Back in 2002 as a doctor

Is it really an air embolism?

When Wang Cheng was in a daze, a stern voice said, "Adjust your body position, keep your head low and your feet high."

A second later, before running in the operating room, Zhou Congwen smashed a hemostat at the anesthesiologist.

"Crack~"

"Xiao Zhou……"

"Body adjustment, didn't you hear me! Rescue, what a daze!" Zhou Congwen said coldly.

The anesthesiologist shuddered and immediately adjusted the angle of the operating table.

Fortunately, the operating table in the Third Hospital is relatively new, and the angle can be adjusted. Otherwise, it would take at least 3-5 minutes just to position the patient.

"Give 100% pure oxygen."

"Ventilator adjustment mode, continuous positive airway pressure ventilation."

"Shen Lang, find the place where the emphysema spreads under the skin, press it, and twist upwards."

"Director Wang, look directly at the heart and press, pay attention."

"Epinephrine 0.1 mg intravenously."

"Dexamethasone 10mg IV."

"Traveling, looking for the ice cap, hurry up."

A series of rescue orders echoed in the operating room.

Every doctor's order whizzed past like a bullet, and the anesthesiologist, nurse, and Shen Lang began to execute the doctor's order without hesitation.

Wang Chengfa was stunned for a moment, "Who asked you to direct the rescue?"

Zhou Congwen looked sideways at Wang Chengfa viciously, "Wang Chengfa, can you fucking rescue an air embolism?"

"..." Wang Chengfa never expected that Zhou Congwen would have spikes all over his body, and he was no longer as gentle as usual.

Will you save yourself?

Definitely not!

In the event of air embolism, the patient will definitely die, and there is no doubt about it.

Damn Zhou Congwen is willing to take the blame and let him take the blame. Now that he is proud, let him cry right away!

Wang Chengfa instantly understood the facts and confessed directly.

"No, just be honest, pinch your heart, don't need me to teach you." Zhou Congwen stared at the ECG monitoring and roared viciously.

In the operating room, only the sharp alarms of the monitor and the ventilator sounded. The others were overwhelmed by Zhou Congwen's aura, and even found it difficult to breathe.

"Quicken the infusion, give the colloid first."

"Epinephrine 0.1 mg intravenously, dopamine 10 mg intravenously, dexamethasone 10 mg intravenously."

"Preparing to suction the CVP catheter..."

As he spoke, Zhou Congwen was taken aback.

CVP is also called central venous pressure measurement, it was not taken before surgery!

Trouble... Zhou Congwen reached out his hand coldly, "Central venous pressure puncture kit."

"Ah? What do you want it for?" The itinerant nurse was taken aback.

But Zhou Congwen's fierce and domineering gaze made her swallow all the words that followed.

When he heard that it was an air embolism, even Wang Chengfa fell silent, and even beeped a woolen thread himself.

Before the hemostatic forceps came crashing down, the itinerant nurse trotted to find the central venous pressure puncture kit.

Wang Qiang stared at Zhou Congwen in a daze. Zhou Congwen, who had always been honest, suddenly became unknown to him.

He stood in the position of the surgeon to direct the rescue, and every doctor's order was very clear. Although he couldn't figure it out for a while, he could still find the reason in a corner of his memory after trying hard to recall.

The purpose of reversing the angle of the operating table is to place the patient in a left-side lying, head-down position so that the foam is located at the apex of the right atrium or right ventricle until the gas dissolves in the blood or is withdrawn through a central venous catheter extending into the right atrium.

But can he really do it?

impossible!

This is just what is written in the book, there are too many things written in the textbooks, how many people can really do it!

Countless impossibilities floated in Wang Qiang's heart.

Air embolism, the patient is dead... What should I do?

This patient was managed by himself, if he really died on the operating table... no!Wang Qiang immediately thought of a way, "Master, why don't you push it back to our small intensive care unit immediately?"

His meaning was obvious, while the patient was still breathing, he pushed it back first.

Stepping down alive and dying on the operating table are two completely different concepts.

Then "rescue" for a period of time, and the patient's death will be announced after the patient's family has sufficient psychological expectations.

The advantage of doing this is... Wang Qiang suddenly felt as if a needle had been pierced into the skin on his face in a flash, and the sharp pain interrupted his thoughts.

"Go away!" Zhou Congwen cursed in a deep voice, "You are still alive, why push back and wait to die? Just be yourself."

Wang Qiang's face was red when he was scolded, but he couldn't refute.He could only stare at Zhou Congwen angrily, even though Zhou Congwen's eyes never fell on him.

After looking at it twice, Wang Qiang felt very embarrassed, and looked at Wang Chengfa again.Master Wang, who has always been fierce and domineering, was honestly pinching his heart. Wang Qiang couldn't understand what happened and why such a strange situation occurred.

There was a sound of running, and the itinerant nurse ran over with the puncture kit.

The deep vein puncture kit has just entered the operating room, but no one can get it except the director and another anesthesiologist.

Zhou Congwen, can he do it?

Chapter 0057 If You Pee Scared, Will I Come?

The patient's blood pressure was very low, and the median elbow vein became a white line.

Zhou Congwen twisted the trocar with one hand and three fingers and inserted it straight in.

No slapping, no cuffs, simple and straight to the point.

The itinerant nurse was just about to turn around to take the cuff, when she suddenly saw black and red venous blood appearing in the trocar.

Xiao Zhou's level is good!

