Chapter 155 The Last Time
Yang Ping didn't even bother to eat and rushed to the Overseas Chinese Building immediately. Director Kong took Yang Ping to the emergency ward, which was already full of people.
Upper gastrointestinal bleeding, hemoglobin is only 45g/l. Because of the use of artificial liver and magic lung, continuous anticoagulation, now the bleeding is massive, relying on the body's self-coagulation function, it is impossible to stop the bleeding, so conservative treatment is difficult to achieve, and gastroscopy is necessary Stop bleeding.
Mr. Ning has been transfused with blood. Director Gan from the Department of Gastroenterology, along with doctors, nurses and anesthesiologists, has pushed the gastroscopy equipment to the bedside and is preparing to perform emergency bedside gastroscopy to stop the bleeding.
Life is both fragile and tenacious. Things in life are sometimes difficult to predict.
With such a low hemoglobin, Mr. Ning was very conscious, but his face was pale and his forehead was covered with sweat, which was very shiny. He was lying on his side, his body twisting slightly. One hand was held by Miss Ning, and the other hand was holding on to the bed sheets. He was making a final struggle.
The anesthesiologist wanted to use propofol for intravenous general anesthesia, but he refused.
"What time is the flight? Qiqi!" Mr. Ning was very weak and seemed to die at any time.
"The flight left at 15:55 yesterday afternoon, Canadian time, and arrived at Nandu Airport at 21:30 tonight. It should be 11pm when we get here." Miss Ning helped her father wipe the sweat from his forehead, which was very greasy.
"I can't hold on for much longer. I know that I really can't hold on this time! Help me! Can you help me hold on until night? I'm really afraid that I won't be able to wake up once I'm anesthetized. I'm sorry to bother you, Doctor Yang. Please be patient. Can you stay by the side?" Seeing Yang Ping appear, Mr. Ning grabbed Yang Ping's hand.
Every time, Yang Ping could pull him back from death. In his heart, Yang Ping was a god who could protect the fire of life and make it burn longer.
"It's okay, I'll stay here!" Yang Ping patted the back of Mr. Ning's hand with his other hand.
"It won't work without anesthesia, it will be very painful."
Director Gan and his assistant had already put on disposable sterile gowns, sterile caps, masks and sterile gloves. They quickly prepared the instruments and applied lubricating oil on the lenses.
"I can do it!" Mr. Ning was very stubborn.
Miss Ning's eyes were full of tears. She was really about to say goodbye this time. She suddenly grabbed Yang Ping's hand: "Doctor Yang, please think of a way."
She wanted her father and younger brother to see each other for the last time, to untie the knot in her father's heart for ten years, to fulfill his last wish, and to leave this world without any regrets.
She found that she was too excited and lost her composure, and immediately let go. Yang Ping nodded: "Don't worry, I will find a way! Director Gan, no need for anesthesia, let's get started, he can do it."
What can be done, I can only give him hope and comfort in his last moments.
Mr. Ning nodded and lay on his side. The colleagues in the gastroscopy room moved quickly and skillfully. The nurse had already laid out the disposable sterile drape and was sitting next to him, holding Mr. Ning's head.
"Open your mouth!"
When Mr. Ning opened his mouth, Director Gan skillfully inserted the lens. Like a snake, the lens immediately penetrated deep into the pharynx, sucked out some sputum, and then entered the esophagus. Perhaps the stimulation of the air caused the esophagus to peristaltic, and Director Gan did not wait. The peristaltic wave passes, and the gastroscope is directly and dexterously pushed into the stomach.
"This kind of emergency gastroscopy is very risky, especially without anesthesia. The stimulation of the gastroscopy can cause vomiting, and vomiting can cause aspiration!" Director Gan said while doing it.
"Don't be afraid. His lungs have almost stopped working now. He relies on magic lungs to replace them. Let's do it." Yang Ping looked at the screen and put on sterile clothes, a hat, a mask and gloves.
Miss Ning also encouraged Director Gan: "We have signed the informed consent, and if anything happens, we are willing to bear the consequences."
