super anesthesiologist

Chapter 113 30 Electric Volt Electric Injury ([-]) (Please subscribe, please collect, please recommend)

Lin Xiaobei was startled, and quickly checked the monitor, the heart rate had risen to 150 beats per minute.He pressed the blood pressure button again, and it showed BP 75/46mmHg after beating.

shock!

The shock in this patient cannot be simply interpreted as hypovolemic shock.Because he has a large area of ​​necrotic tissue and absorbed a lot of toxins, septic shock is also very likely.

Fortunately, Lin Xiaobei's internal jugular vein was threaded quickly, and he immediately connected Liu Qin to the infusion tube.After the internal jugular vein infusion channel is established, the use of rescue drugs is much more convenient.

No matter what kind of shock it is, it is impossible to distinguish which kind of shock carefully at this time, and there is no time to distinguish it.If it is not dealt with, it is likely that the patient's heartbeat will stop.

Use whatever methods and medicines are effective. This is Lin Xiaobei’s personal experience in rescue, rather than mechanically copying the arguments in the book that “adrenaline is used for anaphylactic shock” and “glucocorticoids are used for septic shock”. .

In reality, the symptoms of patients are seldom as typical as those mentioned in the textbooks, and there are few single diseases, and they are often complex lesions.When a patient suffers from shock, it is often caused by the crossing of different shocks caused by several reasons, which is very difficult to deal with.

At this time, if a single drug is used, the effect is almost negligible.

Lin Xiaobei used 20 mg of dexamethasone, 1 mg of epinephrine, and then pumped a large dose of norepinephrine.

After 2 minutes, blood pressure was measured again, BP 105/62mmHg.

"Try again." He said to Liu Catkin.

It was worth it for this girl to sacrifice her personal time on weekends, stabbing pigs everywhere, and now her blood vessel puncture skills are comparable to senior residents, even though she has only been in the clinic for a few months.

After the catkins were threaded through the artery and the arterial blood pressure monitoring was established, an arterial blood gas analysis was checked immediately.

Respiratory acidosis combined with metabolic alkalosis.

After treatment, the patient's vital signs barely remained within the normal range.

But this is just the appearance, Li Xiangneng is far from out of the risk of death.The more this kind of moment, the more we cannot relax our vigilance.

Lin Xiaobei asked Liu Xu to pay attention to the monitor and check the vital signs, while he paid attention to the progress of the surgeon.

In martial arts novels, there are often ruthless people who chop off their arms with a single knife, and then tie a rope or a belt to stop the bleeding.

In clinical practice it is far from that simple.

Let's just say that the writers don't understand how much pressure is put on the arteries of the human body.Cut the aorta of a pig, and the blood pumped by the heart can reach a height of several meters, let alone a human body.

Therefore, when our surgeons perform amputation, they always separate the aorta very carefully first, and then dare to do other work after ligating the aorta.

The same is true of the hand surgeons on the stage, who are so careful to separate the charred muscle tissue.

Li Xiangneng was seriously injured by the electric shock, but it is unbelievable to think about 30 electric volts.We all know that 220 volts can kill people!
He was still alive.

But this kind of disability brought a lot of trouble to the surgeon. Lin Xiaobei watched them fiddle with the charred tissue, and for no reason, he thought of the sweet potato that was burnt in the stove pit when he was a child...

The surgeon operated according to the normal method, but slowly separated the burnt muscles, which continued to prolong the time, and the bleeding from the wound was also very serious.

This patient has gone into severe shock!If we continue to deal with it in such a slow manner, the subsequent hemorrhagic shock plus the septic shock caused by toxin absorption will be even more difficult to deal with.

"Director Ma, can you hurry up?" Lin Xiaobei urged.

At this time, it is time to cut through the mess, act decisively, and don't act too cautiously because of concerns about the patient's residual limb pain in the future.

"Well, I know, we're coming soon." Director Ma Yue responded casually, his movements still slow.

Lin Xiaobei was annoyed, but it was inconvenient to get angry.At this moment, Liu Xu exclaimed, "Mr. Lin, the patient's heartbeat seems to have disappeared."

Everyone present was shocked and shocked.

In other words, even if this patient really died on stage, there is no controversy. After being injured by an electric shock of 30 volts, the possibility of survival is very small.But just now he still had vital signs, proving that he was still alive, and all the doctors on the operating table did not want the patient to die suddenly at this moment.

As a doctor, no one wants patients to die by their own hands.

Lin Xiaobei checked the ECG monitor, and the ECG area actually turned into a straight line.He touched Li Xiangneng's left carotid artery, checked the connection of each electrode pad at the same time, and then shouted: "Hurry up for cardiopulmonary resuscitation!"

All the doctors stopped what they were doing and quietly watched Lin Xiaobei carry out the rescue from the side of the stage.

However, a strange thing happened again at this time, and Li Xiangneng's heartbeat recovered. Although the heart rate was only more than 40 times, it showed that the heartbeat had recovered.

"Give me atropine."

After administration, the patient's heartbeat continued to rise and slowly rose to 70 beats/min.

Li Xiangneng's vital signs recovered quickly, and all the doctors on the stage let out a sigh of relief.However, Lin Xiaobei frowned. Just now Li Xiangneng's heart stopped beating, he believed in his own feeling.

But why?He looked at the stage and suddenly said, "Director Yue, do you want some local anesthetic?"

Yue Kun was holding tweezers and scissors to continue the operation.When he pulled the tweezers in his hand, Li Xiangneng's heart rate dropped rapidly.

Very remarkable eye-centered reflex!
Like Ma Yue, Yue Kun was carefully removing the necrotic tissue in the eye socket.However, the vagus nerve in the fundus is rich and dense, and it is easy to slow down the heart rate due to the vagal reflex caused by stretching stimulation.

At this time, the most effective measure is not to use drugs that speed up the heartbeat, but to use local anesthetics to block the vagus nerve.

It is estimated that Director Yue Kun thought the patient was under general anesthesia and did not pay attention.In fact, although the patient is anesthetized clinically, some nerve reflexes still exist, such as oculocardiac reflex, gallbladder reflex during gallbladder surgery, gastric fundus vagus reflex during mesentery stretching...

If these reflexes are not dealt with in time and correctly, it is likely to cause the patient's cardiac arrest.

Not only Director Yue Kun, but even Lin Xiaobei ignored this issue just now.

After being reminded by Lin Xiaobei, Director Yue Kun immediately responded, "Give me some ropirin."

After that, Li Xiangneng's heart rate became much more regular.

But even though it was a false alarm just now, everyone was more cautious like a frightened bird.

"Why hasn't the blood been delivered yet?" Lin Xiaobei frowned.

There is not much bleeding in the operating area on the stage now, and the two directors have done a good job of stopping the bleeding on the stage.However, the patient's trauma area was too large, especially in the separation area of ​​the upper limbs, and blood continued to ooze slowly, and a large piece of gauze was dyed red after a while!

The burned right nostril was left untreated during the operation, and more importantly, the right forehead was covered with burnt black scabs, which had to be removed.These wounds also cause more blood loss.

Lin Xiaobei couldn't help secretly anxious.

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(End of this chapter)