Vol 3 Chapter 2609: Vagus nerve reflex
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Live Surgical Broadcast
- 真熊初墨
- 1237 characters
- 2021-03-01 09:06:54
Zheng Ren held a 50ml syringe in his hand. After simple disinfection, he inserted a needle 0.5cm above the pubic bone.
The urine-filled bladder is against the abdominal wall, and needle injection is not difficult. Immediately, Zheng Ren began to extract the urine accumulated in the bladder.
A 50ml syringe needle was used to draw a tube of about 60ml. Six times of suction, Zheng Ren looked at the ECG monitor.
With Su Yun's heart compression and decreased urine accumulation in the bladder, atrial fibrillation heart rate appeared on ECG monitoring.
"Continue with heart compressions, Gu Xiaoran! Prepare for electric defibrillation!"
"Adrenaline and lidocaine are given intravenously."
Gu Xiaoran took the defibrillator's head from the mobile nurse and asked, "How much energy?"
"200J."
"Mr. He, I'm defibrillated." Gu Xiaoran still greeted Lao He very carefully, but he saw Lao He holding a syringe in his hand and was waiting for himself to do defibrillation. He was inexplicably panic.
It's like a machine that worked well, but suddenly it's stuck for a reason.
"Xiao Ran, give it to me, hurry up." Su Yun knelt on the operating table in a very awkward posture while doing heart compressions, he said anxiously.
"Oh, oh." Gu Xiaoran immediately gave the defibrillator to Su Yun.
"Bang ~"
At 200 Joules, the patient's ventricular fibrillation showed some improvement.
"Continue." Zheng Ren directed the rescue.
As the heart rate appeared, what he said was not as dense as it was at the beginning.
After Zheng Ren pumped out 600ml of urine, he took out the syringe needle.
"General Manager Yu, make a bladder fistula." Zheng Ren said looking at General Manager Yu.
"Oh oh, okay." Yu Zong stood at the operation area, watching the heart rate and ECG displayed on the patient's ECG monitoring from normal to disappearing, and from disappearing to normal, the process has nothing to do with himself, as if watching an extremely standard The teaching of emergency rescue is average.
It's just ... I seem to be the magician, and I should be the one who stands in the middle and directs the rescue. Looking at Boss Zheng's center command, Yu always felt envious.
Zheng Ren glanced at the patient's electrocardiogram, which had stabilized, and finally breathed out.
"It's okay, Mr. Yu first made a fistula, and then went out to get the nails." Zheng Ren said.
Although ECG monitoring still occasionally issued two alarms, with three times of electrical defibrillation and the drug effects of epinephrine, lidocaine, and atropine, it has gradually returned to normal.
The most important thing is that the urine in the bladder has been drawn out by Zheng Ren.
After a few more minutes of observation, the patient's vital signs had returned to normal when the general sterile sheet was laid out and the bladder ostomy was started.
"Boss, you are really the same as mice and ants." Su Yun was a little sweaty in front of the sterile cap, not because of nervousness, but because she was just half-kneeling on the operating table for emergency chest compressions.
In fact, it was enough to stand under the operating table and add a footstool, but at that time, the heart rate suddenly fell like a cliff, and the ECG was drawn in a straight line. Who has time to think about so many things.
I'm sure how fast and how quickly.
"Urine retention in the bladder stimulates the vagus nerve." Zheng Ren didn't want to come to the stage to help the general meaning, it was just a bladder ostomy operation. By the way, I checked whether the 50ml syringe needle was damaged to other organs. The operation can only be said that the operation of Zheng Ren will not go.
"Another rich clinical experience?" Su Yun sighed subconsciously, a hot air could not pass through the three-layer mask, and spilled out along the space above the bridge of the nose.
"Well, sure." Zheng Ren said frankly, took off the sterile gloves and turned back to sit on the original stool.
"Boss Zheng, Brother Yun, what's the matter?" Yu Zongxin asked with lingering fear.
Just when the patient's heart rate fell steeply, and the ECG was drawn straight, the person was embarrassed and didn't know to be afraid. And now everything has passed, and thinking back, Yu Zong was afraid.
This is hell! Good patient, who walked in by himself, how did he die suddenly after a few minutes of surgery? !!
"Just said, the vagus nerve was stimulated." Zheng Ren said faintly, leaning his back against the wall, feeling the coolness from the wall, he was also a bit lucky.
Fortunately, in the end, I couldn't find the answer. When I came out of the system operating room, I heard Su Yun and General Yu chatting. When talking about the high pressure of the bladder, the urine may be ejected the moment the last nail is opened.
This idea led Zheng Ren to turn back to the system operating room and perform a bladder fistula before performing the operation. The subject did not experience cardiac arrest.
The problem was found, but it was a little regrettable that the patient's heartbeat had stopped before Zheng Ren said.
But it was good to be saved, Zheng Ren thought to himself.
Seeing that Boss Zheng was unwilling to speak, Yu Zong had to look for the pubic bone, prepare to make an incision on the holding, and perform a bladder fistula, while looking at Yuner with an inquiring gaze.
"The walking nerve is widely distributed in various tissues and organs throughout the body, and it completes various physiological activities with the central nervous system through the form of reflex arcs." Su Yun said, asking, "Have you ever performed eye surgery?"
Yu shook his head.
"Where did you graduate, didn't you go to ophthalmology during apprenticeships and internships?"
"Have been there, but the professor will definitely not let me do it. It would be good to go to the operating room and take a look at it, but the professor who has the point can't even go up to the operating room, just write the medical records below Now. "President Yu.
"Don't talk about fucking, I guess you will soon become the kind of professor in your mouth." Su Yun smiled, "Did the boss say that, in the end, you became the one you hated the most Kind of person. "
"..." Mr. Yu froze for a moment, then smiled and said, "Let's borrow your good words, Brother Yun."
But his smile was so stiff at this time, UU reading www.uukanshu. com hasn't been relieved from the sudden change.
Accidents in the operating room can happen anytime, anywhere, and God knows where there is a problem. It's just that this problem appeared and resolved faster. Yu Zong hadn't responded yet. The rescue was over.
It's just ... what does it have to do with ophthalmology?
"Brother Yun, what's wrong with the ophthalmology, you continue to say." President Zong asked while cutting the skin and separating it layer by layer.
"Ophthalmic surgery has a rare condition called eye-cardiac reflex. When the eye muscles are stretched, they will produce a vagus nerve response, causing the vagus nerve to over-excited, causing arrhythmia and slowing the pulse, which is called eye-cardiac reflex."
"Well, it's no wonder students who don't get internships come on stage."
"The reflex arc is the trigeminal nerve branch to the nucleus of the trigeminal nerve, then to the dorsal nucleus of the vagus nerve, and finally the myocardium responds, which can seriously lead to cardiac arrest. This patient is also the same reason, the cardiac arrest caused by the vagus nerve reflex, right? Boss . "
"Um." Zheng Ren nodded.