When doctors have a simulated operating room

The wounded man was lying on the ground, and the wounded man was lying on the ground.

"Broken leg?"

Zhang Yi looked up and found Qi Fei kneeling on the ground with gauze to stop the bleeding.

A female nurse from the Sixth Hospital squatted next to him, establishing an intravenous access.

Zhang Yi took a few big steps over.

A bloody smell came over, the kind that could reach the top of the head even through the mask.

This is an adult male, probably around 35 years old.

He was wearing a dark green down jacket on his upper body, but the green was no longer green at this time, as it had been stained with blood for more than half.

The jeans on his lower body were very thick, but Qi Fei had cut them open with scissors in order to rescue him.

The right thigh was completely broken, leaving only a section of the thigh root.

The thigh root was covered with muddy muscle tissue and skin.

It is not an exaggeration to describe the wound as a bloody mess.

The left leg was also broken, but it was not separated by the collision.

Under the body of the male victim, the asphalt road was also printed with a large pool of dark liquid.

"Hu... Hu... Ah! Leg... Leg pain!"

The patient was still conscious but not much. He knew to scream in pain, but if you look closely, he was in a semi-comatose state.

The breathing was very fast and the face was pale.

Zhang Yi's first reaction was shock!

This patient was not much better than the girl just now!

Both of them were in great danger!

"What should I do? This blood vessel can't be inserted!"

The nurse who had been inserting the needle suddenly raised her head and said nervously.

She tried twice, but the needle couldn't get into the blood vessel, which made the nurse sweat anxiously.

This person was bleeding seriously. The most important thing now was to infuse fluids to replenish the blood circulation in the body.

But the needle couldn't be inserted!

She was really anxious.

The nurse looked up at Qi Fei and Zhang Yi, her eyes looking for help.

Zhang Yi hurriedly walked to her side and said:

"He lost too much blood, his blood pressure is low, and his blood vessels can't be filled. It's normal that he can't get a needle.

Hurry up and change a long needle. I'll insert a central venous catheter directly! Hurry!"

"Oh... OK!"

The nurse nodded repeatedly and took out the spare catheter at a very fast speed.

Central venous catheterization, in layman's terms, is to insert the needle into the jugular vein, subclavian vein and femoral vein, which are relatively important large blood vessels that can withstand the infusion of a large amount of fluid in a short period of time.

There are many uses for central venous catheterization, such as when doing central venography, long-term antibiotic injection, plasma exchange, long-term infusion patients, etc.

But the most urgent and useful is when a large amount of infusion is needed.

Just like now, patients with blood loss and shock.

The veins in the arm are relatively thin. Under normal circumstances, it is completely sufficient to infuse antibiotics or something like that when encountering ordinary patients.

But in cases of severe bleeding or some emergency renal dialysis treatment, the arm veins are not enough.

It is necessary to use the method of central venous catheterization, and a large amount of fluid must be injected in a short period of time to drive the circulating blood volume of the whole body.

The most important point of the rescue indicator of shock is fluid replacement.

A large amount of fluid replacement increases the blood volume of the whole body, so that the blood pressure can be stabilized.

Otherwise, like this patient, the blood loss leads to low blood pressure and the needle cannot be inserted.

While the nurse was preparing the needle, Zhang Yi also took an iodine cotton swab to disinfect around the patient's neck.

The puncture point was selected in the internal jugular vein.

It is close to the heart and there is no need to waste time taking off clothes.

"Here, Doctor Zhang!"

I saw Zhang Yi tilt the patient's head to one side and hold the needle handle to puncture the blood vessel.

Another draw, blood came out, indicating that the needle had entered the blood vessel.

Then remove the needle in front of the needle handle and send the sterile catheter deep into the blood vessel.

Generally speaking, central venous catheterization is recommended to be performed in a sterile environment, but at this critical juncture, there is no way to know whether it is completely sterile.

Let's do it first!

Catheters are also divided into single-lumen, double-lumen, and triple-lumen.

The one in the ambulance is double-lumen, which is just equivalent to two venous channels.

"Okay, put on a patch first, and then change to a large patch to fix it after returning to the hospital. Now hurry up and replenish the fluid!

First, add an epinephrine! Add another dopamine!

On the other side, replenish fluid. If there is plasma replacement, replace plasma. If there is no plasma replacement, use 500 ml of saline with a bottle of furosemide!

Then inject a bottle of pethidine intramuscularly!"

"Okay!"

The nurse nodded and did it.

Qi Fei kept pressing the patient's thigh.

Hemorrhagic shock is also divided into four stages.

Compensatory stage, progressive stage, decompensation stage

Compensation stage and organ failure stage.

Currently, this patient is in the progressive stage.

In addition to rapid fluid replacement, bleeding must also be stopped.

Stopping bleeding is also a top priority!

