When doctors have a simulated operating room

The doctor said that the patient was seriously ill.

"Okay!"

Wang Yufei was the first to nod and immediately led the way for Zhang Yi.

This girl's disease is so strange!

The more you check, the more complications you find!

Wang Yufei even worried that there would be another rash or ulcer on the skin.

It's really weird.

Wang Yufei led the way, and Zhang Yi and his family followed him into the emergency room one after another.

At this moment, the girl on the bed was still in a coma.

"That's her. She's only 14 years old. She's too young. We must do our best to save her.

At first, I suspected that she was poisoned by benzodiazepines, but now it seems less and less likely.

How about... give her an IV injection of flumazenil?"

Wang Yufei walked to the girl's bedside and asked Zhang Yi for his opinion.

Flumazenil is the antidote for benzodiazepines and can relieve the central nervous system sedation caused by benzodiazepines.

At this moment, the family members and Wang Yufei looked at Zhang Yi, waiting for him to speak.

But Zhang Yi's expression suddenly became very ugly!

"What's wrong, Zhang Yi? Is there anything wrong?"

Zhang Yi then raised his head and said:

"Nothing, give me the stethoscope, I'll listen."

"Okay."

After taking the stethoscope, Zhang Yi listened to the girl's lungs and stomach respectively.

Then he looked up at Wang Yufei and said:

"You should have found out the pulmonary edema before the CT scan. The stethoscope is full of wet rales."

Wang Yufei was stunned in embarrassment.

Uh...

He admitted that he was distracted by this inexplicable disease after the rescue of ventricular fibrillation.

He forgot to do the auscultation step.

Then, Zhang Yi asked again:

"Are you sure the stomach has been washed?"

Wang Yufei nodded: "Yes, the county hospital had washed the stomach when it was sent here. I even suspected that the hospital was too heavy when washing the stomach and injured the throat or esophagus, so the throat was full of blood clots."

Zhang Yi glanced at Wang Yufei and thought: You can think of this step, can't you think about it further? ? !

Hey!

"For this girl's symptoms, the blood clot in the throat should first consider the lung and bronchial problems.

Otherwise, how do you explain the high carbon dioxide partial pressure?"

"That's right..."

"Also, you've washed your stomach, right? Nothing came out, right? But why did I hear gurgling sounds in my stomach just now? Could she be hungry?"

Wang Yufei frowned:

"The stomach is gurgling? No way?!"

As he spoke, Wang Yufei also took the stethoscope and listened.

Upon listening, there was indeed a sound in the stomach!

There are only three possibilities for this situation.

First, the girl still has food in her stomach and is still digesting it.

Second, when a person is hungry, the stomach occasionally protests, gurgling and saying that it is hungry and needs to eat.

Third, the stomach may be bloated.

From the perspective of elimination, the first one seems impossible, because the girl has washed her stomach. And it was found that the food in the stomach has been digested.

The second one is that she is hungry.

The girl was in a coma, with central nervous system suppressed, how could she be ‘hungry’?

In the end, only the third one was left.

Flatulence!

Wang Yufei thought for a while before saying:

“Could it be flatulence? Maybe it’s caused by drugs?”

Zhang Yi took a long breath and said:

“Hurry up and bring the gastric tube over, and do gastrointestinal decompression.”

“Xiao He, bring the gastrointestinal decompression!”

“Okay!”

Wang Yufei was a little embarrassed because he almost ignored the important clue of flatulence because he forgot to auscultate!

If the flatulence becomes serious, it will raise the diaphragm, and the raised diaphragm will cause the lungs to be squeezed.

——

It will also cause a symptom of respiratory depression.

Of course, the CT results of this girl showed that her diaphragm was not raised.

Wang Yufei felt a little guilty because he forgot to auscultate and ignored this important symptom.

Oh!

He was so busy that he neglected to listen to the stethoscope...

Soon, the nurse brought the gastric tube and the gastrointestinal decompression device.

Gastrointestinal decompression is a method of drawing the gastric contents out of the patient's body under the action of negative pressure and siphon principle.

Not only gastric contents, but also gas or liquid can be sucked out, so as to reduce the pressure in the gastrointestinal tract, reduce the degree of gastrointestinal distension, and improve the gastrointestinal wall

The purpose of blood circulation.

After taking the gastric tube, Zhang Yi quickly applied lubricant and prepared to insert it directly from the nasal cavity and put the tube into the girl's stomach.

