Chapter 584 Love and justice
When Yang Ping rushed to the interventional operating room, Qin Xiaowei was sitting on the bench at the door, with his head buried and his hands in his hair.
Perhaps hearing footsteps, Qin Xiaowei raised his head and saw Yang Ping. As if he saw hope, he stood up immediately: "Professor Yang, Ajun is inside to rescue him."
Yang Ping pressed his shoulder: "Don't worry, I'll go in and take a look."
"Arjun had a pulmonary embolism before, but the symptoms were very mild. The doctor said at the time that he was lucky. If he was unlucky and had a fatal pulmonary embolism, the hope of successful rescue would be very small."
Tan Xiaowei was anxious and tired, his face was covered with grease and glistening.
What he said is correct. The probability of successful rescue of fatal pulmonary embolism is very low. The average time from onset to death is two hours, and it can be gone in a few minutes.
The emboli of pulmonary embolism come from veins, usually from the veins of the lower limbs. The biggest danger of emboli is to block blood vessels. If they block the peripheral parts, they will quietly cause venous return disorder. Once the emboli fall off, they will flow back to the heart along with the venous blood. Then it flows from the heart into the pulmonary artery, and the artery becomes thinner and thinner. At some point, the embolus cannot pass through, and it blocks the pulmonary artery or branch blood vessels.
The blood vessels become clogged and a chain reaction occurs.
In this way, the pulmonary artery is blocked sequentially, the pulmonary artery pressure suddenly increases, and the cardiac output decreases sharply.
Cardiac blood output drops sharply, causing circulatory failure, especially acute right heart failure, leading to shock and insufficient blood supply to important organs, such as cerebral blood vessels and coronary arteries, which can lead to syncope and even death.
Stimulation of blood vessels by a large number of small emboli will cause vagus nerve excitement, stimulate platelets to release serotonin, thromboxane a2, etc., and nerve reflexes cause coronary artery, pulmonary artery, bronchial artery spasm, pulmonary hypertension, right heart failure, and refractory hypoxemia.
After Yang Ping comforted Qin Xiaowei, he and Song Zimo entered the interventional operating room, while Xu Zhiliang, Gao Qiao, Robert and others stayed outside.
The interventionalist moved quickly, and the angiogram of the pulmonary artery appeared on the screen.
The chief surgeon is Director Ji. Director Ji and Director Guan are the two aces of the interventional department. Director Guan is the director of the department and has profound knowledge in cardiovascular intervention. Director Ji has comprehensive skills and can perform almost all interventional surgeries and is very skilled.
"It developed very rapidly. The main pulmonary artery was embolized. I crushed it first, then used a thrombus ablation device to melt it, and the rest was treated with local drug thrombolysis."
"Look, after I got through it, it immediately thickened like snow. I'll pound it for a while."
"The situation is not good!"
Director Ji has worked with Yang Ping, so he is very familiar with Yang Ping.
"The diameter of the pulmonary artery is normal and there should be no spasm, which means the vagus nerve is not excited. There is hope."
Yang Ping actually received a lot of interventional surgery training in the system operating room, but he didn't use it much on a daily basis.
"That's right, your doctor discovered it early, quickly, and delivered it on time, otherwise there would be no chance of getting on the operating table."
Director Ji is very satisfied with Li Guodong's performance.
Li Guodong stood nearby: "These are Professor Yang's basic requirements for us."
At this time, he was still flattering, but it is true that Li Guodong did a good job this time. If it had been a few minutes later, it would have been a different ending.
Rescue is really a race against time. If you seize the time, you can save your life. If you miss the opportunity, you will be unable to save the life.
Director Ji said while performing the operation, crushing the large thrombus into pieces, and then using the thrombolytic device to melt the remaining thrombus. He used a catheter to inject alteplase into the thrombus, and the surgical effect was very good.
After the thrombus is eliminated in time, the coagulation function does not completely collapse, just like when the snow stops, the blood vessel wall no longer accumulates snow and can naturally remain open.
Director Ji observed for a few minutes and felt that there was no problem, so he asked the doctor in the audience:
"How is the blood oxygen?"
Director Ji asked the doctors in the audience.
"Eighty percent."
The anesthesiologist in the audience replied.
How can this work? This is still ventilator ventilation, and the oxygen injected is high flow.
High-flow oxygen ventilation should not be used for too long, otherwise it will cause oxygen poisoning.
"Get on ECMO, hurry up!"
The blood oxygen has been unable to rise, so ECMO (extracorporeal membrane oxygenation device) can only be used. Otherwise, if the patient is in a hypoxic state for a long time, important organs such as the brain will suffer from hypoxia and damage.
ECMO is only available in the ICU. Director Ji is more experienced. As soon as he saw Li Jun's CT pictures, he knew it was very dangerous. He contacted the ICU in advance and sent an ECMO to the operating room on standby. It happened to be deployed now.
Without ECMO, this young man would have basically no chance.
After being connected to ECMO, Li Jun's blood oxygen began to rise, rising to 100%.
The extracorporeal membrane oxygenation device replaced both of Li Jun's lungs and provided artificial pulmonary circulation.