"Qi Fei, hold it down first, I'll get the arterial balloon catheter in the car to stop the bleeding!"

"Okay!"

Qi Fei nodded.

It actually takes a lot of effort to keep pressing hard.

At this time, Qi Fei's gloves were all stained with blood, and even the white emergency suit was stained with red blood stains.

Seeing Zhang Yi rummaging in the first aid box, Qi Fei suddenly reacted and said in surprise:

"Ah? You want to do REBO here??!"

Zhang Yi nodded:

"Yes! Stop the bleeding! Otherwise, your hand alone will not be very effective!"

Immediately, the expression on Qi Fei's face became wonderful.

Great.

The big guy is going to show off his skills in front of me~!

Wait and see!

There was indeed an emergency resuscitation aortic balloon catheter in the first aid kit.

Zhang Yi put on gloves, assembled the catheter, and took a deep breath:

"Qi Fei, let go after I count 1, 2, 3, I will find the blood vessel, and we will try to put the balloon in as soon as possible!"

"Okay!"

"1, 2, 3!"

After three calls, Qi Fei immediately let go.

Immediately, several blood vessels on the thigh root began to spurt blood.

If it was at the beginning, the blood would definitely be ejected directly.

But now it is already in a state of bleeding, and the blood pressure is not so high.

So the blood is not spurting high, but the flow rate is very fast!

Zhang Yi did not dare to delay, and immediately inserted the catheter into the ruptured blood vessel.

——

Fortunately, Zhang Yi has good eyesight and plug-ins, otherwise who can tell which blood vessel this bloody tissue is in a few seconds? ?

Time is tight and the task is heavy, Zhang Yi can only pretend to be cool.

In Qi Fei's sight, the rubber catheter in Zhang Yi's hand seemed to be guided by something!

In that mass of torn tissue, he actually went all the way forward and really found a large blood vessel!

And it seems that this blood vessel is a branch of the femoral artery!

Tsk tsk tsk!

Zhang Yi is indeed Zhang Yi!

Well-deserved reputation!

Seeing is believing!

This guy is as amazing as the legend says!

"Empty needle!"

After sending the balloon on the catheter to the front of the femoral artery, Zhang Yi instructed Qi Fei.

"Okay!"

Qi Fei immediately drew out ten milliliters of air and handed the empty needle to Zhang Yi.

When air is injected into the balloon, it will swell up, which is equivalent to stopping bleeding directly in the blood vessel.

This method of stopping bleeding is only suitable for emergency treatment.

It can control bleeding in a short period of time, but the real root problem to be solved still needs to be solved in the operating room.

"Okay, the bleeding has stopped. Bring the stretcher and carry this person to the ambulance!"

The bleeding has stopped, and Zhang Yi is relieved.

However, Zhang Yi is not sure whether he can survive.

An adult male has about 4500 ml of blood in his body.

If the blood loss exceeds 1000 ml in a short period of time, symptoms of shock will appear.

Timely rescue of the patient still has a chance to survive, but once it enters the last stage of shock, that is, the organ failure stage.

Then, giving any medicine is useless.

The reason why Zhang Yi tried so hard to rescue is because this person is still in the progressive stage.

There is still a possibility of successful rescue.

As long as there is hope, Zhang Yi is willing to try.

Soon, the stretcher came.

Zhang Yi and Qi Fei worked together to send the injured person to the ambulance.

In the car, Qi Fei stared at the patient's thigh root for several times.

Good guy, there is really no blood left!

It took Zhang Yi just over ten seconds to stop the bleeding!

Wow, that's really awesome!

Qi Fei's admiration for Zhang Yi deepened~!

Boss!

Dare I ask if you will accept me as your younger brother? ?

"Qi Fei, get in the car and follow me to the hospital! Tell them to prepare the operating room!"

Qi Fei turned his head and looked at Zhang Yi:

"What about you? You won't get in the car?!"

"This man's leg was knocked off. I haven't found where his leg is yet. I'll go and look for it. Maybe his leg can be reattached."

"Ah?! You... OK!"

It was important to send the patient back to the hospital, so Qi Fei had to close the car door.

The first ambulance drove away.

It was followed by the second one, which was the little girl that Zhang Yi said could be saved just now.

At the scene, some of the injured were injured by the people who were knocked away.

The injuries were not serious and could be taken away directly in one car.

But there were several seriously injured patients at the scene.

All of them had broken bones and bleeding.

With such a strong impact, not to mention broken bones and bleeding, it was a blessing in disguise that they didn't die on the spot.

!

Four died on the spot, five were seriously injured, and the rest were slightly injured.

And the driver also hit and ran? ?

This is not a death sentence? ?

This is not a death sentence. Zhang Yi's name is written upside down!

Zhang Yi walked to the bodies that had been covered with white cloth and looked at them. They were indeed dead.

