After 100 Days Of Sign-In, The First Operation Shocked The World

Chapter 89

Because there is not enough time at all, the understanding of the condition can only be done inside the operating room.

The workers came in together and asked about the situation while disinfecting.

“What’s the matter?” Zhang Yuan asked.

“Ah~~” The coworkers were also frightened and unresponsive.

“I asked, how did this injury come from?” Zhang Yuan said softly.

“I hung a piece of glass on the construction site, and then it broke, and the glass fell off. Old Liu was making a video call with his daughter. He said that after a few days of vacation, he would buy gifts and go back to his daughter. Then he did not have time to run. Then the glass fell and shattered. It hit Old Liu’s neck…”

“How long has it been since then?”

“10 minutes…no, 15 minutes or so…”

Lin Feng and Zhang Yuan looked at each other.

Such a long distance and such a large amount of bleeding makes the scalp numb!

At this time, needless to say, Lin Feng and Zhang Yuan knew from the patient’s skin that the temperature was low and he was in a state of hemorrhagic shock.

shock!

It is the most common and dangerous symptom after a lot of bleeding!

Its symptoms are: a sharp decrease in effective circulating blood volume, insufficient tissue blood perfusion, microcirculation disorders, metabolic disorders and cell damage. Failure to deal with them in time can be life-threatening.

Of course, shock will also be staged:

Judging by the batch skin temperature and color, there are compensation periods and decompensation periods.

Compensation period: pale, clammy limbs

Decompensation period: cold limbs, obvious cyanosis of the skin and mucous membrane all over the body, and even petechiae and ecchymosis.

Obviously, the worker patient at this time has reached the decompensation period.

“Rehydration!”

“Establish two channels, one from the internal jugular vein and the other from the femoral vein (both are central meridians, the thickest kind of vein, the fastest)…”

“Come on, I’m faster.”

Lin Feng poured iodophor on his hand, disinfected, then disinfected the patient’s two large veins, punctured…

The speed is very quick!

And Zhang Yuan was calling the nurse to dispense liquid.

It is still the general principle of rehydration in the textbook: crystals first, gelatin, salt and sugar, fast and slow, alternating liquid types, see urine potassium supplement.

Basically there will not be much change.

First input Jing 08 body fluids: physiological saline, balanced salt solution, glucose solution to increase the return to the heart blood volume and cardiac output, and control the shock…

Then, enter the colloid: whole blood, plasma, albumin, etc., to reduce the infiltration of crystalloid blood into the outside of the blood vessel…

It took about 3 minutes for many people to work together…

The rehydration work is all done…

“Hurry up to the test, real-time detection of BP (blood pressure) and cvp (central venous pressure)…”

“Yes!”

Soon, the testing instrument was also plugged in and the measurement started.

The test results appear: bp and cvp are both low levels, so rapid rehydration is required.

After finishing these,

The crowd began to formally prepare for the operation.

The patient’s neck is still being pressed by a nurse.

Lin Feng is worried: “The speed should be fast. If you keep pressing on the blood vessels, the brain will have insufficient blood supply and cerebral infarction.”

“By the way, adding aspirin (anticoagulant), recombinant tissue-type plasminogen activator…can reduce the probability of cerebral infarction…”

At this moment,

Lin Feng looked at the worker from the corner of his eyes.

Frozen for a moment.

“What are you doing here?”

“what?”

“Ah what? Get out now!”

“Oh oh oh, I’m going out now…” The worker went out in a panic.

“Wait…what’s the sound?”

Lin Feng heard something.The worker quickly took out the cell phone in his pocket: “This is Old Liu’s cell phone. He is talking on the phone with his daughter.”

Lin Feng happened to see the screen of the mobile phone. A little girl and an old woman with white hair were looking nervously at this side.

“Baba~~Woo~~Baba~~~~~”

The little girl’s tears kept streaming down, obviously terrified.

The white-haired old woman is probably a grandmother or grandmother, crying and comforting the little girl.

Lin Feng quickly grabbed the phone to prevent her from seeing the scene of the operating table.

Lin Feng squeezed a smile from the sun.

“Your father is okay, don’t worry, you will get better soon…”

Then handed the mobile phone to the worker and told him to go out quickly to comfort the little girl.

The workers went out and the emergency door was closed.

Surgery, start!

