Chapter 73 Lightning Operation
On-the-spot experience and daily knowledge accumulation are particularly important at this time.
"Transfusion Anaphylactic Shock!"
After sifting through a series of possible judgments in his mind, Director Tian made a keen judgment.
But before he could say anything, Yang Ping whispered: "Blood transfusion anaphylactic shock."
Director Tian took one look at Yang Ping and immediately ordered the anesthesiologist: "Look at his face!"
The anesthesiologist immediately observed and replied: "The face is red and the eyes are swollen!"
"Transfusion anaphylactic shock! Stop the blood transfusion, replenish fluids quickly, and even remove the blood transfusion tube!"
Director Tian's voice was loud and clear, but he was calm and calm. He glanced at the monitoring screen and the anesthesia machine. The ECG wave was still there, and the patient's heartbeat had not stopped, so there was no need for cardiopulmonary resuscitation. In terms of breathing, the patient was using an anesthesia ventilator, and now the ventilator is assisting breathing, so there will be no problems with breathing.
The anesthetist was pretty good, but the circulating nurse was a bit frightened. One was suffering from anaphylactic shock due to blood transfusion, and the other was bleeding. Any one of them would be fatal, but now both appeared at the same time.
The doctor who was observing was even more heart pounding.
"0.1% epinephrine, 0.5 ml, intramuscular injection!" Director Tian said in a strong tone.
Usually it is subcutaneous injection, but now intramuscular injection? The circulating nurse questioned with a slightly hesitant look.
"Intramuscular injection!" Director Tian repeated sternly.
Under the professor's authority, the anesthesiologists and nurses no longer doubted how he diagnosed anaphylactic shock due to blood transfusion and how he injected intramuscular epinephrine. Time was of the essence and only quick execution was required.
Bleeding and adrenaline are a pair of contradictions. Adrenaline will aggravate hemorrhagic shock, and bleeding will aggravate anaphylactic shock. The two are a pair of entangled contradictions.
While directing the rescue, Director Tian kept moving his hands. The rescue was a lightning operation. Anaphylactic shock is extremely dangerous, and life or death can be determined in just a few minutes.
"Knife, open the abdomen, prepare rubber strips, and temporarily block the abdominal aorta!"
Temporarily blocking the abdominal aorta is a big operation. Most people don't dare to do it. Director Miao has no clue now and can't help, so he can only worry.
"Prepare rubber strips!" The traveling nurse could follow Director Tian's movements.
After getting the gloves, I started cutting the rubber strips. Director Miao helped with the cutting.
The knife was extended along the original incision. Yang Ping's retractor had already arrived to help pull and expose the skin. He incised the deep subcutaneous fascia, then incised the three layers of abdominal muscles, entered the abdominal cavity, and successfully found the abdominal aorta.
The thick abdominal aorta pulses in the abdominal cavity. Due to shock, although the pulse is not as strong as normal, it still gives people a strong visual impact. This is the main artery of the entire lower body of the human body.
The vascular clamp was passed around the back of the abdominal aorta, and Yang Ping's rubber strip was accurately fed in.
As soon as the rubber strip was pulled out, Director Tian tightened it. Yang Ping's vascular forceps had clamped the rubber strip to form an elastic band, which tied up the abdominal aorta. Without any words, Yang Ping could predict Director Tian's movements in advance every time. Actions, never mistakes, never late.
The main gate was successfully closed and the bleeding stopped.
The abdominal aorta cannot be temporarily blocked for too long, but it can last for forty-five minutes. Forty-five minutes is enough for Director Tian to find the broken blood vessel.
"Continue the operation!" Director Tian said.
If the operation is stopped at this time, the risk is even greater, just like a ship entering a vortex, and will either be swallowed or escape from the vortex.
The suction device is gently inserted through the fracture gap to remove accumulated blood and try to find the bleeding death artery. This is a challenging task.
"Is there an intervention department?" Song Zimo asked. He was in the audience, a bystander, but he also had to make suggestions.
Director Tian said decisively: "No need."
We went to the interventional department for at least half an hour. The interventional department was unable to accurately embolize those messy bleeding spots on CT angiography, so they could only risk main trunk embolization, which would have serious consequences of necrosis. Unless there was no There are other ways.
The bone fragment was carefully opened. The assistant's hemostatic forceps had clamped a blood vessel and gently pulled it out. Director Tian raised his head and met Yang Ping's confident and calm eyes.
"No. 4 Silk Thread!"
