Back in 2002 as a doctor

"Lidocaine 100mg, IV, push!" Zhou Congwen said in a cold voice while buttoning his mask.

The anesthesiologist next to him was startled, and subconsciously glanced at Director Lei.

"Bang~" Liu Wei took advantage of the interval of cardiopulmonary resuscitation and kicked the anesthesiologist's calf, "Hurry up and rescue!"

"Oh oh oh."

"Prepare amiodarone, 300mg intravenous infusion, every minute... start with a higher dose."

"Epinephrine 1MG, IV, push."

"..."

As the orders were issued one after another, the doctors in the anesthesiology department had already forgotten Director Lei aside and rushed to rescue him.

The clock hanging on the door lintel ticked, the second hand moved 162 times, the ventricular fibrillation disappeared, and the QRS-T waveform finally appeared on the ECG monitor again.

Liu Wei was as tired as if he had run 3000 meters, and the sterile cap was already wet with sweat from his forehead and temples.

"Director, why hasn't the director come yet!" Liu Wei finally had time to find someone to take the blame, and asked in a low voice after shouting, "Xiao Zhou, what else do you need?"

Zhou Congwen did not communicate with Liu Wei, but removed the oxygen mask and asked questions loudly in the patient's ear.

The patient recovered effective heart rate and gradually regained consciousness, but hypoxemia remained.

Zhou Congwen asked questions and found that the patient was unconscious and lethargic, but responded to simple instructions, and still said he had chest pains and headaches.

"I'm going to raise my blood pressure with norepinephrine, and I'm fine for the time being," Zhou Congwen said.

Liu Wei let out a long breath.

"I suspect that the patient has a myocardial infarction. An arterial catheter is placed and he is ready to be rescued at any time. Can Director Li of the People's Hospital do an angiography?" Zhou Congwen asked.

"Myocardial infarction? The patient doesn't seem to have a history of cardiovascular and cerebrovascular diseases." Liu Wei said in a low voice.

"Acute coronary syndrome after carbetocin injection."

"..."

"..."

"..."

Everyone in the operating room was stunned.

Acute coronary syndrome after carbetocin?What the hell is this? !

The third hospital focuses on obstetrics and neurosurgery. The number of children delivered every year ranks second in the city. It can be said that the volume of operations is very large, which is not comparable to that of a small department like thoracic surgery.

Obstetricians have never heard the weird saying that oxytocin can also cause myocardial infarction.

"Zhou Congwen, where's your director?" Director Lei also calmed down and asked in a cold voice.

"It's not about the chest department." Liu Wei turned sideways, standing between Director Lei and Zhou Congwen, "Director Lei, our anesthesiology department has been doing rescue work, and now it is suspected to be acute coronary syndrome after carbetocin."

"..." Director Lei was taken aback.

She knew Liu Wei very well. He was the technical backbone of the anesthesiology department, and he was willing to play mahjong in a calm manner.

Although he is willing to play, he is indeed a good player on the operating table.

Liu Wei was the first to learn and apply many techniques, such as arterial catheterization and single-lumen ventilation.

Usually, Director Lei is also willing to work with Liu Wei on the stage. Who doesn't want to cooperate with a high-level anesthetist?

But why is Liu Wei repeating Zhou Congwen's words like a repeater?Talking nonsense with your eyes open?

"Prepare the defibrillator." Zhou Congwen's voice came from behind Liu Wei coldly.

"Huh? Ventricular fibrillation just now, the defibrillator is not ready yet?!" Liu Wei glared at the anesthetist who was standing beside him dumbfounded.

"I'm going, I'm going."

"Get ready, Xiao Zhou, is there a serious problem with the patient?" Liu Wei asked in front of Director Lei.

"Many tests are not available in our hospital." Zhou Congwen answered irrelevantly.

Liu Wei understood Zhou Congwen's meaning, without an objective inspection, it was useless to say anything, and he knew all kinds of methods of throwing blame in clinical practice very well, and he was handy.

"What's going on?" The director of the anesthesiology department strode in, asking while glancing at the patient's ECG monitor.

"Director, the patient suffered sudden ventricular fibrillation and has been rescued. I don't know exactly how it happened. The patient is in critical condition. I suggest..."

As he spoke, Liu Wei glanced at Zhou Congwen.

"Hurry up for surgery and transfer to the circulatory department."

"It is recommended to hurry up for surgery and transfer to the circulatory department after surgery."

