Start as an Emergency Physician

For dozens of long minutes, Li Li failed to see her husband, and what was in front of her was the "Informed Consent Form for Surgery" and the "Critical Illness Notice".

Who would have thought that the man who was still joking with him an hour ago would become two cold documents at this moment!

Zhang Ling also saw that signing at this time was too cruel for Li Li, but he had to do so.

The situation at that time was too critical, so Zhou Yuan directly underwent open heart surgery. But thoracotomy is already a major surgery, and this surgery must be signed by a family member.

It could have been done after the operation was completed, but Zhang Ling ran out on his own... Zhao Qiang's mortality rate is very high, once there is an accident, no, it should be said that Zhao Qiang may die under normal circumstances, at this time, if the patient's family finds that the patient has had an extra operation before death, things will become extremely troublesome.

Of course, it also depends on whether the patient's family understands or not, if they don't understand, it will definitely be a serious doctor-patient dispute.

Li Li's hands were trembling, she held the pen in pain, and signed her name word by word.

"This is a critical illness notice. Zhang Ling tried his best to keep his tone soft.

Li Li gritted her teeth and nodded, and also signed her name.

......

In the rescue room, Zhou Yuan's eyes were always closed.

He could already clearly feel the heart muscle tone gradually increasing, and as he pressed, the soft, enlarged heart gradually hardened and became smaller.

He Jianyi's face was full of surprise, he looked at his chest through the gap, and found that at this time, Zhao Qiang's heart had turned from dark red at the beginning to bright red.

Zhou Yuan gradually increased the frequency of compressions, and the ventricles began to fibrillate, and the small fibrillations of the muscle fibers began to thicken, but the heart did not recover.

"Electric shock to tremble. Zhou Yuan said with a calm face.

He Jianyi finished charging and quickly gave Zhao Qiang an electric shock defibrillation.

Defibrillation is followed by CPR, and defibrillation is needed if it does not improve.

For example, it is completely wrong to have multiple continuous electric shock defibrillation in film and television dramas, and electric shock defibrillation without interspersed cardiopulmonary resuscitation to improve myocardial hypoxia and strengthen myocardial tension does not have much meaning, and may even cause damage to the patient.

After two cycles of defibrillation and cardiopulmonary resuscitation, the wave of myocardial fibrillation changed from fine to coarse.

"One milligram of adrenaline intravenously. Zhou Yuan said while pressing.

In cardiopulmonary resuscitation, epinephrine is an excellent adjunct to increase the perfusion blood flow of the coronary arteries, which can make the blood flow better throughout the body during chest compressions.

Of course, one thing that should not be ignored is that epinephrine is also toxic, which may cause necrosis of the contractile zone of myocardial cells, damage the heart muscle and blood vessels, and even if you play it, you will have chest and abdominal pain, one-time hypertension and pulmonary edema.

Of course, it is a hooligan to talk about toxicity regardless of dose, although epinephrine has a toxic reaction, but it is still a life-saving drug in the case of moderate injection, and one milligram of intravenous push is enough to have an effect and will not bring side effects. +

He Jianyi took an injection needle and quickly inhaled a milligram of epinephrine and pushed it into the patient's veins.

The flutter wave regained its fine tremor again.

"Lidocaine. "

He Jianyi smashed the test tube of 2% lidocaine, inhaled it with a needle, and then administered an intravenous bolus to defibrillate Zhao Qiang.

When defibrillation is not effective, the patient needs to be defibrillated immediately. Of course, this is also a last resort, and if the drug does not work, it can basically be declared dead.

At the same time, Zhou Yuan gave Zhao Qiang positive pressure ventilation, and the drug diffused into the bronchi on both sides under the impetus of pressure, and was absorbed into the left heart through the bronchial mucosal capillaries.

After the lidocaine injection, Zhou Yuan ordered the voltage to be raised, and after dozens of compressions, the epinephrine injection was repeated again, and the electric shock defibrillation was performed again.

"Still haven't regained his heartbeat!" He Jianyi's face turned extremely pale.

Zhou Yuan's expression became solemn.

Can't you save a perfect CPR?

Could it be that a living patient fell in front of him, and he could be saved by cardiopulmonary resuscitation, but the perfect technique still couldn't be recovered?!

His mind spun quickly, and a lot of knowledge about cardiopulmonary resuscitation quickly flashed through his mind, and he understood it well!

The international cardiopulmonary resuscitation-related literature, rare cases, high-risk cases, etc. have all emerged, and various proven and risky treatment measures have also flashed one by one.

Zhou Yuan fell silent.

He Jianyi's face was ugly, and he glanced at the ECG monitor again, and the results on it were still heartbreaking.

"Or..." He Jianyi was just about to persuade Zhou Yuan to give up.

In the hospital, there are so many people who can't be saved, He Jianyi has seen too many powerlessness, Zhou Yuan is the first time to encounter such a situation, it may be difficult to accept, but there is a first time for everything.

On the road to becoming a great doctor, he must have irreparable patients in his hands, and these people will become the eternal thorn and motivation in his heart, inspiring him to grow and progress.

"Otherwise..."

Before He Jianyi finished speaking, Zhou Yuan, who had been silent, suddenly raised his head and said in a deep voice again: "Teacher, immediately use two hundred and fifty milliliters of five percent sodium bicarbonate at home!"

At the same time, Zhou Yuan didn't wait for He Jian to make a move, and immediately opened another needle, inhaled five milliliters of one percent of procaine, and punched it into Zhao Qiang's heart.

Sodium bicarbonate is mainly used to correct acidosis after prolonged hypoxia, while procaine acts directly on the ventricles to reduce myocardial irritability.

"The patient's myocardium is still responding, there is help, insist on rescue!" Zhou Yuan's words made the doctors in the emergency room move again.

Sodium bicarbonate was injected repeatedly three times in total, and procaine was injected a total of four times...

Intravenous access has been opened for rehydration transfusions.

Bang.

Increase the voltage and click again.

Immediately afterwards, Zhou Yuan immediately began to perform chest compressions, and at the same time, He Jianyi supplemented adrenaline and lidocaine again.

Bang.

The second high-voltage electric shock.

Drip, drip, drip.

In the silent rescue room, the ECG monitor suddenly rang violently!

Zhou Yuan and He Jianyi looked over in surprise, and the ECG monitor, which had not moved, suddenly beat, and then the patient's heartbeat recovered...

The faces of everyone in the rescue room were ecstatic, and after 34 minutes of rescue, the patient was finally saved!

The heartbeat returned to beating on its own, and the patient's blood pressure gradually stabilized.

Zhou Yuan took a hand out of the patient's chest cavity, and he could see that fine small blood spots began to appear on Zhao Qiang's chest wall and pericardial incision, which is a sign of the recovery of the heart's pumping function, absolutely good news!