super anesthesiologist

Chapter 105 Chapter [-]: Emergency management of bronchial asthma

The sound of the monitor changing suddenly shocked everyone present.

Generally speaking, experienced doctors know that it is normal for a patient’s vital signs to fluctuate during the perioperative period. There are too many, and the patient's own situation is also a huge influencing factor.

Some people have done investigation and analysis, and clinically sudden medical accidents are more concentrated on those young people who have no underlying diseases.

Why is this?Because the examination of such people is often not comprehensive enough, not sufficient and detailed enough, and it is difficult to arouse the high vigilance of doctors.

Some people say that doctors should pay enough attention to all patients.This sentence is easy to say, and it sounds reasonable, but in reality, who can do it completely?
Think about it, if a person is always highly concentrated all the time, then after a long time, it will definitely be a neurasthenia. Doctors are ordinary people when they take off their white coats, and it is also difficult to find them with a magnifying glass in the crowd.

Also, if a doctor is always highly stressed, it is not a good thing for the patient.For example, if a patient with indigestion comes to see a doctor, if you are so serious, people will think that you have an incurable disease, and your originally happy mood will gradually become depressed.

Also, if perfection is pursued too much, then all patients have to undergo comprehensive examinations, such as simple appendicitis patients, CT, ultrasound, magnetic resonance and other examinations, and the diseases that can be cured by thousands of yuan will cost a few thousand dollars. Ten thousand……

But saving money is prone to missed diagnosis, and some seemingly impossible diseases happen, and they happen quietly, without any symptoms.In reality, many cancer patients are only discovered during physical examination┄┄
Medicine is so contradictory.

It is common for most of the students present that the alarm from the monitor is common. If it happened in their own operating room, they would not feel strange or flustered at all.But this sudden situation happened in full view, and there was a live broadcast to communicate with the outside world, so the people present couldn't help but not panic.

Lin Xiaobei felt the same way, he had discussed this patient with He Yunkai before the operation, and carefully read the medical records to understand the general condition of the patient.It was precisely because of his confidence that he dared to accept Director Pan Yang's arrangement.

What he has been worried about is that the surgeon will make things difficult for the anesthesia effect during the operation, and he is negligent about whether the patient himself will have an accident.

Also panicked was He Yunkai, entrusted by director Pan Yang, who had specially selected this case from the general surgery department. Except for appendicitis and acute abdomen, there was almost no other disease basis.

He Yunkai's first consideration is whether the monitor cable is disconnected or poorly connected, which is one of the most common reasons for the monitor to issue an alarm.

Lin Xiaobei first checked the patient's complexion.If the patient's complexion does not show signs of hypoxia and the pulse fluctuates normally, then the problem is most likely caused by the monitor or the influence of the electrosurgery on the table.

He only observed for a few seconds, then his face darkened, the situation is not good!
The patient's face turned dark purple in an instant!
The patient was lying quietly on the operating bed, but at this moment he suddenly became restless, his hands were waving aimlessly in the air, trying to grab something.

In this situation, some people may panic and panic, thinking that the patient is possessed by evil spirits.

The surgeon stood by the stage with a look of astonishment on his face. There was no problem with his operation.

The instrument and the itinerant nurse looked confused.This itinerant nurse should be quite experienced. After only a few seconds of astonishment, she came back to her senses and grabbed the patient's hand and pressed it down to prevent contamination of the operation area.

At this time, as an experienced anesthesiologist, he does not have to think about why the patient suddenly became like this, and has no time to think about it.The patient is now in a state of severe hypoxia, and his abnormal and crazy movements are the struggle before the feeling of dying.

The most important thing at this time is to take effective treatment measures for the patient's symptoms.

Lin Xiaobei hurriedly buckled up the mask to pressurize and give oxygen. At this time, he discovered that the patient's airway pressure was very high!Oxygen is given by the mask, but the oxygen cannot be given in at all, which seems to be more fatal to the patient.On the one hand, he urgently needs to breathe oxygen to alleviate the hypoxic state, on the other hand, the oxygen lingers in his mouth but cannot enter the lungs, like a drowning person who sees a wooden board in front of him but cannot grasp it.