The reason why Zhang Yi was so anxious was because...

In Zhang Yi's sight...

This girl didn't have her stomach washed at all! !

There were obviously some food residues and yellowish-white diluted drugs in the stomach! !

But why did the county hospital say that it was washed? ?

Haha!

Maybe they did wash it! !

But they didn't wash the stomach, but the lungs! !

Why do you say that? ?

Because the food in the stomach was not washed clean at all, but the lungs were full of water!

Zhang Yi guessed that before the gastric lavage, the county hospital should have done tracheal intubation to correct the girl's hypoxia symptoms.

As a result, the tracheal intubation was too strong and directly poked a hole under the cricoid cartilage!

The doctors in the hospital over there probably didn't know about this?

In Zhang Yi's sight, the area just below the throat was almost full of blood clots!

Looking at the lungs again, both sides of the lungs were almost full of water!

The right side was better, but the left side was just like the dense shadows on the CT report.

No wonder I thought it was pulmonary edema. How could it not be swollen after washing the lungs? !

Zhang Yi was also shocked!

How could such a thing happen?

No wonder the carbon dioxide partial pressure was so high. The lungs were like this. The girl was lucky to be alive until now!

Zhang Yi's movements were very fast!

He held the lubricated gastric tube and inserted it in.

It was a bit difficult to enter the blood clot blockage, but Zhang Yi had a strong hand and could see the whole process, so in less than five seconds, the gastric tube was completely in the stomach.

Wang Yufei whispered:

"How did you get it in so easily? I was just trying to insert the trachea and it was blocked there and couldn't go in."

Zhang Yi didn't say anything, his eyes were fixed on the transparent gastric tube extending from the nasal cavity.

There is still food in the stomach, and under the effect of negative pressure, the food in the stomach should be sucked out soon!

"The throat is indeed a little blocked, let's do a video laryngoscopy to see the situation later."

"Okay."

Just then!

The remaining food in the gastric tube was sucked out under the effect of negative pressure!

Wang Yufei suddenly showed an incredible look on his face!

Even the family members next to him were suddenly shocked! !

"This... this... what is this?!"

"No... how... how could these things come out of my daughter's stomach? What is this?"

Wang Yufei reacted immediately after a brief shock, looking at Zhang Yi and said:

"Is this food in the stomach?! How can there be food in the stomach?! Did the county hospital wash the stomach?!"

The family members nodded and explained:

"Washed! The doctor over there really did wash the stomach, and we watched it!

We also looked at the water used for the gastric wash at that time. Except for a little blood, there was nothing else."

Zhang Yi finally couldn't help it, frowned and asked the family members:

"Are you sure that it was the stomach that was washed?!"

Immediately, this sentence hit the family members like a blow to the head!

It made them dizzy! Their backs felt cold!

Wasn't it the stomach that was washed?

Then what was it that was not the stomach?

The family members were confused, and the girl's mother was scared and cried again.

It really killed me! What on earth is going on? ? !

Sometimes this, sometimes that!

What happened to my daughter? !

On the side, Wang Yufei understood it completely.

A bold guess gradually emerged in his mind...

At this moment, he carefully reviewed the condition again!

Started to recall from the moment he received the call!

Coma, convulsions, coughing up blood, acidosis, high carbon dioxide partial pressure, even after oxygen inhalation and ventilation, the effect is difficult to relieve.

Then there is pulmonary edema...

Gradually, an answer that I dared not even think about became clearer!

At this moment, the girl's gastrointestinal decompression device has more and more food, which means that the food in the stomach is really sucked out now.

The county hospital did not wash the stomach at all... but the lungs! !

Wang Yufei looked at the family and asked:

"What were the symptoms of your daughter when she was first sent home by her classmates?"

"Trembling! At first, she was trembling all over, and then she fainted. No matter how we called her, she wouldn't respond!

Then she was sent to the hospital, and she started to convulse on the way to the hospital!"

At this critical juncture, the family members answered very seriously.

Wang Yufei then asked:

"What happened next? Did she start coughing up blood after arriving at the hospital? Or did she start coughing up blood after the gastroscopy?"

"Well... she started coughing up blood after the gastroscopy! When she was sent to the hospital, she seemed to have stayed in the emergency room for ten minutes, and then

I was sent to do gastric lavage.

After gastric lavage, I wanted to see if the situation had improved.

About 20 minutes later, the doctor came out and told us that the child was coughing up blood.

