Monday morning, before dawn, the neurosurgery was arguing. Asked why, they said that the surgery on the day was ahead of schedule and could not wait.
Dr. Duan, who put down the phone, thinks, can’t wait two hours?
Though she thought, her actions didn’t stop. Put on the coat and hurried to the neurosurgery.
It was only when I arrived at the neurosurgery that I learned that this patient was delivered the night before. When it was delivered, the man was already in a coma. It was diagnosed as intracranial hemorrhage. Due to the severe bleeding at the time, conservative treatment was the only option. Once the bleeding has stabilized, seek surgery to remove the hematoma. The reason why I can’t wait for work time is because the neurosurgery is worried that the hematoma will compress for a long time and the brain damage will be more serious.
Seeing that the blood pressure on the monitor was more than 200, Dr. Duan hesitated for a while, but said: Then go to the operating room as soon as possible.
If it is elective surgery, this blood pressure is absolutely unacceptable. As far as blood pressure indicators are concerned, blood pressure is generally required to be controlled within 180. However, it is obviously unlikely for patients with cerebral hemorrhage and intracranial hypertension.
Signing, a familiar face appeared in front of Dr. Duan. Doctor Duan took a closer look. Isn’t this the owner of a small restaurant next to the hospital?
The restaurant owner said: This is his relative, please take care of him. At that time, the doctor was thinking: Why are there so many relatives in your family? !
But on second thought, don’t expose others. After all, in order to make more friends, everyone is his relatives.
After some investigation, I found out that this patient fainted while drinking in his restaurant. According to his description, several people took turns toasting. When he got to him, he drank three times in a row. As a result, he vomited a lot, and then fell headfirst. At the time, everyone thought it was too much. But soon everyone discovered the anomaly. Then, he was rushed to the hospital.
A CT scan showed that one side of his brain had been severely squeezed to the other. Butterfly-shaped lateral ventricle, with only one wing left.
Despite the blood pressure almost breaking the table, Dr. Duan did not hesitate to urge everyone to make various preparations as soon as possible. On her own side, she immediately started anesthesia and intubation.
Such high blood pressure is not scary, what is scary is the moment when the meninges are opened. Since high blood pressure is caused by intracranial pressure, once intracranial pressure drops, blood pressure will also collapse. Therefore, how to withstand blood pressure is the key to this anesthesia. Paradoxically, massive infusions are not an absolute good idea either. Too much infusion can cause edema of brain tissue. The brain tissue was edematous, and postoperative recovery was not good.
Fortunately, under the control of infusion and medication, the blood pressure did not get out of control. Just a few words, in fact, can not describe the tension at that time. For example, the moment you open the dura, you have to turn your head to look at the waveform on the monitor while holding a booster syringe in one hand. If it is found that there is a downward trend, it is necessary to quickly push the booster medicine. At that time, the blood pressure on the monitor may still be stuck at 200. In other words, the “blood pressure of 200” also has to push the vasopressor quickly. Otherwise, once it falls, it is easy to collapse. Thus, there is little room for error by the anesthesiologist.
Once the dura is fully opened, only half of the syringe is left. He took a long sigh and started blood gas analysis and adjustment of various parameters. The liquid that was injected before may also be excess at this time. After seeing half the bag of urine out of the urine bag, the anxiety can be relieved a little.
Looking back, the bend was full of blood clots. Everyone didn’t speak, and stepped up to deal with…
After entering the stable stage, everyone’s chatterbox is also opened. even, We also talked about the reasons for his accident. Everyone agrees that such a serious accident would not have occurred if it were not for the underlying disease of high blood pressure. In addition, drinking was obviously a fuse, and the atmosphere at that time was a test for his blood vessels. Obviously, he didn’t stand the test. What awaits him may be a lifelong disability, or he may never wake up again.
Finally, I would like to remind those who have high blood pressure again, especially friends who run around every day in various wine bureaus: No matter how many reasons, high blood pressure should not be ignored! No matter how much money there is, in the end, it may be empty, and the wife may also belong to someone else!
[Warm reminder] Please pay attention, here are a lot of professional medical science, to reveal the secrets of surgical anesthesia for you~