"Teacher He, listen to his lungs." Lin Xiaobei said to He Yunkai calmly, the patient actually had bronchospasm!
At this time, He Yunkai was so frightened that he seemed to have lost his soul and stood mechanically aside.

If he was alone in charge of the anesthesia for this operation, he might be able to calm down and handle it calmly.This sudden situation is not unexpected for a senior doctor, and he may not panic to such an extent.But today he came to cooperate with Lin Xiaobei, subconsciously regarded himself as a low-level doctor and had no idea.

Lin Xiaobei reminded He Yunkai, and he quickly picked up the stethoscope to auscultate the patient's chest.

"Doctor Lin, his lungs are full of wheezing."

Lin Xiaobei took He Yuankai's stethoscope and listened to it himself. The patient's lungs were filled with dry rales, like the sound of beating metal steel pipes, or like birds singing to the sky.

"Teacher He, give me some acetaminophen, 100mg." Lin Xiaobei suggested.

Oxygen given by the mask can barely increase the patient's blood oxygen saturation, but it just hovers around 80% and cannot rise.Oxygen consumption increases during the patient's struggle, so the hypoxia becomes more serious at this time.

His bronchospasm also made it difficult for oxygen to get into the lungs.

10ml of sedative was pushed in, and the patient quickly calmed down and stopped struggling, but the blood oxygen saturation was even lower at this time.This is because the patient previously had spontaneous breathing function, but now he relies entirely on passive oxygen supply.

This is the Achilles heel of Propylene Glycol.Since the drug came out, it has played a very important role in the rapid development of anesthesia technology. Some experts even believe that the research and development of acetaminophen is a milestone in the development of anesthesiology. It makes many small operations that were difficult to perform before very convenient.

In the gynecology clinic, I often heard heart-piercing screams coming from inside, but now it is healed, the medicine is pushed, the patient sleeps in it, wakes up and the operation is over.Some who like to compete even think that the doctor did not operate on her.

Propaminophen is also affectionately called "Women's Friend" by gynecologists.

Fast onset and fast metabolism are the biggest advantages of Propylene Glycol, but its disadvantages are also obvious, which has a great impact on breathing and circulation.The circulatory system is fine, because the human body has its own regulating system, as long as there is no organic heart disease, it will generally not cause cardiac arrest.However, the effect of acetoninol on breathing will be a fatal killer if you encounter a doctor who is not a professional anesthetist or a doctor who does not know how to deal with the airway.

In China, there was once a tragedy in which private clinics secretly used acetaminophen to perform painless abortions on patients, resulting in fatalities.

He Yunkai was very nervous, and the patient's blood oxygen was still dropping.

However, Lin Xiaobei became calmer at this time. He obviously felt that the patient's airway resistance was much lower when he was giving oxygen manually, and an airflow waveform also appeared on the anesthesia machine monitor.

Pan Yang, Su Wenqi, Lin Chaobing and Wenxin rushed over at this time.

They were supposed to stay in the office to rest, and they just waited for Lin Xiaobei to successfully complete the training task after his performance.A few people were having a good time drinking tea and chatting inside, when they suddenly heard a commotion outside, and when they inquired about a major problem with the live broadcast of the operation, they rushed into the operating room in fright, not even changing their surgical gowns, surgical shoes, etc., let alone anti-pollution measures .

"What's going on? Yunkai?" Pan Yang asked He Yunkai.

Lin Chaobing looked at Lin Xiaobei seriously, why did you lose the chain here?

Su Wenqi looked at Lin Xiaobei with a complicated expression.

Warmth is full of worries.

He Yunkai must have been confused by fright, he was stuttering and unable to speak.

Lin Xiaobei said calmly: "Just now the patient suddenly developed bronchial asthma."

(End of this chapter)