He said that he was worried about the seriousness of the situation and that the gastric lavage did not wash out anything, so he suspected that the drug had been absorbed.

They didn't have a forensic doctor, so they could only ask us to send her to a large hospital for treatment. "

"You mean the coughing up blood only occurred after the gastric lavage? Didn't cough up blood before at a classmate's house, at home, or in the car?"

"Yes! Not before, but only after going to the hospital!"

"When was this examination done?"

Wang Yufei took out the blood gas result report from the county hospital and asked.

The family member looked at the time on it and recalled:

"This list... seems to have been done after the gastroscopy.

At that time, the doctor told me that I needed to do another examination to see what was in my daughter's blood?

Oh, we didn't understand those professional terms, so we did whatever the doctor said at the time.

Who knew the result would be like this! "

Wang Yufei sighed after hearing this.

Now the result is very clear. The girl did take drugs to cause coma and convulsion, but she did not cough up blood at the first time.

Coughing up blood appeared after gastric lavage. Now... all we need is a visual laryngoscope to confirm Wang Yufei's bold guess!

Just when Wang Yufei asked the family members, Zhang Yi had already arranged for someone to send the patient to the laryngoscope room.

Two nostrils, one for a gastric tube and the other for a laryngoscope.

(The gastroscope can directly see the condition of the esophagus and stomach when it enters the mouth, and the laryngoscope must enter the nasal cavity to better observe the condition of the nasal cavity and bronchi. The two are different.)

At this moment, most of the gastric contents have been drawn out of the gastrointestinal decompression device.

It is estimated that there is nearly 100 ml.

The girl's appetite must not be Only this much, but after a few hours, the food must have been digested again.

Draw out as much as you can!

After the laryngoscopy, go directly to wash the stomach, and then do blood filtration.

Of course, it has to be fast!

Wang Yufei saw that Zhang Yi was always one step faster than his reaction, and he felt an indescribable feeling in his heart.

Damn it.

How can this person be so powerful! !

No!

Is Zhang Yi too powerful, or am I careless this time? ?

Oh!

The more I think about it, the worse I feel, so I just give up and follow Zhang Yi's ass.

Laryngoscopy room.

The girl was sent in.

Zhang Yi followed in worriedly.

The doctor doing the laryngoscopy is also an otolaryngologist, and he almost didn't recognize Zhang Yi when he saw him in casual clothes.

"Hey, family member, what are you doing? This is the catheter of the laryngoscope, you can't move it!"

Zhang Yi looked up at him:

"I... am Zhang Yi. "

The doctor took a quick look and apologized:

"Sorry, sorry! Assistant Zhang! I didn't recognize you because I was in a hurry."

Zhang Yi shook his head: "It's okay, I'll do it."

The laryngoscope doctor was stunned!

What??

You're stealing my job??

No...

After all, I'm an ENT doctor, and I'm definitely more professional than you in laryngoscope!

You're...

Zhang Yi took the laryngoscope catheter and inserted it directly into the girl's nasal cavity.

The action was not hesitant or dragging.

It went in in a flash!

The action was so fast!

If this patient was awake, he probably wouldn't even feel the pain?!

On the display screen, the patient's nasal mucosa and oral cavity were intact, without any damage.

The camera went down to the throat and cricoid cartilage.

At this time, a blood clot appeared!

The laryngoscope doctor's eyelids jumped and said:

"Why is there so much blood in this girl's throat? ! "

Zhang Yi did not speak, and continued to move the lens down.

More and more blood clots accumulated under the cricoid cartilage and almost submerged the lens.

"Bring the suction device over and suck it." Zhang Yi ordered.

"...Okay!"

As soon as the mouth was opened and a few suctions were given, the girl began to cough violently.

She began to struggle unconsciously.

There was no choice, Zhang Yi had to call Wang Yufei and the family members outside in.

Several people held down the girl's body, and the laryngoscope continued, and the suction also continued.

The girl coughed violently and even opened her eyes to look.

The family members cried and comforted their daughter.

The decibels in the entire laryngoscope room were not small at all.

"Suction again! There is more below!" Zhang Yi frowned and said.

"Okay! "

Squeak~Squeak~

The transparent suction tube was full of sucked blood clots and coughed blood.

After a while, the blood clots blocking the bottom of the circular hose on the display screen were all cleared.

At this time, everyone

Take a clear look at what's going on below this girl's trachea!