Start From Emergency Doctor

Chapter 244

Zhou Yuan ran over quickly.

Lying on the hospital bed was a traffic policeman with only a few obvious blood stains on his body, which seemed to be fine.

“The patient lost consciousness!” Zhang Ling said hurriedly.

Zhou Yuan stepped forward and immediately checked the wounded’s nose and mouth.

Sure enough, the airway was blocked.

“Zhang Ling, quickly cut open the wounded’s clothes!”

This is to prevent clothing from affecting your breathing.

The reason for cutting clothes is to avoid moving the injured person’s body. Any movement of the injured person at this time may bring fatal hazards.

Zhou Yuan opened the wounded man’s mouth, put his gloved hand into the patient’s mouth, and pulled out the vomit.

“The wounded is likely to have internal bleeding!-” Zhou Yuan’s expression changed.

Internal bleeding is one of the most difficult to judge among the injured in a car accident.

After a car accident, doctors in the emergency department will often pay special attention to those who have experienced a car accident but are alive and well, and even help organize rescues.

These people often have a high probability of internal bleeding. At the beginning, they can’t see anything. The wounded just feel a little uncomfortable. However, compared with the big car accident and other bleeding patients that they have just experienced, it doesn’t seem to be anything. care.

However, by the time they really feel particularly uncomfortable, it may be too late by then.

There was an internal bleeding in a car accident in the hospital. At that time, all the doctors were busy saving people with trauma. No one thought that this enthusiastic man who helped doctors and nurses push the bed was abnormal. After more than an hour, he fainted. He fell to the emergency department and died on the spot.

The cause of death was internal bleeding.

If internal hemorrhage occurs, it can be manifested as a progressive decrease in blood pressure, weak pulse, weakness, pale complexion, progressive anemia, a gradual decrease in hematocrit, and a gradual shock phenomenon. The most common hepatic spleen and kidney rupture and hemorrhage are manifested in the abdomen. Pain, swollen abdomen, low blood pressure, etc.

Now the patient has entered a coma, unable to judge from the main complaint, and can only rely on Zhou Yuan’s experience.

Zhou Yuan needs to determine the cause of the patient’s loss of consciousness. If it is hemorrhagic shock and there is no obvious external wound, it is most likely hemorrhagic shock.

The consequences of hemorrhagic shock are extremely serious.

When the blood volume is insufficient to exceed the compensatory function, the symptoms of shock syndrome will appear. It is manifested as a decrease in the amount of blood discharged from the heart, constriction of peripheral blood vessels, and a drop in blood pressure. Reduced tissue perfusion promotes anaerobic metabolism, leading to increased blood lactic acid content and metabolic acidosis.

At this time, further constriction of blood vessels will cause cell damage. The damage of vascular endothelial cells causes loss of body fluid and protein, aggravates hypovolemia, and eventually multiple organ failure will occur.

Zhou Yuan took off his gloves and touched the patient’s skin.

The typical symptoms of hemorrhagic shock are pale, cold, clammy skin. There is also tachycardia or severe bradycardia.(Read more @ wuxiax.com)

These can be directly diagnosed on the body surface.

After a while, Zhou Yuan felt the cold touch on traffic policeman Mao An’s body, and the sweat made Mao An’s whole body appear clammy.

“Hemorrhagic shock! The patient has suffered from severe bleeding, so he should be rescued immediately!” Zhou Yuan said categorically.

“It’s him! This traffic police saved many children. If he hadn’t blocked the Mercedes and warned the children, more people would be injured!”

Several family members of the patients passed by the rescue room. They all saw the traffic policeman lying on the bed, and they were all grateful.

“Doctor, you must save him! He is a good man and saved many children!”

“It must be saved!”

Zhang Ling turned her head and said, “Don’t squeeze here, we will try our best to block other medical staff from rescuing here, and it will affect the rescue!”

The family members nodded and left quickly.

Zhou Yuan quickly arranged first aid.

“Immediately open the venous channel, and provide fluids to the wounded at any time! In addition, quickly get the blood type report of the wounded, go to the blood bank to bring the blood! At least 2000cc!”

What makes Zhou Yuan a little frightened is that the patient still has pneumothorax…

Obviously, Mao An had a pneumothorax before the accident, and the accident caused Mao An’s pneumothorax.

“Treat the patient’s pneumothorax, perform thoracic puncture and drainage, and prepare a ventilator. Once the condition is serious, immediately go to the ventilator to maintain the patient’s breathing!”

Zhou Yuan closely observes the patient’s symptoms and signs.

“Disposable needles.”

Zhou Yuan quickly drew a tube of blood.

Mao An developed a pneumothorax and was restricted in breathing. He needed to draw arterial blood for blood gas analysis.

Zhang Ling and others performed sinus rhythm recovery, while Zhou Yuan quickly thought about countermeasures.

Generally speaking, there are only two ways to solve the problem of hemorrhage: minimally invasive and surgery.

Minimally invasive is the use of laparoscopy for intervention. This method is suitable for non-urgent internal bleeding, and the wound is relatively small and easy to handle.

Mao An’s situation is obviously an emergency internal bleeding, and it has been only about 20 minutes since he was sent here, and severe hemorrhagic shock has occurred, and the area of ​​internal bleeding is certainly not small.

At this time, there may be organ fragmentation. If you have to open the abdominal cavity, you can enter the abdominal cavity and directly block the bleeding blood vessel. If necessary, the organ needs to be removed.

Zhou Yuan quickly said: “Push to the operating room and perform an open surgery immediately! Another intravenous channel is established, a large amount of rapid rehydration is given, and two liters of isotonic balanced salt solution are quickly infused to restore blood volume!”

……… …….. …

The blood type hasn’t come out yet, and Mao An can’t wait any longer. Zhou Yuan pondered for a moment and calmly said: “Immediately take the o-shaped concentrated red blood cells and enter them into the wounded body through another venous channel!”

O type blood is a universal blood supply. The situation is critical now. After applying balanced salt solution to restore blood volume, concentrated red blood cells should be transfused to make hemoglobin reach more than 10g/dl to ensure the patient’s blood circulation.

Soon, the patient was pushed into the operating room.

At this moment, several operating rooms were all full, and He Jianyi, Jiang Xiaoqi and others were all rescued in the operating room.

Wuying waited, Zhou Yuan picked up the scalpel.

“The anesthesia is over.” The anesthesiologist said immediately.

Zhou Yuan nodded and quickly made an incision at the place marked by Mao An’s abdomen, dissected the abdominal cavity, and revealed the abdominal cavity.

“Extracorporeal drainage tube!”

Because of the lack of manpower, Zhang Ling was the only nurse, instrument nurse, and anesthesiologist for this operation.

The anesthesiologist is the one who immediately ran to other operating rooms for anesthesia after completing the anesthesia.

Although Zhang Ling participated in few operations, she can tell from the suture kits in her bedroom that she usually works very hard.

Therefore, Zhang Ling’s movements were very neat, and soon the drainage tube was inserted into Mao’an’s abdominal cavity, and he began to drain the abdominal cavity.

Zhou Yuan quickly looked for bleeding points.

Ten seconds later, a situation that made Zhou Yuan a little desperate appeared. A.