I can see the status bar

Chapter 1005 D+1 day (5) (addition 04 for the leader "changing the name is too expensive")

This chapter is Chapter 4, which is updated for the leader "changing the name is too expensive". After this chapter, there are three more chapters waiting to be updated.

There is not much need to be careful about ECMO catheterization. Like other operations, anesthesia and analgesia should be done well, and bleeding should be controlled during the operation.

However, unlike other operations, this "ECMO operation" is performed in the ward, and the patient's vital signs are very poor.

Mr. Shen was lying motionless on the hospital bed, like a dry and dead old tree—his skin was all dry and cracked. Since he could not take a bath while lying on the bed, the skin that had died normally could not fall off from the original tissue. So it became like this.

Since the VV-ECMO mode was adopted, Dr. Jiang chose the femoral vein as the approach, and the jugular vein in the neck as the infusion point.

But what is troublesome is that the commonly used percutaneous catheterization cannot be the first choice this time—Mr. Shen’s femoral vein has some congenital deformities. artery.

"Scalpel." Dr. Jiang Yanming stood beside the bed, took a deep breath, and then gave instructions to Hu Jia who was beside him.The risk of percutaneous catheterization is too great, and now only surgical incision and catheterization can be used.

Mr. Shen is currently in a calm state of tracheostomy ventilation, and muscle relaxants have been taking effect.For him to perform ECMO surgery, he only needs to add a little local anesthetic.

In order for this small operation using local anesthesia to go smoothly, Sun Lien stood beside Director Lu Zhimin who was seriously ill, Deputy Director Zhong Jiguo of the Department of Pediatric Internal Medicine, Director Meng Hongxiang of the Department of Hematology who worked with Director Lu, Deputy Director Jiang Yanming who was the chief surgeon, and himself.The five directors got together and completely surrounded Mr. Shen's hospital bed.Fortunately, everyone is more measured, at least they can pay attention to avoiding the position of the light during the process of watching, giving Deputy Director Jiang Yanming a better operating field.

Hu Jia and Jiang Yanming, who were born as surgical nurses, cooperated fairly well.Although it is the first time to cooperate, it is still not possible for the other party to hand over the equipment as soon as the other party has an idea.However, due to the full anticipation of the preparation of the equipment, Hu Jia quickly entered the state and assisted in this "surgery".

"The amount of bleeding during the operation was a bit heavy." Jiang Yanming completed the femoral artery catheterization of Mr. Shen, and after confirming that the catheter connection was intact, he completed the skin suturing treatment on the leg.If it was in the fourth hospital or a hospital in the former Shanghai stock market, when Jiang Yanming completed the femoral vein catheterization, another ECMO director should have completed the jugular vein catheterization by the way.But here, the ECMO director is alone.He had to do all the work himself - including the stitching.

Due to the use of incision catheterization, rather than percutaneous catheterization.The process of catheterization inevitably caused a certain degree of damage to Mr. Shen's body.From the current point of view, the injury this time is a little bit large-about 50 ml of blood transfusion during the operation.

Fortunately, the three unnamed arteries were not cut, otherwise the amount of bleeding would have gone up to 200.

"The blood preparation has 200cc." Hu Jia said from the side, "The rewarming has been completed, should I hang it up first?"

"Hang." Jiang Yan said succinctly, he walked to the shoulder of old man Shen, then took a deep breath, and scanned the old man's neck with a B-ultrasound.

During the previous scan, he judged that the neck should be capable of percutaneous puncture.But... now he is a little confused.

There are still three innominate arteries wrapped around the femoral vein.Where does this make sense?

Fortunately, when he cut the base of Old Shen's thigh, several innominate arteries did not grow out of the jugular vein to hinder his percutaneous puncture. B-ultrasound showed that everything was normal.

After locating the jugular vein with a B-ultrasound, Dr. Jiang Yanming chose the safest option.He took off the cap of the pen, and marked the positioning point on Mr. Shen's neck with a marker.Then began to disinfect the skin and insert the needle.

"Okay." After confirming that the blood returned, Jiang Yanming stood up carefully, and then covered the wound with a polymer transparent dressing.

"That's all right?" Sun Li'en took two steps back, looked at the status bar above Mr. Shen's head and asked with a frown.The status bar said that the old man is still in a state of "hypoxemia".

Dr. Jiang rolled his eyes, "Why are you in a hurry?" He walked to the ECMO machine and turned on the switch.

There was a low humming sound, and the two thick dark red pipelines vibrated slightly, and then returned to calm.

"Hypoxemia" on the status bar faded faster than ever before, and disappeared completely after a few seconds.The monitor at the side also quickly updated the blood oxygen saturation of Mr. Shen.From 88% at the beginning to 91%, then 95%.When the data was updated for the third time, his blood oxygen saturation returned to 100%.

Everyone in the ward breathed a sigh of relief, including Mr. Shen himself - after his blood oxygen saturation went up, his complexion suddenly looked much better.But Dr. Jiang Yanming remained cautious. He touched old man Shen's right foot and relaxed a little after confirming that there was no problem with the blood supply to the extremities.

"Okay, we can start the transfer." After exchanging a few words with Dr. Jiang Yanming, Sun Lien gave the transfer order.Hu Jia packed up the surgical kit, pushed the ECMO machine aside, and carefully followed the hospital bed.On the other hand, Sun Li'en led a person to push the cart, walking slowly while paying attention to the blood vessels of the ECMO machine to remain unobstructed without twisting or deforming.

The transfer distance of more than 20 meters, a nurse and five directors walked cautiously for almost half an hour.Under the careful escort of everyone, Mr. Shen was listed as a "bed-rushed" patient, and finally settled down in this temporary "intensive care unit".

"The next work will be more cumbersome." Sun Lien sent Dr. Jiang Yanming to the yellow zone to rest.Then he said to Director Lu beside him, "This intensive care unit must not reach the level of Ningyuan's intensive care unit, right?"

"The level of monitoring alone is not enough." Director Lu Zhimin nodded and said, "The monitors are now connected to the Internet, and they can be seen from the duty room. But there is no video surveillance, which is a problem."

Video monitoring is also important for intensive care, allowing doctors to detect abnormal changes in some patients in time—symptom monitors such as agitation or wheezing may not be recognized.

"Monitoring this..." Sun Lien frowned and thought for a while, "I can think of a way, but I'm afraid I won't be able to solve it in a short time."

Installing video monitoring equipment for ICU is a very serious system engineering.Professionals are required to handle everything from power supply, equipment installation to commissioning and networking.This kind of work is not something that Sun Lien, who is not good at installing computers by himself, can handle.

However, Sun Li'en doesn't need to worry about these things now.For Yunhe, which is fighting for support all over the country, ECMO masks, protective clothing and hospital beds may not be easy to deal with.But everything else related to medical treatment is not a problem.

(End of this chapter)