The recent Abe incident has become one of the hot topics of media and even public attention. It can be said that this is the first time that such a big event has been felt in the peaceful era.
As a doctor, you must look at problems from different angles. No matter how annoying the other person is, in the eyes of the doctor, he is just an ordinary patient and a life.
However, with the passing of this life and recent media coverage, we even question the rescue at the time. If it wasn’t like that, would he still have a chance to live?
Of course, we have to put our emotions aside. At this point, he was just a severely shot patient.
We noticed that a prominent report titled “Abe was shot without anesthesia and opened his stomach…”.
What a shock at first glance! But think about it calmly: it’s entirely possible. Because, at that time, Abe was already in a state of cardiopulmonary arrest and severe shock and coma.
It was impossible for him to feel pain in that state.
This is evident from the definition of pain. Pain is an unpleasant experience of the human body to adverse stimuli.
When the brain has lost consciousness, there is no pain.
Another angle: the essence of modern anesthesia today is only to eliminate the pain experience, not to make the whole body press the pause button. In the process of surgical anesthesia, although the role of anesthetic drugs, but the heart, liver, spleen, lung and kidney and other important organs still have to continue to work.
Suffice to say, it may be a little cruel for the public to see words like “disemboweled”, but it’s medically painless.
Actually, we are not concerned with the rescue work after Abe was sent to the hospital. Because, in the eyes of the anesthesiologist, those rescues may be hopeless.
Why do you say this, please read down, we will go into detail:
First, he was shot badly. It was only a few seconds from when the second shot was fired until he fell to the ground. This means that either the heart is damaged or the large blood vessels leading to the brain are damaged. This has been confirmed by subsequent reports.
Someone said, could it be a shot in the head?
No. If he was shot in the head, he would not take a step down the steps or cover his chest, but would simply lose any conscious movement.
Secondly, there was a big problem with the rescue at the scene. Therefore, the later rescue is basically useless.
The biggest problem with field rescue is that CPR was performed immediately.
Someone says CPR is wrong? Since they performed CPR on Abe, it means that cardiopulmonary arrest must have occurred at that time. This, for a person with a little training, will make judgments.
From the point of view of the anesthesiologist, the mistake is here!
According to various reports, not only chest compressions but also an automated external defibrillator (AED) was used.
Automated external defibrillator, also known as automatic external shock, automatic shock, automatic defibrillator, cardiac defibrillator and fool shock, is a portable medical device.
It diagnoses specific cardiac arrhythmias and delivers shocks for defibrillation, and is a medical device that can be used by non-specialists in the rescue of cardiac arrest patients.
In the event of cardiac arrest, defibrillation and CPR with an automated external defibrillator (AED) within the “golden 4 minutes” of optimal rescue time will The most effective way to stop sudden death.
All indications are that the heart stopped beating.
However, we must understand how the heart stops beating!
Starting from the cause, it is not only suitable for the diagnosis and treatment of chronic diseases, but also for acute diseases. In the race against time and life, running in the wrong direction is not allowed. Therefore, the more the crisis is, the more we must find out the reasons as soon as possible.
At that time, I don’t think anyone would think that he fell because of some kind of heart attack, norThe heart will not stop beating due to cerebral hemorrhage or lack of oxygen.
The only cause of death is heart damage or massive blood loss.
From the follow-up rescue or anatomy, it was confirmed that there was indeed heart damage, destruction of large blood vessels, and massive blood loss.
In this case, the heart is like a leaking car engine, no matter how hard you start a fire or forcibly drag the car, you can’t make it run.
The only thing that saved his life was that there was an operating room at the shooting site, with a strong cardiothoracic surgery team, cardiopulmonary bypass team, blood supply team, and anesthesia team.
Someone said, is there still time for anesthesia?
The answer is, no.
But the role of an anesthesiologist is not anesthesia, but a commander off the operating table. At this point, the commander on the operating table controls everything on the operating table; the commander off the operating table controls everything off the operating table. The two groups of people must cooperate closely before it is possible to snatch this person back from the god of death.
From the perspective of details, there is no need for disinfection, no need for anesthesia, and there is a chance to open the chest directly, or even open the abdomen.
