I can see the status bar

Chapter 701

What are the chances of surviving a patient with brain herniation?

If it is a foramen magnum hernia, then the probability of survival is basically equal to zero.In the case of a tentorial herniation, the chance of survival is about 0% if treated within two hours.Other herniations have a slightly lower mortality rate, but are still a potentially fatal disease.

The last thing any doctor wants to see is a patient in his charge showing symptoms of dying.But when they really encountered it, there was no good way for anyone except to bite the bullet and cover up the water and earth.

For Zhang Junyi now, what he needs most is a neurosurgery.Intracranial pressure is released after removal of a large skull flap to prevent brain tissue from being squeezed into other pores of the brain.

There is mannitol on the 120 ambulance.If it can be infused in time, it can slightly reduce the risk of Zhang Junyi's brain herniation.But in the bumpy car, looking at Zhang Junyi whose limbs were tightly tied to stop the bleeding, the pre-hospital first responders had some difficulties-he couldn't complete the difficult operation of deep vein catheterization in the car alone.

"Give me the needle." Seeing the embarrassment of the first responders, Dr. Brunn stopped sending WeChat messages on his mobile phone, took out a pair of clean latex gloves from the car and put them on, "I Come for the injection, you sterilize—don’t rub your neck!” He glared at the front of the hospital, “Put the jugular vein in the car, do you think he didn’t die fast enough? It’s too expensive to get the vein! Prick the left side!”

"Ah?" The front of the hospital looked really nervous. He was about to disinfect Zhang Junyi's right arm, but Bruen stopped him.

"The arm on the right is almost twisted into a twist, so you still disinfect the right arm?" Dr. Brunn stared at the front of the yard dissatisfied, then shook his head.After tearing open the syringe package, he completed the infusion preparation extremely skillfully.And start the IV in the dangling car - hit the nail on the head, the effect is not like a doctor.

Rather like a senior nurse.

"When I was doing medical tours in the Caribbean, I didn't have any nurses to help me." After completing the needle injection, Dr. Brunn seemed a little proud of his skills.After he muttered something like this, he turned his head and said seriously to Sun Li'en, "You must never tell the nurses in our hospital... When I give the doctor's order, they let me do the work by myself. I can't stand it."

The ambulance had already stopped at the entrance of the hospital when Sun Lien and Brunn were talking.The doctors who received the 5 forecast 120 minutes in advance and were notified by Sun Lien and Brunn more than a minute in advance were already waiting at the door.A wounded person like Zhang Junyi who fell from a high altitude must take the green channel.

The biggest advantage of the green channel is that it eliminates all other unimportant processes.Zhang Junyi is like the most important person in the entire hospital, jumping in line everywhere is a basic operation.In order to wait for Zhang Junyi, the CT room that received the notification had already stopped the examination of other patients.Although most of the patients were dissatisfied and did not understand at the beginning, after seeing Zhang Junyi lying on the bed, all dissatisfaction disappeared immediately.

His injury was really...too serious.Even if ordinary people can't see his brain herniation and spinal fracture, they can tell just by looking at the deep bony wounds on the limbs and the twisted arms-this person is seriously injured.

Before the examination in the CT room, the doctors in the emergency department had attached the vital signs monitoring equipment for Zhang Junyi during the transfer.And a more appropriate emergency treatment for his open pneumothorax - replacing the plastic sheeting with gauze sheets soaked in petroleum jelly.

CT examinations usually end within a few minutes.But under the current circumstances, the doctors still need to hurry up to snatch Zhang Junyi back from Lord Yan.Every second of delay may be the cause of Zhang Junyi's death, but every second of inspection may win Zhang Junyi more chances of life.This is a dilemma, how to balance the time consumed by the examination and the time wasted before emergency surgery-for any doctor, this is a very difficult choice.

"After the CT is done, send it to the operating room immediately." Liu Tangchun, who rushed to the scene, roughly glanced at the CT image, and gave the order decisively. "The seam is already deviated, and it will be too late if there is no surgery."

As a result, the CT examination was forcibly stopped.None of the doctors at the scene had any objection to Liu Tangchun's judgment.For Zhang Junyi now, brain herniation is the most likely cause of his death.By comparison, bleeding and the like aren't even top of mind for doctors.

"The patient's abdomen is obviously distended, and there may be serious internal bleeding." Sun Lien reminded, "For emergency surgery, do you have to invite doctors from the liver and gallbladder?"

"That's for sure." Liu Tangchun nodded in agreement with his apprentice's judgment.Zhang Junyi's current blood pressure is not very high, and the monitor shows 125/95mmHg.This is not the same as the general cerebral hemorrhage patients.

Ordinary patients with cerebral hemorrhage either have chronic hypertension themselves.Either the cerebral hemorrhage leads to abnormal activation of neuroendocrine systems such as the sympathetic nervous system, renin-angiotensin system, and corticosteroid system, and increases the levels of biologically active substances such as catecholamines and brain natriuretic peptides in the circulatory system, resulting in a sudden increase in blood pressure.Or because the increase in intracranial pressure exceeds the tolerance range of the brain's self-regulatory function, it is necessary to increase peripheral blood pressure to maintain cerebral perfusion pressure to produce Cushing-Kocher reaction—that is, the brainstem compression reaction.

All in all, whether cerebral hemorrhage occurs spontaneously or due to external shock, the vast majority of patients will have severe symptoms of hypertension.But now Zhang Junyi's blood pressure is only slightly higher than normal.This basically shows a very serious reality, his blood volume is seriously insufficient.

Although the injuries to the limbs were serious, Liu Tangchun, a battle-tested veteran, could tell at a glance that these injuries basically did not hurt the arteries.Moreover, the right side of Zhang Junyi's body obviously had more and deeper scars than the left side, which should be due to the body's self-protection mechanism when he fell.

When the human body is protecting itself, it will subconsciously protect the favorable side.In the bodies of many trauma patients, this kind of self-protection will be manifested as obvious differences in the injuries on both sides of the body.

Since the lack of blood volume was not caused by limb injury, it could only be internal bleeding.According to Sun Lien's "abdominal distension", Liu Tangchun estimated that either the patient had a ruptured liver or a ruptured spleen.

Judging from Zhang Junyi's current blood pressure level and heart rate, Liu Tangchun is more inclined to liver rupture.If it had been a ruptured spleen that would have caused a distended abdomen, he would probably be dead by now.

From being pushed into the CT room to Zhang Junyi being sent to the operating room on the fourth floor, the doctors of the Fourth Hospital only took four minutes and 17 seconds.

(End of this chapter)