My medical skills are a billion points

"Xiao Chu, let me tell you. I learned from you. You can't hide your secrets. Otherwise, you can't eat this barbecue casually."

Xiao Chu joked: "It depends on how you honor Master!"

Soon it was time to get off work at noon, Xiao Chu washed his hands, prepared to drink saliva, rested for a while, and went to the hospital cafeteria for lunch.

At this time, an intern rushed in and shouted: "Director Xiao, the patient in bed 10 suddenly became out of breath. Go and see it."

It was about to get off work, and there was an unexpected situation in the ward.

Xiao Chu didn't dare to neglect, and hurriedly ran towards the ward.

When I came to the bed, I found Wang Panpan, a trainee doctor, performing tracheal intubation on ten patients.

Bed ten is a male patient, Xiao Chu has a little impression of this patient.

It is a patient with left maxillofacial space infection admitted by Zhou Ziqiang yesterday, and he is going to have surgery tomorrow.

But now there is a sudden difficulty in breathing, so there is only one reason.

That is, the infection on the left side of the patient was aggravated, and the swelling severely compressed the trachea, causing dyspnea.

The patient's current condition is obvious inspiratory dyspnea.

Whenever he inhales, the supraclavicular fossa is obviously sunken, his lips are cyanotic, and his consciousness has been blurred.

The trainee doctor Wang Panpan was holding a video laryngoscope and intubating him.

In other words, Wang Panpan also realized that it was the infection and swelling on the left side that compressed the trachea and caused the difficulty in breathing.

Therefore, the tracheal intubation is performed first to ensure that the airway is unobstructed to prevent the patient from suffocating to death.

But Xiao Chu saw that Wang Panpan was sweating profusely, holding a laryngoscope in his left hand and a tracheal intubation tube in his right hand, but he did not insert it for a long time.

Xiao Chu hurriedly asked: "Wang Panpan, what's going on?"

But Wang Panpan didn't care to wipe off the sweat from his head, and hurriedly replied: "Director Xiao, this patient has edema in his throat, and the endotracheal tube cannot be inserted."

Xiao Chu hurriedly took the video laryngoscope from Wang Panpan's hand, and carefully looked at the patient's throat.

It was found that the patient's throat was very serious, and there was almost a gap left in the glottis.

According to this situation, it is impossible to insert the endotracheal tube.

The cause of laryngeal edema is obviously also caused by severe infection of the maxillofacial space.

At this time, the patient has gradually lost consciousness, and his face has turned purple.

He was still trying to inhale, but less and less air was coming in due to the edema of his throat.

The situation is very urgent!

Xiao Chu hastily pulled out the laryngoscope, threw it aside, and shouted at Gao Yingjun: "Hurry up and get a gas cutting bag."

Gao Yingjun ran to the emergency room without saying a word.

In just five seconds, he got back a gas cut bag.

Now the patient has fallen into a coma.

The blood oxygen saturation on the monitor dropped sharply, and now it is only 60.00%.

The blood oxygen saturation of normal people is above 90.00%, but now the patient's blood oxygen saturation is only 60.00%, and it is still declining, indicating that respiratory asphyxia has occurred.

If the airway obstruction cannot be resolved within 30 seconds, the patient's heartbeat will stop.

At that time, once the heartbeat stops, even if the airway is opened, it may be in vain.

It stands to reason that if a tracheotomy is performed, one must go to the operating room.

But now the situation is urgent, and the patient's life is counted in seconds.

There was no time to carry it to the emergency room or operating room, so I had to make a decisive decision in the ward and perform a tracheotomy.

Several family members saw with their own eyes that the patient went from being awake to coma, and now he was almost out of breath, and immediately burst into tears.

Xiao Chu shouted: "Family members get out quickly, don't interfere with the rescue."

Then pull up the curtain of the hospital bed to block the view of other patients.

He had already put on sterile gloves, and after urgently disinfecting the patient's neck, he picked up a scalpel and cut an incision of about [-] centimeters at the position of the third tracheal ring under the cricoid cartilage.

Only cut under the skin, but did not continue to cut.

The remaining tissue requires blunt dissection.

No matter how critical the situation is, the trachea cannot be cut directly with a scalpel.

In that case, it is easy to cut the blood vessel and cause massive bleeding.

Now the patient's blood oxygen saturation has dropped to 50.00%.

He was barely breathing, and his heart rate had soared to 120 beats per minute.

That is to say, after another dozen or 20 seconds, the patient's heart rate will drop, and then stop. When the heartbeat stops, it will be too late.

And Gao Yingjun stood on the left side of the patient, giving Xiao Chu a hand.

It is very, very dangerous for a patient like this to face respiratory suffocation.

For him, this is the second time he has encountered such a critical patient.

The first time I encountered was a patient with acute laryngitis.

That was a few years ago, when he encountered this situation, he was at a loss.

It was Chen Bin who performed an emergency tracheotomy on the patient to save the patient's life.

But this time, he faced this situation again, and he still didn't know what to do.

I can only watch Xiao Chu's operation, hoping that he can relieve the patient's airway obstruction as soon as possible and save his life.

Holding a scalpel, Xiao Chu cut open the skin of the neck, and hastily inserted the dilating forceps directly into the trachea, and then stretched it forcefully to widen the opening to facilitate the insertion of the tracheal tube.

