Reasoning diagnosis: Big brother, your wife has been prescribed medicine!

Chapter 200 The heartbeat suddenly stopped!
Although the patient's femoral artery bleeding has temporarily stopped.

But his severely damaged left thigh must be operated on as soon as possible.

Lin Yi briefly bandaged the open wound with sterile gauze, then pushed him into the ward to stabilize his vital signs.

After all the other patients have been settled first, the operation should be performed on him as soon as possible.

Before Lin Yi could breathe a sigh of relief, a nurse hurried over and shouted at him:
"Doctor Lin, this patient is having difficulty breathing, please hurry up and see what's going on."

The other doctors were busy treating the patients, and only Lin Yikong came out at the moment, so he didn't dare to delay, and walked over immediately.

I saw that the injured was a middle-aged man in his 40s, and he could see a large area of ​​abrasions on his front chest.

Although he was inhaling oxygen, he opened his mouth forcefully, and he could feel that his breathing was very difficult!
Lin Yi just observed him for a while, and then he knew what was going on.

Of course he took out his stethoscope and listened, and then he percussed again.

"Doctor, I used to have coronary heart disease, but now I am injured, is it possible that the coronary heart disease has recurred?"

With a painful expression on his face, the wounded asked Lin Yi with difficulty.

Lin Yi shook his head and said directly:
"Your current symptoms are indeed caused by trauma, which belongs to the range of heart disease, but it is not your coronary heart attack."

Lin Yi said, looked at Wang Qiaoya who was beside Wang, and said:

"He has a tamponade, hurry up and get a puncture bag, he has to do a pericardial puncture immediately!"

Next to him, Song Borui was treating the other wounded, and his condition was a little stable. When he heard that Lin Yi was about to perform pericardial puncture on the patient, he hurriedly asked:

"Brother Yi, why don't you give him a pericardiocentesis without ultrasound guidance?"

Lin Yi nodded and said:

"Well, no need!"

Pericardial puncture is a very simple operation for Lin Yi's current surgical technique!

As for the color ultrasound guidance, it is not necessary!
After all, the situation is really urgent now, and there is no time to do this!
And he is confident that the puncture needle can accurately penetrate the pericardium without hurting the heart.

Soon Wang Qiaoya brought the puncture bag.

Lin Yi put the patient in a semi-recumbent position, exposing the front chest and upper abdomen.

At this time, Song Borui finished treating the patient at hand, so he was beside him, watching Lin Yi's movements closely.

He wanted to see how Lin Yi could make a successful puncture without being guided by a color ultrasound.

Pericardiocentesis, he does.

But he did it all under the guidance of color Doppler ultrasound.

The main thing is to be safe and ensure success.

But Lin Yi does not need color ultrasound guidance now, which means that he is completely blind, relying entirely on clinical experience and feelings.

But Song Borui believed that Lin Yi could definitely complete this difficult operation.

Just like the resuscitative aortic balloon occlusion just done, it is amazing!

However, pericardiocentesis differs from resuscitative aortic balloon occlusion.

For resuscitative aortic balloon occlusion, even if the operation is wrong, at most, the bleeding has not been stopped, and it is enough to start all over again.

Even if there is a mistake, it will not kill people.

But if the pericardiocentesis is wrong, it will directly pierce the heart with one needle, and the injured may die immediately.

I saw that Lin Yi disinfected the local skin, covered it with a sterile drape, and gave local anesthesia at the puncture point from the skin to the pericardial wall.

When Song Borui saw Lin Yi, he didn't need to palpate the heart dullness area, and directly administered anesthesia.

Although he believed in Lin Yi in his heart, he also held his heart for him.

Lin Yi clamped the rubber tube connected to the puncture needle, and the puncture needle was inserted into the selected and local anesthetized site.

I saw that the puncture needle was accurately pierced into the pericardium.

It can be seen directly that there is dark red blood flowing from the puncture needle.

Lin Yi connected the syringe to the rubber tube, let go of the clamp, and slowly pumped out the liquid.

After pumping about 50ml of liquid, Lin Yi gradually felt a lot of resistance.

This shows that the pericardial effusion has basically been sucked clean.

So Lin Yi immediately pulled out the needle, and after disinfecting it again, covered it with gauze and fixed it with tape.

Song Borui looked at Lin Yi in shock.

He thought it would take almost half an hour for Lin Yi to complete the entire operation under such a blind operation.

But it turned out that it took Lin Yi less than 10 minutes to complete the pericardial puncture and drain the fluid in the pericardial cavity.

The speed was so fast that he didn't even have time to react.

At this time, the injured had obviously felt that his breathing was smooth.

He quickly said to Lin Yi: "Thank you doctor, thank you for saving my life, I feel much better breathing now."

"You said that I didn't have a coronary heart attack, but it was also a heart attack. What's going on with my disease?"

Lin Yi explained to him:
"In your case, after the chest was traumatized, the heart was contused, so there was cardiac tamponade."

"And cardiac tamponade will cause chest tightness and difficulty breathing. If the cardiac tamponade is not resolved in time, it will be life-threatening."

Hearing Lin Yi's explanation, the injured instantly felt that he had lost his life.

Thank you again and again to Lin Yi.

Seeing that the injured person's condition was basically stable, the nurse pushed him to the ward and continued to observe.

Song Borui couldn't help giving Lin Yi a thumbs up, and sighed sincerely:
"Brother Yi, your skills are really amazing, I'm really ashamed of myself!"

"The resuscitative aortic balloon occlusion and pericardiocentesis were all performed blindly. To be honest, this is the first time I have seen it."

"I have been in emergency surgery for so many years, and I have seen a few cases of pericardiocentesis, but most of them are done under the positioning of color Doppler ultrasound, but you can do it directly blindly, which is awesome!"

"What's more, it's the first time I've seen resuscitative aortic balloon occlusion in our emergency department. It's really an eye-opener! This operation can still be done like this."

"I think it's not an exaggeration for you to publish a paper with this operation."

Lin Yi suddenly smiled and said:

"No, it's just an operation. It's too exaggerated to publish a paper."

As soon as Lin Yi treated the injured man with cardiac tamponade, Chen Qiang shouted at Lin Yi:
"Brother Yi, this patient's heartbeat has stopped."

"What? Which!"

Lin Yi asked back, and immediately looked over, only to see that the patient with a piece of glass stuck in his chest just now had a sudden cardiac arrest.

The monitor sounded a rapid siren.

Two nurses and two interns in the emergency department saw that the patient's heartbeat had stopped, but there was a piece of glass in his chest, which made it impossible to perform chest compressions. They panicked and didn't know what to do!

(End of this chapter)