2720 If we return to the past
Time was no longer counted in days or hours, but in seconds.
As the seconds passed, the blood pressure in the patient’s wounded artery steadily dropped. The heart rate stopped changing drastically after it reached 150 beats per minute.
However, this kind of heartbeat was already very scary. He didn’t know when it would fall like a cliff, which could declare the patient’s death.
The blood oxygen saturation level had dropped to about 66%. Due to the lack of oxygen, the anesthetist had begun to change to a 100% pure oxygen ventilator.
Under the effect of pure oxygen, the blood oxygen saturation level rose for a short time and then fell steadily.
“Department Director Liu, there’s a gas embolism, right?” The anesthetist was a little flustered. All the possibilities he could think of had been eliminated, leaving only this diagnosis with a high mortality rate.
“It would be terrible if there was a gas embolism,” the anesthetist said with a trembling voice.
Department Director Liu took a look. The hemlock was placed at the junction of the kidney vein, and it completely clamped the kidney vein. There was no possibility of a large amount of carbon dioxide traveling along the vein and entering the blood circulation through the pressure difference during the establishment of a pneumoperitoneum.
He denied the anesthetist’s statement, but he still cautiously stopped inflating the abdominal cavity with carbon dioxide and pulled out the traroka to relieve the abdominal cavity.
However, the patient’s condition did not change at all. The emergency medication had been given once, but the vital signs displayed on the monitor Monitor were still declining.
“Call Department Director Miao,” Director Liu said in a deep voice.
The circulating nurse was stunned for a moment. She felt as if she had gone back in time to half a year ago. No matter what happened, she could solve it by calling director Miao.
However, she did not hesitate. She did not care that director Miao had already retired. Instead, she immediately called director Miao.
……
……
Department Director Miao was sitting at home, chatting with Zheng Ren and Su Yun.
They talked about all sorts of things, but not about medical treatment. After working for a lifetime, he had already retired and returned to the fields. He should just let all of that leave him.
“Director Miao, my mom also does square dancing at home. I just don’t understand what’s so good about it. Please tell me, what are the benefits?” Su Yun said,”what do you mean by ‘wind and rain will not stop’? the old man and old lady are so proud of this thing.”
“Everyone’s just here to join in the fun. ” Department Director Miao said with a smile. His voice was full of vigor. He had basically recovered completely. Other than the bone fracture causing a little problem when he walked, he was fine.
“I don’t have much to do at home, so I’m just bored.”
“I have a dog at home, why don’t you help me walk it? I’ll take it. Blackie’s legs were broken during the earthquake relief, so he can’t run fast. Don’t worry, it’s as good as your legs. ” Su Yun asked with a smile.
Department Director Miao was just about to jokingly scold him when his phone rang.
He leaned back on the sofa and picked up his phone leisurely. He took a look and saw that it was a call from the operating theater. He sat up straight abruptly, and the smile on his face disappeared, leaving only a dignified and solemn look.
“What’s wrong, Department Director Miao?” Su Yun asked.
Department Director Miao waved his hand and did not answer Su Yun’s question. Instead, he picked up the phone.
“What’s the matter?” Department Director Miao asked in a deep voice.
The sound of wailing came from the other end of the phone. It was very urgent and loud. Zheng Ren and Su Yun heard some parts of it.
“Uh … The patient’s condition during the surgery is not good?”
The two of them looked at each other. If they were in Room 912, they would have rushed to the operating room by now.
But now, she was at director Miao’s house. By the time a car arrived and she rushed to the hospital, the cucumber would have turned cold.
‘Department of Urology, there’s a laparoscopic Kidney Resection Surgery in the afternoon. Did they touch a blood vessel that they shouldn’t touch?’
“Video call. I’ll take a look at the patient’s condition.” After listening to the simple introduction, director Miao said in a serious voice,”
After hanging up the phone, director Miao saw Zheng Ren and Su Yun staring at her, so she explained,””He was carrying out a laparoscopic kidney resection, but his blood pressure and heart rate suddenly became unstable, and his blood oxygen saturation level dropped rapidly.”
It really was like this!
“You touched a blood vessel?” Su Yun asked.
“That shouldn’t be the case. It would be over if he touched a blood vessel and stopped the bleeding.” Zheng Ren said,”it’s probably something that happened out of nowhere. Is it caused by a vyssal nerve reflex?”
Department Director Miao shook his head slightly.”Cardiac arrest caused by the vacuous nerve during a hepatectomy is rarely seen. It’s better to take medicine.”
Just as he said this, the sound of a video call from WeChat rang, and director Miao accepted the video call request.
“Director, the patient …” Director Liu’s voice came from the video. He was holding his phone, and the screen was facing the television screen of the laparoscope.”There’s no bleeding. The patient’s heart rate, blood pressure …”
“His heart has stopped! It’s CPR!” The anesthetist shouted.
Zheng Ren and Su Yun quickly went to director Miao’s side and looked at the screen.
Their heart rate dropped like a cliff, and their blood oxygen saturation level reached 52%. The alarms on the ventilators and monitors kept ringing. Even if they were at home, the three people’s bodies would naturally secrete a large amount of dopamine, adrenaline, and glucose.
“Anesthetist, please adjust the operating table. Keep your head low and your feet high.” Director Miao said.
However, the scene on the other side was a mess. The anesthetist was pushing medicine, and Vice President Yu was doing chest compressions. As they had not found the problem, everyone was panicking.
“Anesthetist! Little Liu, adjust the beds, lower head and higher feet!” Department Director Miao raised his voice and said in an unquestionable tone.
Soon, the bed was adjusted to another angle, and the position was changed according to director Miao’s instructions.
Epinephrine, epinephrine, and epinephrine were administered one after another. Department Director Miao gave out instructions for intravenous injections while he carried out the medical advice on the other side of the video call.
It was as if an invisible hand had turned back time and returned to the past. At this time, Department Director Miao was standing in the operating theater and presiding over the rescue.
“Department Director Miao, what do you think …”
“Establishing the pneumoperitoneum resulted in gas embolism.” Department Director Miao said with certainty.
If Zheng Ren was present, he could use the system panel to make a judgment. Without director Miao, Zheng Ren would probably have to think about it for a while before he could be sure.
After all, gas embolism caused by a erect pneumoperitoneum was very rare. At the very least, Zheng Ren had never encountered such a situation when he performed laparoscopy in the General Surgery Department.
Laparoscopic kidney resection … Zheng Ren quickly searched for similar information in his mind.
For patients with kidney disease, laparoscopy was a minimally invasive, safe, and effective surgical treatment method. However, because it required the establishment of an erect pneumoperitoneum, the risk of Qi embolus was inevitable.
The occurrence rate of gas embolism was very low, about 0.002% to 0.02%. Once it occurred, the death rate could be as high as 50%.
Looking back on the literature, there were only five reports of gas embolism in laparoscopic kidney surgery.
The older the ginger, the spicier it was. Perhaps director Miao had encountered a similar situation before and knew what had happened at a glance.
After all, Department Director Miao was one of the first surgeons in the country to use laparoscopes for surgery. He had encountered all kinds of situations before.