Immediately after Xiao Chu dilated the neck incision, a stream of gas mixed with blood burst out from the trachea incision, and sprayed directly onto Xiao Chu's chest.

But Xiao Chu didn't seem to notice, he held the expansion forceps with his left hand, picked up the trachea cannula with his right hand, and quickly put the cannula in at the incision.

All of this happened in the blink of an eye.

The patient's life only has 30 seconds left.

If an unobstructed airway is not established as soon as possible within these 30 seconds, the patient will undoubtedly die.

As for Xiao Chu, it only took ten seconds to completely open the patient's airway.

After the tracheal tube was placed into the trachea, the patient's extremely weak breathing movement began to gradually increase.

You can already see the obvious chest rise and fall, and you can also feel the airflow exhaled from the tracheal tube port.

Xiao Chu hastily inflated the air bag, then fixed the tracheal cannula, and connected the oxygen to the tracheal cannula port.

The oxygen concentration has directly reached five liters per minute.

As the patient's chest rises and falls and becomes stronger and stronger, the blood oxygen saturation on the monitor is also rapidly increasing.

One minute later, the blood oxygen saturation reached more than 1%.

At this time, the unconscious patient also opened his eyes.

Chapter 268 No matter how critical the operation is, the surgeon must be steady

Only then did Gao Yingjun let out a long sigh of relief.

It's really dangerous!

In just a few seconds, the patient's life might be gone.

And when he saw Xiao Chu's rock-steady movements, his admiration for him increased.

If he had to do this operation himself, he didn't know if he could save the patient's life.

After all, the situation just now was too dangerous.

The patient has less than 30 seconds of rescue time, once this time is exceeded, the patient's heartbeat will stop.

Once the heartbeat stops, the patient is likely to suffer from hypoxic-ischemic encephalopathy.

It may also be a vegetable after being rescued.

And Xiao Chu faced this kind of crisis situation, his psychological quality was very strong, and he didn't panic at all.

It took only ten seconds to perform a tracheotomy on the patient, and then opened the obstructed airway, saving the patient's life.

Most people really can't do such a thrilling rescue that races against time.

Gao Yingjun asked himself, he was still not confident.

Even a few years ago, he had seen this happen once.

For him now, it is still a huge challenge.

Be it psychologically or technically.

Gao Yingjun admired him sincerely: "Director Xiao, you were really racing against death just now.

Depending on the patient's condition, another 30 seconds may kill the patient. "

"I didn't expect you to cut the trachea and open the airway at such a fast speed. I really need to learn from you in terms of emergency rescue of patients."

Xiao Chu packed up the instruments, wrapped them up, and then took off the sterile gloves.

"Let's not talk about this, let's call the family members in and talk to them about the situation. Although he has had a tracheotomy and the airway obstruction has been relieved, but the infection of the maxillofacial space requires an operation now, I will give them Tell the family."

Hearing this, Gao Yingjun opened the door of the ward, and let in the family members who had been waiting outside the ward, who had been worried all the time.

As soon as the family members saw the patient, their eyes were open now, but a tracheal tube was inserted in the neck.

His daughter asked in a crying voice: "Doctor, what's wrong with my father?"

Xiao Chu said: "Your father's toothache caused infection in the maxillofacial space. Due to the aggravation of the infection, it caused swelling and oppression of the trachea.

That's why your father had difficulty breathing and even suffocation. Now I have performed emergency tracheostomy on him and relieved the airway obstruction.The patient is now conscious. "

After speaking, Xiao Chu turned to the patient, and said to him: "You are very clear now, you are not sullen, right?"

"You have had a tracheotomy now, and you can't speak. Just nod if you understand."

The patient has now returned to normal.

But due to the tracheotomy, he couldn't speak, so he nodded to Xiao Chu.And he raised his right hand and extended his thumb to Xiao Chu.

He was at the gate of hell just now, after walking for a while, he was dragged back by Xiao Chu.

At the moment when he lost consciousness, he felt that he would definitely not survive.

But after only 20 or [-] seconds, after Xiao Chu's rapid tracheotomy, he finally breathed fresh air.

The oxygen supply to the heart and brain was also restored, which made him slowly wake up.

At this moment, he felt that he was born again.

And this chance of rebirth was brought to him by Xiao Chu.

Seeing the patient nodding his head and giving Xiao Chu a thumbs up, his daughter also wept with joy, and hurried over to grab his hand.

"father!"

The patient's daughter is also very fortunate.

Fortunately, the doctor rescued him in time, otherwise, his father's life would have been lost.

The young woman held his father's hand and looked at Xiao Chu.

"Doctor, what should my father do in this situation?"

Xiao Chu said: "Now the patient's infection has obviously worsened, and it is compressing the trachea, so surgery must be performed as soon as possible.

We are going to operate on him now, otherwise the infection will get worse and he will be prone to complications such as septic shock. "

"Okay then, doctor, we'll listen to you."

Then Xiao Chu talked to the patient's family about the risks of the operation in detail, and asked them to sign a consent form for the operation.

Zhou Ziqiang has already completed the preoperative preparations that should be done, and he is waiting for the operation tomorrow.

And now in an emergency, all the things he prepared happened to be used.