Start From Emergency Doctor

Chapter 388

In the long tens of minutes, Li Li failed to see her husband. What she placed in front of her was the “Informed Consent for Operation” and the “Notice of Critical Illness.”

Who would have thought that a man who was still playing jokes with him about an hour ago turned into two cold documents at this moment!

Zhang Ling also saw that signing at this time was too cruel for Li Li, but she had to do so.

At that time, the situation was too critical, so Zhou Yuan directly underwent thoracotomy. But thoracotomy is already a major operation, and family members must sign for this type of operation.

It could have been performed after the operation was completed, but Zhang Ling ran out by herself… Zhao Qiang’s mortality rate is very high. Once an accident occurs, no, it should be said that Zhao Qiang may die under normal circumstances. If the patient’s family finds it at this time The patient has to undergo an additional operation before death, and things will become extremely troublesome.

Of course, it also depends on whether the patient’s family understands it or not. If it does not, it will definitely be a serious doctor-patient dispute.

Li Li’s hand was trembling, she held the pen in pain, and signed her name word by word.

“This is a critical illness notice.” Zhang Ling tried her best to calm her words.

Li Li gritted her teeth and nodded, and also signed her name.

…

In the rescue room, Zhou Yuan kept his eyes closed.

He can already clearly feel the myocardial tension is gradually increasing, and in the process of pressing, the soft, enlarged heart is gradually hardening and shrinking.

He Jianyi was surprised. He looked at his chest through the gap and found that Zhao Qiang’s heart had changed from dark red at the beginning to bright red at this time.

Zhou Yuan gradually increased the frequency of compressions, the ventricles began to appear fibrillated, and the fine fibrillation of muscle fibers began to thicken, but the heart did not recover.

“Electric shock defibrillation.” Zhou Yuan said with a calm face.

He Jianyi finished charging and quickly gave Zhao Qiang an electric shock to defibrillate.

Defibrillation is performed once, and then cardiopulmonary resuscitation is continued. If it does not improve, defibrillation must be continued.

For example, multiple consecutive defibrillation shocks in movies and TV shows are completely wrong. Without interspersed cardiopulmonary resuscitation to improve myocardial hypoxia and strengthen myocardial tension, the shock defibrillation does not have much meaning, and may even cause damage to the patient.

After two cycles of defibrillation and cardiopulmonary resuscitation, the myocardial fibrillation wave changed from fine fibrillation to coarse fibrillation.

“One milligram of epinephrine intravenously.” Zhou Yuan said while pressing.

In cardiopulmonary resuscitation, epinephrine is an excellent auxiliary drug, which can significantly increase the perfusion blood flow of the coronary arteries, and can make blood better flow through the body during chest compressions.

Of course, one thing that cannot be ignored is that adrenaline also has a toxic reaction, which may cause necrosis of the myocardial cell contraction band and damage the myocardium and blood vessels. Even after playing, there will be chest pain, one-time high blood pressure and pulmonary edema.(Read more @ wuxiax.com)

Of course, regardless of the dose and toxicity, it is a hooliganism. Although adrenaline has a toxic effect, it is still a life-saving medicine when injected with a proper amount. One milligram of static push is enough to have an effect without causing side effects. +

He Jianyi took an injection needle and quickly inhaled a milligram of adrenaline and pushed it into the patient’s blood vessel.

The tremor wave resumed its fine tremor again.

“Lidocaine.”

He Jianyi smashed the test tube of 2% lidocaine, and after inhaling it with a needle, he gave Zhao Qiang an intravenous bolus to defibrillate Zhao Qiang.

When the electric shock defibrillation has no obvious effect, the patient needs to take the drug defibrillation immediately. Of course, this is also the last resort. If the drug does not work, it can basically declare death.

At the same time, Zhou Yuan gave Zhao Qiang a positive pressure ventilation. The drug diffused into the bronchus on both sides under pressure, and was absorbed into the left heart through the bronchial mucosal capillaries.

After the lidocaine injection, Zhou Yuan ordered the voltage to be increased. After pressing dozens of times, he repeated the injection of epinephrine drugs and performed electric shock defibrillation again.

“I still haven’t recovered my heartbeat!” He Jian’s face was extremely pale.

Zhou Yuan’s expression became serious.

Can’t perfect CPR be saved?

Could it be that a living patient fell in front of him, and he could obviously be saved by cardiopulmonary resuscitation, but perfect skills still cannot be saved? !

His mind quickly turned, and a lot of knowledge about cardiopulmonary resuscitation flashed through his mind quickly, and it was integrated!

The international CPR-related literature, rare cases, high-risk cases, etc. have all emerged, and various proven effective and risky treatment measures have also been flashed one by one.

Zhou Yuan fell silent.

He Jian had an ugly face. He glanced at the ECG monitor again, and the results above were still heartbreaking.

“Or…” He Jianyi just wanted to persuade Zhou Yuan to give up.

In the hospital, there are too many people who cannot be saved. He Jianyi has seen too many helpless people. This is the first time Zhou Yuan has encountered such a situation. It may be difficult to accept, but everything has the first Times.

On the road to becoming a great doctor, he will inevitably have irreparable patients in his hands, and these people will become the eternal thorn and motivation in his heart, inspiring him to grow and progress.

“Forget it…”

Before He Jianyi finished speaking, Zhou Yuan, who had been silent, suddenly raised his head and said in a deep voice again: “Teacher, immediately use 250ml of 5% sodium bicarbonate!”

At the same time, Zhou Yuan didn’t wait for He Jian to do it, and immediately opened another syringe, inhaled five milliliters of procaine at a concentration of 1%, and penetrated into Zhao Qiang’s ventricle.

Sodium bicarbonate is mainly used to correct acidosis after prolonged hypoxia, while procaine acts directly in the ventricle to reduce the stress of the myocardium.

“The patient’s myocardium is still responding, there is rescue, insist on rescue!” Zhou Yuan’s words made the doctors in the rescue room move again.

Sodium bicarbonate was repeatedly injected three times, and procaine was injected four times…

The venous channel that has been opened has already begun for fluid and blood transfusion.

boom.

Increase the voltage and click again.

Immediately afterwards, Zhou Yuan immediately began to perform chest compressions, and at the same time He Jianyi supplemented adrenaline and lidocaine again.

boom.

The second high voltage electric shock.

Dididi.

In the silent rescue room, the ECG monitor suddenly rang violently!

Zhou Yuan and He Jianyi looked at them in surprise. The ECG monitor, which had not been moving, suddenly beat. Then, the patient’s heartbeat recovered…

Everyone in the rescue room looked ecstatic. After thirty-four minutes of rescue, the patient was finally rescued!

The heartbeat returned to beating spontaneously, and the patient’s blood pressure gradually stabilized.

Zhou Yuan took a hand out of the patient’s chest, and he could see that Zhao Qiang’s chest wall and pericardial incision began to appear fine small blood spots. This is a sign of the recovery of the heart pumping function, absolutely good news! .