…

Zhang Yuan, Lin Feng, anesthesiologists, nurses wash their hands, dress, wear gloves…

Back to the operating table.

At this point, the patient has been anesthetized.

Lin Feng stood in the seat of a helper.

Zhang Yuan said, “Come on, I’ll learn something…”

Lin Feng declined for a while, but Zhang Yuan refused, because he could indeed learn from Lin Feng, and his speed was not as fast as Lin Feng.

“Then I’m not welcome.”

Lin Feng took a deep breath.

Zhang Yuan took over for the nurse to press to stop the bleeding. The nurse who originally pressed to stop the bleeding left the field. The fingers often moved two centimeters more proximally and distally, leaving Lin Feng’s vision of the wound.

Lin Feng quickly disinfected the visual field of the wound with iodophor, repeated disinfection, and observed glass slag, but did not find it.

After disinfection, Lin Feng began to use surgical forceps to find the location of the arterial wound.

It stands to reason that it is best to do a high-resolution NMR, but doing NMR under the current situation will greatly delay the time and cause further cerebral infarction in the patient.

You can only use experience to find and repair first, and then go to the MRI to see the situation after the operation is completed.

As for finding the blood location…

Such a large amount of bleeding can only be arteries, or arteries + veins.

There are many arteries in the neck, common carotid artery, superior thyroid artery…a dozen…

Among them, the common carotid artery and superior thyroid artery are the thickest at this position.

Open the wound and probe.

It’s easy to see.

The total carotid artery is ruptured!

The superior thyroid artery is ruptured!

Look at the other blood vessels again, luckily it was all right (after the operation, I will get an MRI approval)!

This is unfortunate and fortunate, they are fine, so it can save a lot of time for Lin Feng’s surgery.

At this time, the nurse began to report quickly:

“BP has returned to normal levels, but cvp is still low…”

Lin Feng: “This shows that the blood volume has almost recovered, reduce the infusion, and control it… In addition, 10 mg heparin and 30 mg papaverine are injected. I am going to have an operation…”

Itinerant nurse: “Yes!”

…

The operation officially begins!

“absorb……”

Hiss~~~~

The suction device quickly cleans the blood under the skin, and finally exposes a clear surgical field.

Lin Feng first blocked the rupture of the common carotid artery and clamped the large blood vessel to the distal and proximal blood vessels.

Then the superior thyroid artery is blocked, and the blood vessel clamp is still clamped at the far and near ends.

At this time, Zhang Yuan could finally let go.

At this time, Lin Feng began to trim the two broken ends of the two arteries, cutting off 2mm from the edges of the blood vessels… (because of the elasticity)

1% lidocaine, 50ml to flush blood vessels…

Then warm salt water and compress…

Finally, Lin Feng picked up the 5-0 undamaged thread and sutured the common carotid artery first. The specific method was to make two-point positioning and intermittent sutures, and then intermittent mattress sutures for several stitches between the positioning sutures.

It’s done in 5 minutes.

Connection is complete!

“Let go of the common carotid artery clip and see…”

Lin Feng is not worried about arteries. He is concerned about cerebral infarction. He needs to provide blood oxygen to the brain as soon as possible. It can be as fast as one second, and every second can greatly reduce the risk of cerebral infarction.

First put it slowly closer,

The proximal vascular clip was opened and arterial blood began to pour into the wound.

No blood oozes!

Continue to open the distal vascular clip, and the blood gurgled to the far end, rushing to the brain.

No drop of blood oozes out!

“Success!”

Lin Feng is not happy or sad, because it is not difficult for him.

Next,

It is the turn of the superior thyroid artery, which is almost the same technique, connected, and finally sutured with an intermittent mattress.

This time it was 4 minutes, and the connection was complete.

bloodletting!

Proximal first, then distal.

Open, and there is no drop of blood in the end!

The operation was basically successful!

Lin Feng breathed a sigh of relief and finally gave the little girl an explanation.

but……

There is also a shadow over Lin Feng’s head.

During the seventeen or eighteen minutes of compression blockade, did the patient suffer from cerebral infarction?

Also, are other blood vessels broken or damaged?

…

Next,

Lin Feng carefully inspected the inside of the wound, made sure that the bleeding point of the wound was not visible to the naked eye, and then began to suture the wound.

