Great doctor starts with adding points
Chapter 232 Personal charm and helplessness (for subscription)
First aid, only two words.
Urgency is the nature, and salvation is the purpose.
But there are different forms - on-site first aid, transport first aid, hospital first aid.
In all pre-hospital procedures, medical resources are extremely limited.
Just like now, in such a large-scale accident, the expert medical team urgently formed in Enzhou cannot guarantee that each patient's atopic trauma will be treated by a specialist doctor.
But the focus is clear, any form of first aid with any team has only one purpose.
Save your life, save your life, or save your life.
Among first aid, hemorrhagic shock is the most deadly factor, not even one of them!
Even intracranial or head injury should be ranked after hemorrhagic shock.
Hemorrhagic shock is prolonged and sustained blood loss accumulated over time.
At this time, time is life and will be fully interpreted.
But such a thing is not something everyone can do.
Immediately, Yang Xianming took a small step back, stepped aside decisively, and asked Wu Xie, "What are you going to do?"
"Stop the bleeding!" Wu Xie replied directly.
No time to explain.
There are many types of hemostasis.
Physical blocking to stop bleeding, electrocoagulation to stop bleeding, and various other methods that can stop bleeding can all be classified as hemostasis.
What Wu Xie wants to do is the simplest way to stop bleeding, mechanically blocking blood vessels.
Vascular ligation!
The theory is simple, detect the blood vessel and then tie it off.
If it's in the operating room, any orthopedic resident can handle it!
But it's on the spot!
The conditions are simple and various factors are limited.
There is no electrocoagulation knife, no unlimited gauze, no operating table, and no aseptic principle.
When doing arterial exploration, there is not enough surgical field for you to clarify arteries and veins.
If you go to the wrong place during the investigation, the only result will be accelerated blood loss, accelerated shock, and accelerated death!
Wu Xie put on the gloves quickly, pointed to the complexed iodine in the small bottle next to it, and explained briefly: "Disinfection, blunt dissection exposure, clamping."
"The smooth process takes about one minute."
"Without the intervention of sharp instruments, there is less risk of injuring other blood vessels!" Wu Xie explained to Zhong Ying.
Zhong Ying is the leader of the medical team, the captain!
On-site first aid pays attention to all actions and obeys the command.
Wu Xie was just an assistant called by Yang Xianming. If Zhong Ying agreed to persuade him, he would avoid a lot of trouble.
Employers do not suspect, suspects do not.
Zhong Ying heard the words and made a decisive decision: "Hurry up and save lives first! Buy more time for the fire brothers."
A leader of several firefighters heard the words and explained: "Conditions permit, within 20 minutes at most, we can take out our hands!"
If you don't stop the bleeding first.
For more than twenty minutes, who knows how much more blood he will bleed?
What's the use of keeping a hand after a person dies?
Only then did they ask their superiors for instructions, and the superiors appointed a team of experts like Zhong Ying, who originally said they were going to amputate the limbs to drag the person away, but now another doctor who looks younger came and changed the emergency mode instead.
And listening to the young doctor's tone, it seems that there is something like that...
Yang Xianming cooperated with Wu Xie to pour the complex iodine near the deltoid muscle, and the purple-red complex iodine instantly stained the cut of the clothes into a strange color.
Yang Xianming quickly wiped it several times with sterile gauze with sterile gloves.
He leaned back half a step, and then turned his head to see how Wu Xie was operating.
Wu Xie's words were simple, and Zhong Ying's reply was also simple, but Yang Xianming was having a brainstorm right now.
How to bluntly break the muscle space through a small incision, reach the arteriovenous, distinguish the arteriovenous and precisely clamp?
And Wu Xie only talked for more than a minute.
Wu Xie was able to complete this series of operations within five minutes, he was so awesome.
Yang Xianming is still thinking about it!
With the blessing of expert-level basic anatomy, Wu Xie quickly found the positioning mark, and quickly cut a two-centimeter incision.
The sharp knife cuts into the fat layer under the skin.
Blood oozes...
Soon the wounds were covered.
Wu Xie threw the knife to the side, and quickly used the vascular forceps to dig out the lower layer of fat. After pulling out a certain gap, the vascular forceps in Wu Xie's hands seemed to have eyes!
