godfather of surgery

Chapter 139 Cricothyroid membrane puncture

The two rested under a tree by the roadside.

"When you get back, you can drive. Drive slowly. The key is not to panic. Especially when you see a lot of cars, you should predict the traffic situation in advance. In an emergency, just don't make a mistake with the accelerator and brake. You just drove When the throttle is switched on and the brakes are switched freely, the memory will be formed after driving too much."

Xiao Su summed up Yang Ping's driving just now, and taught Yang Ping his years of driving experience.

Another pair of men and women on the side of the road seemed to have had enough rest and got into the Honda SUV. Before getting into the car, the man did not forget to look this way.

Yang Ping and Xiao Su rested for a while, Xiao Su checked the car's battery, it was enough, and it was full when it came out.

The two circled around the university town a few more times, and they were almost done practicing. Xiao Su took Yang Ping to practice reversing the car into the garage.

For parallel parking spaces, diagonal parking spaces, and vertical parking spaces, Xiao Su found a parking space and asked Yang Ping to practice all of them. He passed the test in every project.

Yang Ping learns very quickly. Every project is mastered at one time. After practicing several times, he still has his own experience.

After practicing very proficiently, the two found a self-service hot pot restaurant and followed the navigation.

The popularity of this hot pot restaurant is relatively high, and the price is not expensive. One hundred yuan per person, the two found a booth by the window.

The bottom of the mandarin duck pot was brought up by the waiter. Yang Ping and Xiao Su picked a lot of ingredients, and they were hungry, so they were ready to eat happily.

"You learn things so fast, you have become so proficient in one afternoon." Xiao Su put ingredients into the hot pot.

Yang Ping felt embarrassed: "I originally went shopping with you, but I became a practice car with me."

Xiao Su said with satisfaction: "I've been shopping for a few hours, enough, you see, I bought it, I bought it, I ate it, I'm really happy today!"

When Xiao Su filled up the ingredients, Yang Ping covered the pot, and the two waited for the hot pot soup to boil.

Xiao Su said thoughtfully and thoughtfully: "You go to the consultation on Tuesday, drive my car, and when you return to the hospital next time, I will fully charge the battery. There is an area in the underground parking lot of our hospital, which is full of charging piles. Then you will go to the attached hospital. One, there are charging piles in the third floor of the underground parking lot in the E area."

"Are you familiar with Fuyi?" Yang Ping heard her say that, and even knew where there were charging piles.

Xiao Su nodded: "If you drive an electric car, you know where there are charging piles in the entire G city. After all, charging piles are not as common as gas stations, so mileage anxiety is inevitable."

"This pure electric car feels like a mobile phone. It is very interesting. When I go home, it is not to refuel, but to charge. I will buy a pure electric car in the future. It is environmentally friendly and healthy. It is quiet." Yang Ping is interested in this electric car. .

"You also buy this one. This one comes in black and several colors." Xiao Su recommended.

Yang Ping shook his head like a rattle: "No, no, this is too expensive, I'll buy a BYD one, a domestic one."

"It seems that BYD's battery is safer and can pass the acupuncture test." Xiao Su was able to keep up with the topic.

The two chatted while eating, from daily life to surgical operation, Xiao Su asked for some professional knowledge that she did not understand, such as the use of a certain instrument, why a certain step was done, Yang Ping answered patiently, and felt that she It is really easy to learn, and I am really thinking about the steps of surgery to better cooperate with the main surgeon.

The ingredients were on the disc, Yang Ping asked Xiao Su what else he wanted, and was about to get up to pick the ingredients.

Suddenly, there was a bit of noise in the store, Yang Ping turned his head to look, and following Yang Ping's gaze, Xiao Su also looked.

Someone had an accident, and in the hall, a girl in her 20s fell to the ground.

Yang Ping and Xiao Su rushed over immediately to see what was going on.

"It was fine just now, but suddenly his face became ugly and he fell down."

The girl's boyfriend had no idea at all. He panicked and asked everyone for help. He picked up the phone and dialed 120, stuttering.

"I'm sorry, let me go, I'm a doctor." A middle-aged man separated the crowd and hurriedly squeezed in.

He made a simple judgment on the condition, touched the underside of the xiphoid process, and began to perform cardiac compressions on the lower part of the sternum. He was extremely skilled. This kind of proficiency was not only through simple training, but should be acquired through years of long-term training.

