When doctors have a simulated operating room

The patient was taken to hospital, but the doctor said that he was not allowed to go home.

"Yes, if the patient is allowed to go home, the consequences will be disastrous!"

Zhang Yi nodded and said, "Let's look for him again. If we can't find him, forget it."

"Okay."

After that, Zhang Yi and Chen Fang looked at the emergency room door and outside again, but still didn't see anyone.

Forget it, since the patient doesn't want to be treated, there's nothing they can do.

The doctor from the gastroenterology department came over and was also confused. How could the patient be gone in a short time?

"What's going on? Where's the patient?"

Chen Fang sighed helplessly: "He ran away, saying he didn't believe he had cancer."

"Ah? This... What if he bleeds heavily on the way?!"

"What else can we do? He wants to leave on his own, so let it go."

After Chen Fang looked for him for a while and couldn't find him, he was too lazy to look for him anymore, so he just let it go.

During the lunch break, Zhang Yi didn't sleep much.

He was always thinking about how to talk to Dean Qian.

In fact, Dean Qian and Tianhe Hospital have been very good to him in the past six months.

But people should also distinguish between reality when they should think about their future.

Now the conditions offered by Union Hospital are not only better, but they are also willing to open a special clinic for him.

Opening a department for him in Union Hospital is a treatment that not everyone can get.

So, Zhang Yi thought, he still had to pick a day to have a good talk with Qian Zhenggang.

...

At six o'clock in the afternoon, the handover time, Zhang Yi had just got off work and changed his clothes when the ambulance brought in a patient with gastric bleeding.

And he was vomiting blood like crazy!

It happened that Chen Fang was on duty at night, and he recognized the patient as soon as he arrived!

Isn't this the patient with esophageal cancer who ran away in the afternoon? !

"Quickly test the blood type! First bring the replacement plasma, and then ask the blood bank to adjust the blood as quickly as possible, plasma, red blood cells, and platelets are all needed!"

Chen Fang hurriedly gave the order.

When this person ran away in the afternoon, he knew something was wrong!

See! Something really happened!

The platelet test in the afternoon showed that it was mild to moderate anemia. If he continues to vomit like this, I'm afraid he will have hemorrhagic shock in less than 20 minutes!

Chen Fang looked around and asked:

"Where are the family members? Why don't I see any of them? His condition is so serious that he needs them to come."

The emergency doctor also looked helpless:

"I don't know. He called the emergency number himself. When we went there, he could still talk, but he had already vomited two pools of blood in the room.

We don't know what the cause is at present, but we suspect it is gastric varices or gastric ulcer bleeding?"

Chen Fang immediately denied:

"No, it's not gastric varices or gastric ulcer, it's esophageal cancer!

This man had an examination in our hospital this afternoon, but he didn't believe that he had cancer at such a young age, so he ran home without treatment.

Unexpectedly, he was brought here by ambulance now!

How much blood has he vomited from just now to now?"

"If not a thousand, at least seven or eight hundred."

Chen Fang looked solemn after hearing this.

The blood must come quickly, otherwise it will be too late to rescue him from hemorrhagic shock!

At this moment, the misfortune really happened!

"Ugh... Ugh..."

"Oh no! The patient is vomiting blood again!" the nurse exclaimed.

As she spoke, she quickly took a plastic bag to catch it.

But the blood was vomited so suddenly that she couldn't catch it at all!

The whole pillowcase and bed sheet were instantly soaked with blood!

"Ugh..."

Still vomiting!

The patient was unconscious at this time, so vomiting blood was an instinctive reaction.

The bright red blood was shocking to everyone.

"Oh no! The blood pressure also dropped suddenly!"

Before any patient enters the emergency room, ECG monitoring, oxygen, and establishment of intravenous access are standard rescue equipment.

At this moment, the blood pressure on the ECG monitor has dropped from 84/60mmhg to 70/52mmhg!

"Oh no! When this person was admitted to the hospital for examination in the afternoon, his blood pressure was only 94/64mmhg! Now it has dropped to more than 70! Hurry up and give him a blood transfusion!"

Chen Fang's voice was not loud, but everyone present could hear the seriousness of the matter.

If the blood pressure drops further, the patient will die!

In addition, the patient's clinical manifestations of night sweats and rapid breathing, which are close to shock, are becoming more and more serious.

But the problem now is that there is a tumor on the esophagus, and it will bleed if it is gently poked.

In addition, there is no way to do a gastroscopy to check the situation in the case of heavy bleeding, and there is no way to reach into the stomach to stop the bleeding.

It can only be stabilized by blood transfusion.

"The blood has not come yet

, plasma replacement is here!"

"Hurry up!"

If there is no blood, you can first transfuse fluid to expand the blood volume, which can be used to relieve the pain for a while.

"Call the gastroenterologist and ask them to come down and take a look."

"Okay!"

Zhang Yi, who had just changed his clothes and was about to get off work, heard the movement in the emergency room.

Before he got close, he smelled a strong smell of blood.

Unable to resist his curiosity, Zhang Yi went to the emergency room to take a look.

Immediately asked in surprise: "Is this person the esophageal cancer patient you mentioned in the afternoon?"

Chen Fang looked anxious: "Yes, I told him not to run around, and look, he was sent to the hospital by ambulance in just a few hours. "

Looking at the bloodstains all over the bed and the floor, Zhang Yi knew that the tumor blood vessels on the esophageal wall of this person should have completely ruptured.

As a result, when Zhang Yi looked at the patient's esophagus and stomach, he frowned immediately!

Huh??

This is not esophageal cancer?!

I knock!

This... This is not esophageal cancer at all!

Ding ding ding!

Suddenly, the ECG monitor sounded again!

This time, not only the patient's blood pressure was dropping, but also his heart rate was gradually dropping!

Even the ECG ripples began to gradually stabilize to the point where the fluctuations were almost invisible!

"It's over! It's cardiac arrest! 1 mg of epinephrine is injected intravenously, and one ampule of lobeline is injected intravenously!"

Chen Fang gave instructions while standing by the bed and performing cardiac compression.

"Okay!"

"Wait!" Zhang Yi quickly grabbed Chen Fang: "Don't do cardiac compression!"

Everyone turned and looked at Zhang Yi in confusion.

"Why don't you do cardiac compression during the rescue? This man's heart is almost gone!"

Chen Fang didn't understand what Zhang Yi meant.

Shouldn't CPR be performed for cardiac arrest?

"His bleeding point is in the lower esophagus, right? It's right near the heart. If you press it again, the bleeding will be even worse?!"

Chen Fang was stunned.

Yes...

He will die faster this way...

"Then...what should we do? Wait for him to die?"

Chen Fang had no idea.

Fortunately, the blood came at this time!

"Blood is coming, blood is coming!"

The nurse at the blood bank quickly sent over red blood cells, plasma, and platelets, a total of 600 milliliters.

"Hurry up and put it in. Here's his checklist this morning. Let me see what tests he did. How was it diagnosed as esophageal cancer?"

After Zhang Yi appeared, the command of the scene was unconsciously handed over to Zhang Yi.

"Chest X-ray, electrocardiogram, gastroscopy, and blood routine tests were all done. "

Chen Fang took the medical examination form that the patient had thrown away in the morning.

While Zhang Yi was reading the medical examination form, he asked Chen Fang to use the pressurizer to squeeze fresh blood into the patient.

In the infusion tube, the blood was originally flowing at a rate of drops, but under Chen Fang's strong squeezing, it turned into a straight line and kept flowing into the patient's body.