This doctor has a system

Chapter 412 477. Massive bleeding
Gao Feng looked at the patient and felt that his condition was critical, so he was sent to the ICU directly. As for the lung cancer patient, he can stay in the general ward.

"Hello, Director Gao." The doctor on duty in the ICU greeted Gao Feng warmly, "You are here."

"A patient was just sent here. Let me see what's going on in his airway." Gao Feng replied.

"The tube has just been intubated, and we were talking about contacting the bronchoscopy room to do a bronchoscopy." The doctor on duty was very happy, "You just happened to be here." Then he didn't have to worry anymore.

He knew Gao Feng's bronchoscopy skills, and they must be many times better than him anyway.

After the preparations were completed, Gao Feng picked up the bronchoscope beside the bed and entered the patient's airway along the tracheal intubation. The situation inside made him frown.

The patient's airway mucosa was obviously congested, edematous, and accompanied by erosion. The right bronchi was more obvious, and some white sticky stuff could be seen inside, which should be the nutrient solution that had been injected previously.

Gao Feng lavaged the patient with normal saline. The clear normal saline turned extremely turbid as soon as it was injected, and a large amount of yellow-white thick sputum came out from below. This showed that the patient's lung infection was serious.

"Didi, didi, didi." The monitor sounded the alarm.

"Director, the heart rate is too fast." The doctor on duty in the ICU said nervously.

"Now it's recurred again, and the hospital below can't handle it, so I took him to the provincial hospital."

Therefore, it is not a loss for him to have squamous cell carcinoma of the lung.

"They said they were going to do a bronchoscopy, but this doctor is a bit young. You know, after all, my dad."

"My brother hasn't come yet, so I thought it would be better to wait for him to come." The patient's daughter said the excuse she had thought of for a long time.

In China, it is the son who can make most of the decisions for his parents. As the saying goes, the daughter who gets married throws away the water, and the daughter is more responsible for the care.

The patient's general condition was so bad that he obviously couldn't bear the long bronchoscope operation, so he could only perform multiple short-term lavages.

Aren’t those experienced doctors supposed to be old men and women? She had some dissatisfaction in her heart.

"I've asked around. Director Zhang from the First Affiliated Hospital is doing a great job." A classmate called and said, "The provincial hospital doesn't know what's going on."

The patient's daughter finally hung up the phone, and her classmate promised to ask her questions as soon as possible.

"They provide sewer lines for people," the patient's son replied.

"When he gets better, he can be transferred to the general ward." He said casually.

But lung cancer is a disease that treats everyone equally regardless of whether you are rich or poor. Of course, if you like to smoke, you will be more favored by it.

Don't tell me, sewer tubes and gastric tubes seem to have something in common.

This patient with lung cancer has no financial problems, as can be seen from the jade pendant he wears around his neck. It is a piece of mutton-fat white jade with a soft luster. Anyone who knows it knows that this is the top grade of jade.

"This" Director Zhang was very hesitant. To be honest, he didn't really want to admit this patient. The family's expectations were obviously very high. It would be bad if something went wrong.

Well, now, staying in the ICU costs several thousand a day, which is very taxing for an average family.

Gao Feng also discovered that the patient's family financial situation was not very good.

The two exchanged a few words and soon got down to business.

Whoever pays has a greater say.

This patient was a heavy smoker when he was young. He worked in an institution and his position was quite small.

"What is your profession?" Gao Feng asked.

He is the wise man who put a gastrointestinal tube on his father.

"As you know, my dad got lung cancer the year before last."

She also gave Director Zhang’s phone number to the patient’s daughter, who immediately contacted Director Zhang from the First Affiliated Hospital.

"Your dad's condition is more serious." Gao Feng said to him, "But if he can survive these 2-3 days, I think there is still a lot of hope for improvement."

Gao Feng also noticed this situation and stopped the operation immediately.

Bu Zhengyang didn't ask any more questions. He thought this reason was reasonable.

"Yes, I am also very worried, so I want to ask you again." The patient's daughter said, "Director Zhang, do you think this is okay? We will transfer to you."

"The risk is indeed very high." Gao Feng said to her, "But I am still relatively confident."

The patient's daughter is still worried. She feels that Director Gao is a bit too young.

"Our director Gao's bronchoscopy skills are second to none in the province." Bu Zhengyang said from the side, "Hurry up and make an appointment."

"Ahua, this is Jianing." The patient's daughter contacted her classmate, who worked in Z state and was also a member of the system.

"Why didn't you go to the appointment?" Bu Zhengyang wondered. He had just gone to the bronchoscopy room, but he didn't see the patient's pleasant message.

You have to have one after you finish doing it. This is called a post-event cigarette.

"Director Gao, how is my dad? Can he survive?" As soon as Gao Feng came out, the patient's sons gathered around him.

"Who's in charge of the bed over there?" he asked casually.

"Director Gao, I heard that bronchoscopy is very risky." The patient's daughter was very worried, "Will there be any big problems?"

But sometimes this is not the case, for example, the daughter's financial strength is relatively strong.

"Then let's take a look." The patient's son felt very regretful at this time. If he had known better, he would not have done it by himself.

"Dad, this is quite tricky." Director Zhang said thoughtfully, "The stent must be covered with tumors. Cleaning it up is a big project."

I smoke at work, at the dinner table, I smoke when I get home, I smoke when I get up, I smoke when I go to bed, I smoke one whenever I do.

"My name is Bu Zhengyang," said the patient's daughter, "but he didn't do the bronchoscopy, but a younger doctor."

"My name is Gao Feng, and everyone here calls him Director Gao."

Director Zhang remained silent for a long time.

"Aren't you riding a donkey looking for a donkey?" He said dissatisfiedly, "The guide is set by others, why are you messing around here!"

He simply hung up the phone, leaving the patient's daughter confused for a moment.

"Hey, this is a big job." Anesthesiologist Wu Xingfeng cheered up, "I need to prepare more milk."

The milk he was talking about was propofol, a type of general anesthetic.

"Xingfeng, why have you gained so much weight?" Gao Feng asked curiously. The other person went to study some time ago and gained a lot of weight this time.

"We go out to eat every day, and we don't have anything to spare all night." Wu Xingfeng touched his belly.

He went out to study in order to get promoted to a professional title. When he arrived at the further training unit, he underwent several surgeries, and the teacher who taught him was a little unable to sit still.

"You are more capable than me."

The teaching teacher was overjoyed and directly became the hands-off shopkeeper, saying that he would be able to train himself better and grow better.

Then I took him to eat and drink every day. After a few months, his neck and belly became a lot thicker. "Everyone has started snoring now." Wu Xingfeng felt a sense of crisis, "I have decided to lose weight." After he said this, the patient quickly put on the anesthetic.

Gao Feng picked up the bronchoscope and quickly inserted it in. The scene inside made the trainee doctors who were watching around him exclaimed in amazement.

The ferocious tumor tissue almost filled the right main bronchus. After careful inspection, it was discovered that the previously placed bronchial stent was covered with layers of tumor granulation tissue, giving people a feeling of extreme inner discomfort.

"The blood supply looks very rich. It won't be easy to clean up." Someone whispered.

"Yeah, the risk is too great." Someone said next to him.

"What's the point of going through all the trouble." An older doctor in training also expressed his opinion, "It's already late, so what's the point of spending so much money to live for a few more months."

Some people agreed with what he said, while others opposed it.

Gao Feng felt that what he said made sense. If the family's financial situation was not good, he would not recommend further trouble.

After all, a silicone stent and bronchoscopy are expensive, and they need to be done multiple times.

There is no need for families with no money. The dead can just walk away, but the living must continue to live.

Many children are always afraid of leaving any regrets in their hearts. In fact, as long as they work hard, they will be fine.

Of course, if you have money, then do whatever you want, money is for spending.

Gao Feng also felt that the risk was a bit high. With just a slight touch of the mirror, blood began to ooze out of the lesion, making the field of view under the mirror very poor. The nurse setting up the stage gave him a troubled look.

"Push the argon gas over here." Gao Feng signaled, and he was going to burn it first.

The advantage of argon is that it can simply and crudely burn off diseased tissue, thus preventing tumor tissue with a rich blood supply from oozing blood.

With his delicate and meticulous operation, the tumor tissue blocking the front of the tracheal stent was removed one by one, and the complete airway stent revealed its original appearance.

This is a covered stent, which has been somewhat deformed when squeezed by the tumor tissue.

Gao Feng clamped it with pliers, and with a little force, the bracket moved. Just when everyone felt that they were done, a large amount of blood suddenly came out.

"It's over! The patient is dying." This was the voice of most of the people watching.

This amount of bleeding is extremely dangerous in the airway. If the bleeding point cannot be found in time and effective hemostatic treatment is carried out, it will be impossible to save the patient.

Is it easy to find the bleeding point?

Of course it's not easy.

There is a red patch under the mirror, and the lens is covered with blood. How can you find the bleeding point?
Gao Feng frowned, the worst happened.

It should be that the stent moved and tore the connected blood vessels, which caused such a large amount of bleeding.

The first thing at this time is to take out the stent, otherwise the bleeding area will be under the stent and you will have no way to deal with it.

Power works wonders. Thinking of this, he directly exerted force and the complete stent graft was clamped out.

"Quick, use the thrombin first." Liang Congyue said loudly.

"Let the patient lie on the affected side and push a pituitary gland." Gao Feng added, and at the same time he inserted the flexible bronchoscope.

First, I suctioned it, and all that was sucked out was bright red blood, which showed that the bleeding was still continuing.

Gao Feng asked the nurse to inject 50 ml of ice-cold saline, and then adjusted the angle of the bronchoscope.

"Take thrombin."

"What should we do next?" Liang Congyue asked.

"Wait." Gao Feng said.

"Wait?" Liang Congyue was stunned. Is it useful to wait at this time? Can the bleeding stop on its own?

"The bleeding site should be at the ridge between the middle lobe and the basal segment." Gao Feng explained, "I am now using a bronchoscope to block it."

? ? ? Liang Congyue
Not only Liang Congyue felt speechless, but also some doctors who were training were dumbfounded.

"Are you kidding?" a training doctor blurted out, "Can this be blocked?"

You can't see anything. Are you saying you're blocked?

Why are you so naughty?

What's going on?

"Why don't you call the thoracic surgeon to come over and take a look?" Someone suggested, "You can't see anything. Are you watching the patient die?"

If the bleeding cannot be stopped, the patient will definitely die. The lungs are the organs for gas exchange in the human body. Once the airways are filled with blood, the consequence is that the patient will be suffocated to death.

It must have been painful.

But fortunately, the patient is under a deep anesthesia. If this happens, he should not feel any pain.

However, it was useless to ask the thoracic surgeon to come in at this time. The thoracic surgeon was not a god and could only play a comforting role.

"It should be enough to wait another two minutes." Gao Feng said, his tone was the same as before, but in this situation, everyone felt a little calmer.

Seeing that he didn't look panicked at all, Liang Congyue inexplicably relaxed a little. In his impression, Gao Feng had never made any mistakes during bronchoscopy.

However, some training doctors could not stand any longer, and the bronchoscopy room was noisy.

After a while, Gao Feng felt that it was almost done. He lifted the mirror up and motioned to the nurse to pour some more ice salt water into it.

As soon as the ice salt water entered, the vision under the mirror became much clearer, but the place where the eyes entered was still full of blood.

"It doesn't seem to happen much." Liang Congyue was a little excited. Logically speaking, if the bleeding was still continuing, it shouldn't be the current amount.

The training doctors on the side all widened their eyes. This result was beyond everyone's expectation.

"Bleeding at this speed is not normal for the patient even if he or she dies." A well-traveled doctor in training muttered, and everyone nodded. This patient's luck was so unlucky.

Gao Feng cleaned up the blood in the left airway, and then moved the bronchoscope to the right.

Because of thrombin, the blood in the right trachea had coagulated a lot and the bronchoscope couldn't pull it out. Gao Feng asked the nurse to push the cryoscope over.

"Do we need to clean it up?" Liang Congyue was a little worried, "Don't let it bleed again."

He felt that the bleeding had just stopped, so it would be better not to provoke it again at this time, and we would get over it as soon as possible.

"It's okay, I'll just clean up the surrounding area." Gao Feng said. He didn't know how to explain to the other party. He couldn't say that I was cheating. I had rehearsed it in advance.

The cleaning went smoothly. The coagulated blood was frozen out like phlegm plugs. Gao Feng used argon gas to burn the bleeding area.

"Okay." He also breathed a sigh of relief, the dangerous place was finally over.

The next step is to place a stent, otherwise the rapidly growing tumor tissue will soon block the cleared airway. After the stent is placed, the speed will be slowed down.

(End of this chapter)