"Can the family please go out for a moment?" Director Gan heard Miss Ning's voice and found that there were family members inside.
Miss Ning was unwilling to let go, Yang Ping said: "Let her stay inside!"
Director Kong has already greeted Director Gan. This patient trusts Yang Ping the most. Any treatment will be more convenient as long as Yang Ping is here.
Director Gan said nothing and continued the gastroscopy.
"Looking at the source of the bleeding, it should be the rupture of the esophageal and gastric veins caused by portal hypertension. You can see that it is full of blood and it is still coming out. It is very fierce. If it does not stop, blood transfusion will be useless. The coagulation factors will be consumed quickly, causing dispersion. Sexual intravascular coagulation is more dangerous." Director Gan asked Yang Ping to look at the screen.
The stomach on the screen was full of churning blood, and the suction was too busy to suck the blood away and then gush it out again.
"It's rare to see such severe esophageal and gastric vein ruptures." Director Gan was unhurried and his experience was there.
"Ice salt water, rinse with adrenaline!"
The assistant is ready. Ice-cold saline is injected into the stomach along the clamp channel, which is the instrument channel. It could have a certain effect on constricting blood vessels, but now it seems to have little effect, just like before.
"Still red-blind, I can't find the source of bleeding." Director Gan is very skilled in the operation, but this situation is indeed difficult to find.
"To stop bleeding, electrocoagulation can only be done at the approximate anatomical location."
The special electric scalpel for gastroscopy was inserted through the instrument tube and reached the bottom of the stomach very smoothly. With his rich experience, Director Gan electrocoagulated a few times at the possible bleeding location.
Emergency medicine has an emergency thinking style. Director Gan has also encountered this situation and he knows how to deal with it.
After several electrocoagulations, it got a little better, but it immediately returned to its original state, but it still didn't work.
"Titanium clips stop bleeding!"
This is the last resort and the most effective one. Directly insert the titanium alloy clip into the stomach to clamp the bleeding area.
"It really doesn't work. I'll put in a few more clips. They can always be clamped. Stop bleeding and save lives first. What's your blood pressure?" Director Gan held the operating end of the mirror with his left hand and the handle of the holder with his right hand, and removed the titanium clip from the instrument channel. Sent into the stomach.
"82/40mmHg!" Although there is no anesthesia, the anesthesiologist is responsible for monitoring.
Didi, there was only the sound of machines in the room.
The approximate bleeding location was clamped with a titanium clip. With one click, the titanium clip was in place and the holder was pulled out.
"Go on, one more." Director Gan was very steady and calm in the face of danger.
The blood still came out. Director Gan applied three titanium clips in succession, but it was still useless.
"What happened today?" Director Gan's confidence was shaken. Doctors are like this. They give out the most comprehensive tricks, but if they don't get the expected response, their confidence will naturally be compromised.
Yang Ping is not a gastroscope practitioner, and it is not easy to get involved, but the operations under the microscope have something in common. He can see the bleeding points every time the blood is sucked out. This is the sensitivity trained through systematic physical examination.
"Look, that's the bleeding point!" Yang Ping pointed out to them.
"Where? I can't see clearly!" Director Gan followed Yang Ping's finger.
"Shall I try?" Yang Ping suggested.
This suggestion was inappropriate, but there was no other way. He believed that he could stop the bleeding. They could not see clearly, but he could see clearly.
Director Gan turned to look at Yang Ping. He is also a knowledgeable person. At this time, just give it a try. You are a living horse doctor. If you can't do it yourself, don't let others try it. He is the doctor that patients trust most. They all signed After signing the disclaimer, maybe the surgeon's hands are really more flexible. He is so confident that he must have had a gastroscopy before. It would be good for multiple people to participate and share the risk.
"Come on, Dr. Yang, try it." Director Gan gave up his seat.
Yang Ping took the mirror and instruments in his hand, moved the instruments a little, and found the feeling. Soon he could feel it in his hands. Arthroscopy and gastroscopy have similarities. The basic principles are the same, both are operated with hand-eye separation.
