After hanging up the caller, talk on the phone again.
It turned out that while she was away from Guozhi, everyone followed the consensus of the doctors after the morning meeting and started to try the lung recruitment operation during a series of preparations before the patient recovered and was weaned off the machine, but something seemed to go wrong.
The call came from Director Wang himself. He asked her in confusion: "Didn't you say that the patient is almost ready to be weaned off the machine?"
You can't eat hot tofu if you are anxious. This saying is also very applicable in clinical practice. Originally, after having another patient, the one who should be most anxious was Xie Wanying, but now it seems that she is not at all. It shows whether the doctor is in a hurry or not. In fact, it depends on the doctor.
How much control do you have over the patient's condition?
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Listening to Director Wang's extremely anxious words, Xie Wanying only remembered that she had not said that the patient could be weaned from the machine in the morning.
Weaning itself is a very complicated matter.
Doctors cannot just wean the patient off the machine and wait until the patient is no longer able to intubate the patient. You must know that after the femoral artery is pulled out, the blood vessel wall needs to be repaired. This shows how much harm to the patient's blood vessels is put on the machine.
There are only so many blood vessels in the patient, and it is impossible to have unlimited important blood vessels for doctors to make multiple attempts. Protecting blood vessels has always been one of the key considerations for clinicians. Moreover, this patient was put on a ventilator and a hemofiltration machine in addition to being put on a machine.
Which of the machines should be withdrawn first and later is a question that requires serious consideration by the doctor. Even if it is prudent, the doctor will try to stop the machine without extubating it before weaning it off.
The decision will be made after 24 hours of observation by the machine. Her previous suggestion of adjusting the parameters of the ventilator to perform lung recruitment training on the patient is to inflate the patient's collapsed lungs and promote the early recovery of the patient's lung function. This is actually just the patient's lung function before weaning from the machine.
The first step in the recovery process
.Don’t forget that Mr. Zhang uses VA mode for patients, which includes support for the patient’s heart function. If you want to withdraw membrane lungs, in addition to observing the patient’s lung function, heart function is also essential.
To sum up, the patient's cardiopulmonary function should be restored to the threshold index before he can withdraw from membrane lung. Calculating the cardiopulmonary function index requires very complicated verification work, and it is not simply a matter of looking at a blood report or other single unit.
A report can be concluded. For example, cardiac function indicators, in addition to daily observation of membrane lung machine parameters and electrocardiogram and other routine items, doctors must do special cardiac function tests before weaning the machine. As has been said many times before, the heart function can be more clearly defined.
functional menstruation
Echocardiography examination. In addition to instrument examination, the patient's medication status is also a very important reference value for doctors. For example, if you do not want to intubate after the machine is weaned, the ideal situation is to have a means that can replace the machine.
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Active and inotropic drugs. Whether drugs can be used to replace the effect of the machine just in case requires clinical judgment and experiments before weaning the machine.
Generally speaking, when trying to reduce the membrane pulmonary flow before weaning the machine and injecting a certain amount of the above-mentioned drugs while weaning the machine, a rough assessment can be made. After listening to the series of lectures given by classmate Xie on the phone, Guozhi U’s
Director Wang once again deeply felt the importance of listening to Teacher Xie's lectures. It was a bit late to take out a pen to record the time. He couldn't help but think about how to do it again later.
Go to Mr. Zhang and ask Mr. Zhang to retain talents. Without Teacher Xie's guidance, they will inevitably torment the patients as guinea pigs when they are groping at this moment, and they may even torment the patients to death.