"..." Director Lei was completely speechless, Liu Wei had become a repeater willingly.

Although he did not mention the problem of oxytocin when he reported to the director of the anesthesiology department, it was obvious that Liu Wei had become Zhou Congwen's mouthpiece.

What the hell, an old doctor doesn't even want face, Director Lei scolded in his heart.

"Are you sure?" the director of the anesthesiology department looked at Liu Wei and asked.

Liu Wei didn't speak, but looked at the anesthetist who was in charge of the caesarean section.

"Director, routine spinal anesthesia, the medication has been confirmed, it's all right." The anesthetist said carefully.

"Hurry up for the operation, isn't the baby finished, hurry up and get the stitches off." The director of the anesthesiology department waved his hand.

He turned around to leave, but he hesitated for a while and still didn't leave. Instead, he carried the small round stool where the anesthetist was sitting on the patient's head to the corner, sat on the stool and watched coldly.

Director Lei is the newly mentioned director of the obstetrics department, and she is incomparable with the powerful director of the anesthesiology department, so she dared to yell at Zhou Congwen and Li Qinghua.

While the patient is still in good condition, hurry up and do the surgery, and don't die on the operating table. Director Lei also approves of this plan.

However, after experiencing ventricular fibrillation, Director Lei's hands trembled slightly, and it took a full 20 minutes for the simple finishing work of the operation to be completed.

The patient's blood pressure has gradually increased under the action of norepinephrine, but the blood oxygen saturation is still not ideal.

The waveform of ECG monitoring changed from supraventricular tachycardia to ventricular tachycardia and ventricular fibrillation. After rescue, the waveform of ST segment depression in the left anterior wall lead appeared.

Although Liu Wei couldn't figure out how oxytocin would cause myocardial infarction, he still tended to believe Zhou Congwen's opinion after seeing the ST-segment depression in the left anterior wall lead.

I wanted to ask back, but Liu Wei didn't see Zhou Congwen, he didn't know when he had left.

Chapter 0349

Sending the parturient to the Circulatory Medicine Department took nearly two hours to finish.

However, Liu Wei never wanted to understand what happened. He thought about Zhou Congwen's diagnosis - myocardial infarction caused by oxytocin.

Can oxytocin cause myocardial infarction?Why don't you know?

For Zhou Congwen, Liu Wei has complicated emotions.

At first, his impression of Zhou Congwen was mediocre, he was just a little doctor who didn't like the old director, and he was destined to be ordinary in this life.

At the first meal of the department dinner, the director asked me to drink. Is that drinking?That's the medicine for heartbroken!

The director intentionally or unintentionally wanted to test the obedience of the subordinate doctors, no matter whether he could drink it or not, he must drink that glass of wine in one gulp, even if he was completely drunk afterwards, it didn't matter.

After drinking, try to say something on the scene.

Only after drinking this glass of wine, can the next thing have a chance.

Who didn't come here like this?Liu Wei has his own views on the story between Wang Chengfa and Zhou Congwen.

Zhou Congwen's obedience is not good, and no one can regard him as the most capable doctor under his staff.

As for the operation, I definitely won't let it go, don't even think about it.With such poor obedience, she might not become domineering after surgery.

For the old director, this is called raising tigers.

Originally, things developed as Liu Wei imagined. Wang Qiang was selected for the thoracic surgery department, and he was "fed" for all operations. Zhou Congwen and Shen Lang, two unlucky children, could only be the background cloth.

but.

Zhou Congwen seemed to be a different person this year, which made Liu Wei dumbfounded.

Because he has learned single-lumen intubation, he has a lot of cooperation with the thoracic surgery department and knows many things well.

Just watching Zhou Congwen and Wang Chengfa on the operating table, I don’t know how many times.

It's fine if it's an ordinary little doctor. After being angry, the director must be hysterical and swearing.

But Zhou Congwen was different, air embolism, intraoperative side injury, and pulmonary edema caused by lung recruitment after anesthesia.

Case after case of successful emergency rescue, all of which were extremely difficult.

It doesn't matter if it's one time, who hasn't had a highlight moment yet.But Zhou Congwen went from one successful rescue to the next silently, without any pause, gap, or... mistakes.

Some time ago, Liu Wei also took into account the personnel changes in the Department of Thoracic Surgery. The prince of the Department of Thoracic Surgery of the People's Hospital actually "condescended" to work in a dilapidated hospital like the Third Hospital, and then kicked Wang Chengfa to the outpatient clinic.