The procedure of bare-handed cardiopulmonary resuscitation completely follows the procedure of the latest guidelines. As soon as you go up, you can judge consciousness, breathing, and carotid artery pulse for a few seconds, and then start pressing, and then open the airway.

Press the forehead and lift the jaw, open the airway, check if there is anything in the mouth that needs to be cleaned, and then perform two mouth-to-mouth artificial breaths, and then press the heart again. The ratio of compression and artificial respiration is 30:2.

This person should be a doctor, and should be an emergency doctor or an ICU doctor. The rescue is decisive and smooth, and it is entirely out of excellent professional quality.

Yang Ping also squeezed in, knelt on one knee on the ground, touched the carotid artery and nostrils, checked the skin of his neck and limbs, the carotid artery had a weak pulsation, and his heartbeat had not stopped.In this case, there is no problem with pressing. Pressing can help the weak heart pump blood. It does not necessarily mean that the heart stops beating completely before pressing.

Had some hives on the skin, allergic reaction! It was an allergic reaction! Not sudden cardiac death.Acute laryngeal edema from an allergic reaction, leading to suffocation.

When Yang Ping first obtained the system, he underwent first aid training, and later received physical examination training under the system's super training program, so he was very confident in his judgment.

"Allergic reaction! Acute laryngeal edema! Open the airway urgently!" Yang Ping calmly reminded the middle-aged doctor.

"I'm open." The middle-aged doctor is confident.

"Need to perform cricothyroidotomy or tracheotomy immediately!" Yang Ping looked at him.

The middle-aged doctor didn't stop the pressing hand, and his eyes could tell he was hesitant.

In such an emergency, whether it is cricothyroid membrane puncture or tube incision, it is invasive. Once the judgment is wrong, it will bring adverse consequences, or the patient may not be rescued, and may face trouble.

Although the law stipulates that this kind of first aid will be exempted, but - many things are not as simple as imagined, as a doctor for so many years, I have seen many things.

The doctor and Yang Ping exchanged glances, wanting to make room for Yang Ping, Yang Ping immediately stopped: "You keep pressing, I'll do the cricothyroid membrane puncture!"

Pressing can help the heart pump blood, input the residual oxygen in the blood into important organs, and maintain the perfusion of important organs, especially the brain tissue, which can only tolerate hypoxia for 4 minutes. If the breathing cycle is not restored within ten minutes, the brain will be damaged. Irreversible damage will occur.

"Quick, a small knife and a clean straw! A sharp knife or small scissors will do; a straw, a normal size will do." Yang Ping shouted to the crowd.

Originally, I wanted alcohol or high-concentration alcohol to sterilize the knife with flame method and sterilize the throat, but it takes time to find these things. This acute laryngeal edema causes complete blockage of the airway and death within a few minutes. Save time and eliminate the need for disinfection.

Knives and straws are easy to find, and there is one in the crowd. He carries a Swiss Army knife with him, pulls out the sharp knife, and hands it over immediately. There is a straw at the service desk in the store, and the waiter brings one over. The size is different.

Xiao Su took the knife, picked out the straw, and crouched beside Yang Ping, serving as an assistant at any time.

Scissors, someone handed a small pair of scissors to Xiao Su.

The manager of the hot pot restaurant was sweating profusely. If something went wrong, it would be troublesome.

Yang Ping's brain quickly constructed a topographical image of the larynx.

With a slight finger touch, the position was confirmed, between the thyroid cartilage and the epiglottis cartilage, the soft part, the position of the cricothyroid membrane.

Xiao Su handed over the knife, Yang Ping accurately stabbed the tip of the knife, and a sense of disappointment appeared. The tip of the knife entered the trachea and immediately stopped and pulled it out, and gently inserted the straw into the trachea.

The straw has been trimmed by Xiao Su, the tip is removed, one end is reserved for a suitable length, and the straw is folded into a certain angle in the bending area.

In this way, it is very convenient for Yang Ping to insert the straw, and he can put it in along the trachea without causing damage to the inner wall of the trachea.

Laryngeal edema blocked the airway, and now puncture below the blockage to re-establish an artificial passage for the air to avoid the blockage.

Successful ventilation! The sound of the air flowing in and out was neighing softly like a whistle. Yang Ping touched the carotid artery, and then looked at the patient's face and lips. The paleness slowly turned red.

Seeing this situation, the middle-aged doctor also stopped cardiac compression.

"Acute laryngeal edema caused by allergies, let her lie down, don't move her, and wait for the ambulance to arrive." Yang Ping did all this, waiting by the side.

