The Surgeon’s Studio

“Find someone to do a transesophageal ultrasound!” Director Miao continued.

Su Yun had already picked up her phone and was calling old he. Old he was already preparing to get off work. He was humming a tune and smoking in the on-call room.

When he received Su Yun’s call, old he did not ask what had happened. He only knew that it was a surgery from the Department of Urology, and they needed to immediately do a transesophageal ultrasound.

Old he’s B-ultrasound level was quite high, and he was one of the few doctors who could use ultrasound to judge pneumothorax. This was one of the few skills that boss Zheng could boast about. He didn’t expect that he would be remembered when he was saving the situation.

Pushing the ultrasound machine at the head of the bed, old he jogged into the operating room.

The operating room was in a mess, but the strange thing was that old he didn’t see boss Zheng and Brother Yun. Meanwhile, Department Director Liu of the Department of Urology was holding a mobile phone in his hand. He kept changing the angle of the phone, and Department Director Miao’s voice as he directed the emergency treatment could be heard from the phone.

“What the …” Old he was stunned for a moment. Then, he immediately realized what had happened.

Director Liu was dumbfounded!

It was a habit that he had formed over the years. When he encountered a problem that he could not solve by himself, he would immediately look for the Department Director.

At this moment of life and death, Department Director Liu forgot that Department Director Miao had already retired. He had gone from a first-line clinical department director to an old man who did square dancing every day and enjoyed his retirement.

Department Director Miao’s voice was still calm and steady. It was full of dominance and an unquestionable aura.

What about boss Zheng and Brother Yun? Old he pushed the ultrasound machine to the patient’s head and took the opportunity to look around.

Nobody!

Forget it. Brother Yun said to do a transesophageal ultrasound.

Old he quickly sent the esophageal ultrasound probe into the patient’s mouth. He avoided tracheal intubation, overcame the interference of always performing chest compressions, and sent the probe into the esophagus.

“President Yu, stop for 20 seconds!” Old he shouted loudly.

“It’s smaller than that. Stop the surgery for twenty seconds. The anesthetist will do an ultrasound. ” Department Director Miao’s voice was heard. The memory contained in chief Yu’s body made him stop the action of chest compressions immediately.

“Gas found in the right heart! Gas has also been detected on the left heart!” Old he took a quick glance and saw the gas in the heart. He reported it to director Miao in the video on his mobile phone, took an image, and then took the craning head out.

“Put a small sponge pad on the right side!” Department Director Miao’s voice was heard,”continue to compress and interrupt CPR. A central venous catheter …”

“Department Director Miao, I’ll do this part.” Boss Zheng’s voice came from the video.

Old he knew what was going on, but he didn’t think too much about why Boss Zheng was at director Miao’s house. Instead, he quickly pushed the bedside ultrasound machine to the side, found the central venopurium puncture kit in the cabinet, and quickly came to the patient’s side.

The patient’s head was already crowded with a lot of people. Old he did not explain anything and forcefully created a space for himself. At this moment, his phone rang. He took out his phone before the puncture, turned on the speaker, and put it aside.

“Old he, do a central venous puncture.” Boss Zheng’s deep and steady voice was heard.

Old he calmed down and said as he prepared to perform the puncture,””Immediately, 22 seconds!”

He used the improved method of subclavical central vein puncture. He found the best puncture point at the intersection of the perpendicular line in the center of the right clavicles and the horizontal line of the sterocaljoint. The tip of the needle was pointed at the lower edge of the artillum to perform the puncture.

After the needle was inserted, the central venous catheter extended downward all the way to the right heart. Old he was quite confident in his skills. 22 seconds, not a single second off.

“There’s a Qi lock effect. When you inhale it, you can feel the pressure. ” Boss Zheng’s voice came from the phone.

Although old he knew everything, he felt more at ease for no reason.

“He has entered the right heart cavity.” Old he said,”he’s drawing air.”

He kept testing, but due to the airlock effect, the syringe did not move smoothly.

The airlock effect was also known as the airlock phenomenon. It was a blockage phenomenon caused by different pressure in the flowing liquid. This phenomenon usually occurred at the high points between the pipes, which was why the general centrifugal pump could not pump liquid.

Old he tested it bit by bit. Suddenly, the syringe in his hand moved slightly. It moved a small distance, about 5ml.

“Boss Zheng, draw out 5ml of gas.” Old he quickly drew out the blood and gas while reporting to Zheng Ren.

“Continue. I just watched the ultrasound, and there’s still air in the ventricular cavity.”

Zheng Ren said as he held his phone.

“Boss, it’s normal for there to be gas in the atrium. I’ve never figured out why there’s gas in the ventricle.” Su Yun asked from the side.

Although he was not in the operating room, he could still feel the breath full of adrenaline and dopamine.

Zheng Ren shook his head and said,”there are too few cases, so I’m not too sure. The current cases show that most of them have dual-chamber Qi accumulation, and there are no congenital diseases like right-to-left bypass. “

Abnormal air embolism meant that the air absorbed into the venous system would eventually enter the arterial system.

It usually occurred in patients with heart bypass from right to left. The gas accumulated in the right atrium or right cerebral artery entered the left heart system through the channel from right to left, causing coronary artery or cerebral artery embolism.

This was a question. Now that they were in the emergency room, the two of them had a tacit understanding not to continue talking about this question.

Old he’s operation was passable, and he even overdid it. Soon, the gas in the left heart was also pumped out, and the problem of cardiac arrest was solved.

After about twenty minutes of continuous chest compressions and intermittent tremor relief, the patient’s lifeblood and respiratory function stabilized.

Department Director Miao heaved a sigh of relief. He put his phone aside and leaned against the back of the sofa. Zheng Ren looked at his expression. There was no fatigue on his face, only the relief and joy of a nervous and excited emergency rescue.

“Department Director Miao, are you tired?”

“I’m not tired. ” Department Director Miao smiled and said,”this is the first time an old man like me has ever seen someone directing the rescue through a phone.”

“A treasured saber never ages!” Su Yun gave him a thumbs up and praised.

“I’ve encountered gas embolism caused by laparoscopy once before. I was dumbfounded at that time, and I pondered about it while I rescued him. However, I made a mistake that time. I easily thought of the carbon dioxide entering the blood vessels. The patient had no complications after the surgery and was discharged after a few days. “

“How many years ago?” Su Yun asked.

“It’s the end of the last century. ” Department Director Miao said.

“At that time, laparoscopy was just launched, and you already encountered gas embolism? Why didn’t you write a report on the case?” Su Yun asked out of curiosity.

“The case report … Has been written.” Department Director Miao said,”I think this case should be very rare. He didn’t even submit it to a Journal with a Chinese prefix. He went straight to the lancets. Unfortunately, my English is average and I’m not very clear about the format, so there’s no point in it. “

“I see,” Zheng Ren laughed.

“Chief, how are you feeling?” Department Director Liu’s voice came from the phone.