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Zhou Chengdu is almost drunk. Is this person an intern?

This was in the operating room. The patient was under general anesthesia and intubated. He was just in shock and low pressure, not cardiac arrest. There was an open intravenous channel. The operation was in progress. She said she was going to call the teacher. Why not give fluids quickly at this time?

Have you ever read the book?

All procedures for in-hospital emergency care are basically moving closer to the current good infrastructure. Tracheotomy and intravenous access are now readily available!

After hearing Zhou Cheng's words, she turned around anxiously.

"Epinephrine, 1 mg, intravenous injection! Hurry up!" Zhou Cheng urged in a louder voice!

This voice called her back.

Anesthesiologists in the anesthesiology department always have dopamine, norepinephrine, and epinephrine on hand during the operation, and dopamine and norepinephrine are continuously pumped in.

But now, this kind of continuous pumping is not enough, so intravenous medication is required!

"Circuit, speed up the intravenous infusion immediately, inject colloids and crystalloids under pressure at the same time, and raise the room temperature in the operating room to 25 degrees Celsius."

"Director Hu, Director Mo, please look for the bleeding point in the abdomen." Zhou Cheng said as he moved out of the way.

At this time, the patient suddenly went into shock and the senior anesthetist was not available, so someone had to step forward.

Neither Mo Youcheng nor Hu Kaihua stood up, so Zhou Cheng could only stand up.

"Device, please step down and call the head nurse and ask her to send someone to support immediately. The blood bank must send plasma products and blood products."

"Notify the anesthesiologist to come to the operating room immediately and take blood gas analysis immediately." Zhou Cheng stared closely at the patient's vital signs.

Currently, my heartbeat is very fast and my blood pressure is very low, which definitely exceeds the shock index.

Zhou Cheng is checking to see if there is ventricular tachycardia or ventricular fibrillation.

Although shock first aid in the operating room falls within the scope of the anesthesiology department, this anesthesiologist is really unreliable, so he can only stand up.

However, doctors in all clinical departments have the right to give medical orders when rescuing patients in the hospital. In the surgical ward, when a patient goes into shock, it is the surgeon who takes the role of issuing medical orders!!

"Take off your gloves, don't care about your clothes!" Zhou Cheng looked at the equipment nurse and was about to take off his clothes and cursed.

The other party quickly took off his gloves and walked to the timing panel in the operating room before making a call.

Zhou Cheng returned his gaze to the monitor, and then calmly gave the order: "20mg dopamine, intravenous injection!"

Dopamine can be injected intravenously. The general dose is 20 mg directly intravenously. It can also be treated by intravenous drip. When dopamine is intravenously dripped, the dosage is different, and its effects are also different. Dopamine is a neurotransmitter that can be used to help cells.

Deliver pulses.

Low-dose dopamine can relatively selectively dilate visceral and renal arteries. It can be used in patients who are unresponsive to diuretics to increase renal blood flow and maintain glomerular filtration rate; it can also act directly on renal tubules.

To achieve a diuretic effect.

Moderate doses of dopamine can increase the activity of adrenergic receptors in the heart and strengthen the contractility of the myocardium.

Large doses of dopamine can cause extensive vasoconstriction and have a blood pressure boosting effect.

While restoring blood volume, adding a large dose of dopamine can effectively ensure the blood supply to important organs.

The circulating nurse immediately responded and went to help the anesthesiology doctor start executing the medical orders.

At the same time, after the equipment nurse who had stepped down made a phone call, the anesthesiologist who was doing the blood gas analysis hurried over, his face turned pale.

Then I saw Zhou Cheng staring closely at the vital signs monitor, while Mo Youcheng and Hu Kaihua hurriedly searched for bleeding spots.

"How's it going?" he asked quickly.

"Now the patient's blood pressure has risen slightly, but it is still very low. It is estimated that the blood volume is still insufficient. What were the results of the previous blood gas analysis? Is there high potassium?" Zhou Cheng did not turn around, watching that the heart rate had risen to 130, calmly

ask.

Fortunately, the blood oxygen level is still normal for the time being. In other words, there is no shortage of blood oxygen in the peripheral blood supply for the time being. It should be just stress-induced hypovolemic shock, not other shocks.

The anesthesiologist saw that the patient's high pressure was only 40+, and immediately adjusted the dosage of norepinephrine and dopamine pumped through the vein, and then said: "There is slight hyperkalemia. Prepare insulin and glucose for intravenous infusion."

"Remove the compound sodium chloride first and replace it with soda water."

As he spoke, he quickly started squeezing the hanging whole blood into the patient's body.

Then he quickly took over Zhou Cheng's instructions: "Epinephrine, 1 mg, intravenous injection!"

The circulating nurse quickly repeated: "12:14 Adrenaline 1 mg, intravenous injection."

The instrument nurse starts taking notes.

Mo Youcheng and Hu Kaihua raised their heads: "There is no active bleeding in the abdominal cavity. We have already tied out all the blood vessels that should be tied out."

