This doctor has a system

Chapter 286 275. Rescue
"You have completed the familiar trap task and you have obtained 10 skill points." The system prompted.

Gao Feng curled his lips. It seemed that the system was not very satisfied with his performance.However, he really couldn't refute it in his heart. Everyone warned him when he posted the mission: a familiar trap.

The physical examination was still not detailed enough, Gao Feng thought.

But in fact, there is nothing you can do about it. The patient is dying, and it is unrealistic to cooperate with you in the physical examination honestly.

Moreover, when people are particularly uncomfortable, the symptoms and signs they display are not necessarily real.

In any case, Mrs. Hu Huarong was finally out of danger. Otherwise, patients would come to the department not long after he arrived. Not to mention it was auspicious or unlucky, but he would inevitably feel a little uncomfortable psychologically.

"Let's go." Li Youliang came over, "Ma Liang is probably getting off work soon."

In order to thank Dr. Ma Liang for his strong support to the general medicine department, Gao Feng decided to treat him and several emergency doctors to dinner today.

He came to the emergency department with Li Youliang and Bu Zhengyang and asked the triage nurse. Two patients came now, and Ma Liang was still busy in the clinic.

"Wait a minute, the nurse said it's not a complicated patient, so it should be done soon." Li Youliang said, and the three of them sat down on the stools nearby.

The atmosphere was quite harmonious at first, and the patients in the hall were all quite quiet. It was a rare moment of silence. Suddenly, a middle-aged man hurriedly ran in. He was sweating profusely, with a painful expression on his face. He shouted for help as he ran. Inside the hall Everyone's eyes were attracted, and Gao Feng and the other three also looked at each other.

The middle-aged man stumbled into the hall and saw an empty bed next to him for pushing patients. Without even saying hello to the doctors and nurses, he climbed onto the bed and shouted with his last bit of strength: Help!
Then there was no movement.
The triage nurses were stunned. What is happening to you?But the instinct developed through long-term training allowed him to run up quickly.

"What’s wrong with you?!!!"

The middle-aged man seemed to be dead. He tilted his head and lay on the bed. No matter how much the nurse shouted and slapped him, there was no response.

"The breathing and heartbeat are gone!" Another nurse quickly checked the man's carotid artery pulse and breathing.

"When death knocks on the door: Wu Sidao's life is likely to be gone, and death is ready to harvest his soul. At this critical moment, if you can step forward, maybe the final result will change. Save The patient’s life can gain 50 skill points, and no skill points will be deducted for failure.”

Gao Feng had already rushed forward at this time, but he didn't even hear the system's notification sound for announcing the mission.

"Let me do it!" He directly performed chest compressions on Wu Sidao, and the nurse connected him to the ECG monitor in a chaotic and orderly manner.

"Hurry up and open an intravenous channel for him." Gao Feng said to the nurse beside him.In fact, the experienced nurse had already prepared things without waiting for his instructions. The patient's heartbeat had stopped, which meant death. If the rescue medicine was not used in time, there was a high probability that he would not survive.

Therefore, it is the instinct of every emergency department nurse to open intravenous access in time.

"The blood pressure cannot be measured, the patient's pupils are dilated, and the light reflex is very weak." Another nurse reported the bad news.

Wu Sideo's face was so pale that if Li Youliang hadn't seen him running in with his own eyes, he would have thought that he had been dead for several days.

"Damn it, the patient was calling for help just now, why did his heart suddenly stop?" the nurse complained. At this time, Ma Liang and another doctor also rushed over.

"Holy shit, what the hell is going on here?" Wang Liang was shocked. I just saw an outpatient, and you guys did a big job for me!

"Who knows what's going on!" the nurse who gave the injection replied. The reason must not be clear at this time. For now, the plan is to continue chest compressions and other rescue operations to see if the spontaneous heart rate can be restored.

"Defibrillators!"

The nurse quickly handed over the handle of the defibrillator that had been prepared. Gao Feng took the defibrillator and signaled others to leave. The defibrillator recognized that the patient's heart rhythm was ventricular fibrillation.

Ventricular fibrillation means that the patient's heart cannot beat normally, but vibrates like a worm. Very weak fibrillation is not enough for the heart to pump blood. If this continues, the patient will undoubtedly die.Defibrillation must be performed as soon as possible to restore the patient's sinus rhythm before things can turn around.

After the defibrillation was completed, Gao Feng continued to perform chest compressions.

"1mg epinephrine, push it quickly!" Ma Liang told the nurse. Adrenaline is the most powerful cardiotonic drug and a necessary drug to rescue cardiac arrest.It doesn’t matter whether it works or not at this time.Use it later.

"Let me take over for you for a while." Another emergency doctor wanted Gao Feng to take a rest. Continuous chest compressions were very exhausting.

"No, I can do it." Gao Feng shook his head. He didn't understand the other party's chest compression level. At this time, he felt most at ease doing it himself.

"Hurry up and find your family members!" He said to Ma Liang, "He can run to the emergency department on his own, so he must have family members."

As soon as he finished speaking, a middle-aged woman rushed in.She is the wife of the patient in front of me.

"What's going on?" Ma Liang asked loudly.

The patient's wife was also frightened and stammered, recounting everything that happened before the patient came to the hospital.

Wu Sidao, male, 48 years old, is the boss of a construction engineering team, also known as a contractor.As the saying goes: middle-aged people have no choice but to soak wolfberries in a thermos cup.

Mr. Wu is also experiencing a middle-aged crisis. He usually has a very bad temper in the construction company. He is as smelly and hard as the stones in the latrine!But as soon as I got home, I became soft. As for why I was soft, everyone knows it even if I don’t tell you.
Every time he does that, he always takes a little blue pill in advance. Although taking it can deal with one or two problems, he feels that this is not a long-term solution.

Some people just like to rely on themselves and are not used to the power obtained from the outside world, so Mr. Wu began to seek medical treatment.

"You have kidney yang deficiency!" An old Chinese medicine doctor from the First Affiliated Hospital checked his pulse. "Were you too manic when you were young?"

"That's necessary." Mr. Wu replied, "I used to be too old."

"It's a bit overdrawn." The old Chinese medicine doctor looked at his tongue coating again, "I'll prescribe some Chinese medicine for you to drink for a while and take a look."

Mr. Wu hated drinking these bitter things, but for Mr. Wu, he worked hard for more than half a year.

The effect cannot be said to be non-existent, but it is obviously not as good as Mr. Wu’s expectations.

When I was feeling depressed, a boss said that he had an old medicinal wine that had been brewed for more than ten years at home. A few sips of it could revive him, and the effect was great!It doesn't hurt the body.

Mr. Wu was overjoyed and went to the door with his things in hand to fill a few large bottles.

In the evening, he couldn't wait to drink a drink, and then
"What happened then?" Ma Liang asked, "Did you feel uncomfortable at that time?"

"Say it now!"

"No." Wu Sideo's wife said while crying, "He didn't even reach the bedroom." "Then he said he felt uncomfortable all over his body, he was so flustered, and his eyesight turned black."

"I quickly drove him to the hospital."

Wu Sidao had a very strong desire to survive. Everyone knew what happened next. As soon as the car stopped, he rushed in, yelling for help. When he saw an empty bed, he lay down on it.
"It may be poisoning by medicinal alcohol." Ma Liang speculated.

"Do you want gastric lavage?" a new nurse asked, but he seemed a bit amateurish when he said this.

There is no way to perform gastric lavage at this time. On the one hand, the patient is unconscious. Gastric lavage can easily cause liquid to enter the lungs, leading to aspiration.On the other hand, the heartbeat has not yet recovered, so cardiopulmonary resuscitation is the most critical and cannot be delayed for a moment.

The patient developed a malignant arrhythmia, which means that the drug has entered the blood, and it is necessary to find a way to remove the toxins in the blood.This requires bedside blood purification treatment.

But there is still the same problem. The patient's heartbeat has not recovered yet, and his life or death is uncertain. How can he perform blood purification?

In this case, you can only keep doing chest compressions. Don't stop. Keep pressing. Maybe there will be a chance.

"Hurry up and draw blood. Check everything that can be checked on him!" Gao Feng said quickly, while Ma Liang was performing tracheal intubation on the patient.

Soon everyone knew that this was not going to work.Because even if connected to a ventilator, the patient's blood oxygen saturation is only 85%, while a normal person's blood oxygen saturation is at least 95%.

The patient's cardiac arrest was most likely caused by poisoning, and it is difficult to reverse it with chest compressions and electric defibrillation alone.Even if the button is pressed back by luck, it will immediately fall into a second ventricular fibrillation and then the heart will stop again. This is a cardiac electrical storm.

If the heartbeat cannot be pressed back, all subsequent treatments will be of no use, and death can only be declared.

Gao Fengzhi frowned. The patient's condition was very critical, and conventional methods were probably not possible.

How to do? ?

Wu Sidao's wife had collapsed and started crying uncontrollably. No one had time to care about her at this time.

"This won't work!" Gao Feng motioned to the doctor next to him to take over and continue to perform chest compressions. "You need ECMO."

Artificial heart-lung machine!That is ECMO (extracorporeal membrane oxygenation). Using this machine can temporarily replace the patient's cardiopulmonary function. First stabilize the patient's life, and then find a way to remove toxins from the body, if it is really poisoned by medicinal alcohol.

Gao Feng also believed that the patient was probably poisoned by medicine and alcohol, but he still had room for speech.

"The cost will be very high, at least hundreds of thousands, and there is no way to guarantee the results."

This cost is a huge amount of money for any family.But fortunately, as a contractor, Wu Sidao's family background is quite rich.

"Hurry up and use it! Give him everything he can use!" Wu Sidao's wife spoke with a firm voice, although it was a little trembling.

Ma Liang repeatedly emphasized to her that using an artificial heart-lung machine only increased the success rate of rescue, but it did not mean that she could definitely be brought back to life. This must be understood.He has worked in the emergency department for a long time and knows that sometimes you cannot give too much hope to patients' families, otherwise problems will easily arise later.

Wu Sidao's wife burst into tears, "I understand. I will thank the doctor if he can be saved. If he can't be saved, I will accept it and won't trouble the hospital doctors."

Gao Feng got the response he wanted, and immediately summoned manpower and asked the nurse to quickly prepare the ECMO line for pre-charging.

Although ECMO is expensive, its principle is not complicated.First, a catheter is inserted into the patient's large vein, and the blood is drawn out from the vein. It passes through the oxygenator, inhales oxygen, and releases carbon dioxide, completely simulating the lung function of the human body.

Then transfer the blood back to the patient. In this way, the patient gets enough oxygen.

There is no doubt about the strength of the Provincial Medical Emergency Department. Once the department was put into operation, the efficiency was astonishing. The ECMO team was fully equipped with personnel and equipment in a short period of time, and the ICU was also ready to receive patients.

As mentioned earlier, there are two commonly used methods of ECMO: VV ECMO and VA ECMO.

VV ECMO draws blood from the veins and then returns it through the veins without passing through the heart, so it has no obvious decompression or protective effects on the heart. Simply put, this is just an artificial lung.

VA ECMO refers to draining blood from the veins and then returning it from the arteries. This is a great help to the heart and can reduce the work of the heart. Therefore, this is an artificial heart-lung machine, which replaces both the lungs and the heart. .

For the patient in front of me, he has repeated ventricular fibrillation and his heart is failing. It is not appropriate to simply do VV ECMO. VA ECMO is the most appropriate.

Director Liu Qianjin is a key member of the ECMO team of the Provincial Medical Emergency Department. He is usually the one who gets the most time on the machine. When he got the news this time, he happened to be in the hospital and came to the department without stopping.

"I come?"

"I'll do it." Gao Feng said.

Liu Qianjin was stunned for a moment. He recognized Gao Feng, but he obviously had some concerns.

"Are you okay?" he asked. This may seem like his emotional intelligence is a bit low, but Liu Qianjin is usually like this. He is a more down-to-earth person, and almost all patients on ECMO have a narrow escape. Without asking him clearly, he is really I feel uneasy.

You can't joke with the patient's life.

"Don't worry." Gao Feng was not angry. On the contrary, he had some affection for Director Liu in his heart.

After nearly 21 minutes, Gao Feng finally got the ECMO machine running, and he breathed a sigh of relief. At this moment, he only felt pain in his waist and back.

Is this fast?To be honest, it is a bit slow for high winds, but the current factors must be taken into consideration. During these 21 minutes, cardiopulmonary resuscitation must continue and cannot be interrupted.This is a big challenge for doctors and nurses to get on board.

Li Youliang was shocked when he saw ECMO for the first time.Because after the ECMO started to rotate, oxygen-filled, red arterial blood was continuously returned to the patient, and the blood oxygen saturation finally slowly increased until it reached 100%.

Wu Sidao was transferred to the ICU.

With this ECMO, the patient can survive even if his heart stops beating, and he can even speak. This is the shocking thing about the artificial heart-lung machine.

Wu Sidao's life was temporarily stable, but only temporarily.

Because all the current indicators are supported by ventilators and ECMO. If they are removed, the patient will be returned to his original state immediately, and even the gods will not be able to do anything about it.

(End of this chapter)