"Send to ICU!"
Director Ji handed over the finishing work to his doctors and took off his gloves and surgical gowns.
"Let's go and explain to his family together."
Director Ji invited Yang Ping to communicate with the family members.
When the two came out of the interventional operating room, Qin Xiaowei immediately stood up and asked anxiously: "Professor Yang, how are you?"
Yang Ping said calmly: "We have been rescued temporarily, but it may be due to pulmonary infarction and refractory hypoxemia. A special machine is needed to replace the function of the lungs to survive the dangerous period."
When Qin Xiaowei heard that there was still hope, he did not hesitate: "Professor Yang, I agree, I sign!"
Before the operation, Li Jun wrote a power of attorney to Qin Xiaowei, entrusting Qin Xiaowei with full authority to sign the medical decisions he made while he was hospitalized in Sanbo Hospital.
"The cost is very expensive. It is not covered by medical insurance. It costs 50,000 yuan to start the machine and at least 20,000 yuan a day for follow-up. Including other treatment fees in the ICU, the follow-up treatment fee will be more than 50,000 yuan a day. How long will it last? I don't know now. Will it be possible in the end? There is no guarantee of resuscitation.”
Yang Ping must make it clear to Tan Xiaowei.
"That is to say, the cost is high, and it is very likely that both people and money will be depleted by then. Are you willing to do this?"
Director Ji added straightforwardly.
For many things, feelings are one aspect, but reality is another. Doctors must tell the family members about the current situation and let the family members make their own choices.
Sometimes when faced with this situation, huge financial resources are invested, but in the end the person is still not saved. Some families have to weigh the pros and cons and decide whether to continue or give up.
If you give up, you will not be able to survive psychologically; but if you continue to persevere, the whole family will be involved, and the rest of your life will be spent paying off debts.
"There is very little hope!"
Director Ji's tone was heavy.
"I understand. Help Ajun get on this machine. No matter what, try your best to save him. I will raise money, please!" Tan Xiaowei did not hesitate at all.
He plopped down to his knees.
"Save him, I must save him. No matter how much it costs, I can find a way to raise the money, Professor Yang!" Tan Xiaowei's voice was hoarse and his face was covered with sweat.
He didn't expect Arjun to be so serious. The previous doctors didn't scare him. Fatal pulmonary embolism was almost impossible to save.
Now Arjun still has a glimmer of hope, and he will never give up.
"Don't be like this, get up and talk." Yang Ping helped him up.
With trembling hands, Tan Xiaowei opened his pocket and took out a thick stack of money: "I'm going to pay it now." Then he took out the folded document and opened it: "Look, this is the contract. I As long as you sign, there is a one million down payment, you see, you can call and ask this company, it is true.”
Yang Ping grabbed his hand: "Xiaowei, don't get excited, we have already put Ajun on the machine, and we will try our best."
Tan Xiaowei nodded: "Thank you, please, please save Ajun."
Li Jun was pushed out from the operating room and was already in a coma. Qin Xiaowei rushed up and grabbed Li Jun's hand. With tears still on his face, he sobbed and said: "Jun, don't be afraid. I'm here. Don't be afraid. You must It’s okay——”
Li Jun seemed to understand what Tan Xiaowei said, and tears welled up in the corners of his eyes.
The cart pushed Li Jun all the way to the ICU, but Qin Xiaowei was blocked from the outside. He sat on a chair in the family waiting area. He was very tired, but he forced himself to cheer up.
He searched in his mind for various ways to raise money. He just had a little money on hand, thinking he could handle a kidney transplant.
But God's calculations are not as good as those of humans. The tens of thousands of dollars now are just a drop in the bucket.
Borrow money from friends?
But he quickly gave up this idea. He had a good relationship and understood the economic situation. This problem could not be solved with tens of thousands of dollars, but it would definitely be impossible to raise hundreds of thousands.
Other people's questions are in vain. Regarding borrowing money, even if they are humble, they will not lend it.
Tan Xiaowei held a contract in his hand and held it tightly. He opened it carefully, read it again, and then put it in his pocket.
At this time, the ICU doctor came out and called Li Jun's family members.
In the interview room, several informed consent forms were placed in front of him. The doctor introduced Li Jun's current condition in detail. Tan Xiaowei had no intention of listening, so he just signed.
"Is there anything else you don't understand?" the doctor asked.
Tan Xiaowei was in a daze: "How is Jun? Can I go in and see him?"
The doctor shook his head: "With the support of the extracorporeal membrane oxygenation device, the vital signs are currently stable. We cannot visit you now. I will inform you if we can visit you."
After saying that, the doctor stood up to leave.
Qin Xiaowei thought of something again: "Doctor!"
The doctor stopped and looked back: "What's the matter?"
"If he can hear it, tell Arjun for me that I am outside and tell him not to be afraid. I have a way."
Qin Xiaowei requested.
The doctor nodded: "If he wakes up, I will definitely tell him the exact words. Keep your mobile phone open and don't leave the hospital too far. If the condition changes, we will notify you at any time."
