I can see the status bar

Chapter 561 Amazing skills (June 6, 1th update)
A doctor from the anesthesiology department was invited to perform central venous catheterization because the mother-in-law of District Chief Ouyang was seriously injured at that time. After the severe burn, the patient lost a lot of water in the blood, causing all the veins to collapse. Even the central vein collapsed badly.It's not that Zhou Jun can't do it, but he is worried that if he fails to do it himself, the progress of rescue may be slowed down. On the other hand, it is not easy for the anesthesiology department to do this kind of surgery.

Although it seems from the name, most people's concept of "anesthesiologist" still stays on "they dispense anesthesia".But in the modern medical system, the work of an anesthesiologist in the operating room is almost equivalent to an entire ICU team.It's just that anesthesiologists need to consider how to maintain the patient's vital signs under anesthesia, bleeding, and surgery.It can be said that their working hours are not too long (compared with ICU doctors), but at the same time, the situations that need to be dealt with and the challenges they face are the biggest.

Because the challenge is huge, so the technology is superb.But the current patient... the challenge is not too difficult.At least so far, Zhou Jun is sure to complete the buried tube technique.

Even if the other party has no blood pressure at all, it can be detected.

The fifth defibrillation has been completed, and the sixth defibrillation has not yet started.The 1 minute or so in the middle is the only opportunity to bury the pipe.Although the patient's body is constantly heaving and falling under the chest compressions, in order to save the other person's life, this kind of chest compressions must not be stopped.Even if they had to stop and change people, the time must not exceed five seconds.

"No B-ultrasound." Zhou Jun was already standing on the top of the patient's head. The nurse on the side had disinfected the patient's skin in advance, and Zhou Jun said to the colleagues on the side, "You can do it as usual, and the intensity should be consistent. .”

The thick needle was pierced into the jugular vein by Zhou Jun's finger, and the blood returned to normal, which is the so-called hit the nail on the head.Then the skin expander, which Zhou Jun had held in his hand for a long time, pushed against Wang Baoguo's neck skin along the guide wire.Zhou Jun poked hard with his right hand, and the skin expansion was completed.

The speed at which the guide wire is fed into the blood vessel should not be too fast, otherwise it is easy to cause knots or scratch the blood vessel wall due to the physical characteristics of the guide wire itself.But at the same time, the speed of completing the buried pipe must be fast.Otherwise, Zhou Jun can only choose to let go and let the patient receive an electric shock when he defibrillates next time.And the catheter is in a completely unfixed state-this situation is likely to have serious consequences.

Within 2 minutes, the central venous catheter was completed on a patient with no blood pressure who was constantly rising and falling. At the same time, there was no B-ultrasound guidance. The difficulty of this operation was really high and scary.

"The catheterization is complete." Just as Sun Lien was counting the time nervously, Zhou Jun reached out to the nurse, "Bring the needle holder and the needle."

A total of 58 seconds passed from Zhou Jun's operation until he asked for a needle to suture.

After Zhou Jun took 14 seconds to complete the suture and tested that the catheter could work smoothly, the doctors watching couldn't help but let out a gasp.There are not many things that can amaze an emergency doctor, but completing a non-ultrasound-guided intravenous catheter in the neck of a cardiac arrest patient receiving chest compressions in one minute and 12 seconds is definitely one of them.

This can even be called "magic".

"Continue to press." Zhou Jun took two steps back, watched the nurses connecting and maintaining the central venous catheter, and said to the doctors who were admiring, "If you are not tired, then come and line up to continue the chest surgery. Press."

As soon as the words were said, Wang Baoguo, who was receiving chest compressions, suddenly heard a crisp "click" in his chest.Sun Li'en glanced over, and a new message "Right Fifth Rib Fracture (00.00.01)" was immediately updated in the status bar.

"Director Zhou..." Dr. Cao Yanhua was pressing. He said intermittently while pressing, "Maybe... a rib was broken."

