super anesthesiologist

Chapter 137 There is nothing to love in life (Please subscribe, please recommend, thank you!!!)

Division of labor and cooperation, nurses and doctors each have their own busy schedule.

The patient's blood pressure has dropped to 62/41mmHg, and his heart rate is 138 beats/min.

After Lin Xiaobei waited for Liu Qin to get the injection, he began to give booster drugs, but the effect was not very good.

This thermal burn patient is different from ordinary hemorrhagic shock.Patients with thermal burns have severe exudation due to necrosis of muscle tissue cells.Moreover, the exudate did not seep to the surface of the tissue, because there was no obvious ulcerated wound, it could only accumulate under the skin and form swelling.

This is also the reason why the patient's face became abnormally swollen, which was even bigger than the 30-volt electric injury in the night shift last time.

It is precisely because of the large amount of exudation that the patient does not seem to be bleeding much on the surface, but the blood volume is seriously insufficient.

Lin Xiaobei asked Liu Qin to pressurize the infusion and infuse 500ml in a few minutes. A drop of water is also water. Although this amount is insignificant, it still increases the capacity.After infusing a bottle of crystals, the effect of the booster drug was more obvious than before, and the blood pressure was measured again at 82/53mmHg.

Continue to pressurize the infusion and infuse colloidal hydroxyethyl starch 130.

Lin Xiaobei was going to push the intravenous anesthetic for the trainee doctor to intubate.

"Negative value from Wang Jianguo, +30."

Wang Jianguo said with a sad face: "Mr. Lin, it's better for you to come, I, I can't do it."

Lin Xiaobei glanced at him, and suddenly thought of a famous saying "a child cannot be taught".The more nauseating and difficult the tracheal intubation technique, the more it can improve the anesthesiologist's operating level.For doctors like them, such an opportunity is really rare.

Unexpectedly, Wang Jianguo gave up on his own initiative.

Lin Xiaobei sneered secretly.Although the smell of barbecued meat emanating from the patient's body, especially his face, was very uncomfortable, he didn't dislike it.He just felt that such opportunities should be reserved for junior doctors.

Wang Jianguo didn't want to do anything, so he had to come by himself.

"You can go through the artery, preferably the dorsalis pedis artery." Lin Xiaobei instructed Wang Jianguo.At this time, as an anesthetist, he should not stand aside and watch anxiously, but actively participate in the battlefield.

It is estimated that Wang Jianguo has never encountered such a scene, and he cannot accept it psychologically.That's right, the patients who were slightly difficult in the rural hospitals were immediately transferred to the higher-level hospitals. It was impossible for Wang Jianguo to encounter such patients in his own hospital.

There used to be a trainee doctor in a state-run factory hospital that was even more bizarre.When he came to the anesthesiology department, he was only willing to learn spinal anesthesia and nerve block surgery, and he only wanted to learn touch typing for nerve block surgery, and he refused ultrasound guidance.

It's not about how awesome his skills are, he's as confident as Lin Xiaobei.But this dear friend said frankly: "The main patients in our hospital are cesarean section, appendicitis, hernia, and trauma caused by mechanical operation, so there is no need for general anesthesia at all, and our hospital does not have ultrasound, so it is useless to learn it. It’s better to gain some experience in touch typing.”

As for preferring to learn touch typing rather than using ultrasound, Lin Xiaobei can accept this point. Indeed, an ultrasound can cost hundreds of thousands, which is not something that ordinary rural hospitals can equip.

But it's hard to understand that this man refused to learn general anesthesia. Does he not know that endotracheal intubation is a necessary skill for an anesthesiologist?Don't they have acute myocardial infarction or cerebral hemorrhage or other critical acute abdomen patients in their hospital?
Although these patients will not be treated in their hospital, the necessary pre-treatment, especially endotracheal intubation, is what they should do, right?

Unexpectedly, the man waved his hand: "If you don't deal with it, it will take time to deal with it. It's better to let the ambulance tow it away."

Lin Xiaobei was completely speechless...

But many anesthesiologists don't take it seriously, especially the senior teachers, who seem to be accustomed to it with more experience.