You must know that indwelling intravenous access for shock patients is a big problem. During the emergency rescue, the nurses were sweating profusely but not able to penetrate it, and some people even cried anxiously at the end.

Seeing Xiao Zhou's technique was so proficient that the itinerant nurse had a slight hallucination, as if he didn't even look at it, and the blood was seen with one needle.

Insert the guide wire along the cannula and withdraw the trocar.

Zhou Congwen did not use a dilator to expand the skin and subcutaneous tissue, but directly took the corresponding catheter. Each lumen of the catheter was filled with heparin saline, and inserted into the central vein along the guide wire.

The itinerant nurse had been trained and wanted to remind Zhou Congwen, but saw this scene.

Xiao Zhou is going to heaven!

When will he have a central venous puncture?And so proficient!

"Xiao Zhou, the guide wire needs to be taken out." The itinerant nurse said nonchalantly.

"It's useful for me to keep it. Has the ice cap arrived?" Zhou Congwen asked with a frosty face.

The aura contained in the evil dragon who has been entrenched in the pinnacle of medical treatment for so many years is not pretending, but a simple sentence makes the itinerant nurse's heart beat wildly, as if he has made some unforgivable mistake.

"I'll go right away." The itinerant nurse didn't even look at Zhou Congwen's operation, and turned to whoever ran.

Zhou Congwen operated the J guide wire along the median vein to the supraclavicular vein and then to the superior vena cava, and then into the heart.

Without the guidance of B-ultrasound, he can only rely on the memory of countless operations in his previous life.

Although it was difficult, it was not to the extent that Zhou Congwen couldn't do it.

But Zhou Congwen also felt lucky, this kind of small operation is not very tricky, it mainly depends on experience.In terms of experience, he doesn't think anyone has received more training in the system operating room than himself.

The force transmitted back from every point touched by the "J"-shaped guide wire, and the length of the "J"-shaped guide wire that has entered the blood vessel allow Zhou Congwen to have a judgment on the corresponding anatomical structure.

After entering the top of the right atrium, Zhou Congwen pulled out the "J"-shaped guide wire.

The 20mL syringe was withdrawn, and about 10ML of black and red blood foam was sucked out.

Seeing the blood foam, Zhou Congwen let out a sigh of relief, and it was almost done.

"Xiao Zhou, is this the embolized air?" the anesthesiologist asked in surprise.

"Yes." Zhou Congwen nodded, "Increase the amount of fluid and pay attention to the amount of urine."

"Oh." The anesthesiologist didn't dare to say anything, but just nodded.

"By the way, Brother Sun, listen to the patient's sternum and see if you can still hear the noise of wheels running over."

Hearing the name Sun Ge, the anesthesiologist burst into tears.

He knew that the rescue should have ended with the bloody foam drawn out from the deep vein channel, Zhou Congwen knew to call himself brother grandson, so he must be fine.

Why didn't you call Sun Ge when you were so fierce just now?Even though he thought so, he understood.Emergency rescue, or a critical illness like air embolism, who has time to care about your emotions with a hippie smile.

Everything is centered on getting the patient back.

The anesthetist held the stethoscope and placed it on the left side of the patient's sternum, listened carefully for 20 seconds, and then said with certainty, "It's all right."

"pupil."

"Sensitive to light reflection, about 3mm in diameter."

"Cyanosis."

"Relief."

After questioning and answering, Zhou Congwen was quite satisfied with the rescue.

The frantic alarms of the monitor and ventilator disappeared at some point, and the blood pressure, heart rate, and oxygen saturation all returned to normal, and the electrocardiogram was slightly abnormal, but it was not a problem.

The itinerant nurse took the ice cap back and put it on the patient.

"Another 5 mg of dexamethasone and 10 mg of epinephrine."

"20ml of 250% mannitol, full speed."

"Take a breath, hurry up and send it for inspection."

Zhou Congwen was not completely relieved until the blood gas analysis reported back.

Blood gas analysis: pH 7.21, PCO235mmHg, PO2138mmHg, BE-12.9mmol/L, HCO34.9mmol/L, Lac1.5mmol/L, SO299%, FiO240%.

It is still more convenient to rescue in the operating room, and all kinds of equipment are readily available.There are no family members of patients, no idlers, etc., and it runs faster.

Turning around to step down, Wang Qiang asked in a daze, "Why are you going?"

"The clothes are dirty, keep closing your chest." Zhou Congwen said lightly.

"..."

"Director Wang, should I write the rescue records or you? Or Wang Qiang?" Zhou Congwen asked.

Wang Chengfa didn't curse in his heart, but was a little dazed.

Just now Zhou Congwen pushed himself away abruptly, and taking over the command of the rescue was a big mistake in medical treatment.

The command of this kind of emergency rescue originally belonged to him, but Wang Chengfa asked himself. He was completely stunned when he heard the word air embolism, so that now he has no courage to scold Zhou Congwen.

air embolism,

must die,

These words have been hovering in Wang Chengfa's mind until now.

He didn't dare, and couldn't even believe that Zhou Congwen pulled the air out of the right atrium abruptly.

Is this still an air embolism that turns pale? !

When did the little doctor I had been suppressing turn into a dragon?

Wang Chengfa couldn't figure it out.

"Director Wang, if your legs go limp and you pee, I'll close your chest?" Zhou Congwen took off the contaminated sterile surgical gown, looked at Wang Chengfa and asked calmly.

In normal times, just this one sentence could make Wang Chengfa go berserk and punch Zhou Congwen with old fists.