It's not that hard to open a hospital in another world, right?

Chapter 446 A person with general anesthesia, how do I know he is going to faint?

Gretel's hand was steady.

His heart is also very quiet.

A 20ml syringe was filled with normal saline and inserted firmly into the lumen of the severed brachial artery.Hold the syringe with the index finger and middle finger of the right hand, press the piston head with the thumb, and push forward slowly.

In the previous life, the injection needles used for blood vessel flushing should be flat, so as not to damage the intima of the blood vessels.However, when Gretel was making needles before, he didn't expect this one.

All needles are beveled!Let the gold coins be made and sterilized now, and it's too late!Transplanting a severed limb requires a race against time to minimize the damage...

He can only use his own stable operation to make the needle always parallel to the longitudinal axis of the blood vessel, so as to avoid the sharp needle from being inserted into the inner wall of the blood vessel.Then, inject the liquid slowly and steadily, let the saline enter the artery along the lumen of the blood vessel, and gurgle forward along the passage of the blood vessel.

Can't be fast, can't be slow.If it is too fast, the water column will hit the intima of the blood vessel cavity, which will damage the extremely delicate intima; if it is too slow, the saline will not reach the extremities, and then flow back along the vein.

The limbs have been severed, there is no heartbeat, no arterial constriction, and only the pressure from the syringe injection can push the normal saline forward in the blood vessel.It must reach the end in order to flush out the accumulated metabolites and blood clots in the tissue, and dilate the spasmodic, closed small blood vessels and capillary network.

In his previous life, he had never done replantation of severed limbs, nor had he done organ transplantation.What is the proper injection speed? He can only try it out bit by bit according to his own estimation.Well, first of all, there is no pressure when injecting, which means that there is no blood clot nearby, which is fine...

Inject a tube of normal saline, then suck another tube, and continue to inject.Gretel muttered while washing:

"Oh, it would be great if there was a pump...Using a syringe to flush, can't always guarantee a uniform and stable pressure...Heparin saline should be used here..."

"Heparin?" The silver dragon girl interrupted suddenly.She was exactly the same as Gretel. She pulled a floating plate as a stool and leaned over to watch.Hearing Gretel mutter, he immediately asked:

"What is heparin? Is it extracted from the liver?"

"You heard it!" A few steps behind the operating table, Elder Brock's voice was loud, his feather crown vibrating:

"Master Healer needs a liver! Someone get a piece of liver! Fresh ones!"

Under his heavy gaze, someone immediately turned around on the spot and rushed out.Great Khan:

"do not!"

Although heparin is, um, discovered from the liver, it doesn't mean that you can extract heparin by squeezing a piece of liver!
Whether it is unfractionated heparin or low molecular weight heparin, the production process is quite complicated and precise!If you give me a piece of liver, I won't use it!
Besides, the current heparin is mainly extracted from the mucous membrane of bovine lung or small intestine of pigs, so there is no such thing as liver...

The elder who ran out slammed on the brakes.Serila sat at the far end of the operating table, staring at the wound of the severed limb through the secret method, and asked in a low voice:

"What should I do?"

"No matter what to do, if you don't have it, you don't have it..."

Gretel answered dully through the mask.In the final analysis, flushing with normal saline is to physically remove the thrombus; and the application of heparin is to prevent the blood from coagulating again.

Well, as long as he connects the blood vessels fast enough and throws enough healing techniques, he won't be afraid of blood clots!
"Grete, what are these red, blue, and yellow things?"

"Ah, it's the blood vessels and nerves I marked...the red ones are arteries, the blue ones are veins, and the yellow ones are nerves..."

"So later on, it will be red to red, blue to blue, yellow to yellow, right?"

"That's right. That's about it..."

Gretel stared at the wound of the severed limb and explained to her in a low voice.The sorcerer's trick is really convenient. If it was in the previous life, you would use silk thread to mark it when cleaning the wound.Not to mention the difficulty of the operation, how fragile the blood vessels and nerves are, there must be physical damage if you pierce them!

Behind the refuge hut, the elders gathered to listen to the class let out a sigh of relief, and were so grateful that they were about to kneel down to worship.

Miss Elf, you are so understanding!Your question, the healer answered casually, saving us a lot of research work!Well, after picking up the broken arm later, I must give her a gift!Give lots of gifts!

Gretel replied in a low voice, operating carefully, trying to maintain the stability of the movement.He was slightly relieved when he saw the flushing fluid stained red flowing out:
Well, the bone marrow cavity is starting to flow out of the flushing fluid, which is good;

The cephalic vein, basilic vein, and brachial vein all have flushing fluid flowing out, indicating that the normal saline has reached the extremity and returns along the capillary network;

These three small spots were marked before, and they should be the radial accessory artery, the middle accessory artery, and the ulnar superior accessory artery, all of which also had flushing fluid flowing out, great!
Of course, there are indeed bruises and swelling in some places, after all, it has been held in the mouth of a leopard once.Gretel will clean up what he can, and if he can't, he can only let him go temporarily.

After the blood vessels were flushed, he assessed the situation and turned to Sai Wei, who had been watching tremblingly with a broken arm:
"Lie down, I'm going to start picking up!"

Sai Wei's face turned pale.Although I had prepared myself mentally, it was still quite scary to lie down and be stabbed by someone.In particular, what he lay on was not a table, but three connected discs, which were slippery, translucent, and could move when pressed...

Circumstances are stronger than people.The elders of his own tribe even winked, and a group of spellcasters stared at him, but he could only obediently climb up and lie down.When a confinement technique fell, he couldn't speak, couldn't move, and froze there stiffly.

"Uh, there's no need to..."

Gretel wanted to say this very much, but when the words came to his mouth, he swallowed them back:
Replantation of severed limbs in the arm, in theory, only needs to anesthetize the brachial plexus.However, considering the patient's acceptance of the operation, in order to avoid half of the operation, the patient jumped off the operating table and ran away. Let's go to general anesthesia!
Peace of mind!

Anyway, magical anesthesia is not drug anesthesia, there are no problems such as anesthesia metabolism, liver and kidney burden, so it's just numb...

He threw out the silver skull and manipulated the skull to cut Saiwei's skin, pull the muscles, and clamp the proximal blood vessels.Then, he raised the broken arm, and compared the trimmed stubble of the broken bone forward.

Hey, it was broken on the upper arm, which is relatively easy to pick up. There is only one humerus.If the forearm is broken, it is the two bones of radius and ulna.A colleague who worked in the orthopedics department cried and complained that the two bones were reset together, the radius was healed, the ulna was crooked, the ulna was healed, and the radius was misaligned again...

How can anyone who hears it cry, but whoever sees it is sad.

Gretel had one hand, the Silver Skull had two hands, and five or six mage hands, flying up and down, busy.Clamping blood vessels, trimming the shape of broken bones, holding a rongeur, clicking, clicking, clicking...

During the debridement before, Gretel had already repaired the broken bone.But now, after cutting the proximal skin and seeing the broken bones with his own eyes, he trimmed them with extra care, smoothing them as much as possible so that they could fit together.

"Is it okay? Can I throw the healing spell?"

Cerilla probed her head, eager to try.Between the fingers, a ball of white light has condensed, ready to press it anytime, anywhere.Well, Gretel is just a fifth-level priest, and his spiritual power is only so~~~ so little. His spiritual power should be saved for more important things!

Treatment or something, I'll come!
"Shh!"

Gretel whispered to her to be quiet.Ah, I don’t want to make the cross-section into a trapezoidal shape, occlude each other, and fix it without Kirschner wires or screws. I don’t feel so used to it...

But if it is made into a trapezoid, the bones, as well as the entire arm, will be significantly shortened.Here, the healing of the bones does not take too long, and there is no need to use trapezoidal occlusion, internal and external fixation to increase strength...

He calculated and operated.The heavy rongeur was as light as nothing in the silver skull's hands.Click, click, click, compare them for a perfect fit, and then cover the bone stubble with the periosteum that was peeled off before.

be careful!
Be more careful!
It is best not to hurt the soft and delicate periosteum!Only when the periosteum is covered, the broken bone can grow back easily.Although the healing technique is powerful, if you can save a little, just save a little...

"Okay! Cerilla!"

"coming!"

A mass of condensed white light descended.Gretel stared closely at the section of the humerus, watching the periosteum tightly wrapping the broken bone, and watching the gaps in the bones gradually grow together.

Lie down a little more, took a photo with Celera's headgear, and looked at the bone seam bitten by the black clouded leopard at the far end, and it was filled with the healing technique, without any cracks...

Great!

Healing skills are high!
Miss Yinlong Saigao!

The strength of this healing technique has surpassed that of treating slanderous injuries, so it is enough to treat serious injuries!It completely landed on a single bone, no wonder the bone was completely stitched together immediately, exactly the same as before it was injured!
Gretel was overjoyed, gave Cerilla a thumbs up, and continued to work.Well, the bones are fixed, and the next thing is the blood vessels.If the blood vessels can be successfully anastomosed, the arm will be alive, and the only question left is how much function will be restored.

Gretel put away the silver skull, closed his eyes, and concentrated his mind.Then, the thumb and index finger of the right hand made a circle, and gestured to Miss Yinlong:
Magic magnifying glass, come~~~
"Too close! Move farther away! Farther away!"

"Magnify the magnification! No, I'm not asking you to make the magnifying glass bigger, but to make the magnification bigger!"

"It's crooked! It's crooked! Raise the left side a little bit higher!"

"Raise a little higher, your hand will touch it! It will pollute the lens!"

Facts have proved that the tacit understanding between Gretel and Miss Yinlong still needs to be cultivated...

Up and down, stumbling.The magnifying glass was finally adjusted to a comfortable position for Grete, and Grete concentrated on the anastomosis of blood vessels.Brachial artery, cephalic vein, basilic vein.One movement and two stills, the anastomosis of the three blood vessels is completed, and the blood vessel clamp is ready to be opened——

"Cerilla, prepare for healing! If he is dizzy, palpitated, and his eyes are black, cast the spell immediately!"

The blood volume has not been replenished, and the blood pressure has not risen back. Once the artery is opened after the amputated limb is connected, the patient's blood pressure will easily drop!

At this time, we can only rely on healing techniques to support the scene!
"...But he is imprisoned there, how do I know that he is dizzy and palpitating?"

"..."

"..."

This is a good question... A person with general anesthesia, you don't even know he's fainted!
You should get the sphygmomanometer out as soon as possible!
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(End of this chapter)