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Chapter 55 Establishing Intravenous Access
Fentanyl is a class of controlled drugs, the most tightly regulated drug in hospitals.Doctors who write prescriptions need to use red prescription slips commonly known as "red tickets".

Each red ticket has an independent number to facilitate the hospital review department to track the flow of prescriptions and drug usage.And Xu Yourong had just joined the treatment team for a few hours, and the number of the red prescription slip she held still belonged to the Department of Neurosurgery—the red slip that can be used in the emergency room has not yet been triggered in her hands.Although he really wanted to relieve the pain of the patient as soon as possible, Xu Yourong could not do anything about it.

Not to mention Sun Li'en, he doesn't have the right to prescribe yet.But fortunately he was smart enough, after seeing Xu Yourong's troubled expression, Sun Lien turned his head and rushed out of the emergency room.He grabbed Liu Tangchun who was about to go back to the office, "Teacher Liu, hurry up and prescribe [-] mg of fentanyl!"

For the second time in a short period of time, Liu Tangchun was pulled back by Sun Lien's arm.Poor Director Liu is in his 50s. Although he was a soldier when he was young, his body is not as good as it was 30 years ago.In desperation, Sun Li'en lost the importance of his hands again, and dragged Director Liu to stare.

In fact, it is also possible to find other doctors in the emergency department for such things as red sheets, and it is not necessary to kidnap Director Liu from the lobby.It's just that Sun Li'en has other ideas - he has already carried out emergency treatment for severe burns according to the requirements in the textbook.But the rupture of the corpus callosum made him a little uneasy.Whether it was in the morning or after dinner at night, Sun Lien did not see this state in Zhao Weihong.Then there is only one possible inference, that Zhao Weihong's corpus callosum rupture occurred after he was discharged from the hospital.Counting begins after discharge from the hospital until being sent to the ambulance again.During this hour, Zhao Weihong's corpus callosum, which had been functioning normally for 67 years, was severely damaged.

What Sun Lien was afraid of was that the burn injury was just a trick, and the injury to the corpus callosum was the real killer.He must let Liu Tangchun realize that the patient has serious brain tissue damage as soon as possible.In case the burn was to cover up damage to the corpus callosum...

Sun Li'en has no hope for the humanity of Zhao Weihong's family.

Liu Tangchun quickly issued a red ticket.The intern male nurse who had been waiting for a long time took the red ticket and ran towards the pharmacy.The severe pain caused by the burns acted on Zhao Weihong's body in reverse, and the intense pain stimulated her brain to continuously secrete dopamine.And after the dopamine entered the viscous blood, it directly stimulated her already overwhelmed heart to continue beating rapidly.If the pain cannot be relieved as soon as possible, it is only a matter of time before the heart stops completely.

If the heart fails, Zhao Weihong will basically be dead—with her current condition, it is absolutely impossible to undergo a heart transplant.And extensive burns mean that there will be a lot of waste in the circulatory system that needs to be disposed of. If the liver and kidneys cannot get enough blood supply during the over-restricted operation, they will also enter the ranks of strikes one by one.

This is the first level of extensive burns - multiple organ failure.

Three minutes after Zhao Weihong was sent to the emergency room of the Fourth Central Hospital, doctors from the anesthesiology department finally arrived at the scene.

Maintaining the operation of the circulatory system is the specialty of anesthesiologists. Unlike the cardiology and respiratory departments that treat diseases, the main work of the anesthesiology department is maintenance rather than treatment.Therefore, in terms of treatment methods, the anesthesiology department is also very rough.Except for a very few doctors who like to say "Da Lang, drink up the medicine...", the doctors in the anesthesiology department usually don't talk much.They need to monitor the patient's heartbeat, breathing, blood pressure, and sometimes even pay attention to the patient's urination
"Are you on the painkiller? Don't use morphine, use fentanyl directly. The painkiller of morphine is not strong enough." The one who came to help was an attending doctor from the anesthesiology department. When he visited Lin Lan's operation in the morning, Sun Lien had seen him by the side , although his entire face was covered by a mask and a surgical cap, Sun Lien was deeply impressed by that pair of black plate-rimmed glasses with white horizontal stripes.

"A red slip has been issued, a fentanyl, the nurse is going to get the medicine..." Before Sun Lien finished speaking, the door of the emergency room was pushed open by the intern male nurse.In his hand was a small plastic basket containing a glass vial filled with a clear liquid.

"Prescribe a B-ultrasound to guide me." The anesthesiologist wearing zebra glasses put on gloves, took out the tools in the central vein puncture suit familiarly, and after disinfecting the right neck of Zhao Weihong who was lying on his side, looked at the Guided by the B-ultrasound, starting from the head, the needle on the syringe was pierced in the direction of Zhao Weihong's neck.

It stands to reason that the deep jugular vein puncture requires the patient to lie on his back, but Zhao Weihong's carbonized outer layer of back skin directly made Zebra dispel this idea.The fentanyl is still in the dosing, so let Zhao Weihong lie down now, lest she will hurt herself to death.The bold anesthetist of Yigao did not choose the subclavian vein or femoral vein, which are easier to penetrate but also have higher risks.Instead, the jugular vein, which is best suited for massive fluid rehydration, was still chosen.

The tube was inserted very smoothly, and the [-]-[-] cm long needle was inserted less than halfway, and the dark red blood instantly returned to the syringe, which also marked the successful opening of the rapid fluid rehydration channel.Insert the guide wire from the channel next to the needle, stop the hand at the position of the guide wire scale mark, and then pull out the needle. At this time, the skin expander in the puncture set will come in handy.

The skin expander is a very hard hollow plastic tube. The guide wire passes through the hollow place, and the plastic tube is close to the position where the needle is inserted. Squeezed into the skin.The pinholes that were already quite thick were poked thicker.

Sun Lien, who was watching the deep jugular vein catheterization for the first time, was terrified and sighed in his heart—if he had stayed in the hospital honestly and actively cooperated with the examination, why would Zhao Weihong suffer so much?
After pulling out the skin expander, Dr. Zebra took out the remaining liquid tube of the suit. After passing through the guide wire, he slowly followed the liquid tube in the direction of the jugular vein, which looked a bit like a sewer Workers are running wire through a blocked pipe.

After going down for about ten centimeters, Doctor Zebra stopped in satisfaction.He slowly pulled out the guide wire, used a syringe to draw a little blood out along the infusion tube, nodded and said, "It's done, let's start rehydration." The nurses went to help - dispensing painkillers, which is also one of the jobs of the anesthesiologist.

(End of this chapter)