Liu Miqiao changed roles with Dr. Zou again.
The focus now is on flushing the ventricles. Whether there will be complications in the future will depend on whether the flushing is successful.
This patient is very time-consuming, it has been two full hours, and the cerebrospinal fluid flushed out is still red, indicating that there is still a small amount of active bleeding.
"500 ml of normal saline, add 10 mg of dexamethasone." Liu Miqiao gave another oral doctor's order.
This time, the nurse carried out the doctor's orders without hesitation.
Next, Liu Muqiao used hormone-added physiological saline to flush the cerebrospinal fluid. This method is very popular abroad.
After finishing another bottle of salt water, Zhao Yilin said: "How long will it take? I'm afraid the patient in bed 35 won't be able to wait any longer."
Liu Muqiao glanced at bed 35. Over there, Liu Jianxin was waiting for Liu Muqiao to perform surgery.
Liu Muqiao was not impatient and had to come one by one. The key point was that the patient's bleeding had not completely stopped. If it stopped now, the danger would not be eliminated.
Just at this time, Liu Jianxin suddenly became busy, where he was doing extracardiac massage.
Stopped?
"Doctor Zou, go help."
"Lu Lu, take over from Dr. Zou."
Dr. Zou ran over holding the defibrillator.
No one is more deft than him in defibrillation.
"Bang!"
"Bang!"
"Bang!"
Three more times, the heartbeat was successfully restored.
"Let's move the battlefield." Liu Muqiao said, "Lu Lu, you come and take over, Wang Xinyu, you come too, this patient will be handed over to you two. Slowly inject the normal saline solution, be careful to do it slowly! No more than 1 per minute.
milliliter, never less than 0.5 milliliter."
The two novices suddenly became energetic. Isn't this because they were ordered to do so in a critical situation?
Whether it works or not, it depends on today whether he will be the core figure of Liu Maqiao's team in the future.
Liu Muqiao moved the battlefield and quickly performed brain punctures on 35 patients.
This patient suffered from cerebral lobe hemorrhage. There is no doubt that he took the closest puncture.
This time, he adopted the method of rapid bloodletting, so he did not have to worry about the problem of brain herniation in turn, because there was edema on the bleeding side, and no matter how much bloodletting was done, new brain herniation would not be formed.
60 ml of blood was released at once.
"100 ml of mannitol, drip quickly." Liu Miqiao gave the oral doctor's order. The nurse here is also new, a neurosurgery nurse.
He looked at Liu Jianxin.
"Execute."
Although Liu Jianxin didn't know Liu Muqiao very well, Zhao Yilin had just given a demonstration, and the director said that Liu Muqiao could give oral medical orders, so what else could he say?
Besides, he generally knew Liu Muchiao's performance in the capital.
Although this patient is not complicated, his condition is equally serious. He had already told everyone about his cardiac arrest just now. He may die at any time and become the second patient to die since Liu Miqiao participated in the treatment of cerebral hemorrhage.
Zhao Yilin is still standing there.
Liu Muqiao handed the drainage here to Dr. Zou, looked at it for a moment, and then returned to the first patient.
"Well, it's too slow. You only have 0.5 ml, which can't have a flushing effect." Liu Miqiao directed Lu Lu.
Wen Xingyu was diligently drawing blood and flushing the hematoma. When Liu Miqiao didn't come, he wasn't nervous and his hands didn't shake at all. Now that Liu Muchiao is standing by the side, his hands are shaking involuntarily.
Lu Lu is twenty-seven this year. He has a master's degree and is a resident doctor. He graduated from Qingjiang University School of Medicine. He is Liu Muqiao's senior brother.
Wen Xingyu is twenty-nine years old. He has a master's degree and is a resident doctor. He graduated from Shanhe University School of Medicine. His hometown is Qingjiang City and he returns to his hometown to find a job.
Liu Muqiao took a step back knowingly, and then focused on the patient's vital signs.
"Take another bottle of mannitol." Liu Muqiao said, "You must pay special attention to the timing when using dehydrating agents. If you use too much, it will be useless. If too little, you will suffer from severe edema, which is not conducive to the supply of brain tissue. The interval of about 20 minutes is better."<
/p>
He seemed to be talking to himself, but actually he was talking to Zhao Yilin.
The knowledge in his mind is expert level. Although Zhao Yilin is also an expert, the difference between the two is huge.
Liu Muqiao naturally hopes that Zhao Yilin can master this knowledge as soon as possible.
Zhao Yilin was also listening attentively. In the past few days, he had deeply felt Liu Maqiao's erudition and talent in the field of cerebral hemorrhage.
"Is there a limit to the number of times mannitol can be used?" Zhao Yilin said.
"Strictly speaking, no. It is both a dehydrating agent and an anti-free radical drug. However, you must pay attention to the frequency of use. If the frequency is too frequent, it will have no effect and will affect the next time's effect."
"More than twenty minutes?"
"Yes. It can also be used alternately with other dehydrating agents. However, it is not recommended to use hypertonic sugar. Blood sugar has certain toxicity to nerve cells."
"Well, it turns out that there is still a lot to pay attention to in this aspect."
Although Liu Muqiao was talking to Zhao Yilin, his eyes never left Lu Lu and Wen Xingyu. He could not be completely relieved.
"Lu Lu, push slower."
In the curved plate that connects the cerebrospinal fluid, cerebrospinal fluid is dripping and the color has faded. This is a good sign.
Patients with this kind of cerebral hemorrhage are most worried about the sequelae.
The sequelae of limbs are certain and there is no way to avoid them.
This kind of patient also has a very dangerous complication, that is, the blood in the cerebrospinal fluid can stimulate cerebral vasospasm and cause large-scale infarction. Therefore, flushing the subarachnoid space can avoid vasospasm.
Secondly, flushing also has the function of clearing the aqueduct. Once it is blocked, cerebrospinal fluid circulation disorder will occur, and the final result will be hydrocephalus.
Liu Muqiao naturally wouldn't think so much in the past, but now that he has tens of thousands of cases in his head and his knowledge is at the forefront, he has to consider these issues comprehensively.
Liu Miqiao looked here and there. Dr. Zou's patient was much better, and the ECG monitoring values were basically normal.
Returning to the first patient's side, Lu Lu controlled the speed roughly accurately, and Liu Miqiao didn't say much.
If it is slightly incorrect and does not affect the efficacy, he will not talk more. Young people need to exercise and encourage them.
"Mu Qiao, there are 8 more cases today. Now these two cases have taken more than three hours. Can the 8 cases still be arranged?"
Zhao Yilin said.
These 8 cases are accumulated patients. Liu Muqiao and the others went to a meeting. Although they greeted the hospital below, they still sent 8 patients with relatively small bleeding volume because of the strong request of their families.
"Arrange, even if it takes all night."
"Another all-nighter?"
Zhao Yilin was trembling a little. He had just returned from a plane and hadn't gone home yet. Not only was he tired from the journey, but he hadn't eaten yet.
The food on the plane is just for fun.
The door opened.
Xiang Lifang came in.
"Old Zhao, we're here for business again. Two people suffered from severe cerebral hemorrhage on the way."
It was obvious that Dr. Zou shuddered.
He was also planning to go home and hand in his homework, but it seemed that there was no hope.
This chapter has been completed!