He turned around and looked at the other seriously injured patients. The doctors from the Sixth Hospital and Wang Yufei were also helping to rescue them.

There were also a lot of red blood stains on Yang Caini's white emergency suit.

It was the blood of the long-haired woman in front of her whose face could not be seen clearly.

This woman had very long hair, but her entire cheeks from the forehead, eyes, nose to mouth were covered with blood.

There was even blood oozing out of the nostrils and corners of the mouth.

Normal people's legs are straight, but this woman's legs were directly bent backwards!

The X shape is not like an X shape, and the right angle is not like a right angle.

In short, the shape of the legs has been completely deformed.

The right side of the chest was also bleeding, and the fat and mammary glands of the entire half of the chest were gone.

The left breast had also begun to swell, so she had to go to the hospital immediately for drainage and breast removal, otherwise the bleeding would not stop.

The liver was also torn, and the seventh rib was also fractured.

There was also subarachnoid hemorrhage in the patient's head, but the amount of bleeding was less than that of the girl, less than ten milliliters.

But the amazing thing was that this woman was very conscious!

More sober than other injured people!

In this situation, she just lay on the ground, waiting for rescue without crying or making a fuss? ?

One of her eyes was already covered with blood and could not be opened at all.

Zhang Yi took a look and found that the eye covered with blood was useless, and the eyeball inside was crooked.

This meant that even if the rescue was successful, she would only have one eye.

"Ah? What did you say?!"

Yang Caini was doing the bleeding work, and suddenly heard the patient say something to her, so she lay down and asked again.

"I said... my..."

The patient's voice was so low that even Charlie Yang couldn't hear it.

"Ah? What did you say? I really can't hear it..."

Charlie Yang was also anxious. What the patient said at this time might be her last words.

After all, she was so seriously injured that even if Charlie Yang was a doctor at Union Hospital, she couldn't guarantee that she could save her life.

"My... I..."

The patient was also very anxious. As she spoke, tears gradually gathered in her only eye.

The despair and worry conveyed in her eyes made Zhang Yi couldn't help but be moved.

Zhang Yi squatted down, observed the patient's whole body, and then leaned over to her ear and asked:

"What do you want to say? You'd better not speak now. You are seriously injured. You have to hold on! We will send you to the hospital immediately!"

Just at this time, Zhang Shengwei came over with a stretcher, and several people were about to help lift the woman into the car.

But she suddenly grabbed Zhang Yi's white sleeve with all her strength.

In an instant, a bloody handprint appeared on the white clothes.

"Doctor...doctor...my...my daughter...where is my daughter?"

Everyone was shocked! !

What? !

She has a daughter? !

But where are the injured little girls at the scene?

Except for the 15-16-year-old girl who was sent away just now.

But it's obvious that these two are not mother and daughter. The girl is 15-16 years old, and even if the woman's face is covered with blood, it can be roughly seen that she is not very old, less than 30 years old.

How can a girl less than 30 years old be the mother of a 15-16-year-old girl?

So the daughter she mentioned must be someone else.

But the strange thing is, where are the children at the scene? ?

The ambulances of the Sixth Hospital are full of injured people, and there is no underage person.

There are no children on the side where the bodies are placed.

So where is the daughter this person is talking about?

"How old is your daughter? What color clothes are she wearing?" Zhang Yi asked.

"She...she's only...she's only six months old...doctor...please save her..."

This sentence was like thunder, and the three doctors present were so shocked that they couldn't speak.

A six-month-old child? ? !

Oh my god!

There's actually a newborn baby? !

A six-month-old child definitely can't walk. Since the mother was hit, the child must have been knocked away in the posture of being held in the mother's arms.

"Damn! There's still a child?!"

This fucking world, at a speed of 130 yards, where would such a small child be knocked to? ?

"Find! Find quickly! Don't worry, I'll go find your daughter now!"

After Zhang Yi said this to the woman, he immediately got up and went to find the child.

Yang Caini also comforted her:

"Don't cry, don't get excited, you are seriously injured now, don't worry about the child, our doctors will help

, OK? "

The woman was seriously injured, but she was so conscious?

Zhang Yi thought, she must be hanging on here because she didn't know her daughter's safety.

Zhang Yi immediately found the traffic police and told them about it.

The traffic police was also shocked. There was a six-month-old child??

So, the police around immediately began to expand the search for the injured.

Although this is a crossroads, there are still many green belts around the intersection.

There is also an overpass in front. According to the speed of the car, a six-month-old baby may be knocked onto the overpass under such a sudden impact.

Of course, the first thing to do is to find the green belt below.

The police expanded the scope of the cordon, and the passers-by around heard the reason and began to help find it.

Finally, the six-month-old baby was found in a green belt more than ten meters away from the accident site...