In the evening, the bus was about to pull in. I only heard that the bus suddenly slammed on the brakes, but it was too late, and a battery car was hit straight out.
Despite wearing a helmet, the middle-aged man driving the battery car fell unconscious immediately.
After being sent to the hospital for the first time, the hospital immediately opened the green channel. Almost all the preoperative preparations were carried out on the way to the operating room: during the movement, the nurse drew blood for him; the anesthesiology department, who came to hear the news, checked his breathing and circulation while evaluating the intubation. Condition; emergency department doctor, trying to reduce intra-abdominal bleeding by forcefully strangling a abdominal belt around his abdomen.
After arriving in the operating room, I also arrived at the site of the anesthesiology department. Several anesthesiologists immediately gathered around: some performed deep venipuncture; some “popped” the medicine bottle; some were preparing for tracheal intubation…
Dr. Wang of the Department of Anesthesiology, although she is young, the director intends to train her. All major surgery, let her participate. Therefore, progress has been particularly rapid in recent years.
The reason why she is reused by the director is that she has the basic potential of an excellent anesthesiologist – solid theory and enthusiasm for practice. The key is that she has a kind heart.
The work of anesthesia is behind the scenes. It can be said that it is an anonymous worker. However, patients lying on the operating table need our comfort, so kindness has become an important part of anesthesia work. Perhaps a little comfort can stop the patient’s trembling shoulders.
This time, Dr. Wang also rushed up with the director.
At the critical moment, her solid technical skills did not hold her back at all, and she completed the deep vein puncture in a few minutes. Having this blood transfusion channel is equivalent to having a life channel. To save the patient’s life, it is more certain.
However, the difficultly measured one-time blood pressure on the machine is extremely low, so low that diastolic blood pressure is sometimes displayed, sometimes not.
In the face of such blood pressure, it is obvious that direct anesthesia cannot be performed. With direct anesthesia, blood pressure will definitely be lower. Most likely, the heart stopped beating due to extreme ischemia. Bleeding and stop jumping, the difficulty of rescue is undoubtedly sky-high.
After a quick infusion of a bag of blood and a bag of fluids, the blood pressure seemed to go up a little. At this point, we couldn’t wait any longer. The director gave an order to start anesthesia and induce intubation.
That’s it, pushing the vasopressor while anaesthetizing. When the patient’s breathing just disappeared, my doctor skillfully inserted the tube quickly.
Breathing is assured, and everyone is a little more at ease.
However, despite the use of vasopressors, blood pressure has dropped to unbearable levels. Therefore, everyone began to pressurize blood transfusion and infusion with all their strength.
To be honest, at the rescue scene, many rules are not so strict: blood transfusion requirements are slow. However, if it is slow, the patient will be gone; the blood transfusion requires flushing the tubing and then changing another bag, and everyone just flushes it symbolically. Looking at the blood pressure over there, everyone is in a hurry!
The blood pressure is a little resistant, and the surgeon is already ready, just waiting for the anesthesiology department to call “start”. With a “start”, the surgeon quickly unfastened the patient’s abdominal girdle.
Some people say, why do you wait for you to shout “start”?
What we are saying is that surgery is not a one-person affair. Especially this kind of major surgery requires teamwork.
Why can’t I untie the belly belt? This is because when the abdominal belt is tied to the abdomen, on the one hand, it can reduce the continuous bleeding of the abdominal cavity; on the other hand, it can also increase the pre- and post-load of the heart, making the heart less ischemic. If you are not ready to untie it, it is likely to cause a rapid decrease in the cardiac preload and cardiac arrest.
Although I was well prepared, my blood pressure dropped by more than 10, which was a near miss.
Looking at the bagWhen a bag of red blood cells, plasma and cryoprecipitate was infused into the patient’s body, Dr. Wang suddenly thought of a problem: such a large number of low-temperature red blood cells were directly infused into the patient’s body, and the patient was prone to hypothermia. If hypothermia occurs, it will undoubtedly worsen the blood coagulation system. Once the coagulation mechanism is not good, even if the blood is infused, it may leak out from the incision and wound surface. Finally, maybe…
She didn’t dare to think further. Subconsciously, she picked up two bags of blood and placed them under her armpits. In an instant, two strands of coolness rushed into the chest and went straight to the scalp.
In this way, a weak body against the cold continues to transfuse blood, adjust breathing parameters, record anesthesia information…
Suddenly, her move was discovered by the director, who wanted to grab the blood bag, but she said: I’m fine!
The director didn’t insist any longer, and picked up two bags of blood and put them under his armpit.
After two hours, the patient was saved.