Sleepless Doctor

The nerves that Ren Haitao had just relieved suddenly became tense, and the levels of various hormones in the body instantly soared, exceeding the threshold.

Originally, the corner of his eye had been looking at Wu Mian who was chatting with Chu Zhixi in the opposite corner, but after feeling the resistance of manual ventilation, Ren Haitao's vision was all focused on the patient, and all the surroundings became blind spots.

Iron lungs! It must be iron lung! !

Ren Haitao made a judgment instantly.

Iron lung, also called silent lung, is a complication of anesthesia, which is generally common in patients with bronchial asthma.

Before the operation, Ren Haitao had asked the patient that he did not have a history of bronchial asthma, and this rare possibility was basically ruled out. Although the patient complains that he often catches colds and coughs, he has not developed symptoms recently.

And the most likely period of silent lungs is about 30 minutes to 1 hour after the surgeon opens the stage. Now that I have just given sedatives and induced anesthesia, why do I just fall silent? !

The hairs on his back stood up, Ren Haitao immediately called to his assistant to pinch the ball and ventilate manually. He picked up the stethoscope beside him for auscultation.

No breath sounds in both lungs... I listened to the stethoscope three times repeatedly, and even a single breath sound was not heard in both lungs of the patient.

The absence of breathing sounds is really terrible. At this time, even a little wheeze is fine. Ren Haitao desperately desires that the stethoscope can hear a trace of life.

Had he not checked all the equipment, including the stethoscope, before the operation, he would definitely think the equipment was broken.

"Brother Ren, the airway resistance is large, there is no way to effectively mask oxygen." The assistant said anxiously, "Is it outside the airway..."

The so-called extra-airway intubation does not mean that the trachea is punctured, but the tracheal intubation that should be lowered into the trachea enters the esophagus.

Sometimes when the ventilator blows, the patient's stomach bulges first, which is the case.

It shouldn't be, I take it seriously, it's impossible for this to happen. Besides the extra-airway intubation, you will never hear the slightest breath sound in both lungs.

"Did you bring the bronchial mirror?" A cold voice sounded in Ren Haitao's ear.

"Take it!" Ren Haitao immediately replied subconsciously.

Wu Mian didn't say anything else. He moved his left foot across the patient's head, put his hands on the ball, and squeezed Ren Haitao's assistant away with his left shoulder.

At the same time, Chu Zhixi used the middle finger, ring finger, and little finger of both hands to hold the patient's lower jaw in an E shape, while the thumb and index finger held the two ends of the mask in a C shape.

Wu Mian squeezed the balloon with both hands to send as much oxygen as possible to the patient's lungs.

The standard double-handed E-C method buckle the mask to give oxygen, the action is precise, like a textbook. Wu Mian and Chu Zhixi cooperated tacitly, there was no language exchange, but the actions were incomparable.

Everyone present except Ren Haitao and his assistants had begun to rescue when they didn't know what happened.

"Mr. Wu, laryngoscope!"

Ren Haitao was too late to sigh with the perfect and tacit understanding of Wu Mian and Chu Zhixi's rescue operations. He brought a box from the corner that didn't get in the way and said anxiously.

"What model?"

"PV112042, a product of VerathonMedicalULC, Canada."

Wu Mian handed the ball to Ren Haitao, opened the box quickly and without chaos, and took out the electronic visual laryngoscope from the inside.

With the fastest speed, Wu Mian completed the tracheal intubation operation under the direct view of the glottis. After confirming that the tracheal tube is in the airway, the resistance to squeeze the breathing sac with both hands is still great, and the hand feels "iron lung". There is no breath sound on both lungs after auscultation.

Then Wu Mian began to connect to the ventilator.

Ren Haitao's assistant wanted to stop him in surprise, which was useless operation in his opinion. In emergency first aid, every minute and every second may determine the life and death of a patient. Why do invalid operations need to be done?

But before he could speak, Ren Haitao completely squeezed his assistant away and assisted Wu Mian to connect to the ventilator.

Mechanically controlled volume ventilation, no end-tidal carbon dioxide waveform appeared on the ventilator's screen.

"Quiet Lung, ready to rescue!" Wu Mian said in a deep voice.

The coldness in the voice was gone, but it was still cold and cold.

"Sevoflurane batch number, model number." Wu Mian asked.

"The production batch number: S044C829, Baxter Healthcare, Spain." Ren Haitao answered quickly.

"The concentration is 8%, and the flow of fresh oxygen is increased to 8L/min."

"Salbutamol aerosol batch number, model number."

At this time, one hand passed the salbutamol spray bottle, and Ren Haitao took the aerosol and glanced at it.

"Production batch number: K63J, Spain; production."

"Intra-airway administration, 3 presses."

While directing the operation, Wu Mian held a stethoscope on the patient's chest for auscultation.

After spraying salbutamol, the patient still had no breath sounds in both lungs.

"Intravenous bolus of adrenaline, 1 mg."

"Production batch number: 1709301, Tianjin Jinyao Pharmaceutical Co., Ltd.." Ren Haitao pushed the medicine while reporting the dosage form and production company.

Wu Mian's meaning Ren Haitao understood, the silent lung for some reason may be caused by drug allergy, although it is unlikely. The core doctor in charge of the rescue must have all the information, even the manufacturer and batch number of each drug.

Others can't do such a meticulous thing, but it doesn't mean that Teacher Wu can't do it either.

Ren Haitao did not understand the difference between the specific manufacturers and the different drug effects of the batch numbers. As long as Wu Mian needs it, he tries his best to do it well.

As the adrenaline was injected, irregular waveforms gradually appeared on the screen of the ventilator, and wheeze appeared in both lungs on auscultation.

After every 2 minutes, Wu Mian would give an intravenous bolus of 1 mg of epinephrine, giving a total of 3 mg of epinephrine, and at the same time intermittently inject salbutamol aerosol into the tracheal tube, 2 presses each time, 4 times in total.

As the drug concentration increased, more regular waveforms gradually appeared on the ventilator screen. At this time, Wu Mian auscultated and heard that the patient's lungs were no longer silent, but full of wheezing.

Although this is also a particularly difficult situation for the anesthesiologist, as long as there is a voice, it is stronger than a dead silence!

"Hydrocortisone."

"Production batch number: 021703066, Tianjin Biochemical Pharmaceutical Co., Ltd.." Ren Haitao still added the medicine while reporting the drug batch number and production company.

"100mg dissolved in 100ml saline intravenously."

"1mg of adrenaline."

"Suction."

"Pay attention to the depth of suction."

"80mg methylprednisolone was injected intravenously, aminophylline~www.wuxiaspot.com~ stopped pumping propofol and remifentanil, given epinephrine 1mg diluted 20ml, 0.3mg tracheal tube instillation, and continued manual breathing."

Wu Mian stood at a later position. Looking at the audience, everyone is his hand, and every detail is under his control.

After 10 minutes, the airway resistance of the hand-controlled airway decreased slightly, and the breath sounds of both lungs were extremely low during auscultation, and wheeze was occasionally heard.

The patient's blood pressure was 165/90mmHg, heart rate was 142 beats/min, and SpO was 290%.

After administering 15 mg of esmolol and 40 mg of pantoprazole, Wu Mian finally fell silent.

Ren Haitao kept sucking sputum, and he didn't worry about his assistant doing this "simple" operation. At this time, any detail is very important and must not be underestimated.

The inhalation concentration of sevoflurane and oxygen flow were gradually reduced, and the patient's state gradually became stable.

　　 Please remember the domain name of the first publication of this book:. 4Fiction Network Mobile Edition Reading URL: