godfather of surgery

Chapter 73 Lightning Action
On-the-spot experience and the usual accumulation of knowledge are particularly important at this time.

"Transfusion Anaphylactic Shock!"

After a series of possible judgments were screened in his mind, Director Tian made a keen judgment.

But before he could say anything, Yang Ping whispered, "Transfusion anaphylactic shock."

Director Tian glanced at Yang Ping and immediately ordered the anesthesiologist: "Look at the complexion!"

The anesthesiologist immediately observed and replied: "The complexion is red and the edema around the eyes!"

"Blood transfusion anaphylactic shock! Stop the blood transfusion, quickly replenish the fluid, and even remove the blood transfusion tube!"

Director Tian's voice was loud and clear, but he didn't panic and was calm.He glanced at the monitoring screen and the anesthesia machine. The ECG waves were still there, and the patient's heartbeat did not stop, so CPR was not needed. In terms of breathing, the patient used an anesthesia ventilator, which is now a ventilator to assist breathing, and there would be no problem with breathing.

The anesthesiologist is still good, and the itinerant nurse is a bit stage fright. One side is in anaphylactic shock, and the other side is bleeding. Either one is fatal, and now both appear at the same time.

The doctor who was watching was even more heart-pounding.

"0.1% epinephrine, 0.5ml, intramuscularly!" Director Tian said in a tough tone.

Usually subcutaneous injection, now intramuscular injection? The traveling nurse questioned with a slightly hesitant look.

"Intramuscular injection!" Director Tian repeated sternly.

Under the authority of the professor, the anesthesiologist and nurse no longer doubted how he judged the anaphylactic shock of blood transfusion and how to inject epinephrine intramuscularly. Time is life, only quick execution.

Bleeding and epinephrine are a pair of contradictions, epinephrine will aggravate hemorrhagic shock, and bleeding will aggravate anaphylactic shock. The two are a pair of entangled contradictions.

While instructing the rescue, Director Tian's hands did not stop. The rescue was a lightning action. Anaphylactic shock was extremely dangerous, and it only took a few minutes to tell the difference between life and death.

"Knife, open the abdomen, prepare a rubber strip, and temporarily block the abdominal aorta!"

Temporarily blocking the abdominal aorta, this is a large-scale operation, and most people dare not do it. Director Miao has no clue now and can't help, so he can only do it in a hurry.

"Prepare rubber strips!" The roving nurse followed Director Tian's movements.

After getting the gloves, he started to cut the rubber strip, and Director Miao helped to cut it together.

The knife extends along the original incision, Yang Ping's hook has reached, helping to pull and reveal, incising the deep subcutaneous fascia of the skin, and then incising the three layers of abdominal muscle, entering the abdominal cavity, and successfully finding the abdominal aorta.

The thick abdominal aorta pulsates in the abdominal cavity. Because of shock, although the pulsation is not as strong as normal, it still gives people a strong visual impact. This is the main artery of the entire lower body of the human body.

The vascular forceps were bypassed from the back of the abdominal aorta, and Yang Ping's rubber strip was fed accurately.

As soon as the rubber strip was pulled, Director Tian pulled it tight. Yang Ping's vascular forceps had clamped the rubber strip, forming an elastic tie, which bound the abdominal aorta. Without any words, Yang Ping could predict Director Tian's actions in advance every time. Action, never mistakes, never late.

The main gate was successfully closed and the bleeding stopped.

Temporary blocking of the abdominal aorta should not take too long, but it can last for 45 minutes, which is enough for Director Tian to find the broken blood vessel.

"Continue the operation!" Director Tian said.

Stopping the operation at this point is more risky, like the ship entering the vortex and either being engulfed or out of the vortex.

The suction device is gently inserted through the fracture gap to remove the accumulated blood and try to find the bleeding dead artery, which is a challenging task.

"Is there an intervention section?" Song Zimo asked. He was in the audience, and the onlookers were clear, and he had to make suggestions.

Director Tian said decisively, "No need."

Looking for the interventional department, before and after, it is not enough for half an hour. For those messy bleeding spots on CT angiography, the interventional department cannot accurately embolize them at all, and can only risk embolization of the main trunk, which will bring serious consequences of necrosis, unless there is no accurate embolization. other way.

The bone block was carefully opened, the assistant's hemostatic forceps had clamped a blood vessel, and it was gently pulled out. Director Tian raised his head and met Yang Ping's confident and calm eyes.

"No. [-] silk thread!"