Of course, if he was still conscious at the time, he would need anesthesia. The medication at this time, on the one hand, is to eliminate the pain experience; on the other hand, the metabolic rate of the organs can be reduced under anesthesia, thereby protecting the organs in the state of blood loss.
The in vitro team next to it also inserts various tubes without disinfection.
With any luck, the body will be established before the blood dries up. In particular, the timely restoration of blood supply to the brain will determine the final result.
The anesthesiologist can puncture the femoral veins on both sides of the thighs, two thick lines, and it is still possible to replenish the dried blood in a few minutes.
In terms of details, there is no need to strictly control the blood transfusion process at this time. Not to mention other things, in the process of transfusion of each bag of blood, it is necessary to observe whether there is any abnormality for more than 10 minutes at first and then quickly, which cannot be done. Because, there is no time for that!
If the blood supply to the brain is re-established within 4-6 minutes, and the blood supply to the heart and other vital organs is restored within 30 minutes, the life will have a chance to be saved.
However, the premise is not to rescue the wrong direction.
As some media questioned, the first chest compression was squeezing out the last drop of blood in Abe’s heart. No doubt this was hastening his death.
Who can first judge the opposite direction?
At present, the division of various disciplines is becoming more and more specialized, and it is normal for surgeons not to have internal diseases.
The same is true of internal medicine, nephrology, respiratory, and digestive, and there seems to be a mountain in the middle. This can be experienced by everyone who goes to the hospital to register. Not “half a doctor”, it is difficult for you to qualify for the department.
But yes, doctors in several departments still know multiple disciplines.
Why use “know” instead of “proficient”?
Because there is so much knowledge in medicine, it is difficult for a doctor to understand the content of his own subject in his entire life, let alone so many subjects!
So, what are the disciplines?
To name a few: general practitioners, emergency physicians, intensivists, and anesthesiologists.
It is perhaps the most surprising thing that anesthesiologists made the list. But, this is the truth.
At one time, President Putin’s entourage would have an anesthesiologist.
Some people say, is it necessary to perform surgery at the scene of the attack?
Of course not.
The role of the anesthesiologist at this time is not anesthesia, but first aid. At this time, the anesthesiologist will immediately integrate the knowledge of various disciplines, and immediately judge what happened to the president? Where are the most fatal injuries? What’s the best way to deal with it?
For example, the Abe incident. If he finds a lot of bleeding in his neck at the first time, he will press the bleeding point at the first time. If you find that the heart is injured, you will definitely not press it directly. Because the more you press the more blood you get. Moreover, the heart has been damaged, and pressing will not allow the heart to play the role of blood pump again.
Here, let’s be clear: the point of chest compressions is not to get the heart pumping again, but to get the heart pumping again.
Therefore, it is a waste of time to find AEDs through loudspeakers at the scene of Abe’s assassination. At that time, it might be better to carry him quickly and run to the hospital, maybe there is still a little chance.
In terms of specific rescue, the anesthesiologist said second, and few dare to say that the rescue skills will surpass that of the anesthesiologist.
In most critical situations, there is a chance of saving as long as the casualty’s two lines of breathing and circulation are maintained. At this time, artificial airway establishment and blood transfusion channel establishment techniques are used, and these techniques are the basic techniques of anesthesiology.
In terms of circulatory maintenance management, anesthesiologists are also masters of medication, and can use various drugs to preserve life.
This is not only technology, but also art. For example, patients with heavy bleeding should not blindly increase blood pressure, because high blood pressure may cause blood to be lost in vain.
Some people say, re-transfusion.
Retransfusion, the quality of blood is incomparable to own blood. In addition, a large number of blood transfusions can also affect coagulation function and affect body temperature. Once the body temperature is too low, the coagulation function will be disordered, the function of each organ will decline, the whole body will enter a vicious circle, and the condition will continue to deteriorate.
When we got here, aside from emotion and national hatred, we not only sighed from a medical point of view, but if there was an anesthesiologist present at that time, the outcome might have been different!
[Warm reminder] Please pay attention, here are a lot of professional medical science, to reveal the secrets of surgical anesthesia for you~