The ambulance drove back to the high-frequency chirping of "Avoid me, avoid me" before Li Min recovered from the shock.The two surgeons on duty at the outpatient clinic today, Li Min didn't know each other.I only had time to introduce myself in a hurry: "I am a trauma surgeon, and I came here this year." ”She first identified herself as a junior, and then she leaned on the side of the flat car and ran to the ambulance to pick up the patient who committed suicide by cutting her wrists.The two surgeons in the outpatient clinic immediately left one of them when they saw that a trauma surgeon was coming.The rest of the one, tie your hands and wait for Li Min to speak.Li Min secretly scolded a foul language, and the provincial hospital, what kind of emergency configuration is this!
But he had to take over the burden of rescue.The first time the patient entered Li Min's sight, Li Min did not feel very good.Excessive blood loss was Li Min's first intuitive judgment.Looking at the pale face in front of him, whose face was swollen and swollen a few days after giving birth, and there were still tear stains on his cheeks, Li Min only had pity for her in his heart.While helping the car to the emergency department, Li Min instructed the nurse who followed him: "Prepare to draw blood and do blood crossing."
INFORM THE BLOOD BANK TO PREPARE 800CC OF BLOOD OF THE SAME TYPE.Do a dextran skin test.Push the ambulance over. ”Fortunately, the nurses in the emergency department were good, they moved quickly, and they did it step by step according to Li Min's instructions.Li Min changed the tourniquet on the woman's forearm, and then untied the towel wrapped around the woman's wrist, revealing the hideous wound."
You disinfect first."
Li Min ordered the stupid male doctor."
Iodophor."
Li Min rolled up her sleeves as she gave the order, and the nurse poured iodine on her forearms and hands.It was too late to brush her hands, so she had to disinfect it with iodine, and then deiodate it with alcohol to reduce the chance of infection as much as possible.As for such damage to the skin, it was not within her consideration."
Pay attention to changes in blood pressure.Connect the ECG monitor. ”Li Min gave the order, looking forward to Dr.
Liu's arrival soon.At this time, there was a cry outside the door: "My daughter-in-law."
If you have a good one, my son can go in for you, and there are only two granddaughters left, how can you let me live?
My family has been moldy for eight lifetimes, and I married you, a mourning star with a bad stomach. ”The deafening cry of the long tone was accompanied by the sound of the door being pushed, "bang"!
The old lady ran into a girl with one hand.The nurse who followed behind her shouted nervously, "Old lady, you come out and come out."
Surgery is done inside. ”The old lady ignored the nurse's shouts and went inside.The two girls were so frightened that they could only sobbed quietly and cried for their mother.Look at the older girl, who is about ten years old; The little girl should not be of school age yet.Li Min was so angry that he could let a child look at his mother like this?
A mourning star who is still angry!
She immediately raised her eyebrows and scolded loudly: "Get out."
If you delay the rescue, you are going to kill someone.Do you want your daughter-in-law to die?
”The woman on the hospital bed snorted, her eyeballs rolling under her eyelids, and strings of tears slipped down her temples and soaked into her short hair.When the old lady saw that it was Li Min, she immediately took a big step back, almost stepping on the feet of the nurse who was chasing after her.The nurse quickly stopped, reached out and pulled her sleeve, the old lady obediently followed the nurse around, let go, and then pulled up the two girls who were in a state of ignorance and followed her turn out, and even the crying was immediately put away.She didn't forget Li Min's ruthlessness in kicking down her in-laws two days ago.The nurse cooperated with Li Min to disinfect, and the male doctor also laid out sterile empty towels at the same time.Unfolding the wound, Li Min gasped and rejoiced.Although the wound looks hideous and scary, probably when the wrist is cut, it is not possible to be ruthless or the knife is too blunt, the abductor pollicis longus, radial artery, and flexor carpi radialis are all partially severed, but the wound is not neat and has to be trimmed.It's okay, it's okay, it's not too difficult."2% lidocaine 10ml."
Li Min restrained himself and gave instructions calmly.The nurse tore open a disposable syringe and landed it in Li Min's open hand.Li Min pulled out the syringe, just as the nurse handed over the severed lidocaine ampoulet, Li Min sucked the potion and prepared to do local anesthesia around the wound.Doctor Liu ran over at this time, panting heavily.He glanced at the wound and said, "Loosen the tourniquet."
You," he ordered, pointing to a nurse, "dilute 30mg of □□ with 1ml of water for injection and flush the blood vessels with Dr.
Li." ”Seeing Dr.
Liu coming, Li Min's tense mind relaxed, and the rest of the things were done according to Dr.
Liu's instructions.Doctor Liu also quickly scrubbed his hands with iodophor and alcohol, and then motioned to Li Min not to move, and sat down on the stool opposite Li Min that the male doctor had given out.He looked at Li Min flushing the blood vessels, and also trimmed the wounds of the blood vessel walls, nodded and said, "Small needle, 9-0." ”"Doctor Liu, our emergency department is only 4-0.""
That's 4-0.Hurry.There are two non-damaging vascular clamps and two vascular clamps.Doctor Li, if you pull this side, you can only lift half a centimeter at most. ”"Okay."
The nurse responded, tearing open a sterile package of needle-bearing sutures.Li Min cooperated with Dr.
Liu to start stitching up and repairing half of the radial artery.Dr.
