Start as an Emergency Physician

Zhou Yuan took the placenta, directly bulldozed the operating table next to him, and spread the placenta on the table.

"You're in... Why?"

"Check the cause of the bleeding!He Jing, you now find a way to slow down the patient's bleeding!"

He Jian also ran in when he heard the situation, and his face turned pale when he saw the blood all over the ground in the observation room.

"I control the patient's blood pressure and heart rate!" He Jianyi immediately walked up.

The child's father stood at the door, looking at his unconscious wife lying on the operating table with a worried expression.

At the same time that Sun Meng took back the emergency blood, the old director of the obstetrics and gynecology department also followed Liu Kai, who went to report the news.

"What's the situation!"

The old director walked into the observation room and was startled by the blood on the ground.

"The girl holding the blood bag will be transfused immediately! If you lose blood like this, you will be gone!"

With that, he put on his sterile gloves, squatted down, and examined them carefully.

"Bad vision... Medical flashlight!"

After observing for more than ten seconds, the old master's face became grim.

"The bleeding is very serious, and if you want to stop the bleeding, there is only one best way now..."

"What!" the child's father asked immediately.

"Removal of the uterus..."

The old director's words made the observation room quiet all of a sudden.

The child's father looked at the old director blankly, thought for a long time, and said, "Is there only one way?"

"The safest thing at the moment is to remove the uterus!"

At this moment, He Jianyi successfully stabilized the vital signs of the pregnant woman, Sun Meng also completed an emergency blood transfusion, and the pregnant woman gradually woke up under He Jianyi's rescue.

"No, I don't cut the uterus, I still have to give birth to a baby!" the pregnant woman suddenly shouted without knowing where the strength came from.

Although the sound was small, everyone heard it.

The old director looked embarrassed: "If you don't remove the uterus, it will be difficult to stop the heavy bleeding!"

At this time, Zhou Yuan, who was frowning next to him, suddenly widened his eyes.

"There is a break on the placenta... A notch!"

Zhou Yuan turned his head to look at He Jing: "He Jing, did you feel any abnormalities in the placenta when you were glass placenta?"

He Jing was stunned for a moment, thought for a moment, and said, "It seems that there are, and there are several places where the placenta is rough." "

Hearing Zhou Yuan's self-talk, He Jing walked over, looked at the place of Zhou Yuan's finger, and couldn't help but be stunned: "There is really a wound..."

Zhou Yuan quickly walked to the side of the pregnant woman and carefully examined it with a flashlight.

"I don't think I need to remove the uterus! I can use thrombin blood, but it doesn't work and then have a hysterectomy. "

Thrombin perfusion therapy is mainly aimed at coagulation dysfunction in the cause of production, such as coagulation dysfunction, thrombin perfusion therapy can achieve good results, but it is ineffective for other causes of postpartum hemorrhage.

Zhou Yuan noticed that the suspected postpartum hemorrhage of the pregnant woman on the placenta was due to coagulation disorders.

To put it simply, because the placenta was not completely dissociated before, the uterine contraction was weak, resulting in the blood vessels on the endometrium could not be contracted and closed, so that diffuse bleeding occurred and the coagulation function could not keep up.

"Are you sure?!" the old director was stunned for a moment before he said in a questioning tone.

Thrombin perfusion does treat postpartum hemorrhage because it has a hemostatic effect.

For general postpartum hemorrhage, acting on the wound surface after local administration can quickly form a stable clot in the blood, and then control capillary venous hemorrhage, which can play a good role in hemostasis.

But...... When there is postpartum hemorrhage in the clinic, the situation is more critical, and the blood volume needs to be replenished in time, and a reasonable treatment plan should be selected according to the specific situation, and when the mother's life is endangered, the removal of the uterus is the best way to control the postpartum hemorrhage.

In the current situation, the old director could not judge the location of the bleeding and the cause of the bleeding at all, and could not complete the effective hemostasis, so he could only choose to remove the uterus.

Truth be told, thrombin perfusion therapy isn't safe...

Zhou Yuan prepared the thrombin medication and said, "I don't think we have the right to deprive a woman of the right to become a mother... I had a certain amount of thrombin perfusion therapy to stop the bleeding. "

Zhou Yuan is confident in his master-level thrombin hemostasis, and the current situation shows that there is a high probability that there is a problem with the coagulation function.

"Prothrombin complex, fibrinogen, which one do you want?"

The old director hesitated for a moment, and finally chose to believe Zhou Yuan.

As he gets older, he prefers conservative treatment, and uterine removal is the most conservative and safest method.

But...... The other party is Zhou Yuan, a doctor who has created miracles in various departments, and now he chooses to gamble!

"Both drugs are ready, and Sun Meng, you go and get some cryoprecipitate, fresh plasma, and prepare some platelets!"

Zhou Yuan squatted down, cleaned the uterine cavity and birth canal, and expelled some of the remaining placenta and fragments of the endometrium.

"He Jing, place an extracorporeal drainage tube!"

This is to drain the blood from the uterine cavity of the pregnant woman.

"Zhou Yuan, two thousand milliliters of blood have been transfused!" Sun Meng changed into a new blood bag and said nervously.

Zhou Yuan nodded, his face was serious, and said, "Old director, please prepare two thousand units of prothrombin complex immediately, plus one hundred milliliters of normal saline solution to inject into the uterine cavity!"

According to Zhou Yuan's estimate, after the prothrombin complex and normal saline are infused into the uterus of the pregnant woman, the amount of bleeding will be significantly reduced within 20 minutes, and another perfusion will be carried out an hour later, plus the infusion of platelets, plasma, etc., which promote blood clotting, can achieve complete hemostasis.

Of course, everything is just Zhou Yuan's speculation now, and as for the result, it can only be taken step by step.

"Two thousand units of prothrombin complex!" the old director handed over.

Zhou Yuan quickly took it and looked at the pregnant woman's lower body.

He Jing has completed the placement of the extracorporeal drainage tube, and a large amount of dark red blood is attracted from the pregnant woman's body and discharged into the external external drainage bag.

"The patient's blood pressure can't be measured!" Director He's face changed.

Zhou Yuan was stunned.

"Director He, please rescue it, no hemorrhagic shock can occur at this time!"

Zhou Yuan hesitated.

Right now...... Whether to remove the uterus, or to perform thrombin perfusion...

If the uterus is removed, it means that the woman has lost the most basic characteristics of being a woman, including reproductive function, menstrual period, and so on.

However, thrombin perfusion can be dangerous if the patient has already developed hemorrhagic shock and more than 2,000 ml of whole blood has been transfused...

Soon, a slightly joyful voice came from He Jianyi's side again: "Zhou Yuan, the rescue is back, the patient has regained consciousness!"

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