I'm really an intern

Chapter 22 The Bloody Fountain

"Which bed?"

"41 beds!"

What the hell!

Zhang Tianyang secretly said badly in his heart.

Why is it 41 beds again!

This number is unlucky!

I hurriedly followed the little nurse to the intensive care unit, and saw the family member's hand pressing on the neck of the old lady in bed 41.

"Doctor!" The family members seemed to be grabbing straws in the water, their faces full of horror.

"Doctor, please see what's going on with my mother, the tube in her neck is bleeding all the time!"

Zhang Tianyang rushed to the hospital bed in a hurry, and saw the blood soaked on the gauze and paper towels under the family members' hands at a glance.

The layers of gauze were almost soaked in red, and the paper towels that the family members pressed on were more than half red!

"Fuck!"

This is bleeding after internal jugular vein catheterization!

After a pause, Zhang Tianyang rushed out at a faster speed than when he came.

"Xiaolin! Ask the family members to pressurize and hold down! Pressurize! Be sure to pressurize!"

Bleeding is one of the complications of internal jugular vein catheterization, and it is also a situation that clinicians are more afraid of encountering.

There are many causes of bleeding after internal jugular vein catheterization.

It may be that a small blood vessel under the skin was damaged during the puncture, or the internal jugular vein may be penetrated, and what is even more terrifying is that a small artery was punctured.

Looking at the bleeding volume of the old lady in bed 41, Zhang Tianyang was afraid that it was really a small artery that might break.

A broken artery anywhere is likely to cause the patient to bleed too much and die!

Zhang Tianyang's slightly slack spirit instantly tensed up.

While running to the treatment room, he took out his mobile phone to contact the superior doctor.

First of all, I called Professor Liu, but after only two rings, I was hung up by the other party.

The second call was to Senior Sister Liang, but unfortunately Senior Sister Liang seemed to be undergoing surgery, so no one answered at all.

Brother Wang usually arrives half an hour late for work in the afternoon. If Zhang Tianyang calls him, it is possible to find someone.

But it's probably useless for senior brother Wang to come.

There was no way, Zhang Tianyang could only briefly summarize the situation in the small group, and then began to search in the treatment room.

Gauze, ordinary gloves, sterile gloves, Amur iodine, cotton swabs, endotracheal tube, video laryngoscope

Pushing the treatment cart non-stop and running back to the intensive care unit, Zhang Tianyang saw that there were already two balls of blood-stained paper towels on the table beside the hospital bed.

"Doctor, what should I do!"

The family member was a woman in her early thirties, and the hands holding the old lady's neck were trembling at this time.

Seeing that the mood is about to collapse.

Zhang Tianyang ignored her.

In times of crisis, there is no time to explain the illness!

"Xiao Lin, help me read Professor Liu's reply!"

He moved quickly, stuffed the mobile phone into the arms of the little nurse Lin Lin, and put on the gloves in two seconds.

"Hands off."

The hands of the family members and the nurse were pushed aside by him.

Carefully and quickly lifted off the blood-red gauze around the old lady's neck, revealing the situation inside.

The internal jugular vein extends from the neck, and the wound is constantly oozing blood.

high speed!

Zhang Tianyang's heart was beating wildly in his chest, but his hands remained steady.

Quickly disinfect and replace with new gauze, then press and hold.

The dark red blood still oozes firmly but slowly, soaking the pure white gauze bit by bit.

Zhang Tianyang's heart sank little by little.

Depending on the situation, I have to incision at the bedside to detect the bleeding point!

"Xiao Lin, did Professor Liu reply?"

The voice turned into a roar unknowingly, and the nervousness of the little nurse was mobilized.

"Calling!"

It's Professor Liu's phone number.

Professor Liu was speaking at the meeting, but the patient was in critical condition, so he ran out of the meeting room to communicate with Zhang Tianyang.

"I'm going to contact the professor downstairs in the dialysis room who put the internal jugular vein catheter on bed 41!"

Professor Liu made the same choice as Zhang Tianyang.

"Cut and explore the bleeding point!"

"The professor over there will take at least 5 minutes to come up, you should get everything ready first!"

"Hold on!"

Professor Liu is far away in another province, beyond his reach.

Only Zhang Tianyang can stand in front here.

