Dr. Zhao is the main force of Keli’s youth, and he usually rushes forward in challenging tasks. As a result, this day was “overheaded”.
On this day, the orthopedic doctor informed that an 80-year-old lady was going to have an operation, and the anesthesiology department should go to see it in advance.
Such a notification immediately alerted the anesthesiology department. Because, according to normal circumstances, if there is a patient who needs to arrange an operation, a notification can be sent on the computer. Such advance, oral notification, presumably the patient’s situation is unusual.
With all kinds of speculation, Dr. Zhao bravely took over the job and said: I will go and see the patient. However, when he saw the patient, his heart was a lot colder. Because, this is a hemiplegia patient who is bedridden all the year round.
A few days ago, while holding a cup, I accidentally dropped it.
Don’t look at the height of less than one meter, but it is too high for her, who is bedridden, osteoporotic, and has no muscle protection for her bones.
On examination: Broken collarbone, fractured femur, and three ribs.
It can be said that without surgery, this old lady’s life will immediately enter the countdown. And, this countdown is very short, maybe a month, maybe only a few days.
Orthopedic doctor, still the same expression: We can do it, it depends on whether you dare to anesthetize it?
Seeing this expression, Dr. Zhao really wanted to spray them with a few words: What do we dare not anesthetize? As long as you dare to operate, we will dare to anesthetize.
However, he knew very well that as long as he dared to shout like that, the orthopaedic department didn’t care about that, and he really dared to perform surgery.
The organs of the elderly are very fragile.
As long as you stay in bed, every day will be worse. However, she was a bedridden patient. Fortunately, the family took good care of it, and I can know one or two from the fact that there is no bedsore on my body.
The results of various examinations also made Dr. Zhao feel unprecedented pressure:
The lower border of the lung is 5 cm higher than the normal lung. Moreover, the vicissitudes of life of the lung has obvious performance of hypostatic pneumonia. There is a certain degree of ischemia in the heart, but in front of the anesthesiology department that has experienced strong winds and waves, this is nothing.
Another thing that worries Dr. Zhao is that the old lady used to have severe high blood pressure. It is said that after cerebral infarction it is normal.
Having doubts, he personally tested the old lady’s blood pressure, and it turned out to be bad.
Attentive, he found that this blood pressure is a bit abnormal: at the age of 80, the blood pressure must be a little higher to be considered normal. However, the old lady’s blood pressure was only over 110. Moreover, the low pressure is only more than 50.
This signal tells him: This person is weak and weak! He didn’t know how weak it was, he could only see it on the operating table.
Because of multiple fractures and the need to deal with ribs, the only way of anesthesia is general anesthesia. In order to reduce the possible delay in recovery from general anesthesia or excessive circulatory inhibition, Dr. Zhao also carefully prepared a compound nerve block plan.
After the general anesthesia was advanced, what Dr. Zhao worried about happened: the blood pressure dropped to 80 in a short time. Dr. Zhao was so frightened that he hurriedly pushed the booster medicine that had been prepared.
Fortunately, Dr. Zhao has already placed a deep vein puncture for the patient. If there is no such smooth blood vessels, it is really hard to say.
Although it was only a severe drop in blood pressure, the alert Dr. Zhao had already determined that the old lady was very intolerant. After that, a trace of anxiety accompanied Dr. Zhao throughout the operation.
Despite breaking the theoretical limit and cutting down on medication, the old lady who is nearing the end of the operation doesn’t seem to be recovering at all.
While the final answer is yet to be revealed, a delay in awakening is almost inevitable.
At this time, Dr. Zhao quickly summed up all the elements before and after: cerebral infarction, hypertension, hypotension, bed rest, lung…
He quickly concluded that the preoperative hypotension was an artifact: on the one hand, hypoperfusion. With so many fractures, the fluid loss is enormous. However, the orthopaedic surgeons deliberately reduced the infusion for fear of filling the patient’s lungs.
On the other hand, having been in bed for too long, her vascular function and even heart function have long been different from those of normal people. Although she can still live normally while lying in bed, her organ functions are fragile and cannot withstand strong winds and waves.
Holding all kinds of anesthetics that had only been pushed “a little” in his hand, Dr. Zhao was filled with an unprecedented sense of frustration.
However, the patient is still on the operating table and he needs to cheer up.
Although at this time, he could feel that the orthopedic doctor seemed to be asking: Why is he still not awake?
But he told himself it was time to calm down. Such patients must work hard in the recovery stage. Once sent to the intensive care unit, what will happen next?
Someone said: Is the intensive care unit bad?
Good! It must be good for definite major diseases, but for such a complex, routine treatment may miss some details, some details that determine success or failure.
Seeing that the patient’s arm was still limp, Dr. Zhao kept the patient warm while adjusting various parameters of the patient’s internal environment.
At this point, the biggest question is not whether the patient can wake up. Controlling the patient’s vital signs throughout the process without major fluctuations for a long time, as long as there is no problem with the brain, Dr. Zhao is very confident that the patient can wake up.
The biggest problem is that an inadvertent movement or word of the orthopaedic surgeon or even the nurse seems to be hitting Dr. Zhao. This kind of beating may be interrogation or questioning.
Fortunately, the patient’s vital signs are all in Dr. Zhao’s brain, and he tries to stay calm as much as possible. At this time, he must not be chaotic. If he is messed up, the old lady’s ending may be very different.
In the awkward atmosphere, an hour passed.
Suddenly, Dr. Zhao noticed that the old lady’s eyelashes moved. This move is comparable to the excitement of rescuing a person. After that, the old lady’s head slowly moved.
Finally, Dr. Zhao pulled out the tracheal tube as the old lady became intolerable.
At this point, an operation that consumed almost all of Dr. Zhao’s physical and mental energy has ended.
Although the family members were still full of doubts when sending the patient out of the operating room, Dr. Zhao was open-hearted and had a great sense of accomplishment.
[Warm reminder] Please pay attention, here are a lot of professional medical science, to reveal the secrets of surgical anesthesia for you~