crazy scalpel

Lin Weitang was supposed to be on duty tonight, Xie Ke planned to stay to check on Dong Fengjiao's situation and go back later.

At this time, hearing that Lin Fengjiao's situation had changed, she couldn't care less, and hurried over with Lin Weitang.

The nurse on duty was very experienced, and Xie Ke had specially taken care of her to pay attention to bed 7. At this time, she had already prepared all the rescue items.

When Xie Ke and Lin Weitang arrived, Dong Fengjiao had already passed out.Xie Ke knew it was shock at a glance. He stretched out his hands swiftly, reached behind Dong Fengjiao's cheeks, found the two vertical branches of the left and right mandibles, and lifted them up with his fingers, so that Dong Fengjiao's chin was pushed upwards. Lift up.After Xie Ke let go, Dong Fengjiao lifted her head back, the lower teeth were higher than the upper ones, this was mainly to allow her to breathe freely.

After Xie Ke finished these, he immediately said to the nurse: "0.1ml of 1% epinephrine, subcutaneous injection." Dong Fengjiao was Xie Ke's patient, so even though the doctor on duty, Lin Weitang, was there, she didn't say anything, but just watched from the sidelines.

Xie Ke watched the nurse finish injecting the medicine, and was about to breathe a sigh of relief, but he keenly heard a sudden grunt in Dong Fengjiao's throat, followed by a bellows-like hissing sound, his lips were also cyanotic and purple, and his neck was very swollen.Xie Ke was startled, turned around and said to Lin Weitang, "Non-infectious laryngeal edema."

Lin Weitang was frowning, and nodded when he heard what he said.Then he asked uncertainly, as if talking to himself, "Intubation?"

Xie Ke looked at Dong Fengjiao, thought for a while, but said: "Inserting a tracheal tube and using an artificial respirator must be done as soon as possible, and it is best to be awake. Not only is her condition very bad now, but even the edema is on the verge of dying." spread to the face."

Lin Weitang glanced at the thyroid cartilage in Dong Fengjiao's throat, and said, "Then, how about cricothyroidotomy?"

Xie Ke shook his head, "It's very swollen. If it is punctured, it may cause bleeding or worsen the edema. I think the trachea should be cut immediately." He looked at Lin Weitang with bright eyes.

Lin Weitang thought that Xie Ke was expecting his senior to be able to take care of this first aid technique, so he said, "Okay then, I'll do it."

Xie Ke's eyes became more radiant, and he looked at Lin Weitang with a piercing look, and asked expectantly, "Can you let me come?"

Lin Weitang looked at him in surprise: "You want to do it? Can you do it?"

Xie Ke nodded, "I will."

Lin Weitang looked at Dong Fengjiao, thought for a while and said, "Alright then, I'll watch you from the side."

Xie Ke excitedly turned his head to let the nurse prepare.

Tracheotomy is easy to understand, that is, the trachea is blocked and cannot breathe, so another opening is needed to prevent people from hypoxia, and it is generally used for first aid.People like Dong Fengjiao, although they are lying down in the hospital, but there is no time for medication and intubation, they can only do this.

The operation process and method are not difficult, and it belongs to the first aid operation that all clinicians should master. Special attention should be paid to avoiding the thyroid gland and innominate artery in the throat and neck, and the operation must not be cut by mistake.

Dong Fengjiao's situation couldn't afford to wait, so Xie Ke cut her cricothyroid membrane first when notifying the anesthesiologist, and then performed a tracheotomy after her dyspnea eased slightly.Xie Ke held a small scalpel in a pen-like manner, his fingertips and the tip of the knife slowly fused together.The place where the knife entered was between the thyroid cartilage and the cricoid cartilage. With Xie Ke's fingertips and the tip of the knife, he easily drew a 2 cm incision.

His hands were very steady, and the strength was just right. Lin Weitang glanced at the incision in admiration, and just for this, he believed that Xie Ke could really perform this operation, and maybe he could do it more neatly than himself.

Xie Ke quickly found the cricothyroid membrane. After incision, he used curved blood vessel forceps to support the large incision, and inserted the tracheal tube.

Lin Weitang: "You..."

Xie Ke raised his face, "What's wrong?"

Lin Weitang: "Your hands are really white."

"..." Xie Ke: "I brush my hands when I have nothing to do, so there are fewer bacteria."

"..." Lin Weitang: "Oh."

