Chapter 515: : Really a personal thing!

This is the most critical patient Chen Cang encountered in his life!
none of them!
The most critical is not the most serious. Many serious patients have no possibility of rescue in front of Chen Cang.
At this time, Chen Cang felt that there was a chance!
Actually, it is most suitable to make an X-ray film at this time, but ... Where can I go back to do it?
The blood pressure of the patient is almost gone, the ascending aorta ruptures, and the heart is tamped. It is not sure whether the heart is damaged. If it develops according to the general situation, the patient may be gone before being sent to the hospital.
During this time, Chen Cang hated cardiovascular diseases, especially for emergency treatment.
He clearly remembered that the latest report recorded that the incidence of thoracic aorta in the traffic accident in the country last year was about 15%, and the ascending aorta rupture was only 5% of this, and of these 5%, only A 10% chance of being delivered to the hospital, and of this 10%, only 20% will be successful!
What this means is self-evident!
Doesn't Chen Cang know that there is a greater chance of infection in the car?
Doesn't Chen Cang understand the chest radiograph and make a clear diagnosis under SCT or EBCT? Is it better to do an angiogram of the aorta to identify the site of the injury?
However, all this is allowed under the circumstances of the injury.
Don't talk about ct and radiography now, even the chest radiograph has no chance!
Chen Cang clearly remembered!
In the latest guidelines, if aortic rupture is suspected, extremely unstable circulation accompanied by signs of direct rupture and secondary penetration (hemothorax, cardiac tamponade), surgical exploration should be immediately rescued!
Therefore, Chen Cang will now choose to open the chest directly to detect hemostasis.
When you have no choice, the guide is your reliance and your legal basis!
Doesn't he know that everything he does now will be accompanied by risks?
He is all clear!
However, at this time life is passing, where there is time to delay!
Chen Cang said decisively: "Lao Yang, stop ahead."
The driver Lao Yang could not help but hold back:? ? ?
Through the rearview mirror, he saw that Chen Cang was about to undergo surgery, and his face suddenly changed!
But I didn't say a lot, but I found a suitable place directly, and the car was quite good.
On the way of the 120 ambulance transporting patients, the doctor's words were like military orders, and Chen Cang was the leader of the rescue team.
Chen Cang looked up at the two patients and said, "Get out of the car and hurry to the Second Provincial Hospital."
The two men's faces suddenly changed, and the bald man still wanted to speak. Obviously, Wang Qian didn't give them a chance and sent them directly.
Chen Cang took a deep breath and was a little nervous.
This was the first time he had handled such a critically ill patient independently, and it was the first time he had performed an operation in an ambulance.
Anesthesia in this case requires smooth, less or no drugs that inhibit the circulatory system. For the critically injured, it is best to perform local surgery first, and then perform anesthesia induction or tracheal intubation.
Conditions are limited at this time, Chen Cang can only perform local anesthesia!
Local anesthesia came into effect quickly, not long.
Chen Cang picked up the scalpel and made a direct incision in the middle of the chest!
Wang Qian said nervously: "Not much gauze ..."
Chen Cang nodded, and then carefully pulled away the sternum ... Gradually saw the scene of scalp numbness!
This is a sea of ​​blood.
Chen Cang turned to Wang Qian and said, "Draw blood!"
Wang Qian also changed his face, but he picked up the syringe and started to draw blood!
And Chen Cang's eyes stared at the pericardial area. At this time, the pericardium was like a big steamed bun filled with blood. Chen Cang cut a little, and a burst of blood poured out.
"Hemostatic forceps!"
Now the bleeding place has been exposed, that is, the beginning of the left ventricle exit, which is relatively fixed, so it is easy to cause rupture after being shocked by violence or sudden deceleration!
Fortunately ... the ribs didn't hurt the heart.
This may be the only thing to be thankful for.
The blood pressure is very low, Chen Cang is helpless, but this is a fight without choice. If he does not work hard, the patient will die.
Chen Cang cut the pericardium decisively, and the bleeding site was completely exposed.
"Are there non-invasive hemostats?"
Wang Qian froze, and immediately shook his head: "No!"
Who prepared these things in the rescue car?
Chen Cang hesitated. Suddenly he took his hands, pressed it on top, and squeezed the tear to his hands. The blood was no longer flowing.
Blood pressure is temporarily stable ...
But the life of the patient is still swaying in the wind like the leaves of this season.
Fortunately, after contact with the pericardial tamponade, the patient's bleeding was also controlled, and blood pressure had gradually increased.
Chen Cang said to Lao Yang, "Back to the hospital!"
Lao Yang glanced at Chen Cang from the rearview mirror, nodded solemnly, started the car steadily, started, and drove towards the hospital.
With both hands, Chen Cang can clearly feel the power of blood flowing in his hands, and he can clearly touch the traces of life.
A few minutes later, the car was parked directly at the special aisle door of the emergency department of the Second Provincial Hospital.
Chen Cang did not dare to move, and the driver Lao Yang jumped directly behind him, and Wang Qian carefully lifted the bed down.
The following Li Baoshan, Tao Yan, Xia Gaofeng and others are already waiting anxiously!
Chen Cang said quickly: "Go to the operating room immediately!"
There was no doubt that everyone had him. At this time in the operating room, Wang Kaian, Zhou Xiaodong, and Zhang Wenfu outside the heart were all dressed and waiting for the patient's arrival!
The blood transfusion department, laboratory department, medical department, anesthesiologist, etc. are all waiting for Chen Cang's return.
With the arrival of Chen Cang, rescue preparations officially kicked off!
Everyone has started orderly preparations!
Blood drawing, emergency testing, blood matching ...
Medical contact, sign, authorize ...
The anesthesiologist was Liu Jian. When he saw that Chen Cang had opened his chest and pressed his hands against the heart, he could not help but widen his eyes.
Extracorporeal circulation machines have begun preparations.
At this time, Wang Kai'an held a non-invasive vascular forceps and glanced at Chen Cang: "I'll come!"
The voice is not loud, but it is firm.
Chen Cang nodded and completed the handover carefully.
When Chen Cang went out, Wang Kai'an took the three and the anesthesiologist to start related work.
Intravenous!
Establish extracorporeal circulation!
Liu Jian started tracheal intubation ~ EbookFREE.me ~ to prepare for anesthesia.
This operation needs to be performed under cardiac arrest. When everything is ready, Zhang Wenfu blocks the distal aorta and prevents blood from passing through.
When Tao Yan and Xia Gaofeng saw the beginning of the ascending aorta of the patient, which penetrated the outer part and the torn mouth under the pericardium, they could not help but tremble.
This ... It's really like Chen Cang said, it's hard to go back to the hospital.
Thinking of Chen Cang and Wang Qian just now returning from blood, thinking that Chen Cang used his fingers to stop bleeding, all the way back to the hospital ...
They both admire!
Xiao Chen, really a personal thing.
(End of this chapter)