My medical skills are a billion points

Chapter 248 Chest Opening and Cardiac Compression

He wanted to see how Xiao Chu could successfully puncture without being guided by a color ultrasound.

Pericardiocentesis, he'll do it too.

But he has always done it under the guidance of color Doppler ultrasound.

The main thing is to be safe and ensure success.

Xiao Chu does not need color ultrasound guidance now, which means that he is completely blind, relying entirely on clinical experience and feeling.

Gao Yingjun also believed that Xiao Chu was completely capable of this operation.

Just like the resuscitative aortic balloon occlusion just done, it will be amazing.

However, pericardiocentesis is different from resuscitative aortic balloon occlusion.

If you make a mistake in that operation, the bleeding will not stop at worst, just do it all over again.

One mistake will not kill anyone.

If the pericardiocentesis is wrong, the needle will pierce the heart directly, and the patient may die immediately.

This is no joke!

Xiao Chu sterilized the local skin, covered it with a sterilized drapery, and gave local anesthesia to the puncture point from the skin to the pericardial wall.

When Gao Yingjun saw Xiao Chu, he didn't need to palpate the heart dullness area, and directly administered anesthesia.

Although he believed in Xiao Chu in his heart, he also held his heart for him.

Xiao Chu clamped the rubber tube connected to the puncture needle, and the puncture needle was inserted into the selected and local anesthetized site.

I saw that the puncture needle was accurately pierced into the pericardium.

It can be seen directly that there is dark red blood flowing from the puncture needle.

Xiao Chu connected the syringe to the rubber tube, let go of the clamp, and slowly pumped out the liquid.

About 40ml of fluid was pumped.

Xiao Chu felt great resistance.

This shows that the pericardial effusion has basically been sucked clean.

So Xiao Chu pulled out the needle, sterilized it again, covered it with gauze, and fixed it with adhesive tape.

Gao Yingjun opened his mouth halfway, a little absent-minded.

He thought that under Xiao Chu's blind operation, it would take almost half an hour to complete the entire operation.

As a result, Xiao Chu completed the pericardial puncture in less than 10 minutes.

And the fluid in the pericardial cavity was withdrawn.

The speed was so fast that he didn't even have time to react.

At this time, the patient has obviously felt that his breathing is smooth.

He quickly said to Xiao Chu: "Thank you doctor, thank you for saving my life, I feel much better breathing now."

"You said that I didn't have a coronary heart attack, but it was also a heart attack. What's going on with my disease?"

Xiao Chu explained briefly.

"In your case, after the chest was traumatized, the heart was contused, so there was cardiac tamponade."

"And cardiac tamponade will cause chest tightness and difficulty breathing. If the cardiac tamponade is not resolved in time, it will be life-threatening."

Hearing Xiao Chu's explanation, the patient instantly felt that he had saved his life.

He thanked Xiao Chu again and again.

Seeing that the patient's condition was basically stable, the nurse pushed him to the ward and continued to observe.

The two of them had some free time for a while.

Gao Yingjun gave Xiao Chu a thumbs up, and sighed sincerely: "Xiao Chu, your technique is really amazing. I don't know how long I have to learn before I can catch up."

"The resuscitative aortic balloon occlusion and pericardiocentesis were all performed blindly. To be honest, this is the first time I have seen it.

I have been working for several years, and I have seen a few cases of pericardiocentesis, but most of them were done under the positioning of color Doppler ultrasound, but you can do it blindly, which is really awesome! "

"What's more, it's the first time I've seen resuscitative aortic balloon occlusion in our emergency department. It's really an eye-opener! This operation can still be done like this."

"I think you can rely on this operation, and it will not be a problem to publish a paper."

Xiao Chu smiled and said: "It's just an operation, it's not enough to publish a paper."

Hearing Gao Yingjun's surprised tone, Xiao Chu knew that he was not in the habit of going to Xinglin House.

If he often went to Xinglin Family Forum, then he should have known that Xiao Chu had already performed a resuscitative aortic balloon occlusion at the scene of a car accident.

Of course, there are still a small number of doctors in the country who can go to the Xinglin Family Forum.

Those who can often browse medical forums, except for a few experts and professors, look for information.

Most of them are doctors from some county-level hospitals, as well as those medical workers who are not busy at work.

Doctors in large tertiary hospitals like the provincial hospital seldom browse medical forums.

They are usually so busy that they don't even have time to eat.

How can I have time to surf the Internet?

Not to mention the emergency department as the busiest department in the hospital.

Therefore, some time ago, the resuscitative aortic balloon occlusion performed by Xiao Chu at the scene of the car accident did not attract Dr. Corey's attention at all.

