super anesthesiologist

Chapter 114 Totally Sleepless Tonight (Please Subscribe, Thank You!!!)

The blood transfusion department finally delivered the blood, and Lin Xiaobei breathed a sigh of relief.

If there is no blood supply, the patient will continue to lose blood. Even if hemostasis is perfect, he will not be able to withstand the continuous extravasation of the wound.

At the same time, patients with massive blood loss all have one thing in common, excessive consumption of coagulation factors, which may lead to another evil result: disseminated intravascular coagulation, also known as DIC.Moreover, this patient has inhaled a large amount of toxins, so the possibility of DIC will be much higher.

The blood transfusion department sent 5 bags of red blood cells, a total of 10 units, and 500ml of plasma. The role of plasma is to improve blood coagulation.

With the blood supply, Lin Xiaobei felt a little more confident.

The hand surgery finally amputated Li Xiangneng's burned right upper limb. With the development of modern medicine, the best treatment for large wounds is VSD negative pressure drainage.However, the main problem of this patient at present is to prevent further bleeding, so Director Ma Yue quickly performed a pressure bandage.

The director of the ophthalmology department, Yue Kun, also quickly removed the necrotic tissue in the patient's eye socket, including the eyeball, and then stuffed it with gauze.

The two directors retired, and Director Hu Bin of the Department of Otolaryngology and Director Fan Ming of the Department of Burns and Plastic Surgery stepped in to deal with the black scabs on the patient's nasal passages and forehead.

The treatment of the nasal passages is relatively simple. The burnt bridge of the nose is partially excised to expose the turbinates.

The current pattern is very strange, sticking to the face, it only burns the shape of the nose, but it does not damage the inner structure at all.Moreover, the transmission from the eyes did not actually damage the brain tissue.Otherwise, with such a high voltage alone, the tofu-like brain tissue in the head would have been burned to fly ash.

Li Xiangneng's left nostril was not injured on the outside, but when the right side was burned, the huge heat was transferred to the left side, so the left part was also burned like barbecued meat. Although no black scab was formed, there was a strong smell of barbecued meat, especially It is especially noticeable during excision.

Everyone felt nauseous, even the calm Lin Xiaobei couldn't help feeling sick.In order to prevent Liu Xu from getting dizzy again, Lin Xiaobei deliberately blocked her behind her so that she would not look directly at her, but this girl squeezed her head out and poked her head out to watch.

After experiencing many bloody scenes, she has developed a strong immunity.

Perhaps this is the charm of medicine.

Lin Xiaobei once met a strange female classmate. After taking an anatomy class, she asked the teacher to borrow a femoral head and said she would take it back for study.Later, the roommate in their dormitory couldn't stand it and said that this girl actually put the femoral head directly on the bedside...

After director Hu Bin removed the necrotic tissue, he did not injure the internal turbinate, so the bleeding was not much. He simply spread a layer of hemostatic sand on the outside and then stepped back from the operating table.

Relatively speaking, it is much more difficult to treat necrotic black scabs on the forehead and face.

Due to the exudation of necrosis, Li Xiangneng's face was slowly swollen, and the entire face seemed to double in size.This is the performance of cell edema.

The facial blood vessels and nerves are densely covered, so when Director Fan Ming was removing the black scab, he kept using an electric knife to stop the bleeding, which made it difficult to speed up the treatment.Moreover, the black scab is no more carbonized than normal muscle tissue. It is as hard and tough as leather. With a little force, the blood vessels under the black scab are torn, and blood columns shoot out like small arrows.

Head debridement takes as much time as amputation of the right upper extremity.

Lin Xiaobei looked at the bandaged Li Xiangneng and even had a strange idea in his heart. If a person with hollow eye sockets, no skin on his forehead, and no external nasal passages walked on the street, what kind of commotion would it cause?
When the directors left the stage, everyone breathed a sigh of relief and secretly rejoiced: Fortunately, no accident happened during their own operation time!