If there is no ghost in it, Liu Wei will definitely not believe it.

After more than ten years of struggling in the big dye vat of society, Liu Wei is no longer a simple student who came out of the ivory tower.

He observed carefully, until Li Qinghua underwent surgery, and when Zhou Congwen carefully checked every medicine and the date of manufacture, he vaguely guessed that Li Qinghua must have insider transactions with Zhou Congwen.

Moreover, Li Qinghua was very cautious and worried, for fear that something might go wrong with his operation. Zhou Congwen was also very cooperative, and even checked whether the medicines were opened.

From that day on, Liu Wei deliberately "flattered" Director Li Qinghua, no matter how late it was, as long as he called himself, he would definitely come to the thoracic surgery desk.

No matter how many specialists are invited to operate on weekends, he will definitely give up rest and perform single-lumen intubation.

No complaints.

Even Liu Wei did not teach others single-lumen intubation, except for Li Wenbo who realized it by himself, he tried his best to stay close to thoracic surgery.

It was rumored in the hospital that Li Qinghua issued a military order, and within three years, the number of operations exceeded that of the People's Hospital.This "joke" has been told intentionally or unintentionally by everyone, especially other surgeons, who can't laugh when they mention it.

But Liu Wei didn't think so.

What happened today may seem like an accident to others, but Liu Wei still doesn't think so.

Oxytocin causes myocardial infarction?Liu Weineng could see from Director Lei's face how much disdain she felt in her heart.

Carbetocin is a synthetic long-acting nonapeptide analog of oxytocin with agonist properties.A single dose intravenously may be administered immediately after cesarean section under epidural or spinal anesthesia to prevent uterine hypotonia and postpartum hemorrhage.

Liu Wei often uses this drug, and all patients who undergo caesarean section must be given it. It acts on the uterus, and there is no precedent for myocardial infarction.

but!

The patient's electrocardiogram confirmed Zhou Congwen's statement.

After Liu Wei stepped down, he didn't go to Zhou Congwen, but went through the matter from beginning to end, found the manual of carbetocin in the trash can, and took a taxi home.

Sitting on the sofa, Liu Wei carefully studied the instructions of carbetocin, especially the section on side effects.

Adverse events with carbetocin were observed in clinical trials in the same pattern and frequency as those observed with oxytocin administered after epidural or spinal anesthesia for cesarean delivery.

Nausea, abdominal pain, pruritus, flushing, vomiting, heat sensation, hypotension, headache and tremor often occur (10%-40%) after intravenous carbetocin.

Infrequent (1%-5%) adverse events included back pain, dizziness, metallic taste, anemia, sweating, chest pain, dyspnea, chills, tachycardia, and anxiety.

At that time, Director Lei asked the anesthesiologist to look at the situation, probably because he suspected a similar situation.

The side effects and contraindications of the drug instructions did not mention myocardial infarction, and Liu Wei frowned a little more after reading it carefully.

Why did Zhou Congwen say that?

Suddenly, Liu Wei thought of a past event.

At the beginning of its establishment, the Third Hospital existed as the health department of the group company.Later, because the first dean was awesome, he abruptly turned the clinic into a large public hospital.

But the goal of the dean is relatively clear, obstetrics and gynecology, geriatrics are the main medical direction.Originally, everything was going smoothly, but a woman in the obstetrics department died suddenly during childbirth the year before last, and the family of the patient really made trouble for a long time.

This incident had a huge impact on the third hospital, which had just developed. Although the accident occurred in the obstetrics department, the operation volume of all surgeries dropped a lot.

Did the woman take oxytocin?

Liu Wei was puzzled, and he wrote it down.

Zhou Congwen seemed a bit interesting.How did he know?Thinking of Zhou Congwen's expression and attitude, Liu Wei became more and more sure that he knew that carbetocin might cause myocardial infarction.

Does he even know the complications that don't exist in the instructions?The more Liu Wei thought about it, the more curious he became.

Before Monday, when night fell, Liu Wei called his familiar colleagues in the medical record room.

He wanted to look through the medical records to confirm his guess.

Because of the high level of technology, the medical staff and family members of the hospital are willing to seek Liu Wei for surgery. Liu Wei is also righteous and does not accept red envelopes, so he has a good reputation.