The vascular forceps were handed over with silk threads, and Director Tian went around them and tied a beautiful surgical knot.

"Sewing!"

He sewed another stitch, another stitched, and another ligated, two stitches should be safer.

Director Tian loosened the rubber strip of the abdominal aorta, and the blood in the operation area came out again. He quickly tied the abdominal aorta again, and Yang Ping's vascular clamp went up again and clamped the rubber strip.

Wasn't this one the artery of death?Or have two dead arteries?

His eyes looked at Yang Ping, Yang Ping seemed to guess what he was thinking, and nodded: "There should be two dead arteries, and the proximal and distal ends should be ligated, which is equivalent to finding four blood vessels to be ligated, and they form It is useless to ligate only one end of the circuit."

He was right, he was better than himself, and he was faster than himself in finding the first artery of death just now.

"Give me the attractor! Come on!" Director Tian took the attractor in Yang Ping's hand and began to suck blood.

Although he is confident, he needs to be quick at this time!The sooner the better, he will not put the patient at risk for the so-called face, now 1 minute faster, there is more chance of winning.

The second blood vessel was found.

Tie, sew!Two more.

The third, the fourth!
Two blood vessels, all four broken ends were found, and all were sutured and ligated.

The rubber strip of the abdominal aorta was released again, and there was no more blood in the operation area.

Director Tian thought that Yang Ping's judgment was faster than his own, and his actions were faster than his own. No wonder Director Han asked himself to take him with him.Involuntarily, he turned his appreciative gaze to Yang Ping, who took the straw from his hand again.

These small movements on the stage could not be seen by the people under the stage. Director Miao was already paying attention to the patient's vital signs at this time, and had no intention to watch the operation.

Director Tian hesitated, should he continue to finish the operation?

But Yang Ping was already focusing on the work of a helper at this time, and the suction device in his hand sucked up the remaining blood in the surgery field, preparing for Director Tian's next operation.

Director Tian smiled and continued. He crossed the danger of death artery and can rest for a while. The rhythm of the operation must be mastered. Just now, he took the risk to continue the operation in order to resolve the contradiction between adrenaline and bleeding. Now he can breathe a sigh of relief.

Anaphylactic shock, which came fiercely and went quickly, the patient's vital signs had stabilized, and his blood pressure had risen.

In fact, in anaphylactic shock, in just a few minutes of prime time, if you are rescued, you will be alive, and if you have not been rescued, you will never wake up.

The blood bag and blood transfusion tube just now were sealed up for the purpose of finding out the cause.

Although he encountered such a dangerous accident, Director Tian did not panic in the whole process. He reconfirmed that his vital signs were stable, which further verified his judgment.

"continue!"

The doctors in the audience have experienced the rescue roller coaster of life and death just now, and their mood has not yet calmed down. Now the operation is still going on. The professor is indeed a professor, with a general demeanor.

The front wall of the anterior column of the acetabulum is reduced and fixed, followed by the iliac wing, then the sacrum fracture, and finally the separation of the sacroiliac joint.

Any single fracture here is a difficult operation, let alone several mixed at the same time.

The iliac wing fracture is reduced and fixed, the sacral fracture is reduced and fixed, and finally the sacroiliac joint is reduced and fixed!
The rest was easy in Director Tian's hands. Even in the face of the complicated venous plexus near the sacrum, with the cooperation of the two, only a small amount of blood was shed.

Perspective, repositioned and fixed perfectly.

Rinse and place drainage tube.

Director Tian started to sew and Yang Ping cut the thread.

"Anaphylactic shock, it was so dangerous just now! Director Han and I have encountered it during surgery before." Director Tian had completely forgotten the existence of Director Miao just now, and then he remembered to explain.

Director Miao had lingering fears, like waking up from a dream. Fortunately, Director Tian was doing it.Think about it, if you are doing anaphylactic shock, death arterial hemorrhage, one of them, let yourself drink a few pots, let alone the two at the same time, you can handle it.

Fortunately, the professor invited to do it, I am afraid!The surgical gown on the back was wet.

"Sent to the ICU for at least 24 hours of monitoring after the operation. There was not much bleeding from the fracture, and it was mainly for the follow-up monitoring and treatment of anaphylactic shock." Director Tian ordered.

The doctors who observed were all grateful for the rescue they had just experienced, the calmness of the professor on the stage, the accurate judgment of the condition, the decisive rescue, the risky continued operation, and the danger was finally saved.

Enough to remember for a lifetime.

If only you were so powerful.

(End of this chapter)