Liu held a needle in one hand and a forceps without damaging blood vessels in the other.He lifted one side to insert the needle, then took the needle out of the other side that Li Min was carrying, and tied the knot with vascular forceps.Li Min is a pair of pliers and scissors in one hand, and then cuts the thread.The 4-0 needle is about the same thickness as a human hair, and the needle has sutures on it.The diameter of this woman's radial artery is about 2mm, and the cut half, Li Min roughly estimated in his heart, and it will take about 16 stitches.Dr.
Liu did the full-thickness vascular anastomosis with a needle, and Li Min didn't even dare to blink, staring at his eyes to concentrate his mind on every square inch, and trying to cooperate with Dr.
Liu's every action.After a while, I felt that my eyes were dry and astringent.After Dr.
Liu finished cutting a thread, he raised his head and closed his eyes."
You close your eyes and rest, too.Prepare heparin sodium for Dr.
Li to rinse. ”Li Min put down the thread scissors and carefully rinsed both ends of the blood vessel wall that Dr.
Liu had lifted.The two then proceeded to repair the radial artery.After the last stitch, Dr.
Liu put down the needle holder and let out a sigh of relief.He moved his stiff fingers and trembled arms slightly, revealing the nervousness he had just had."
Open the tourniquet."
Dr.
Liu then easily opened the vascular clip."
Salt water gauze."
Li Min followed and asked for something.The little nurse poured half a bottle of normal saline into a small stainless steel basin on the instrument table, and Li Min threw in a piece of dry gauze herself, pinched it dry and stacked it on the wound.The gauze covering the wound slowly turned pink.Li Min carefully removed the gauze, and no blood gushed out of the wound."
Alright.The big job is done.Tissue scissors. ”Dr.
Liu began to trim the tendons of the tooth and wave teeth.Li Min treats the bleeding points around him.......
"Doctor Liu, my blood pressure has come down."
The high voltage is 60, and the low voltage cannot be measured. ”Dr.
Liu looked up at the dextran hanging on it, turned around and asked Li Min, "Is there any blood?"
”"Matched, let's prepare 800 blood.""
Hurry up and go to the blood."
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Dr.
Liu's face was distorted and hideous, and he shouted at the nurse loudly.The little nurse ran out in response, and Dr.
Liu sped up the movements of his hands.Then he naturally said to himself: "TM, this is how long it took to hurt before it was sent."
This is definitely not a case of sending it over immediately after cutting your wrists.Hurry up and open another fluid path on the foot and compress the perfusion.Look at the ECG monitor. ”"Small needle, line 0."
Doctor Liu kicked the male doctor's calf, "Find a small list and put the back of your hand up a little."
What kind of department are you so stupid?
”"I'm here for further training."
Dr.
Liu originally wanted to scold, but immediately shut up when he heard the words.He just didn't come to study because he wasn't good enough, and it was useless to scold him.The flexor tendons have not yet been stitched, and the ECG monitor is screaming "dripping".Dr.
Liu looked back at the ECG monitoring, then left the needle holder and stood up.Wearing blood-stained gloves, he touched the fluctuation of the woman's carotid artery, and in about ten seconds, his face changed greatly, so he went to pick her eyelids to look at the pupils, and then slapped her shoulder vigorously.The patient did not react in the slightest.Li Min subconsciously stood up and looked at the dense wavy lines pulled out of the ECG monitor.Ventricular fibrillation?
When she just came in, didn't the woman still hum and chirp and shed tears?
Dr.
Liu had already started to do chest compressions at this time."
Doctor Li, pay attention to your airway."
He reminded Li Min, who was a beat slower to react.Li Min quickly covered the wound with saline gauze, shook off a piece of dry gauze, covered the patient's mouth, lifted his neck with one hand and pinched the patient's nose with the other, and blew in a big breath."
Epinephrine 1 mg, intravenous push."
Li Min finished blowing and shouted while counting the number of compressions of Dr.
Liu: "Prepare to defibrillate." ”The nurse was scrambling to prepare the chest patch, and the man who was standing was finally able to reach out and charge the defibrillator."
How much?""
150 joules."
Dr.
Liu replied."
Alright."
Doctor Liu stepped out of the way, Li Min also stepped back, and the male doctor quickly pressed the button.The patient's body jumped, and Dr.
Liu went to do chest compressions again.The electrocardiogram was still the wavy line, and Li Min's face swelled with sadness.The little nurse held up the injection and said, "Epinephrine 1mg, ready." ”"Static push."
Dr.
Liu gave instructions."
Atropine 1 mg, lidocaine 50 mg.Static push. ”He then did the compressions.Li Min leaned over and blew again, the little nurse who had gone out to promote blood just now came back, and Li Min shouted at her, "Tracheotomy bag." ”Dr.
Liu was already sweating on his forehead after doing three sets, and the nurse opened the tracheotomy bag."
Doctor Li, you can continue to do it."
Li Min stepped onto the narrow bed with her shoes on, her knees between the patient's waist, and took over from Dr.
Liu for chest compressions.Dr.
Liu didn't care about changing his gloves, so he went for a tracheotomy.1，2，3…… 12, "Blow"!
Li Min drank the male doctor who was a little in the way and couldn't help much.The male doctor immediately took a deep breath and blew a big breath on the patient with a similar movement as Li Min.The patient's chest may see a noticeable rise and fall.After a few times, the man was able to catch up.…… After another 150 joules defibrillation, the patient still did not return to sinus rhythm.() The distance is a bit far