Medical road ahead

"It's too late to send it in, and perform electrical defibrillation on the spot!"

Seeing this, Wang Xiaobo shouted, and immediately let the surrounding pedestrians get out of the area, leaving the 120 and emergency department medical staff to rescue the patient.

After the doctor at 120 quickly dried the patient's chest skin, and then put him on his back with his head turned to one side, Wang Xiaobo then turned on the power switch of the defibrillator, and took over the hands that were evenly coated with special conductive paste by the nurses in the emergency department. Control the defibrillation electrode board, place the (STERNUM) electrode board on the bottom of the patient's heart (on the second and third intercostal spaces on the right sternum and clavicle midline), and place the (APEX) electrode board on the patient's apex (the left axillary midline first On the fourth and fifth intercostal spaces).

Immediately afterwards, he estimated the distance between the two electrode plates, and after confirming that the distance was more than 10 centimeters, he turned his head and shouted at the colleague next to the hospital bed: "Stay away!"

Nourishes—

After charging the defibrillator, Wang Xiaobo pressed the discharge button with both hands. It took only 20 seconds for the patient to recover sinus rhythm and the defibrillation was successful.

"call……"

Wang Xiaobo breathed a sigh of relief, and the rest of the people were also disappointed.

"Send to ICU."

Although the patient's heartbeat had recovered, Wang Xiaobo and others did not dare to neglect, and immediately pushed the stretcher into the hospital through the fast lane.

On the way, he asked the accompanying 120 colleagues: "When I rescued the patient just now, I found that she didn't seem to be in a coma caused by a violent attack, but more like septic shock."

"Doctor Xiao Wang made a good judgment."

The doctor at 120 nodded and said, "The situation was urgent just now. I didn't have time to explain clearly. In fact, the patient called 120 for help, saying that she felt pain in the wound after eye liposuction, but the medical staff of the plastic surgery hospital But she said it was a normal phenomenon, and only applied ice compresses to her, without any other treatment. Later, her pain intensified, and it had spread from the eye wound to her whole body. Seeing that no one responded, she had to call 120 by herself."

"This is obviously a complication caused by postoperative infection!"

Wang Xiaobo frowned, and asked again: "Which plastic surgery hospital is so unprofessional? Have you called the police?"

"It seems to be Meililai. After the patient is settled, we will report this matter to the relevant department." The doctor at 120 said.

After the patient was sent to the ICU, the medical staff from the general surgery department rushed to the hospital and examined the patient while listening to the detailed description of the patient's condition from 120 doctors.

"Cough! Little Orange."

Seeing Chen Tiancheng who came in with Hu Zhiwen, Wang Xiaobo greeted her with some ease.

However, at this time, Chen Tiancheng's attention was all on the patient, she just nodded back, and went to help Hu Zhiwen.

"Doctor Hu, the patient appears to be in toxic shock."

Lifting up the patient's sleeve, Chen Tiancheng immediately found the rash scattered on the patient's arm.

Hu Zhiwen only glanced at it, then speculated based on his past experience: "It should be suppurative fasciitis caused by postoperative infection. However, we still need to check first before making a diagnosis."

"First conduct a blood routine examination on the patient, and at the same time clean the wound tissue for pathological examination, and then increase the oxygen delivery." He then ordered.

Then, he looked at the doctor at 120 and asked, "Does the patient have a history of allergies?"

"Remember to ask before you come, she has lost consciousness." The doctor at 120 frowned and shook his head.

Hearing this, Chen Tiancheng asked Hu Zhiwen: "Deputy Director Hu, do you need to give the patient a skin test?"

"Give her potassium permanganate, pay attention to the ratio of concentration." Hu Zhiwen said.

"Ok."

Chen Tiancheng nodded seriously, and got busy with several other nurses.

Wang Xiaobo stepped forward and asked, "Do you need my help?"

"After we draw her blood, please take it to the hematology department for examination." Chen Tiancheng said.

"Ah."

Wang Xiaobo stayed to help, while the doctors at 120 left the ICU, preparing to report the medical accident to their superiors.

"Red blood cells and hemoglobin showed a moderate decrease, the white blood cell count was 25×109/L, there was a left shift of the nucleus, and toxic granules appeared."

After getting the results of the urgent blood routine test, Wang Xiaobo hurried back to the ICU ward and read out the results directly.

"Pathological examination of the debridement tissue revealed extensive white blood cell infiltration, focal necrosis of fascia and adjacent tissues, and microvascular embolism." Chen Tiancheng also made a diagnosis report.

"Diagnosed as postoperative suppurative fasciitis."

After diagnosing the patient, Hu Zhiwen observed her vital signs, and said to Chen Tiancheng and the others: "Prepare for debridement and drainage."

"Can I learn from others?" Wang Xiaobo asked timidly.

"no problem."

Hu Zhiwen nodded with a smile, and directed his doctors and nurses to debride and drain the patient to achieve the fastest and best therapeutic effect, and explained to Wang Xiaobo: "Because I don't know the patient's previous medical history and allergy history, I dare not increase the dose of antibiotics." Therefore, debride the wound as needed to completely remove the necrotic fascia and subcutaneous tissue until the tissues cannot be separated with fingers.”

"Understood, if the patient has no history of allergy to antibiotics, he can use large doses of antibiotics for treatment, and wait until there is no obvious effect in 1 to 3 days before choosing surgery, right?" Wang Xiaobo speculated.

"Correct!"

Hu Zhiwen nodded and added: "Besides, there are extensive vascular thrombus in and around the lesions of suppurative fasciitis, and it is usually difficult for drugs to reach them. Therefore, surgery may still be performed in the end. Of course, if surgery is possible, try not to. Operation."

Wang Xiaobo wrote it down carefully, and then watched and studied.

Because the infection was caused by the extraction of eye fat, the wound is not large. It is only necessary to remove the healthy skin of the infected part for later use, then remove the necrotic tissue, clean the wound, and finally perform free skin grafting to cover the wound.

This method can effectively prevent a large amount of serum exudation from the wound, and is beneficial to maintain the balance of body fluids and electrolytes after surgery.

"Pay attention to protecting the healthy fascia, otherwise it will cause the infection to spread after injury." Hu Zhiwen reminded from the side.

After the end of debridement and drainage, the treatment for this patient is not over, and supportive treatment is still needed.

"The patient's electrolytes are not disturbed now, but she is anemic and needs fresh blood transfusion, and contact the nutrition department to prepare a high-nutrition, elemental diet for the patient, either nasal feeding or intravenous feeding, so that the patient's calorie intake is sufficient. "

After arranging supportive treatment, Hu Zhiwen instructed: "During this period, the patient's blood pressure, pulse, and urine output should be closely observed, and hematocrit, electrolytes, blood coagulation mechanism, and blood gas analysis should be done. , timely treatment is required to prevent the occurrence of disseminated intravascular coagulation and shock."

"Remember to observe the complications well, because the complications of suppurative fasciitis are many and dangerous, any of them, such as disseminated intravascular coagulation, toxic shock, multiple organ failure, etc., can cause the death of the patient"

After finishing speaking, he solemnly exhorted again.

"Uh……"

At this moment, the patient finally woke up slowly and survived the dangerous period.

She never imagined that she just did a simple eye liposuction, and she walked around the gate of hell...