.Therefore, the most common application scenario is to rescue patients with hemorrhagic shock—intravenous injection is required. Although intravenous bolus injection can also be used in extreme cases, the risk is extremely high, and it is generally not done this way.Isoproterenol is usually used to relieve asthma and relax bronchial smooth muscle, mainly by aerosol administration or sublingual administration...

Sun Lien stared blankly at Huang Bingxian's hospital bed. Bruen had already done three rounds of chest compressions, and Dr. Pascal was next to take over.

"No..." Dr. Pascal performed two rounds of chest compressions, and it was Yuan Ping'an's turn to do it again.Sun Li'en stood up slowly, looked at the cardiopulmonary monitor showing a straight line, "It's useless."

"Time of death, 1:3 p.m. on January 21." Xu Yourong glanced at the wall clock in the emergency room, "Get the electrocardiogram."

Although everyone had expected Huang Bingxian's death, his ventricular fibrillation happened too suddenly.There is not even a sign of abnormal electrocardiogram.Moreover, the onset of ventricular fibrillation was extremely stubborn. From the onset of ventricular fibrillation at 45:21 to the announcement of death at [-]:[-], during more than half an hour of rescue, Sun Lien and the doctors in the entire treatment group successfully restored sinus rhythm once in a while There is no chance.

Generally, for other patients, after the onset of ventricular fibrillation, timely medication and electrical defibrillation can restore sinus rhythm to some extent.Some may be defibrillated until doctors treat the disease that caused the ventricular fibrillation, while others may have another ventricular fibrillation attack without treatment or even diagnosis.

But Huang Bingxian's ventricular fibrillation attack was a bit too decisive. It was [-] mg of epinephrine and [-] consecutive defibrillations.Even if it's a stone, with so much adrenaline pumped in, it should move.

"Leave the rest to the forensic doctor." Dr. Brun walked up to Sun Lien, and sat down on the ground next to him.The Texan bumped Sun Lien with his shoulder, "Your physical fitness is too weak."

"My wound isn't healed yet." Sun Lien glared at Brunn, "Your skills are too poor."

Dr. Pascal stretched out his hand and pulled Sun Lien up from the ground, and then sympathized, "You shouldn't let him do it, even if you find an intern to sew more carefully than him!"

Sun Lien nodded seriously, "At least the intern won't slap the wound hard after sewing up the wound."

"Hey!" Dr. Brunn was angry, "I've already stitched it up very carefully! I usually use staples to close the wound like yours!"

Sun Li'en laughed, "And charge me 1000 yuan for one suture? Your doctor is too black-hearted."

Staples have a relatively civilized name-disposable skin stapler.Doctors still prefer to call it "staples," though.The reason why doctors do this is also very simple, the name of the staple is more intuitive.Although the price is expensive, the working principle of the disposable skin stapler is indeed not much different from that of a stapler.By pressing, the sterile titanium nails puncture the skin and tighten the skin on both sides to close it.The operation is convenient and quick, and most importantly, when dealing with relatively large wounds, the stapler can save much trouble than suturing.

It takes about 1 minute for Zhou Jun to sew five stitches on a patient.The stapler takes about 2 minutes.In the case of smaller wounds, doctors can actually suture faster.However, it would take at least 10 minutes for Zhou Jun to sew up the seventeen stitches on Sun Lien's body.Because when suturing with multiple needles by hand, not only the suturing technique must be considered, but also the tension of the suture must be adjusted continuously to ensure that the wounds on both sides have enough tension to bond together.If the tension is too small, the wound will not heal; if the tension is too high, a centipede-like scar will be left.

And the stapler sutures seventeen times in a row, which takes about 5 minutes.And because each titanium nail is independent of each other, and the tension provided is constant.Therefore, the probability of severe scars is also lower-if the stapler that can only be used once at 1000 yuan is not effective, no one will use it.

"You physicians, you are so ignorant." Dr. Brunn grumbled and complained, "It only took me 20 minutes to sew seventeen stitches on the chest and abdomen by hand, and there was no needle withdrawal or failure in the middle." !"

Sun Li'en blinked, and decided not to use Zhou Jun to attack Brunn - after working in Ningyuan for a year, Brunn's stitching speed will definitely be much faster.

The number of patients in China's large hospitals is much higher than that in the United States.

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In a large emergency center hospital, the most indispensable thing is always a variety of trauma patients.

The Fourth Hospital seems to have been stabbed with a knife today. Starting from 04:30 in the afternoon, every three or ten minutes on average, there will be at least one unlucky ghost rushing to the Fourth Hospital with his head or arms or something else.During these two hours, there were eight scalp lacerations and cuts alone.The speed at which the cleaning aunts of the property wiped the ground could not even keep up with the speed at which the floor was stained with blood.

"I just complained that there are too few patients who need sutures." Dr. Brunn stretched his arms with difficulty, trying to relieve the pain caused by finger cramps, "There is no need to involve so many people at once. Bar?"

Sun Lien didn't turn his head back and said, "Old Bu, you go to see Dr. Cao Yanhua after get off work."

"Doctor Cao?" Bruen frowned and asked, "Why are you looking for him?"

"Look for him to receive special education in the emergency department—never think the job is too easy." After finishing the last stitch, Sun Lien put down the arm in front of him, and said to the owner of the arm, "It's ok, remember not to let the wound Get in the water, don't do too much activity, and start tomorrow, come to the hospital to change the dressing every day. It will last for a week."

The young man looked at his arm very depressed and asked, "What if the outpatient clinic is on holiday?"

"If you don't want to bother, you can go to your community hospital to change your dressing." Sun Lien lowered his head and prescribed the medicine again and again, "If you have to come to the Fourth Hospital to change your dressing, you can come to the emergency department when the outpatient clinic is on holiday. But there is no way for the emergency department." Follow the sequence, if you come to change the medicine, you may have to wait for a while."

"I know, the emergency department should deal with critical illnesses first." The young man sighed, put on his clothes and left, "Thank you, doctor."

"Okay, I see that there are no patients who need debridement at the door." Yuan Ping'an took off the gloves on his hands, squinted at Dr. Brunn, "Old Bu, I beg you, please don't say anything." Nonsense."

Dr. Bruen was at a loss, "What did I say? I mean the patients who need sutures recently..." Before he finished speaking, Yuan Pingan blocked his mouth with his hand, "Just this sentence , Just this sentence! Don't say it!"

"It's a little less." Bruen said the last few words vaguely, "What's wrong? What I said is the truth!"

Yuan Ping'an covered his face in pain, "Master Brunn!"

"Dinglingling!" The phone at the duty desk rang suddenly, and Xu Yourong answered the phone, "The emergency room of the Fourth Hospital."

"Understood." After a short silence, Xu Yourong hung up the phone, "Ningyuan 120 Forecast, a male patient, the steel bar was inserted through the thigh, pierced through the left shoulder, and it will be delivered in 15 minutes."

After a brief silence in the emergency room, all the doctors fell silent, and then they burst out in a neat sentence, "Master Brunn!"

Bruen, who was being scolded, scratched his head, "So wicked?"

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This kind of severe trauma patients predicted means that the entire emergency room will have to be busy.No, it's not just the emergency room, orthopedics, general surgery, hepatobiliary surgery, transfusion medicine, imaging, and even thoracic surgery and neurosurgery.Which departments should be busy depends mainly on how many organs were injured by the patient pierced by steel bars.

It's not that the Fourth Hospital has never had contact with such patients before, but it's just like ordinary people intuitively feel-this situation is very dangerous.It penetrates from the right leg and exits from the left shoulder, which means that almost all organs in the patient's abdominal cavity may be injured.At the same time, the spine, aorta and main veins, and even the respiratory system including the diaphragm may be damaged.

And the 15 minutes forecast in advance is the best time left for Sun Lien and the others to call for support.

Hello, Brother Pheasant?Dongxing's rotten boy has made a big deal!
(End of this chapter)