Lin Xiaobei also breathed a sigh of relief. The patient's necrotic tissue has been removed, and he will no longer continue to absorb toxins, nor will he bleed extensively. Now he only needs to strengthen brain protection, maintain his vital signs and transfer him to the ICU.

However, just when he was about to notify everyone to transfer the patient, the ECG monitor sounded a frightening alarm again, and then the ECG changed into a sinusoidal waveform of ventricular fibrillation.

I rely on!The patient has ventricular fibrillation!

Lin Xiaobei didn't expect it, this is the prelude to cardiac arrest!
If a patient suffers cardiac arrest during the operation, no one can blame anyone.But now the directors of various departments have stepped down, and the vital signs of the patients were still there before stepping down, barely close to normal.

If there is another accident at this time, the anesthesiology department may bear the main responsibility.In an environment where the relationship between doctors and patients is tense, no one has the ability to bear the responsibility for medical malpractice alone. Once it happens, they will try their best to throw the blame away.

Lin Xiaobei encountered this kind of bad luck when he worked the night shift for Wen Xin, can he not be in a hurry?

"Defibrillate quickly!" Without too much time to think about other trivial matters, Lin Xiaobei gave the patient's heart compressions while instructing Liu Xu.

……

After a series of first aid and treatment, the patient's heartbeat returned to more than 80 times, and the rhythm became sinus.

At this time, the blood gas was checked again, respiratory acidosis combined with metabolic alkalosis, hemoglobin was 7.5g, but the oxygen partial pressure was 235, which is barely enough.Unable to delay any longer, Lin Xiaobei hurriedly asked Liu Qin to notify the ICU to prepare and quickly transfer Li Xiangneng.

After treating this patient, it was already four o'clock in the morning the next day.

This point is the best time for people to sleep.Everyone else hurriedly climbed onto the bed to make up for their sleepiness, but Lin Xiaobei sat alone in the office thinking.

Although the patient was safely sent out of the operating room, it did not mean that he was out of danger.The patient's vital signs during the operation were erratic, which is certainly related to his serious condition, but is anesthesia treatment the most correct and perfect solution?

……

"Mr. Lin, what are you thinking about?" Liu Xu didn't sleep, she came and sat next to Lin Xiaobei.

"Why don't you go to rest?" Lin Xiaobei asked.

"Too nervous to sleep."

Lin Xiaobei smiled, why not.

"Why did you come to the department?"

Liu Xu said firmly: "I heard the sound of an ambulance in the dormitory. I felt something happened tonight, so I came to check it out. I didn't expect it to happen."

Lin Xiaobei nodded. Anesthesiologists are particularly sensitive to the sound of ambulances, and he has had them before.When I first started working the night shift, I had a very strange feeling. I felt regretful that the sound of the ambulance did not ring, but I was very nervous when I heard the sound of the ambulance.

"What do you think might be the cause of this patient's second cardiac arrest?" Lin Xiaobei asked Liu Xu, this was a question he had been thinking about.

"Maybe it's shock? Although the bleeding has been stopped and transfused, it feels like he's bleeding a lot, and his oozing is also a lot, and the volume is seriously insufficient." Liu Xu analyzed while thinking.

"This is just one of the reasons. I think it is likely that the toxin caused a reaction, and the possibility of septic shock is relatively high. Fortunately, it was discovered in time."

Just as Lin Xiaobei and Liu Xu were analyzing and summarizing, Liu Qin stood at the door of the office with sleepy eyes, "Lin Xiaobei, you unlucky guy, who asked you to replace Wen Xin?"

Lin Xiaobei raised his head: "What's the matter?"

"Emergency cesarean section!" Liu Qin said angrily, her voice was very loud, as if she was shouting.

"You call Liu Bo, he will call me when he is too busy."

Liu Qin smiled and said: "Hmph, don't think you have an assistant, let me tell you, three cesarean sections are performed at the same time!"

Lin Xiaobei shrugged helplessly: "Hey, I have no sleep at all tonight."

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(End of this chapter)