"You can't imagine how simple their conditions are." They all have this view.

It seems that there are still many backward areas in our country. There is only one anesthesiologist in a hospital, and he also works part-time in medicine and surgery...

Lin Xiaobei didn't ask where Wang Jianguo was from. He didn't know this training doctor, so he was probably new.

Lin Xiaobei just felt that compared with the group of people in the emergency department who followed him to study, this elder brother was a little bit worse.It's not that his skills are bad, but in terms of attitude, he's not very positive.

Even piercing the artery, which is the most attractive operation for trainee doctors, Wang Jianguo was slow.It was night, if there were too many people during the day, Lin Xiaobei didn't need to speak, there would be a bunch of people rushing to wear it.

Lin Xiaobei asked Wang Jianguo to prepare items for puncturing the artery, and he was in charge of general anesthesia himself.Since the patient is already in a coma, there is no need to use sedatives, just a little analgesic.

Because I don’t know the patient’s specific fasting and drinking time, I can’t ask.What's more, the patient was already in a coma, and at this time, the patient's family said that everything stated had no legal significance and was only for reference.

Once, a family member of a patient said that "he only ate a small bowl of rice at night".The patient had vomiting and aspiration during the induction. Although it did not cause a hypoxic accident, it was also a false alarm.Later, Lin Xiaobei asked the patient's family member to describe how big the bowl was, but the family member spread out his hands like a basin...

Therefore, even though Lin Xiaobei didn't know whether the patient had a full stomach or not, in principle, all emergency patients were treated as if they had a full stomach.

And this patient is not only worried about a full stomach, but also has a very difficult endotracheal intubation.His face was swollen too much, and the patient was still breathing spontaneously, and there was a sour smell mixed with the smell of barbecue in his exhaled breath.

No wonder Wang Jianguo was reluctant to intubate.

The patient's lips were already highly edematous. I don't know if it was the reason for the facial swelling. His mouth also appeared very large.

Thick lips, wide mouth.People can't help but think of Ouyang Feng when he was poisoned in "East Becomes West".

The patient's entire chin appeared abnormally large, and Lin Xiaobei didn't dare to lift his mandible when the mask was giving him oxygen, because when he tried hard, his fingers would sink in.

It's all puffy there.

When the laryngoscope was inserted, there were already food residues in the mouth.This patient had already vomited, but judging from the blood oxygen saturation on the monitor, the aspiration should not be very serious, otherwise it would be impossible to maintain it above 90% when he came in.

Lin Xiaobei quickly inserted the endotracheal tube, fixed it, pushed in the loosening agent, and turned on the anesthesia machine for mechanically controlled breathing.

This is Wang Jianguo standing on the patient's feet.

"Are you dressed?" Lin Xiaobei asked, his speed was quite fast.

Wang Jianguo shook his head: "I haven't worn it yet. This patient's dorsalis pedis artery pulse is not clear at all."

Lin Xiaobei walked over, put on gloves and touched it, frowned and said, "Here, you still don't know?"

"Negative value from Wang Jianguo, +100."

"I really haven't touched it, it's too weak." Wang Jianguo said innocently.

Lin Xiaobei think about it, not everyone feels like him.When Wang Jianguo said this, he doubted whether the dorsalis pedis artery pulse of this patient was really very weak, but at the moment the blood pressure on the monitor showed 92/56mmHg.
Under Wang Jianguo's watchful eye, Lin Xiaobei threaded the artery smoothly, connected it to the artery monitor, and asked Wang Jianguo to check his blood gas.

At this time, the door of the operating room opened automatically, and the gatekeeper of the anesthesiology department stood outside wearing a protective suit, "Which of you is on the night shift tonight?"

"I."

"I."

Lin Xiaobei and Liu Qin almost spoke in unison.

The master smiled and said, "According to the notice, there will be a chest department and a brain operation in half an hour."

Lin Xiaobei: "..."

Liu Qin looked at Lin Xiaobei with a look of despair, "What kind of karma have I created? Why are you on duty for Wenxin? You can't drag us down even if you trick yourself!"

"Negative value from Liu Qin, +200."

(End of this chapter)