godfather of surgery

Chapter 35 Race against time
Even if his limbs were amputated on the spot, Yang Ping didn't want to do anything hastily.

Clear the clutter next to it, and a waterproof sheet pads under the thighs.

Xiao Wu's steps are clear and his hands are fast. As Yang Ping's assistant, he wants to be qualified.

The sterile pack is opened, sterilized, and then covered with a sterile bottom sheet and perforated towel.

"Syringe, 10% lidocaine, normal saline, diluted one to one!" Xiao Wu has already handed it over.

There is no anesthesiologist, only local anesthesia.

Local anesthesia for amputation, what kind of superb local anesthesia technique is required? Dr. Lu from the emergency department pinched a sweat.

Local anesthesia is generally used for minor operations, such as small debridement and suture, and small tumor removal.If the dosage is too small, it cannot achieve the purpose; if it is too large, it is easy to be poisoned by anesthetics.There used to be a hospital where a ganglion cyst on the back of the hand was cut, the local anesthetic was overdose, and the patient was poisoned by the anesthetic on the spot and died in the outpatient operating room.

Therefore, a slightly larger operation, even a larger debridement and suture, will not use local anesthesia, the risk is high, and the effect is not good.

Now Yang Ping is going to use local anesthesia for amputation?Everyone was surprised.

Local anesthesia is not simple, it is also a technical activity.Ordinarily, injecting a few needles around the surgical area is also local anesthesia; precise, selecting the innervating nerve of the surgical area to block is also a kind of local anesthesia.

The latter is called a nerve block, which is actually a more advanced form of local anesthesia.If the former analogy is to randomly hit the enemy's position with a cannon, then the latter is to use precision-guided missiles to clear the enemy's stronghold at a fixed point.

To master nerve block anesthesia, you must be very familiar with anatomy, the innervation of each area, and the course of nerves.

Yang Ping is now about to block the right femoral nerve and sciatic nerve.

Anesthesiologists often use color Doppler ultrasound to locate this block, but Yang Ping is now doing it with his bare hands.

Dr. Lu waited and watched, and also opened his eyes - amputation under local anesthesia.

According to the course of the femoral nerve and the sciatic nerve, Yang Ping first blocked the femoral nerve - in the upper part of the thigh, starting from the skin, anesthetizing it layer by layer, carefully piercing it, and when it reached the nerve sheath, the electric shock immediately spread.

"Did you feel an electric shock?"

"Yes!" said the patient through gritted teeth.

The drug is then injected into the nerve's sheath.

In the same way, the sciatic nerve is blocked, and the skin sensation of the entire lower extremity mainly comes from the branches of these two nerves.

Just as the transmission of electricity by a wire is cut off, the impulse to the nerve is successfully cut off by the anaesthetic.
The effect was very good. After a while, the patient's right lower extremity no longer felt, and Yang Ping began to operate the knife.

The knife draws a beautiful tongue-shaped flap, the skin, subcutaneous, deep fascia, muscle, blood vessels are ligated, the nerve is cut at a high position, and the femur is exposed. The broken ends are smoothed.

A tongue-shaped flap is then cut out of the contralateral muscle, deep fascia, subcutaneous, and skin.

The bleeding points were ligated one by one, and the surgical area was clean.

The amputation was done in less than 5 minutes, maybe less.Wrap the stump with a sterile drape, and the rest will continue to be processed in the car.

Several first aiders started, and the patient was immediately carried into the ambulance on a stretcher, oxygen inhaled through a nasal cannula, and continuous ECG monitoring. The nurse quickly connected various pipes and wires, and then sorted them out.

The stretcher was placed in the middle, Yang Ping Xiaowu was sitting on one side, and Dr. Lu and the nurse were sitting on the other side.

The car started and rushed towards Sanbo Hospital.In order to save time, the driver chose the fastest and smoothest road in the navigation.

Local anesthesia with lidocaine, which can last from one to three hours.The anesthesia is still working, and the patient feels no pain.Dr. Lu thought that if he mastered Yang Ping's superb nerve block technique, he would not need any morphine for the pain caused by trauma in the first aid process in the future. The highly selective nerve block would make the patient painless. to the hospital.

In the car, in a limited space.Yang Ping and Xiao Wu carefully washed the amputated end.The drape was sterilized again, and the muscle, fascia, and skin were sutured.Amputation is the end.It's also a matter of minutes.

"Doctor, can I survive?" The patient's voice was already very weak, his face was pale, his eyes were closed, and he was struggling to open them a little bit.