Seeing that the patient's blood pressure had risen a little, Zhou Cheng said: "It should be the stress caused by a large amount of blood loss when the hematoma was just incised, which caused a large reduction in circulation in the body."

"Teacher anesthesia, thank you for your hard work. At this time, you must be very careful and pay attention to the pulmonary edema."

When the anesthesiologist came, Zhou Cheng stopped taking over and waited until the blood pressure rose to above 60mmHg before he came to the operating table again.

The operation continued.

At this moment, Mo Youcheng and Hu Kaihua didn't dare to talk anymore. The situation just now was really scary. Fortunately, Zhou Cheng stood up immediately. Otherwise, as soon as the anesthesiologist ran away,

This surgery is absolutely GG!

But Zhou Cheng is a real tiger. He can even cut such a hematoma. Although he made complete preparations to minimize the blood loss, the undetectable vascular damage still caused a large amount of blood loss, causing irritation.

The patient is on the verge of shock.

After a while, the circulating nurse and the nurses in the operating room helped to open bilateral intravenous channels and started blood transfusions on both sides, and the patient's blood pressure was completely stabilized.

Then, the anesthesiologist began to diss his subordinate: "What on earth were you thinking? How could you even think about running out and calling someone at that time?"

"You are a deserter. If you run away, what will happen to the patients? Who will accept your job?"

"Teacher, me!" The little girl was almost crying now.

Zhou Cheng and others didn't say anything. The girl's behavior just now was really unprofessional. Maybe she was really scared, but as a doctor, if you are afraid of this, then change your career as soon as possible.

This hurdle must be overcome.

After that, the anesthetist did not dare to go out any more. He asked his students to take blood gas analysis and other operations, and he did not dare to leave the anesthesia table for even half a step!

Time passes slowly.

More than two hours passed.

Zhou Chengcai finally sutured all the blood vessels, and then carefully checked the circle again, and said: "Director Mo, this patient must be very cautious. If heart failure and thrombosis occur again, routine antibiotics should be taken after surgery."

Condensation.”

"Although anticoagulation will cause a loss of part of the blood, if the thrombus breaks off, the consequences will be disastrous. In addition, due to shock, one must be extremely careful about cerebral edema and seek neurosurgery consultation."

"After surgery, brain CT scans should be monitored regularly."

Although the temporary life was saved, if the follow-up care or medical instructions are improper, problems can easily occur again. If problems occur after the operation, no matter how good the current operation is, it will not help.

No matter how good the surgery is, what's the point of it if there are no people left?

"I know, Dr. Zhou, thank you for coming today, otherwise, this operation would be really difficult to explain!" Mo You said with lingering fear.

He had previously explored the entire abdomen and found no hematoma. He even closed the abdomen, but there was still retroperitoneal hematoma.

However, even if he discovered it for the first time, he would not dare to touch it.

He doesn't have Zhou Cheng's ability. If he moves, he will die.

Of course, if you don't move it and let it exist and continue to lose blood, the patient's final prognosis will still be catastrophic.

It can be said that the reason why this patient was able to survive was entirely due to Zhou Cheng.

When the shock occurred, if Zhou Cheng had not stepped forward immediately, the patient would still not be able to escape death!

Hu Kaihua also said: "Zhou Cheng, you have really worked hard today! On behalf of the patients and their families, I would like to express my gratitude to you."

Zhou Cheng heard this and saw that the operation was now over, so he asked one more question: "Director Hu, this patient's injury is very special. Why did you consider calling me?"

Not many people know that Zhou Cheng can perform vascular surgeries, and he rarely takes the initiative to perform vascular surgeries, mainly because he doesn't have the right expertise and is afraid of something happening.

Currently, only Yang Yifeng, Lu Bin and others are known.

Cai Dongfan, who was far away in Shashi, also knew about it.

Hu Kaihua then explained: "Dr. Zhou, it's like this. We originally wanted to invite Dr. Yang to come, but Dr. Yang was temporarily busy and couldn't come. However, he suggested that I ask you if you can come down."

"He said, this surgery is not simple, and it might be better for you to do it."

When Hu Kaihua said this, he saw Zhou Cheng looking directly at him with a meaningful expression.

Then he hurriedly explained: "Well, Dr. Zhou, please tell me, the patient undergoing this surgery is my child's teacher. She is a very good teacher. It's a pity that she is not a kind person."

"It has been several years since my child graduated, but we have always talked about her kindness. Naturally, I don't want to ask too much about her family affairs, but this time she was injured, so I have the shame to ask more questions."

"I had no choice but to ask her mother to go to the Traditional Chinese Medicine Hospital to find you in person. Doctor Zhou, please don't take it seriously!"

Hu Kaihua's explanation made Zhou Cheng feel warm inside.

There is true love in the world. Hu Kaihua can put so much thought into his child's teacher, which shows that this teacher is a person worthy of respect.

Indeed, her experience is worthy of sympathy, but there is nothing that can be done about it. It is not easy for outsiders to interfere.
To be continued...