Source: Zhejiang Hospital

At 1:00 pm on February 24th, a rapid whistle sounded, An ambulance rushed to the emergency door of the Sandun District of Zhejiang Hospital. The medical staff who had been waiting downstairs quickly lifted the patient out of the car and made a preliminary assessment of the condition. It only took 2 minutes to complete the admission procedures for him and proceed immediately. Rescue.

What patient is so critically ill?

Around 12:45 p.m. that day, Mr. Hu (pseudonym), a male patient in his 50s, was working in a waste recycling station. He accidentally exploded in the process of cutting a gasoline barrel, causing the air pressure to vibrate, causing his entire body to explode. Multiple trauma pains, obvious abdominal pain, and chest tightness and shortness of breath. The surrounding people immediately called 120 for help.

After the patient was admitted to the hospital (12:50), the trauma emergency team of Zhejiang Hospital immediately started the treatment plan. , Physician Luo Lixin, assistant to the director of the emergency department, reported the patient dynamics in the DingTalk group, chief physician Qian Xianzhong, deputy director of general surgery, deputy chief physician Hu Caibao, deputy director of ICU (2), deputy chief physician of Orthopedics (3) Gui Xiange, orthopedics department (1) Physician Zhang Jun, Deputy Chief Physician Li Bo of the Department of Radiology, Physician Xu Yanhui of Thoracic Surgery, and other team members from the Department of Neurosurgery, Vascular Surgery, and Anesthesiology Department rushed to the emergency room within 10 minutes. With the cooperation of the radiology department, medical laboratory department, and B-ultrasound room, the auxiliary examination was completed at 1:00, and the diagnosis was completed at 1:10: comminuted rupture of liver 2/3, spleen rupture, small intestine rupture, retroperitoneal hemorrhage, inferior vena cava rupture , tear of short hepatic vein, intra-abdominal hemorrhage of 3500ml, multiple rib fractures, pulmonary contusion, right wrist mutilation and injury, traumatic hemorrhagic shock.

Large Trauma “Gold 1 hour”

“When Mr. Hu came in, his blood pressure was extremely unstable, and he suffered extensive trauma, and the situation was very critical. Clinical practice has shown that effective treatment of patients within 1 hour after the trauma will greatly reduce the number of deaths. The mortality rate and disability rate, on the contrary, the mortality rate will be greatly increased, which is called the ‘Golden Hour’.” Gu Zenghui said.

The trauma emergency team led by Gu Zenghui immediately conducted a multidisciplinary consultation on the patient, and after talking with the family members (1:40), Mr. Hu was pushed into the operating room, and Qian Xianzhong performed surgery on the patient. Performed “partial hepatectomy, liver rupture repair, inferior vena cava suture, intestinal perforation repair, and abdominal hematoma drainage”. During the operation, the surgical anesthesia department and the blood transfusion department cooperated fully. Mr.’s blood pressure stabilized.

At 7:20 p.m., Gu Zenghui performed “Right Wrist Reconstruction and Repair” for Mr. Hu to reconstruct and repair his hand. “The 6cm*3cm skin flap at the tiger’s mouth of Mr. Hu’s right hand and the first metacarpal bone and proximal part of the phalanx of the right hand are missing bone, the soft tissue is seriously polluted, the nerves are damaged in many places, and the large and small polygonal bones are fractured.” Such a serious hand trauma, in Under Gu Zenghui’s scalpel, he recovered step by step: rinsing and disinfection, Kirschner wire fixation, repositioning of the metacarpal and part of the phalanx, reconstruction of two segments of the digital nerve, suture… Mr. Hu’s second operation was also successfully completed.

Through the “trauma triad” crisis

After the first stage of surgery, Hu Mr. entered the ICU, and the difficulty waiting for him was the “trauma triad”.

“The patient’s bleeding volume reached 3500ml. At the same time, he suffered severe liver rupture, intestinal perforation, rupture of the inferior vena cava, and even more serious hemorrhagic shock.” said Yan Molei, Deputy Chief Physician, ICU (2), Zhejiang Hospital. , “At that time, the patient’s body temperature was only 35 degrees, in a state of hypothermia, accompanied by metabolic acidosis and coagulation dysfunction, and was in a state of high death risk of ‘trauma triad’.”

The intensive care team of Zhejiang Hospital immediately responded to the The patient underwent a series of active treatments such as active anti-shock, acid correction, respiratory and circulatory support, and improvement of coagulation dysfunction. Mr. Hu began to wake up at 12:00 on the night after the operation, and his vital signs gradually stabilized, breaking through the triad of death due to severe trauma. He came over and was released from respiratory support three days later. On March 11, Mr. Hu was transferred to the general ward.

This treatment gives full play to the strength of Zhejiang Hospital’s trauma treatment and reflects the ability and level of Zhejiang Hospital’s multi-disciplinary cooperation, which not only strives for the chance of survival for patients, but also helps patients overcome difficulties smoothly.

“At the moment of the explosion, I thought I would never see everyone again. After these few days of experience, I deeply felt that the medical staff did their best and made unremitting efforts to save my life. After I leave the hospital, I will cherish my body even more!” Mr. Hu said with emotion.

Review: Hu Haiyan