When Liu Muqiao got out of the car, before he could answer the reporter's questions, he hurried to the Neurology Care Unit.
There are two seriously ill patients waiting to be rescued.
Zhao Yilin and Dr. Zou ran away.
Liu Muqiao said sorry to the reporter and was out of sight of the camera.
The patient has just arrived.
In the past two days, no operations were performed on the mild patients. The two seriously ill patients were lucky enough to finally wait for Liu Miqiao and the others.
Now, Liu Jianxin no longer dares to carry out puncture and drainage at will. The low mortality rate is the data that everyone wants to keep.
Dr. Zou, Lu Lu and Wen Xingyu took the initiative to make preparations. By the time Liu Maqiao finished washing his hands, disinfecting, and wearing gloves, the preparations over there were all ready.
Zhao Yilin is responsible for reporting the physical examination.
Deep coma, blood pressure 170, 120, heart rate 110, body temperature 39.5, pupils like pinpoints, irregular breathing...
All signs indicate that the condition is extremely dangerous, and intracranial hypertension is close to the formation of cerebral herniation. Decompression is the most urgent method at present.
Liu Muqiao stared at the CT film, which was another challenge.
The bleeding volume was 150 ml, which was the most serious one so far.
The basal ganglia bleeds, breaks into the ventricles, and there is blood in the cerebrospinal fluid.
Fortunately, stroke diagnosis and treatment guidelines were launched in Beijing, and now Liu Miqiao has sufficient knowledge to support the treatment of this patient.
"Director, this patient needs a two-pronged approach."
"You tell."
"Puncture and drainage are performed on the top, and lumbar puncture is required on the bottom to flush the ventricles and subarachnoid space."
"Isn't it too dangerous?"
"It is dangerous. We not only need to save him, but also consider the prognosis. If the subarachnoid space is not treated, the patient may suffer from large-scale infarction."
Zhao Yilin was hesitant. Obviously, he was not sure about this patient.
"Okay, I'll listen to you."
Liu Muqiao did not stop preparing while talking.
Lu Lu drilled a hole in the skull, and Liu Miqiao bent down and inserted the puncture needle. He carefully put out 10 ml of blood.
Then after stabilizing it, I felt the intracranial pressure, and then injected another 10 ml.
In this way, he drained blood about every three to five minutes, and he did it nine times.
"Dr. Zou, help the patient change his position and prepare for lumbar puncture." Liu Muqiao said.
Lu Lu and Wen Xingyu did not hesitate. The three of them worked together to move the patient into a lateral position. Liu Maqiao carefully changed some positions and always maintained the stability of the puncture needle.
He tried to add 10 ml of blood again.
"Director, how are you now?"
Zhao Yilin quickly checked on the patient.
"The pupils are slightly dilated, but everything else is about the same. Oh, my breathing seems to be better."
These are all manifestations of brainstem compression.
"You can start." Liu Maqiao said to Dr. Zou.
As a neurologist, lumbar puncture is a daily routine.
Dr. Zou didn't need anyone's help and started puncture.
However, maybe because I was a little nervous, I didn’t succeed the first time.
"It doesn't matter."
Although Liu Muqiao said this, he still had thoughts in his heart. You failed even if you tried to pierce your waist?
Dr. Zou's face turned red and he wanted to slap himself. Such a performance was really a burden to Liu Miqiao's team.
Dr. Zou wants to cry.
Because the matter was not over yet, the second puncture failed again.
"Don't be nervous." Liu Muqiao comforted him again.
After a while, Dr. Zou really cried.
He failed for the third time.
Zhao Yilin couldn't stand it anymore and said, "Zou Qingxiang, go home and buy a pig spine and practice more."
Dr. Zou felt aggrieved, "I have succeeded every time in the past, but this patient is strange."
"It's okay. It doesn't matter if the lumbar puncture fails. Just adjust the direction and don't take it too seriously. Isn't it just a lumbar puncture?"
As Liu Muqiao spoke, he drained some more blood, and the total volume was estimated to be 150 ml.
For the fourth time, Zou Qingxiang finally succeeded.
Sure enough, there was a lot of blood in the cerebrospinal fluid.
Liu Miqiao pushed the needle forward about one centimeter and pulled out bloody cerebrospinal fluid, proving that the needle tip had reached the ventricle.
Next, Liu Miqiao started the second stage of treatment, flushing the ventricles and subarachnoid space.
This is a new treatment method that Antai Hospital has never tried before.
Zhao Yilin did not object, but asked Liu Miqiao: "Is this method reliable?"
Liu Muqiao said: "There are still relatively few people using this method. Only a few well-known hospitals in China, such as General Lu, Xiehe, Xiangya, and Tongji, are using it, and the curative effects vary. Of course, we hope to get better results."
Liu Miqiao began to inject normal saline into the ventricle, and Dr. Zou released the lumbar puncture needle to let the bloody cerebrospinal fluid flow out.
Zhao Yilin watched intently.
He didn't need Liu Muqiao to explain that the most critical thing now was the power in Liu Muqiao's hands, and he must grasp it very accurately, otherwise it may cause brain tissue displacement.
Liu Muqiao concentrated his thoughts without blinking and kept his ears as close to the needle as possible.
Can this also be "listened to"?
Of course not.
This movement has become a habit of Liu Muqiao. When he feels pressure, he likes to do this posture the most.
Very nervous.
Once cardiac arrest occurs at this time, all previous efforts will be wasted.
"Lulu, come here, hold the needle."
Liu Muqiao needs to change his hands. Over there, it's time for him to bleed.
Lu Lu was so surprised that his hands trembled a little. Zhao Yilin reminded him before trying to control his trembling.
However, we all know that when it comes to trembling, it is best not to deliberately control it, as it will often be counterproductive, and the more you control it, the more you will tremble.
Liu Muqiao shook his head and said: "Forget it, Lu Lu, you go on your way. Wen Xingyu, come on."
When Wen Xingyu got excited, his hands trembled even more.
"You also stand aside. Dr. Zou, please switch with Lu Lu." Liu Maqiao arranged the people.
Dr. Zou was more experienced, his hands did not tremble, and he gently took the syringe for flushing the cerebral ventricles from Liu Maqiao's hand.
Liu Miqiao punctured a second puncture needle. After entering the hematoma, another 10 ml of blood was released.
"How's it going?" Liu Muqiao said to Zhao Yilin.
"It's better, blood pressure is 150, 90, heart rate is 106, pupils are 3 mm, symmetrical, breathing is more even. Body temperature is 38.4℃."
"Dr. Zou, now it's up to you to flush the ventricle. Pay attention to stabilizing the level of 12 mm of water column and inject slowly. Oh, by the way, Wang Yi - oh, I'm sorry, Wang Yi is not at work today. Add 1 ml of normal saline to 500 ml of normal saline.
Bronolysin."
The nurse hesitated for a moment. She was not used to carrying out medical orders given by interns, and looked at Zhao Yilin.
Execute? Director.
Zhao Yilin said: "From now on, Liu Miqiao's oral medical orders will be implemented."
"Are narcotic drugs also enforced?"
"Narcotic drugs are also enforced, I just need to sign the signature."
There are strict regulations on narcotic drugs and first-class psychotropic drugs, and prescriptions must be issued by licensed doctors who have passed examinations or certifications. Many hospitals simply stipulate that only deputy chief doctors have the right to prescribe.
The new nurse wanted to say something else. She glanced at Zhao Yilin, then at Liu Miqiao, and swallowed what she wanted to say.
This chapter has been completed!