"Continue." Zhou Jun frowned and moved closer, groping around the patient's chest under Cao Yanhua's body, "There's nothing you can do if the button is broken, keep the rhythm and depth, and leave other things alone."

"I'm worried..." Cao Yanhua continued to press, "Don't be a fucking open fracture, it will be troublesome if the alveoli are pierced."

"You are not Guo Yulai." Zhou Jun patted Cao Yanhua, "Don't worry, let's make another group, and I will take over."

Sun Lien held the defibrillation paddle in his hand, and when he heard the notification sound when the machine was ready, he immediately raised the defibrillation paddle in his hand and said, "Charging is complete, 160 joules, get out of the way!"

Zhou Jun, who had just taken over and performed more than a dozen compressions, immediately jumped off the stretcher bed. Sun Lien quickly pressed the defibrillation button on his hand after confirming that no other medical staff had touched the bed.

The sixth life-saving defibrillation was issued. The electric current with an energy of up to 160 joules first spewed out from the patient's collarbone, driving his heart muscle to stop completely, and then entered the second defibrillation paddle placed at the apex of his heart. .Immediately afterwards, it entered his body again through the second paddle and flowed away through the paddle at the collarbone.

After the two electric shocks with almost no delay, all his heart muscles stopped working, and then they started to operate in an orderly manner again.

Assessment of defibrillation effectiveness was performed during compressions after defibrillation.Wang Baoguo is no exception.Zhou Jun went up and did two sets of compressions before being stopped by other doctors - they had already seen the emergence of sinus rhythm.

Wang Baoguo's fortune was dragged back temporarily.

"Li En, go and treat the injury on your arm." Zhou Jun panted heavily, the hair on his head was messy.He wiped the sweat from his forehead, and said to Sun Lien, "There are too many patients outside, you should work harder, and go to the outpatient clinic as soon as the injury is dealt with."

Sun Li'en nodded, but he didn't feel that the injury on his arm was so serious that he needed to rest by himself.However, under the treatment of Wang Bao and the doctor, Sun Lien saw for the first time how serious his arm injury was.

After the blood was washed away by the normal saline, a five centimeter long wound appeared hideously in front of Sun Lien.The depth of the wound is not shallow, at least one or two centimeters.After the skin was pulled apart by its own tension, the skin at the edge of the wound showed an unhealthy off-white color, and Sun Lien could even see yellow granular fat from his wound.

"This wound is not small." Dr. Wang sighed, took a procaine from the tray beside him and said, "You need stitches. I'll give you a little less anesthesia first."

"Come on, less time." Sun Lien sighed, the dose of local anesthesia is too large, which may cause a certain degree of interference to people's thinking.Unable to maintain a sharp mind is a taboo in the work process.Although it will be painful, it is better than drowsiness, which eventually leads to misdiagnosis.

A bottle of procaine was two milliliters, but the total amount Dr. Wang injected into Sun Lien was less than one milliliter.Infiltration and injection of a small amount of anesthesia is very painful, but compared to the pain of suturing under incomplete anesthesia... it is simply weak and vulnerable.Sun Li'en yelled for a long time before finishing the stitching.

"A total of six stitches were given to you." Because the anesthesia was not complete, Wang Baohe saved as much as he could in the process of trimming the wound and suturing.The five-centimeter wound was sutured with six stitches, all with simple interrupted sutures. "Your wound...may have a scar in the future. Why don't I sew it up for you when I come back from get off work today?"

"Then we'll talk about it after get off work." Sun Li'en said with a hoarse voice and wry smile, "You'll have to give me some more anesthesia...it hurts me to death."

The clothes that Sun Lien was wearing next to his body were completely wet with sweat, and a lot of his own blood was stained on them.He walked helplessly into the lounge, and after searching for a long time, he found a clean hand washing suit and put it on, then put on Xiao Guo's white coat, and walked out of the emergency room again.

"Li Huizhen, patient Li Huizhen, please go to the ninth consulting room." The broadcast began to play in the rescue hall.Sun Lien's Ninth Consulting Room has started to operate.

(End of this chapter)