The liquid has been opened to the fastest speed, and the three channels are infused at the same time, colloid liquid and crystalloid, into the body.

Yang Ping held his hand tightly, it was cold.

"Yes! It must be possible!"

The patient was panting and tried to speak, but was unable to speak a few times.

"Don't talk anymore, it must be alright, hold on!" Yang Ping held his hand and added a little force to show encouragement.

The patient still squeezed out a few words: "Save—I—, the child—reads—junior high school—poor—”

A few words on and off, no more words can be squeezed out.

This kind of ambulance is already very advanced, but it is only an ambulance after all, and it can only provide the most basic life support such as rehydration.

Fluids can maintain volume for a short period of time, but ultimately rely on blood transfusions to replenish red blood cells and maintain oxygen transport.Blood transfusions can only be done at the hospital.

The heart rate has risen to 120 beats per minute, the blood pressure has dropped to 80/40mmHg, and the blood oxygen is barely maintained at 90% by oxygen inhalation.

I don't know if the constantly expanding spleen capsule is broken, if it is broken, it will definitely die.It can only depend on luck, and sometimes, it has to be admitted that there is such a thing as luck.

Dr. Lu can no longer take color Doppler ultrasounds, and there is also a risk of squeezing the ultrasound probe.Even if you see a rupture, you can't do anything for the time being.

"hurry up!"

Yang Ping told the driver in front that he held the patient's hand, his fingers were clasped at the radial artery, his pulse was weak, and he felt that it would dissipate at any time.

"It's the fastest!" the driver shouted, but the accelerator underfoot was still deeper.

The nurse changed another bag of fluids. Dr. Lu was anxious and sweaty.

The ambulance whistle sounded rapidly, and the driver shuttled in the traffic. Some cars in front took the initiative to avoid giving way, but more cars ignored it.The driver is a retired auto soldier with good skills. He steadfastly turned the steering wheel and kept overtaking.

The biggest uncertainty in urban traffic is traffic jams.

We pray in our hearts, don't get stuck in traffic, don't, don't!
The patient was already delirious, shouting loudly, but only moved his eyelids.

The ambulance got on the viaduct, and suddenly, the car in front braked, slowed down, and came to a slow stop.

The ambulance followed the car in front and slowed to a stop. Because the distance between the cars was kept better, the ambulance stopped smoothly, and no patient caused too much bumps.

"What's going on?" Xiao Wu asked.

The driver shook his head: "I'll go down and have a look."

A long dragon formed immediately behind, and looking forward, it was also a long dragon.

The driver pulled the handbrake, opened the door, got off the car and looked around, and then walked a dozen meters forward to inquire about the situation.

He came back and said, "I heard that a truck in front of you broke down and was stuck in traffic!"

I rely on!Everyone cursed.

At this time, there is no way to do the traffic jam. There are cars all over the front, back, left and right, and there are cars that are stuck in the convoy at an angle.

Yang Ping's heart is ashes, and there is only a faint breath left in the pulse in his hand, like a candle in the wind, which will go out at any time.

The fire of life, sometimes tenacious, sometimes extremely fragile, will be extinguished by any disturbance.

Dr. Lu opened the back door of the ambulance, put up a pergola in his hand, and looked forward, but there was no end to the long dragon. Looking back, it was still a long winding dragon.

He was walking back and forth in the back of the car, his right fist slammed into his left palm, anxious.

Time passed minute by minute.

The patient's consciousness was completely blurred, and he stopped moving his eyelids.

The heart rate is getting faster and faster, and the pulse is like a hairspring, fleeting.

After looking at it a few times, the traffic flow didn't move at all. Dr. Lu raised his head and shouted piercingly: "Help, the people in the car are waiting for help!"

Helicopter, even if it is too late to call a helicopter, not everyone has the opportunity to use a helicopter.There are two helicopters in the hospital, one is under maintenance, and the other has been hired by a high-end insurance company to pick up patients.

The screeching whistles and flashing lights of the ambulance, as well as the screaming of the doctor, alerted the nearby car owners who got out of the car to breathe.A big brother wearing sunglasses moved over in the narrow gap between cars and asked, "What's the situation?"

"The people in the car are waiting for help, they are dying!" Dr. Lu was helpless, wiping the sweat with his sleeves.

Yang Ping and Xiao Wu were in the car, Xiao Wu stared at the ECG monitor, and Yang Ping kept holding the patient's hand.

The elder brother touched his head, took off his sunglasses, glanced inside, and then looked at the car dragon.

Open the throat of the northeast accent:

"Quick, quick! Come and help, help, [-] urgent!"

(End of this chapter)