super anesthesiologist

Chapter 136 A wave of unrest and another wave (please subscribe, please recommend, thank you!!!)

Because of the timely blood transfusion and rehydration, the patient opened his eyes and woke up less than 10 minutes after he stopped inhaling the anesthetic after the operation.

The beginning is to prepare to send the patient to the ICU ward, so the patient does not need to be awake at all, because the awake patient cannot tolerate the endotracheal tube.However, it is generally required to be fully sedated when entering the ICU, so as to facilitate the unified observation of the patient's vital signs.

The patient's awakening surprised all the doctors, even Lin Xiaobei himself did not expect it.

Some people are pleasantly surprised that the patient can save his eyes, at least his life is not in danger now; others show a sad expression, where should this situation be sent?
Back to the ward?The doctor in the ward was not happy about it. Although the patient's current condition was fine, it was a very serious patient after all, and there were too many potential risk factors.Moreover, it is late at night, and there are usually only two nurses on duty in the ward, so it is impossible to keep an eye on the changes in the patient's vital signs.And it is very unreliable to count on the family members of patients.

If an accident occurs, the family members can shirk responsibility with any excuse.

"The negative value from Yuan Jiao, +50."

Lin Xiaobei was taken aback, Yuan Jiao was Tian Peng's assistant, the problem was that he didn't know this doctor at all.

"Doctor Yuan, do you think it's okay to go back to your ward?" Lin Xiaobei asked knowingly.

Yuan Jiao seemed to be peeking into his mind, and said a little embarrassedly: "This, this, I have to ask Teacher Tian Peng."

Tian Peng has already returned to his department.

Yuan Jiao called to ask for instructions. Ten seconds later, he handed the phone to Lin Xiaobei: "Teacher Tian wants to talk to you."

"Professor Tian, ​​what instructions do you have?" Lin Xiaobei teased.

"Your sister, why are you waking up the patients so well at this late hour? Our department is full of patients and there are no more beds."

"I didn't urge you, the patient woke up by himself."

Tian Peng said impatiently: "You find a way to sedate the patient and send it to the ICU for observation for a few days before returning to hand surgery. I'm not kidding, don't think the patient is doing well now, in fact he still has many potential dangers. "

"This patient had better be under absolute sedation these days, because the skin on his back cannot tolerate friction."

This reminded Lin Xiaobei that this patient needs to maintain a special position for a very long time after surgery to prevent the skin on the back from being damaged by external forces.

And normal people are difficult to endure other positions for a long time except supine position, side lying position and prone position.

Lin Xiaobei re-introduced 4 mg miren to the patient, but there was no bolus release agent.Patients do not need disease control breathing, and spontaneous breathing will not affect their oxygen supply.And the main problem was keeping him sufficiently calm and still.

Unexpectedly, he was sent to the ICU like this, and almost had a conflict with the ICU doctor.

The ICU doctor's point of view is that it is best to mechanically control breathing when the patient is completely unconscious to prevent excessive sedation and hypoxia.

If machine breathing is not controlled, it is best to keep the patient awake, that is, able to respond to calls and respond to the doctor's instructions.

Doctors in various specialties consider their patients based on the characteristics of their profession, so the opinions of ICU doctors are understandable.

What puzzled Lin Xiaobei was, since the ICU claims to be under 24-hour dedicated care, why are patients worried about hypoxia?

The ICU doctor rolled his eyes at Lin Xiaobei, "Are you kidding me? I have more than 50 patients here, and each patient needs a nurse to monitor them. How many nurses do I need? Do you pay them?"

"Negative value from Fu Qianyong, +50."

Every family has a difficult scripture to recite, and every department has its own difficulties.Many systems are ideally designed, but are impossible to implement clinically.

Let’s talk about Fu Qianyong’s situation.In principle, patients in the ICU are under special care, but it is impossible for one nurse to guard them all the time 24 hours a day, and they work in three shifts.If calculated in this way, one patient actually needs three nurses, and 50 patients need 150 nurses.

This doesn't even take into account the nurses who are off night shift and rest, as well as the nurses who are responsible for spot checks of blood gas and nurse stations...

How many nurses are needed?It is far from enough to support a department in the ICU alone. It is estimated that the director of the ICU will cry to death.

As far as Lin Xiaobei knows, in the anesthesiology department, in principle, there is one surgical nurse and one itinerant nurse.Instrument nurses are inevitable, but itinerant nurses are often in charge of two or even three operating rooms.

Not only nurses, but also anesthesiologists are often in charge of several operating rooms due to insufficient manpower.

So Lin Xiaobei accepted Pay Yong's opinion.There's nothing he can do about it, this is his territory and he has the final say.Even though Lin Xiaobei insisted, after handing over the patient, Fu Qianyong would still inject the patient with a relaxing medicine and then maintain mechanically controlled breathing.

Back in the anesthesiology department, Lin Xiaobei was used to sitting in the office in a daze...

However, before sitting for 10 minutes, Liu Qin slammed the door with a "bang bang".

"Negative value from Liu Qin, +100."

"Lin Xiaobei, why are you so unlucky?"

"What's the matter?" Seeing Liu Qin's unkind expression, Lin Xiaobei murmured inwardly that it was a huge mistake for Wen Xin!
"Prepare to continue fighting. The emergency department called a patient with very severe burns. We will be here soon."

ah!One wave of ups and downs and another wave of ups and downs!
……

Just as Lin Xiaobei finished the anesthetic, he suddenly smelled a smell—the smell of barbecue.

Then the door of the operating room was opened from the outside, and a flat car rushed in.

"Hurry up, the patient is already in shock." Liu Wei, the night shift doctor in the emergency department, was taken aback when he saw Lin Xiaobei: "Mr. Lin, why are you working the night shift here again?"

Lin Xiaobei, hehe, the baby is suffering!

Liu Wei briefly introduced the condition: "The patient suffered a hot burn, not a direct fire burn. Alcohol and ice packs have been given to cool down in the emergency department, but the patient is still in shock, and his vital signs are very unstable. The condition is very bad."

Lin Xiaobei's heart skipped a beat, peat!

Thermal burns are not direct physical contact, but are mostly burns caused by the sudden entry of huge heat energy into the human body.This type of burn is different from general fire burns and electric shocks. The patient's superficial skin is intact and even looks normal, but the subcutaneous tissue is severely damaged.

It's a bit like the "Mian Zhang" and "Seven Injuries Fist" mentioned in martial arts novels, which don't hurt the skin and surface, but only hurt the enemy's internal organs.

The patient's complexion was "ruddy", and his head was bigger than the two Fan Weis.It's not that he's that big, but——his face is too swollen.

The patient was already in a coma, unconscious, Lin Xiaobei rolled his eyelids, the pupils had not yet dilated.

After quickly handing over to Liu Wei, Lin Xiaobei moved the patient to the operating bed together with doctors and nurses.During this process, a strong smell of barbecue made everyone almost vomit.

　The whole hospital worked overtime on weekends, and the dog was sick.

　　
　
(End of this chapter)