"Little Lin! I need a cutting bag, where can I find it!"

"It's available in the dialysis room downstairs! Do you want me to get it!"

"Going right now!"

Zhang Tianyang was yelling, and the little nurse was also yelling, and the entire intensive care unit was quiet.

Everyone seemed to realize that the situation was critical, and subconsciously dared not speak out, for fear of disturbing the doctor's judgment.

The family members of the old lady in bed 41 were anxious and scared, covering their mouths tightly with trembling hands, their eyes were red, and tears were swirling inside.

"Family! Put on your gloves and press here!"

Zhang Tianyang's roar brought the woman back to her senses, and hurried to put on the gloves on the treatment vehicle.

But her hands were too trembling. It took her three or four times to put on the oversized gloves before she managed to put them on.

"This position, press it tight, it will sink in!"

"Press only the right side of the neck, don't touch the left! Are you going to strangle the patient!"

The pressing position was handed over to the family members, and Zhang Tianyang changed into a pair of gloves and began to prepare items.

The video laryngoscope was opened, the protective cover was installed, and the No. 7 endotracheal tube was unpacked and lubricated with lubricant.

During the whole process, Zhang Tianyang never took his eyes off the blood oxygen saturation on the patient monitor.

The danger that patients now face is not only excessive blood loss, but also the possibility of suffocation.

If the blood vessel that is now ruptured and bleeding is really a small artery, then the patient may have developed a hematoma.

Large hematomas can compress the airway, leading to suffocation of the patient.

At that time, before the patient loses too much blood, he will be suffocated to death because of the blocked airway!

Zhang Tianyang stared at the fluctuation of blood oxygen saturation, as long as it showed a slight downward trend, he was ready to intubate the patient!

The onlookers nearby were also arrested by Zhang Tianyang.

"Brother, do me a favor!"

The 40-bed elder brother looks normal except for a little high blood pressure. Zhang Tianyang directed him to the nurse's station.

"Go and tell the nurse that there is a risk of shock in bed 41 due to massive bleeding, prepare Ringer's fluid now!

Dopamine and norepinephrine are also on hand! "

"What liquid?"

"Call a nurse over and I'll tell her!"

Two minutes later, Nurse Xiaolin ran back holding the incision bag, humming and humming.

"Cut, cut the bag, take, take it back!"

The little nurse's face became red from running fast, and her chest heaved violently due to panting.

Zhang Tianyang glanced at it and threw a pair of ordinary gloves over.

"Put it on! Help me!"

He quickly put on the mask and hat, then opened the blue package of the cut bag, and quickly put on sterile gloves.

The little nurse Lin Lin is also very skilled in her movements.

Pour anal iodine, unwrap the sterile gauze, unwrap the sterile gauze, and then unwrap the sterile gauze.

Over there, Zhang Tianyang had been sterilized with Aner Iodine, and then covered with sterile towels.

From the incision bag, I sorted out a large stack of gauze removed by the little nurse, took out two pads and put them on the place where the indwelling tube of the internal jugular vein was bleeding, and folded the rest on the sterile drape.

Disassemble the blade and install the scalpel.

Thread the needle and get the ligature and suture tools ready.

Lidocaine was extracted, and infiltration anesthesia was carried out in all directions along the position of the indwelling catheter in the internal jugular vein.

Everything is ready, just waiting for the chief surgeon.

Professor Zhou, who hurried up from downstairs, saw such a scene as soon as he entered the door.

Everything ready?

For a moment, he doubted his life.

But he reacted quickly, and quickly put on the mask hat and sterile gloves prepared next to him.

After taking the scalpel Zhang Tianyang handed him, Professor Zhou made a slight incision along the position of the internal jugular vein in the direction of the chin.

Cut the skin, cut the subcutaneous fat, cut the connective tissue.

The rate at which the blood oozes out is slightly accelerated.

Professor Zhou's hand gently pressed on the patient's neck

"puff!"

A bloody fountain sprayed out directly!

　It’s true, the Bloody Fountain is five centimeters high, and its shape is probably like turning the faucet upside down at home to let water flow upwards, experience my despair

　　All the senior doctors are gone, and I am the only one left!

　　I'm having a hard time

　　

　

(End of this chapter)