The tip goes deep in!
Wu Xie then manipulated the tail of the vascular forceps to swing a few times, and then shook it left and right twice in the direction of the incision.
Try to hold it open.
There was a stabbing sound as if the fascia layer was being torn apart, mixed with the sound of blood and water rippling out!
Sensing this scene, Wu Xie had already groped for a new pair of hemostatic forceps with his left hand, and put the blood vessel forceps in quickly as he stuck to the position of the blood vessel forceps in his right hand!
Between electric light and flint.
"Crack!" There was a clamping sound.
The click sound is crisp.
After Wu Xie finished, he let go of his hands and breathed a sigh of relief at the same time.
Yang Xianming, who had been waiting for a click, quickly covered the wound with gauze.
Wipe it off.
After the blood dries up.
I also saw more blood inside and continued to ooze out!
Yang Xianming and Wu Xie looked at each other, and their pupils shrank at the same time!
Hemostasis was effective, but more than one blood vessel was injured, and there were still blood vessel breaches.
"I'll try again." Wu Xie said immediately.
"Yes?" Yang Xianming wanted to explain.
"This place is either the axillary artery or the axillary vein!" Wu Xie decisively explained the important anatomy of this location.
Yang Xianming thought, "Is this what I'm talking about?"
The operation of vascular clamp requires a certain operating field.
A debridement kit contains at most two vascular forceps, not many.
Even if you have the ability to clamp to stop the bleeding, there is only one blood vessel clamp now, and there is no tool to assist opening.
Single-vessel clamp exploration + hemostasis, this operation is somewhat inhuman.
This Wu Xie?
Is it really my classmate?
Under the mask, Wu Xie licked his lips a little with his tongue, and moved a little outward and backward along a pair of vascular forceps that had been clamped!
Veins are outside and behind arteries!
This point, unless there is a special anatomical mutation, it will not be bad.
After almost confirming the destination, Wu Xie decisively opened the vascular forceps, and poked it carefully!
There is a layer of axillary sheath outside the axillary artery and axillary vein, and this layer of tough sheath must be broken.
to close accurately.
Before Wu Xie swayed left and right to break the sheath, but the direction he opened was only the axillary artery, and he did not do any special release in the direction of the axillary vein.
but?
This cannot be a reason to prevent Wu Xie from operating, because Wu Xie can still comprehend by analogy.
During neurolysis, the fineness and precision of the release is far more precise and steady than breaking the vascular sheath!
Therefore, Wu Xie didn't hesitate at all.
A few seconds later, after completing the clipping operation, Wu Xie breathed a sigh of relief.
After I took the gauze and dipped some blood in it, I found that the extravasation of blood was almost undetectable.
Wu Xie stuffed all the remaining gauze into it: "The bleeding has stopped temporarily."
Wu Xie told Zhong Ying.
"Continuously monitor blood pressure. If there is a large fluctuation in blood pressure, report it immediately." Zhong Ying ordered a nurse.
"Okay!" The female nurse didn't struggle, the electronic blood pressure monitor was always connected to the opposite side.
Readings can be monitored at any time.
"Little girl, get out of the way, just teach us how to press."
"It's dangerous here." The fireman ordered after approaching. I feel that Zhong Ying is not kind, and put the little girl in this dangerous position.
Of course, several firefighters shrugged as they looked at the buttocks of the vascular clamp inside the human flesh.
This metal thing is inserted into the human body and cannot be pulled out. Isn't this just stabbing the person?
However, among all professions, doctors are the only ones who are specially approved to directly operate on people for the purpose of treatment.
They didn't push any more.
"After the bleeding stops, it shouldn't hurt to delay for more than 20 minutes." Although Zhong Ying is not an orthopedic surgeon, she also knows that the current situation is actually equivalent to a thrombosed limb.
Amputation is the most, you can gamble on the chance of limb salvage, you only earn but not lose.
If there is an operating room next to it, then there is no need to talk about limb salvage at all.
But this world is not perfect, otherwise what happened today would not have happened.
"Contact the stretcher in advance! Instruct the transfer personnel and entrust them to instruct them that these two pliers must not be moved before entering the operating room!"