It's just that this time, Xiao Chu operated again in Corey, and Gao Yingjun happened to see it.

He was naturally surprised.

Just after treating the patient with cardiac tamponade, Liu Qing shouted: "Mr. Xiao, this patient's heartbeat has stopped."

Xiao Chu hurriedly turned her head, only to find that the patient with a piece of glass stuck in his chest suddenly had a cardiac arrest.

The monitor sounded a rapid siren.

The two nurses and a few interns panicked when they saw that the patient's heartbeat had stopped, but there was a piece of glass in his chest, which made it impossible to perform chest compressions.

The flustered eyes looking for help immediately turned to Xiao Chu.

Gao Yingjun on the side also frowned tightly.

The patient's heart stopped and urgent chest compressions and cardiopulmonary resuscitation were required.

However, there is a piece of glass inserted in the patient's chest, so chest compressions cannot be performed!

What can I do? !

He could only stare at the monitor, and then dryly gave a doctor's order.

"One milligram of epinephrine is administered intravenously, hurry up!"

The patient has suffered cardiac arrest and needs to be restored as soon as possible.

Otherwise, the heartbeat stops, and the brain cells will die irreversibly if it exceeds the golden 4 minutes.

Even if the heartbeat is restored, it may be a vegetable in the future.

The situation was urgent, Xiao Chu didn't have time to say more.

He directly brought over a pair of scissors, and without any explanation, cut the patient's shirt.

He's going to open his chest and do chest compressions.

Intrathoracic cardiopulmonary compression requires that after the chest is opened, the palm of the hand is inserted into the chest cavity, and the heart is directly pressed to restore its beating.

Although the risk is high, the effect of compression is much better than chest compression.

After disinfection as soon as possible, wear sterile gloves, and use a scalpel to cut the skin from the 2th or 4th intercostal space to the pleura from 5cm from the left edge of the sternum to the left midaxillary line.

Then Xiao Chu stretched his right hand into the chest cavity and squeezed the outside of the pericardium with one hand.

Keep pressing 80-100 times per minute while closely observing the patient's response.

Gao Yingjun was stunned when he saw that Xiao Chu was going to perform chest compressions on the patient.

Be good!

What Xiao Chu played today was all extreme moves!

It was the first time he had seen the chest opening and cardiac compression in the emergency department for so many years.

Doctors are generally afraid to do this because the risk is too great.

"Xiao Chu, it's very risky for you to do this!"

Chapter 249 Difficult Surgery

The pressing action of Xiao Chu's hand did not stop at all.

Without looking back, he said: "Do you think we still have a choice? Risk or lifelessness, which one is more important?"

Gao Yingjun immediately shut up and stopped talking.

In this case, even if you are not a doctor, you can tell the difference. Of course, the priority is to save the patient's life.

For the rest, wait until you save your life.

Even if the patient has a serious infection due to chest compressions, it can still be controlled with antibiotics.

If the patient's heartbeat cannot be saved, his life will be over.

Looking at Xiao Chu's skillful movements and resolute face, Gao Yingjun swallowed back the words he stopped.

Xiao Chu pressed his heart tightly in a regular way.

Finally, the patient's heartbeat resumed again.

Before Xiao Chu had anything to do with it, Gao Yingjun breathed a sigh of relief.

Can't help but look at Xiao Chu again with admiration.

He found that Xiao Chu performed chest compressions very cleverly.

This chest compression, if he was asked to do it, it would not be so easy and comfortable at all, but the effect is astonishing.

Gao Yingjun felt that Xiao Chu was too mysterious!

He is obviously a resident doctor, why does he have such superb medical skills?

He can't figure it out no matter what!

Gao Yingjun looked at Xiao Chu who was calm and calm, and was full of thoughts for a while.

Seeing that the patient finally recovered sinus rhythm, Xiao Chu also breathed a sigh of relief.

However, the patient in front of him did not survive the danger, but only temporarily stabilized his vital signs.

He still needs to have an operation as soon as possible to pull out the shards of glass stuck in his chest.

Otherwise there is still a risk of cardiac arrest.

There are currently two patients who need emergency surgery.

One is the patient with a comminuted fracture of the left lower extremity and a ruptured femoral artery, who must be operated on as soon as possible.

Otherwise, life is in danger!

Another one is the patient in front of me with a glass in his chest.

If surgery is not performed soon, there is a risk that the heart will stop beating again.

The patient with tension pneumothorax has now been exhausted.

Just watch your vital signs closely.

There are also a few bruises, and patients with broken upper limbs who don't need emergency surgery.

There is also a patient with craniocerebral injury who is still conscious.

Although there is subdural hemorrhage, it is not too much and can be observed temporarily.