"Don't worry! I'm nearby." Tan Xiaowei assured.
After the doctor left, Qin Xiaowei sat in the last row of the waiting area for family members, took out his mobile phone and dialed a number.
There is no one in the waiting area for family members in the ICU, except for him.
The other party's tone was gentle: "Xiaowei, how are you? How have you considered it? Let me tell you, the cliff you chose is not good. The cliff chosen by our boss is more exciting. Today's Internet users have very high tastes and there is not enough excitement. It's hard to attract attention. You are more familiar with the Angel Falls rock climbing section in "The Outlaws" than I am. Our boss followed that cliff to find it, so it will definitely become an instant hit. With your skills, as long as you are fully prepared, you will definitely not be able to do it. Question? There is no free lunch in the world. Is it so easy to get a few million, right? Moreover, if you become famous, you will be worth more than these few million in the future."
"I've thought about it and agree to the terms of the agreement." Tan Xiaowei said calmly.
"Then find a time to come to the company. Let me tell you the truth, how can we do this? We are backed by big companies. It is not convenient for big companies to come forward. We are just acting on behalf of them. You come here and sign the words, and we will pay one hundred in advance." Ten thousand will be paid immediately. After the work is completed, the remaining five million will not be less. Six million, many people will not make any money in their lifetime. I also want to do this job, but I can't do it. People ask you by name. ”
"Also, brother, we will buy you a life insurance worth tens of millions. I am not cursing you. This is an industry rule so that you will have no worries."
The other party is very enthusiastic.
"I'm busy these days——"
"It's okay. Where are you? Give me a location and I'll come over to you to sign. Okay? Brother Xiao Wei, I want to thank you too. If they hadn't taken a fancy to you, we wouldn't have had the chance to cooperate with a big company. I'm also asking you to Let’s make some money.”
When the other party heard that Tan Xiaowei agreed, his tone became even warmer.
With the support of the extracorporeal membrane oxygenation device, Li Jun's vital signs are stable, and his life is at least temporarily saved. However, it is not yet known when he will be able to wean himself off the machine.
When Yang Ping came out of the ICU, Qin Xiaowei was still sitting in the waiting area for family members. Yang Ping greeted him and told him: Li Jun's vital signs are now stable, and the ICU doctors will not see him for the time being and let him eat something.
In the afternoon, the unfinished football game must be continued.
Rescue is a daily routine for doctors. In the buildings of Sanbo Hospital, people are being rescued every day.
Even if there is a fierce game on the basketball court, some department may be performing intense rescue operations.
——
The next day, Yang Ping went to the ICU to see Li Jun. Tan Xiaowei jumped up from his chair in the family waiting area.
"You slept here all night?" Song Zimo asked in surprise.
"Yes, I'm afraid that Arjun's condition will change. If I sleep here, the doctor can find him quickly."
The young man rubbed his bloodshot eyes with a shy expression. He was really afraid that if the doctor couldn't find him, he would give up the rescue.
Yang Ping took everyone into the ICU, and Li Jun's vital signs were stable.
The extracorporeal membrane oxygenation device is placed next to it, making a unique sound. The blood flows out of Li Jun's body. After being oxygenated by the artificial machine, it is then injected into Li Jun's body to supply oxygen to various organs.
"It's still stable for the time being! I just don't know if I can go offline! Long-term use of anticoagulants has disrupted my own coagulation function, so thrombosis is prone to occur."
The ICU director accompanied Yang Ping.
"Yes, it happened once before. Fortunately, it was a mild illness and there was no big problem."
Yang Ping talked with the ICU director.
Song Zimo, Xu Zhiliang, Gao Qiao, and Robert gathered around Li Jun's bed. Song Zimo changed Li Jun's dressing and checked the surgical incision.
Many ICU doctors and nurses came to watch. They heard that several foreigners in Yangping Core came to study, and they were very curious.
In addition to admiration, everyone still admires him. At such a young age, he actually allowed foreigners to come across the ocean to study.
And looking at the expressions of these foreigners, they look like grandchildren.
"This kind of kidney should be replaced as soon as possible, otherwise even if it gets over now, it will be a bomb in the future."
What the ICU director means is that if you get a kidney transplant, you won't need to undergo dialysis so frequently. Naturally, you won't need to use anticoagulants frequently, and the coagulation mechanism will return to normal.
"He never found a kidney source."
Yang Ping just said it casually. As for Tan Xiaowei's successful match with him, Yang Ping didn't say anything.
"His cousin is quite affectionate and kind. He handed over another 300,000 yuan this morning. He seems determined to save her. In this situation, many families will give up after a few days of symbolic support."
I have seen many things about the life and death of ICU directors.
My parents and brothers gave up a lot in the end, but I have never seen my cousin be so awesome.
Tan Xiaowei paid 300,000? Yang Ping was also a little surprised. Did he really sign that contract and get one million?
Although Yang Ping didn't know what the contract was, he felt that this young man was indeed affectionate and righteous.
PS: If it is a chapter, it must be a big chapter. This chapter has more than 4,000 words! It’s equivalent to two chapters!
(End of chapter)