"Whoever moves will be the one who takes the initiative to kill!" Zhong Ying didn't mind putting on the super big hat in advance.
The firefighters nodded, not knowing how to respond.
"We have other tasks, Xiao Wu, you stay here, others follow me!" Zhong Ying said.
"Okay." Wu Xie replied, although he felt that he was a bit unable to use his abilities when he was assigned the task of seeing patients again, but at this time, all actions were under command, and the more organized, the less chaotic.
"Okay Director Zhong." The nurse actually replied.
Zhong Ying had already led people back, but when she heard that Wu Xie had agreed not to follow, she turned around and took a long stride, grabbed Wu Xie's clothes, and said, "Come with me, I will let you go." Wu Yuanyuan is left behind."
Wu Xie followed decisively.
Wu Yuanyuan, who was behind her, explained with a smile: "Handsome guy, we are from the same family. Just now Director Zhong asked me to stay."
"He can't bear to call you here."
Wu Xie smiled back and continued to follow behind Zhong Ying.
"There are only eight medical teams on the scene now!" Zhong Ying said of the seriousness of the matter.
"But so far, the number of wounded is far more than 80, even doubled or even tripled. The members of our eight teams are their first life goalkeepers."
"so……"
Zhong Yingben wanted to emphasize, but after turning a few feet, he saw a person being moved out.
His words came to an abrupt end.
Several people walked up quickly.
This person's upper abdomen was pierced by a steel bar from front to back.
The penetrating position is near the liver.
However, after Zhong Ying approached, a volunteer who accompanied her said that an expert had seen it before and said that the steel bars were not suitable for pulling out, and at most they could only be cut.
But if you use a chainsaw to cut it, the slight vibration of the steel bar will directly shatter the liver, just like killing people.
So it was put on hold for the time being.
The only good news so far is that the steel bars did not break the main artery, otherwise, the person would have died long ago, so it can be put aside and covered with a white cloth.
He also has a dislocated shoulder with associated injuries.
Zhong Ying and others are from general surgery and neurosurgery. Such diseases are their home field, so they started to quickly discuss how to rescue them!
Yang Xianming had time to ask, "Brother Wu Xie, can you do this kind of dislocation and reset?"
Wu Xie frowned: "Resetting is meaningless. This is an open dislocation caused by violent injury and fracture. Open reduction is the best indication. It is not suitable to toss at this time!"
There is no room for ostentation in medicine.
This patient's dislocation type can indeed be reset manually, but the open dislocation has no fixed support from the surrounding structures, and even manual reduction is only a temporary reduction.
It is a blind toss, and this situation is a contraindication to surgery.
"I thought you would dare to dislocate like this." Yang Xianming only made a joke, but his voice was very low.
"Nonsense, if you call me reckless, just say it, after all, you are from Xiehe Hospital..." Wu Xie rolled his eyes.
Yang Xianming pursed his lips, unable to deny it: "I asked you to come, but you didn't come."
"Huh?" Wu Xie tilted her head.
While Wu Xie and Yang Xianming were chatting!
"Crack" sounded.
Apparently the firefighters over there, on the advice of Zhong Ying and other directors, used powerful shears to ‘crack off’ the steel bars!
The broken sound is crisp and loud.
Only a slight trembling made the person who was penetrated let out a sharp cry of pain.
"Ah~~~~"
"Hiss~~~~"
"Ah~~~~~" The voice gasped, constantly contributing to global warming.
But no one laughed at him!
Even if you cry, no one laughs, no one dares.
On his forehead, fine sweat kept breaking out.
But even after the steel bar snapped off, another big problem appeared!
People are not easy to let go!
If it is carried in the prone position, it is equivalent to the steel bars not being swayed, and the steel bars on the chest support the weight of the whole person, which is equivalent to killing people with a blunt sword.
Moreover, Wu Xie also noticed that the middle-aged man's leg was broken!
The abdomen was dripping with blood and blood, the belly was covered with blood scabs and mottled, the left shoulder was openly dislocated, and the right lower limb was fractured and deformed. Only the right hand and left foot were stretched tightly on the ground, like deep-fried bow-shaped shrimp.