The vascular forceps were handed over with the silk thread. Director Tian went around and tied a beautiful surgical knot.
"Sewing!"
He made another suture, one suture, and one ligation. Two sutures should be safer. Director Tian loosened the rubber strip of the abdominal aorta, and the blood in the surgical area came out again. He quickly tied the abdominal aorta tightly, and Yang Ping's vascular forceps came forward again to clamp the rubber strip.
Isn’t the artery of death that was pierced? Or are there two death arteries?
His eyes looked at Yang Ping. Yang Ping seemed to have guessed what he was thinking and nodded: "There should be two death arteries, and both the proximal and distal ends should be ligated. This is equivalent to finding four blood vessels to ligate. They form Loop, only ligating one end is useless.”
He was right, he was better than himself, and he had just found the first artery of death faster than himself.
"Give me the suction device! Come here!" Director Tian took the suction device from Yang Ping's hand and started sucking blood.
Although he is confident, he needs to be quick at this time! The faster, the better. He would not put the patient in danger for the sake of so-called face. Now, if he was faster for a minute, he would have more chance of winning.
Find the second blood vessel.
Ligation, suturing! Two more.
The third one, the fourth one!
All four broken ends of the two blood vessels were found and sutured and ligated.
The rubber band of the abdominal aorta was loosened again, and there was no more blood in the surgical area.
Director Tian thought that Yang Ping's judgment was faster than his own and his actions were faster than his own. No wonder Director Han asked him to take him. He couldn't help but turn his admiring eyes to Yang Ping, and Yang Ping took the straw from his hand.
These small movements on the stage could not be seen by people in the audience. Director Miao was already paying attention to the patient's vital signs and had no intention of watching the operation.
Director Tian hesitated for a moment, should he let him continue to complete the operation?
But Yang Ping was already focused on the first assistant's work at this time. The suction device in his hand sucked up the remaining blood in the surgical field to prepare for Director Tian's next operation.
Director Tian smiled and continued. After crossing the critical threshold of the death artery, he could take a break. The rhythm of the operation must be controlled. He just took the risk to continue the operation in order to resolve the conflict between adrenaline and bleeding. Now he can breathe a sigh of relief.
Anaphylactic shock comes and goes quickly. The patient's vital signs have stabilized and his blood pressure has risen.
In fact, anaphylactic shock only has a few golden minutes. If you are rescued, you will be alive. If you are not rescued, you will never wake up.
The blood bags and transfusion tubes just now were sealed for future investigation.
Although he encountered such a dangerous accident, Director Tian did not panic at all during the whole process. He once again confirmed that his vital signs were stable, which further verified his judgment.
"Go on!"
The doctor in the audience has experienced the life-and-death roller coaster rescue just now, and his mood has not yet calmed down. Now the operation is actually continuing. The professor is indeed a professor, with a general demeanor.
The anterior column and wall of the acetabulum are reduced and fixed, followed by the iliac wing, then the sacral fracture, and finally the sacroiliac joint separation.
Any single fracture here is a difficult operation, let alone several fractures mixed together at the same time.
The iliac wing fracture is reduced and fixed, the sacral fracture is reduced and fixed, and finally the sacroiliac joint is reduced and fixed!
The rest was easy in Director Tian's hands. Even when faced with the complex venous plexus near the sacrum, with the cooperation of the two of them, only a small amount of blood was produced.
Fluoroscopy, perfect reduction and fixation.
Rinse and place a drainage tube.
Director Tian began to sew and Yang Ping cut the thread.
"Anaphylactic shock, it was so dangerous just now! Director Han and I have encountered it during surgery before." Director Tian had completely forgotten the existence of Director Miao, and then he remembered to explain.
Director Miao had lingering fears, as if he had woken up from a dream, but fortunately it was Director Tian who was doing it. Think about it, if you were experiencing anaphylactic shock or death artery bleeding, you would have to drink a few bottles of one of them, let alone both at the same time. How could you handle it?
Fortunately, I hired a professor to do it, but I was afraid! The surgical gown on the back was completely wet.
"Send to the ICU for at least 24 hours of monitoring after the operation. There is not much bleeding from the fracture. It is mainly for follow-up monitoring and treatment of sensitization shock." Director Tian ordered.
The doctors who were observing were all grateful for the rescue they had just experienced, their calmness on the professor's stage, their accurate judgment of the condition, their decisive rescue, their risk-taking to continue the operation, and finally the danger was saved.
Enough to remember for a lifetime.
It would be great if I were this powerful.
(End of chapter)