The system's long-term training for Yang Ping not only improved his skills, but also increased his talent value virtually, so his confidence was not blind, and he really got started quickly.
"Suck blood, keep sucking blood!" Director Gan was commanding from the side. He wanted to find a place to go down the stairs. I came here to do a gastroscopy. I didn't take it. You can take it later. Now that you are saying these few words, you have your own. Credit is mainly a matter of face.
Taking advantage of the gap of blood being sucked away, in the blink of an eye, Yang Ping immediately clamped the bleeding point and hit it with one blow. Soon, as the accumulated blood was sucked out, there was really no more bleeding.
Buckle the titanium clip and exit the holder. A titanium clip solves the problem.
"The bleeding is gone, Dr. Yang, your hands are really amazing, you are worthy of doing five-segment reimplantation." Director Gan said cheerfully.
"No, I've had better luck these days, so I want to give it a try. It can only be completed without Director Gan's command. If it weren't for your command, it would be difficult for me to complete it." Yang Ping said politely, giving him a step at the right time.
"That's right!" Director Gan went downstairs quickly.
"Draw blood, urgent blood routine and DIC complete set, once an hour, dynamic monitoring." Director Gan gave the verbal medical order, and the nurse immediately carried it out.
Miss Ning wiped away her tears: "Has the bleeding stopped?"
"Okay, stop it." Yang Ping handed the equipment to Director Gan.
Rinse it with ice-cold salt water. Director Gan checks carefully and finds that there are no other bleeding points. He extracts the gas from the stomach, inserts a gastric tube, and then removes the mirror.
Mr. Ning had been retching in discomfort. When the mirror was pulled out, it was like vomit being pulled out by the mirror. He suddenly vomited into a puddle, which was full of bloody salt water. It was all over the bed and the floor.
The nurse was also used to it and cleaned it immediately. The nurse next to her moved quickly and went to help.
Director Gan's assistant packed up the equipment and pushed the machine to evacuate. The nurse was busy picking up the garbage. The nurse aunt mopped the floor with a wet mop and then dried it with a dry mop. Except for the doctor in charge of the bed and the doctor and nurse who managed the magic lung, everyone else left the room. .
Mr. Ning wanted to say something, but it was too hard to vomit just now. After the gastroscopy, he was so upset that he couldn't speak for a while, so he just pointed Yang Ping.
Miss Ning immediately caught up with Yang Ping: "Dr. Yang, please stay!"
Yang Ping stopped: "Director Kong, I'll stay for a while."
Miss Ning felt guilty that she always troubled him: "Sorry, Dr. Yang, Dad seems to have something to tell you."
This time it was Dr. Yang who helped him survive the danger. Mr. Ning and Miss Ning always saw it in their eyes and remembered it in their hearts.
Yang Ping walked to the bedside and would stop any patient at this time. In his eyes, there were no billionaires, only patients.
Mr. Ning pointed his hand downward.
"Please sit down!" Miss Ning moved the chair.
Yang Ping sat down. What Mr. Ning needs now is comfort. When life is dying, people always want to catch something. Some people think of God, but Mr. Ning thinks of Yang Ping.
"Can you stay with me?" Mr. Ning prepared for a long time before saying this, and he had to wait a long time for the next sentence.
Yang Ping nodded: "I've been sitting here, don't worry."
Mr. Ning nodded slightly, with a smile on his face.
Miss Ning had a slight embarrassment on her face. She was a doctor and was being guarded, but her father asked so, and with a satisfied smile on her face, she said, "Doctor Yang, this is really troublesome."
"It's okay! I'm sitting here!"
Yang Ping knew that he had just lost so much blood, and then had to transfuse a lot of blood, which might soon cause disseminated intravascular coagulation, and he would not survive the night.
Really, I can't hold on any longer this time. What reason do I have to refuse a dying person's small request?
"What time is it?"
"It's past noon now."
"It's still so long."
Mr. Ning squinted his eyes and lay down.
(End of chapter)