Zhong Ying and others are now assisting in planning to put the patient on a stretcher.
When Zhong Ying and the others lifted and released the patient, the patient's affected limb was stressed, and screams came out of his mouth, and a small amount of blood and saliva were even sprayed out.
"Ah!~~"
"It hurts! It hurts!"
This voice is heart-wrenching.
It is not so painful, so painful, like a baby, but a scream of fear when people are in despair.
Everyone was at a loss for a moment, the traditional first aid handling is to lift with multiple stages of force!
It is useless at this time.
Seeing this, Wu Xie patted Yang Xianming and signaled him to hurry up to help: "Turn sideways!"
"Turn to the right side! His right arm is good!" Wu Xie simply explained.
"The right foot is broken!" Zhong Ying waited for Wu Xie.
"Let's turn sideways first. I'll do the traction of the left lower limb, and lie down on the side first." Wu Xie knelt on one knee while doing continuous traction of the left lower limb with both hands.
After everyone saw Wu Xie start the operation, the patient didn't cry out, but moaned continuously.
He looked at Wu Xie in astonishment.
Wu Xie said quickly: "Cut a section of the stretcher's fabric! Cut the front and rear steel bars close to the flesh. It is best to hide the stumps of the steel bars in the broken opening."
"No, it can't be cut anymore!" Hearing this, the middle-aged man shook his head violently.
"If you cut it again, I will die from pain," he stated.
"It must be cut, listen to me, you won't be in pain!" Wu Xie insisted on his statement.
The patient will definitely not be killed by the pain again, he just didn't figure out the painful part before!
This is what Wu Xie discovered after doing the traction just now.
If the previous pain was caused by the abdomen, it is impossible for the patient's muscle tension to be so high now, so the only explanation is that when the steel bar was snapped, the rebound force caused the micro-movement of the lower limbs.
It was the severe pain at the broken end that caused him to have a severe stress reaction.
Later director Zhong Ying's handling can also confirm this point.
This middle-aged man has a very low pain threshold, he is very afraid of pain, but the pain in his limbs is more sensitive than the pain sensor in his abdomen, and the abdomen is mostly dull pain!
The patient's eyes were like cows, bloodshot all over, staring at Wu Xie, as if looking at an enemy.
Seeing that the patient stopped moving, the firefighters took the opportunity to look at Zhong Ying.
Considering the difficulty of the transfer process, Zhong Ying ordered: "Cut!"
Squeak!
The broken steel bar on the other side ejected and flew.
"Ah!~" The patient himself yelled subconsciously, but the yelling stopped abruptly.
His closed eyes opened immediately, and he looked at Wu Xie in astonishment, gratitude, and emotion.
"Then what posture do you use to transfer in the car?" The emergency doctor who transferred also looked at Wu Xie.
The 120 ambulance only has the kind of cart that can lie flat! Less malleable than a stretcher.
"After arriving on the transfer vehicle, put something in the air at the front and back. I'll reset the fracture first, and then temporarily fix it. The patient's pain mainly comes from the lower limbs." Wu Xie continued to rack his brains to think of a way.
Some things were deduced from common medical knowledge, and some things depended on Wu Xie's solid basic skills in orthopedics.
Fundamentals of trauma surgery.
trauma!
A fracture is a trauma.
People have to be sent to the hospital first.
Zhong Ying immediately ordered the follow-up: "When you arrive at the hospital, open the abdomen immediately. The main inspection is the liver and pancreas. The steel bars cannot be pulled out at will. Careful blood vessels, especially the abdominal aorta and the arteries of the abdominal organs..."
"good!"
When finally handing over to the transfer doctor, Wu Xie was still pulling. This person's tonnage is not light, and continuous pulling is not a small effort.
But Wu Xie just glanced at Yang Xianming.
Yang Xianming understood it, and before Wu Xie could speak, he found a piece of steel bar that had just been cut down and used it as a fixed object. With Wu Xie's traction, part of the lower limbs were vacating!
It is convenient for emergency bandaging with gauze, and Yang Xianming did not waste any time and materials.
This is much faster than looking for a small splint.
Yang Xianming completed the temporary fix.
