Chapter 568: Carotid rupture without hemorrhagic shock
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Live Surgical Broadcast
- 真熊初墨
- 1273 characters
- 2021-03-01 08:57:12
It is a call from a doctor of 120 first aid in an ambulance.
Zheng Ren’s
Huo
stood up and hurriedly asked:
Does the patient still have blood pressure?
"Blood pressure ... 110 / 65 mm Hg." 120 first-aid doctors slightly hesitate, said.
"..." Zheng Ren stunned.
I didn't get it wrong. I just said that the carotid artery is coming.
That is the carotid artery! After the cut, the blood can wrap around the aorta of the roof.
The carotid artery has been cut, and the blood pressure can still be normal. Is the doctor who is not awake or 120 first aid not awake?
"Look at the blood pressure again and re-examine the condition." Zheng Ren said as he pulled out the door of the classroom and went out.
Su Yun made a gesture. After a simple arrangement, he followed Zheng Ren to the emergency department and other patients.
"Zheng Zong, blood pressure was confirmed. The patient's family said that 15 minutes ago, because of the quarrel, the patient smashed a glass to the wall. A glass scorpion flew out and scratched the patient's carotid artery."
120 first-aid doctors rushed to report.
"I have repeatedly confirmed with the patient's family. I did see blood on my neck. But there was only one, and then it was gone."
"Where is the wound?" Zheng Ren asked.
"There was a wound wrapped in a towel at home. I didn't dare to open it. The patient's blood pressure was steady, and I was worried that it would go wrong after opening."
"Okay, it’s done right." Zheng Rendao, "Hurry back."
After that, Zheng Ren hung up.
Strange... Zheng Ren is addicted.
"Boss, come and talk about it." Su Yundao: "Let's see if the family members are drinking."
Well, Su Yun is right.
It may also be after drinking... This is not enough for lunch, and the possibility of drinking is not great.
However, this possibility is not excluded.
The two simply did not go to the emergency room and stood waiting inside the gate.
The flat car in the emergency department had already been there, and Zheng Ren was seen at the inspection. He smiled and said hello.
"Zheng Zong, you are very busy in this class."
"..." Even the accompanying inspection knows? Zheng Ren is speechless.
"I have been in the city for more than five years. The class the night before was the busiest one. I didn't sleep, I ran all night."
"That's perfect." Su Yun sneered at the side: "Just this life, no way."
Chatting, the 120 ambulance sharp call came. The voice is getting closer and closer, and a few people are silent.
As the ambulance stopped in front of the emergency building, the door opened and the emergency surgeon jumped.
"Zheng Zong." He immediately looked at Zheng Ren and said: "The patient is in a stable state."
Zheng Ren nodded.
Whether it is whether the family is drinking or not, or is there any reason to cover up the illness and the onset of the disease, as long as the situation is stable, everything is okay.
The patient was pushed down, and Zheng Ren suddenly saw the carotid artery laceration wound on the system panel on the upper right side of the field of view.
It is consistent with the process described by the family, only the carotid artery is lacerated, and the blood pressure can be ok?
Zheng Ren can not hold the towel to stop the blood from the carotid artery.
In the first two steps, Zheng Ren glanced at the patient.
The face is normal and there is no pale color caused by massive bleeding. Seeing Zheng Ren up, she smiled and just wanted to talk and was stopped by Zheng Ren.
"Don't move, don't move, do you hear clearly?" Zheng Ren said loudly.
"I have nothing to do, doctor." The patient was lying on the flat car, some dissatisfied.
Her left neck was covered with a yellow towel, and the towel did not see blood.
How is this going? Zheng Ren is getting confused.
Pushing the patient to the emergency room, first pressing the ECG monitoring, Zheng Ren took a look.
Blood pressure, pulse, respiration, and oxygen saturation are all normal.
See Zheng Ren carefully, Su Yun is also a bit confused.
He noticed the patient's family, and his behavior was normal and there was no sign of alcohol abuse.
"Talk about it." Zheng Ren stood in the patient's injury test, while asking the family, while carefully taking off the yellow towel.
There was no blood spurting out, and there was no obvious rupture in the neck. There was only a 4mm scratch on the left sternocleidomast muscle.
If Zheng Ren’s eyes are easy to use, this small scratch can easily be ignored.
No bleeding, no bleeding, no subcutaneous hematomas!
Is this manifestation of carotid injury? Zheng Ren once again suspected that the big pig's hooves came.
This product has not been given to the task for a long time, this time also gave such an unreliable diagnosis.
"Doctor, I saw a blood spurting out, and everyone was scared," said a middle-aged man.
"Is it a blood?"
"OK, spray on the ground at home."
120 First-aid doctor said: "Zheng Zong, I saw it, the amount is about 20ml."
Strange.
The diagnosis of the big pig's hoove is consistent with the family's statement, and Zheng Ren has not overlooked the various possibilities of small probability.
Do you have any discomfort?
Zheng Ren began to ask the patient,
Slowly answer, speak slowly, don’t worry.
"Doctor, all are okay." The patient saw Zheng Ren with a serious face, and he carefully understood it. Then he said, "It’s just when you gasp, the left neck is a little uncomfortable."
There are no clear exceptions.
Zheng Ren changed the piece of gauze to the patient and immediately said: "Prepare to do neck CTA."
Su Yun nodded, he knows why Zheng Ren is nervous ~ EbookFREE.me ~ Surgeon, not afraid of flesh and blood, afraid of this seemingly normal, but a blink of an eye no patient.
When you send it, it’s okay to talk. If the carotid artery has something to do, it will be ignored, the patient will die, and the family will not be blamed if it does not cause trouble.
At this time, you can only do the most detailed inspections.
To determine if there is any problem with the blood vessels in the neck, the best check is the CTA of the neck vessel.
One step in place, simple and worry-free.
Zheng Ren cares for the patient and avoids the patient's turmoil, causing irreversible damage. Su Yun went to contact the CT room and said that there is an emergency patient on this side and needs to be examined.
Near noon, the CT room is also ready to get off work.
Just to the last patient, Su Yun replied, Zheng Ren squatted with the first aid kit, let the check cart, took a nurse, and several people rushed to the CT room.
Zhao sister heard the sound of the flat car and knew that Zheng Ren had come, and they greeted it.
"What patient?" asked Zhao.
"Carotid injury." Zheng Ren said.
Zhao sister glanced at the patient and saw that there was nothing wrong with it. He did not refute Zheng Ren’s words, opened the door and let the flat car enter.
Coupled with family members, several people together lifted the patient to the CT bed, and the patient's lover stayed in the CT room. Zheng Ren took a few more words, so that the patient should not move, this is the operation room.
"Zheng Zong, thank you." Zhao Jie saw no family members of the patient, and his condition was not urgent, he said with a smile.
Hmmm?
Su Yun is strange.
Zhao Jie, what do you thank him for?
"My neighbor said that when I went to the medical university, the doctor on the other side was enthusiastic. It was said that the patient of Haicheng Zheng boss, all the way green."