The carotid pulse can now be palpated, and the blood pressure can at least be measured, indicating that the symptoms of acute laryngeal edema are severe, and the symptoms of shock are not severe.

"What else do I need to do?" the middle-aged doctor said, admiring the performance of his colleagues.

Yang Ping said, "Okay, wait for the ambulance."

"I've hit 120!" the girl's boyfriend said while crying, also a young man who had not experienced anything, crying like a child.

The middle-aged doctor's face was a little hot. This young doctor is very courageous. Just now, he made an accurate judgment and acted decisively. He did a cricothyroid membrane puncture without blinking his eyes.All the years have worn away the passion, and the courage has been frightened.

Seeing that Yang Ping was very calm throughout the whole process, without a trace of panic, and rescued the patient, the professional sanctity and honor of the doctor could not help but flood into my heart.

This kind of professional sense of sanctity and honor, the middle-aged doctor has been missing for a long time, and now he is finding it again.

A long time ago, this sense of mission was only available when I first entered the school and took the oath of medicine.

"Thank you, I am familiar with cricothyroid membrane puncture, but my judgment is not accurate; even if the judgment is correct, I would not dare to use it; even if it is used, I will not be as experienced as you, it is done with a knife and a straw, I must be full of brains Look for needles, at least ballpoint pens or pens or something," said the doctor guiltily.

"You are right, this kind of invasive rescue method sometimes makes it difficult to make a decision." Yang Ping understands him, not everyone has their own confidence.

"This doctor is amazing!"

"What I admire most is the doctor."

"If it wasn't for the doctor eating just now, this girl would be in trouble. Good luck."

"Yeah, why did this happen all of a sudden."

"Man, I don't know what's going to happen."

The crowd discussed in a low voice, one sentence from the east, one sentence from the west, and everyone began to return to the table to continue eating.

Yang Ping checked the patient again and found that there were indeed a lot of urticaria on the skin, how could it be allergic?
There are also reports of people allergic to penicillin who accidentally eat foods such as chicken and fish with penicillin residues, but this is rare.

As for what caused the allergy, it is still left to the doctor of the follow-up treatment hospital to judge. After all, this will affect the reputation of other people's stores, so we cannot jump to conclusions.

Yang Ping just analyzed it in his heart and didn't say it.

The doctor of 120 finally came. The doctors, nurses, and first responders, carrying a stretcher, came to the place of the accident under the guidance of the clerk.

"What's the situation?" the visiting doctor immediately asked.

"Acute laryngeal edema, you see, there is urticaria all over the body, and it may have been exposed to some allergen, which caused type 1 allergy. I just had a cricothyroid membrane puncture, a straw was inserted, and the airway was opened. There was no disinfection during the operation.”

Yang Ping briefly introduced the situation, and the visiting doctor checked the patient and said, "Okay, leave it to us! It should be an allergic reaction! Adrenaline—"

The visiting doctor immediately ordered the nurse to take medicine. The nurse had just established an intravenous channel and hung up a bottle of physiological saline.

After the injection of epinephrine, the patient was transferred to a stretcher. The first responder carried the stretcher. The visiting doctor said to Yang Ping and the middle-aged doctor, "Thank you for your hard work!"

The person was picked up by an ambulance, and it was unknown who called 110. The police also came. The manager of the hot pot restaurant, several witnesses, as well as Yang Pinghe and the middle-aged doctor were all questioned by the police.He also left a phone number to cooperate with the investigation at any time.

The police sealed up the hot pot that the patient had eaten just now and took it back for testing to rule out food poisoning.

When everyone saw this, most of them didn't dare to eat it. At first, they didn't think it was a sudden illness.

Now the police have taken away all the leftover food from the hot pot of the patients, how dare they eat it, some even feel a little dizzy, and others feel the need to go to the hospital.

Everyone dispersed, Yang Ping and Xiao Su should also go back, Yang Ping drove, Xiao Su was in the passenger seat and went back to the hospital.

Back at the hospital, they came out of the underground parking lot. When the two parted, Xiao Su gave Yang Ping a bag, which was the clothes Xiao Su said he bought for his family.

"It's hard work today, I'll give it to you as a reward. Wear it for the consultation on Tuesday." Xiao Su blushed, full of shyness.

Yang Ping took the bag, a little surprised, didn't it buy it for her family?
"How do you know my size?" Yang Ping asked stupidly.

"Learn from you!" Xiao Su turned around.

He turned back and waved to Yang Ping: "Rest early!"

(End of this chapter)