The broken lymph is cut away…

Disinfect, rinse…

Stitch the inside…

Continue to stitch…

Finally, the skin is sutured and the operation is completed…

Looking at the time, it took a total of 35 minutes.

On the one hand, the operation is not difficult, on the other hand, Lin Feng tries to speed up as much as possible to provide a favorable time for the brain to supply blood oxygen.

Look at the testing equipment again.

Both Bp and cvp have returned to normal levels, and the shock has survived…

For plasma, 1500ml is used~~

Everything seems very smooth.

Lin Feng can’t help thinking again, is my “lucky” working?

…

Outside the operating room.

A vice president of the construction site came and went through the formalities and money, and waited outside.

The worker awkwardly held his mobile phone and pointed the camera at the door of the operating room.

The eyes of the little girl and grandma looked at the operating room through the Internet and cameras, expecting the appearance of the father inside.

Hum~~~~

The door of the operating room opened, and Lin Feng, Zhang Yuan, and the nurse walked out in a cart.

“Baba~~~~”

The little girl yelled expectantly and worriedly.

Workers and vice presidents rushed over.

Anxious!

“Doctor, how is the operation?”

“Don’t worry, the operation was successful, and the fate was picked back… I would like to thank this uncle worker who pressed to stop the bleeding and provided us with precious time for rescue.”

The worker scratched his head embarrassedly and was very happy.

Lin Feng took his co-worker’s phone and said to the little girl in the phone:

There was a sunny smile.

“Hi, kid, your father is in good health now, you can rest assured~~~~”

“real!!”

When the little girl heard the news, she cheered, and finally bowed to Lin Feng and others with a serious face.

“Thank you, uncles and aunts!”

A group of nurses laughed happily covering their mouths.

The little girl smiled openly: “Uncles and aunts, grandma said, we will take the train tonight and go to the hospital tomorrow…”

Lin Feng laughed haha ​​870: “Okay, uncle will invite you to dinner then!”

Seeing her so happy, Lin Feng felt that he was warm again.

It’s hard work to be a doctor, but it’s good!

…

That afternoon,

The patient woke up.

Lin Feng happened to be before get off work, so he hurried over and gave him a score.

Consciousness is still relatively clear, thinking clearly.

“Thank you doctor.”

“This is what we should do, but the common carotid artery rupture usually has a high mortality rate. You are lucky to get a life back. You have to thank your coworker, if it weren’t for him to stop the bleeding, I am afraid we can’t do anything… …Also, your daughter said that she would wait to get on the train and come here tomorrow to see you.”

“Okay.” There was a happy smile on the worker’s vicissitudes of life, “My wife died prematurely, and the child had no mother since childhood, and the relationship with my grandmother was also broken. I depended on my grandmother and me…thanks to the doctor!”

Thanks for three consecutive times.

Lin Feng nodded.

“I will give you a muscle strength rating… Can you move now? Try both hands and feet…”

According to Lin Feng, the workers began to try.

Soon, a look of panic appeared on his face.

“Doctor, I don’t seem to be able to raise my left arm anymore.”

“Don’t panic, can you move?”

“can.”

“Try moving it horizontally…”

“Yes… but I can’t lift it up…”

Lin Feng frowned.

The left upper limb is scored at level 2. It seems that although I have done relevant prevention, he still caused a cerebral infarction.

The good news is that there is no problem with the right hand and left and right legs, level 5, normal state, indicating that the cerebral infarction is not serious.

(Level 0 means no response, level 1 is able to tremble, level 2 level, level 3 resistance to gravity, level 4 resistance to external resistance.)

“I will send you to an NMR examination, and a brain CT, to see the situation…”

“Okay, doctor.”

Lin Feng is about to send the patient to the imaging department for examination.

However, there are too many patients in the imaging department and will have to wait until tomorrow morning to have time to do it.

In this regard, Lin Feng can only get off work first.

Wait for the check-up tomorrow…

“I hope it’s okay…”

Lin Feng thought of the sad and crying look of the cute little girl, and felt very distressed. He didn’t want her to lose the backbone of the family…

——————————

ps: Many book friends say that there are few updates: I repeat that although there are 3 chapters, the word count is three or four thousand words. I must have more than 6 chapters apart. I am just lazy to score chapters.

Today: 3500+3800+4100=11400 words.

. .