The firefighters cut the middle part of the inner fabric of the stretcher, leaving the place where the previous steel bar breach was suspended, and the upper and lower limbs can be firmly fixed on the stretcher.
The patient's groans gradually subsided.
It's like getting the ultimate redemption.
"Thanks!"
"Thank you!~" The patient kept tilting his head to thank everyone, his eyes were sincere, and the saliva in his mouth was bloody.
Emergency transport personnel immediately took the man away on a stretcher.
Wu Xie sat on the ground a little tired, panting heavily, feeling an indescribable joy in her heart!
No matter what, it's good to be able to temporarily relieve the elder brother's pain and give him a chance to be transferred.
On-site first aid, the operations that can be done are limited.
But my own knowledge can help him alleviate the pain, give him a glimmer of hope, and reduce the pain in the process of turnover. This is where the meaning and value lie.
What you have learned is not useless, and what you have learned is useful, which is a manifestation of pride and value.
Wu Xie's body was covered with dust, which stained his overalls.
Seeing this, Zhong Ying was agitated, secretly wondering what kind of orthopedic person Yang Xianming recommended to him?
Said: "Go over there and change another set. The remaining dust is not good for the patients behind. Just take a rest."
Wu Xie nodded, straightened the sign on his chest, and headed towards the nearest material management.
But this time, because of the badge, Wu Xie got into the car directly, and no one stopped him along the way!
After changing clothes, I jumped down again, and then walked back, and the journey was unimpeded.
However, just as Wu Xie got out of the car and walked a few steps forward, he felt raindrops falling on his face.
The sun and raindrops?
However, Wu Xie looked up and saw it.
In the air under the warm winter sun, in one direction, a spray of blood sprayed into the air with a chirp.
Chi Chi Chi Chi!
Still spraying, like water spray.
It's just that this splash is artificial!
The blood volume of the human body is at most about 8000ml, and if the blood loss exceeds 20%, that is about 1500ml, shock can be reached!
That is the amount of three bottles of ordinary mineral water!
Therefore, this bloody splash is the last bloom of a life!
Wu Xie wiped it with her hand.
The corners of his eyes were red, and the blood stains on the mask had dried.
The height of the blood flower gradually decreased, and the concentration became thinner.
A group of people next to them were covered with blood on their heads and faces. After the blood sprayed against gravity, it dripped along gravity...
The silence was broken immediately...
"Stop the bleeding, stop the bleeding, hurry up!" Someone grabbed the ruptured artery vigorously.
The people next to him rushed up to help!
Everyone crowded together!
In fact, Wu Xie also wanted to run over to see the situation, but after taking two steps away, Wu Xie retracted his stepping foot again!
Go to the direction where Zhong Ying and Yang Xianming are.
Orders and orders are prohibited, and all actions follow orders!
He is now a member of Zhong Ying's medical team, not a free man, not a spectator.
However, when Wu Xie got to Yang Xianming and the others, a very decisive voice sounded over there: "He's gone! He can't be saved."
"Go to the next one."
People are gone again!
This is the second.
Wu Xie's heart trembled.
Although he had come into contact with many dead people in the hospital, it was the first time Wu Xie met such a living life disappearing in front of his face, and there were more than one.
He held back the first one, and he also held back the second one.
It's just that the mood is destined not to be calm.
Death is cruel and cold.
This is the scene of death!
Personal ability can be reflected, but personal ability is limited after all, and many helplessness is doomed to be helpless after all.
Do your best!
When Wu Xie arrived again, Zhong Ying asked him: "What's the situation over there? Some people seem to say that there is no one there?"
The distance is not too far, and there is cheering and yelling from the crowd, so the sound is mixed and difficult to distinguish.
"Director Zhong, I don't know. When I came out after changing clothes, I only saw arterial bleeding!" Wu Xie explained to Zhong Ying.
Zhong Ying was currently treating a patient with an open abdominal wound. Hearing Wu Xie's reply, he looked back at Wu Xie.
Wu Xie's sense of discipline?
This scene is so big, can he resist watching it?
This is not as calm as Wu Xie should be at his age.
I can't stand it anymore, and the update is temporarily reduced for a period of time.
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