Dong Fengjiao's dyspnea finally eased slightly.Xie Ke asked the nurse to push her to the operating room, ready for the formal operation.

In order to prevent Dong Fengjiao from waking up suddenly, which is not conducive to the operation, local anesthesia is still required first, that is, lidocaine is used.The anesthetist was shocked when he saw Xie Ke for the first time. He had never seen him before at such a young age. He thought it was Lin Weitang who performed the surgery, but he didn't expect it to be such a little guy.She didn't know it was new until she was introduced to her by the nurse who performed the operation.

In fact, Xie Ke is purely tender-faced, he is only one or two years younger than Lao Youjun, but Lao Youjun already has the image of a wretched uncle.

The surgical position is of course supine.Once ready, Xie Ke quickly spread the sterile sheet on Dong Fengjiao, and asked Lin Weitang to help him fix Dong Fengjiao's head.The incision had already been made just now, so he pulled out the temporary cannula, and cut open the skin and subcutaneous tissue along the midline of the front of the neck, from the underside of the thyroid cartilage to the top of the chest fossa.Still with the knife on the fingertips and the scalpel, it seems as precise and easy to draw along the reserved line.Even the anesthetist was stunned. At this level, the chief physician was no different.

Shayk used a vascular clamp to free the muscle, and gently lifted the thyroid isthmus with a hook to expose the trachea.

Lin Weitang thought he would cut it off directly, but he didn't expect Xie Ke to do it so perfectly.

After Xie Ke mentioned the isthmus, he handed the hook to Lin Weitang, and Lin Weitang kept carrying it, completely forgetting that he had changed from an instructor to an assistant.

It will be easier later on. Xie Ke directly cuts the third segment of the tracheal ring, and then picks it apart from the bottom up. After opening the incision with curved forceps, put the metal trachea cannula, take out the tube core, put it into the inner tube, and complete the process in one go. .

Both the anesthesiologist and Lin Weitang were intoxicated, and there was almost no bleeding. The whole process took less than 10 minutes.

This is simply genius.Lin Weitang looked at Xie Ke suspiciously, didn't he say that he couldn't become a spirit after liberation!

Seeing that Xie Ke was proficient in rescue, Lin Weitang went back to the office first.Resident physicians should pay close attention to rest when they can, because when they are needed, they must be full of energy, and a little mistake may lead to very serious consequences.

The ward was very quiet, only Xie Ke and the nurse remained by Dong Fengjiao's side.Xie Ke took out Dong Fengjiao's medical record card, marked the red positive sign "+" in the doctor's order and the skin test pg column on each page, and hung the same warning on the bedside.

Respiratory problems are solved, as well as allergy problems.Xie Ke found Dong Fengjiao's husband's phone number, and he had to come to inform the family.

When Wu Xingchuan heard that his wife was being rescued again, he immediately became anxious. Fortunately, he didn't understand what was going on, so he just anxiously told Xie Ke to cure his wife.It's just that it's hard to predict what will happen to him after he understands it afterwards.

Xie Ke's answer was naturally quite satisfactory.As for Lao Youjun, he didn't hold any grudges, and immediately notified him, after all, he was the person responsible for this matter.

After Lao Youjun heard this, he didn't believe it at first, "How is it possible, isn't the result negative?"

Xie Ke: "It should be a slow reaction, which is also possible."

Lao Youjun panicked, "What a coincidence? How could it be? I'll come right away, no, hurry up and give her an epinephrine injection! No, Lao Lin is on duty today, hurry up and ask him to help!"

Xie Ke: "How can Lao Lin help? I have already injected 1 ml. If the symptoms are not relieved, I will reduce the dose and inject again in half an hour."

Lao Youjun became anxious when he heard this, and shouted loudly: "What are you doing at this critical moment? Hurry up and ask Lao Lin to help me, and I will rush over right away! If something happens to her, I will never end with you." Then I just hung up, probably because I was really in a hurry to rush to the hospital.If he came back to the hospital and knew that Xie Ke had performed a tracheotomy to save Dong Fengjiao's life, he would be stunned.

Xie Ke looked at the phone, a little speechless.He thought about the process of his own rescue, and it seemed that there was nothing wrong. Besides, Lao Lin was also present, and although Dong Fengjiao was a patient of Lao Youjun, why did he lose his composure like this.Unable to figure it out, he can only attribute it to the fact that Lao Youjun still cares about the patients.

After half an hour, it really didn't improve, and Dong Fengjiao was still not out of danger.