Even if the leg is amputated on site, Yang Ping does not want to take the matter lightly.
Clear away the debris next to it and place a waterproof sheet under your thighs.
Xiaowu has clear steps and fast hands. As Yang Ping's assistant, he wants to be qualified.
Open the sterile bag, disinfect it, and then put on a sterile bottom sheet and hole towel.
"Syringe, 10% lidocaine, physiological saline, dilute one to one!" Xiao Wu has handed it over.
There is no anesthesiologist, so only local anesthesia can be given.
How high-level local anesthesia skills are required to perform amputation under local anesthesia? Dr. Lu in the emergency department was sweating.
Local anesthesia is generally used for minor surgeries, small debridement and suturing, removal of small tumors, etc. If the dosage is too small, it cannot achieve the purpose; if it is too large, it is easy to cause anesthetic poisoning. There used to be a hospital that cut a tendon sheath on the back of the hand.
Cyst, local anesthetic overdose, the patient was poisoned by anesthetic on the spot and died in the outpatient operating room.
Therefore, local anesthesia will not be used in slightly larger surgeries, even larger debridement and suturing. The risks are high and the results are not good.
Now Yang Ping wants to use local anesthesia for amputation? Everyone expressed surprise.
Even though local anesthesia is simple, it is also a technical job. Ordinarily, injecting a few injections around the surgical area is also local anesthesia; more accurately, selecting the innervation nerves in the surgical area to block is also a kind of local anesthesia.
The latter is called nerve block, and it is actually a more advanced form of local anesthesia. If the former is compared to using cannons to randomly shoot at the enemy's positions, then the latter is to use precision-guided missiles to clear the enemy's strongholds at fixed points.
To master nerve block anesthesia, you must be very familiar with anatomy, the innervation of various regions, and the course of nerves.
Yang Ping will now perform right femoral nerve and sciatic nerve block.
When an anesthesiologist performs this kind of block, he often uses color ultrasound to locate it, but Yang Ping now completes it with his bare hands.
Dr. Lu will wait and see, and he will also have an eye-opening experience - amputation under local anesthesia.
Based on the course of the femoral nerve and the ischiofemoral nerve, Yang Ping first blocked the femoral nerve - in the upper thigh, starting from the skin, anesthetizing it layer by layer, and carefully inserting it. When it reached the nerve sheath, an electric shock was immediately felt. "Do you feel like you're getting an electric shock?"
"Yes!" the patient gritted his teeth and said.
The drug is then injected into the sheath of the nerve.
In the same way, block the ischiofemoral nerve, and the skin sensation of the entire lower limbs mainly comes from the branches of these two nerves.
Just like the propagation of electric current by wires is cut off, nerve impulses are successfully cut off by anesthetics.
The effect was very good. After a while, the patient no longer felt any sensation in his right lower limb, and Yang Ping began to operate.
The knife cuts out a beautiful tongue-shaped skin flap, ligates the skin, subcutaneous tissue, deep fascia, muscles, and blood vessels, cuts off the nerves at a high level, and exposes the femur. In the middle and lower third of the area, the wire saw cuts off the femur and slightly cuts the femur.
The broken ends are rounded.
Then cut out a tongue-shaped flap from the muscles, deep fascia, subcutaneous, and skin of the contralateral side.
The bleeding points are ligated one by one, and the surgical area is clean.
The amputation is completed in less than five minutes, maybe less. Wrap the severed end with a sterile drape, and take the rest to the car to continue processing.
Several first responders took action, and the patient was immediately carried on a stretcher to the ambulance. Oxygen was inhaled through a nasal cannula and ECG monitoring was continued. The nurse quickly connected various pipes and wires and then sorted them out.
The stretcher is placed in the middle, with Yang Ping and Xiaowu sitting on one side, and Dr. Lu and the nurse sitting on the other side.
The car started and headed towards Sanbo Hospital. In order to save time, the driver chose the fastest and smoothest road on the navigation system.
Lidocaine local anesthesia can last for one to three hours. The anesthesia is still taking effect and the patient does not feel pain. Dr. Lu thought that if he mastered Yang Ping's superb nerve block technique, he would be able to treat traumatic injuries during emergency treatment in the future.
For the pain caused, there is no need to take any morphine. Direct highly selective nerve block allows the patient to be sent to the hospital painlessly.
In the car, in the limited space, Yang Ping and Xiao Wu carefully washed the severed ends of the amputated limbs, disinfected and spread the sheets again, and sutured the muscles, fascia, and skin. The amputation was complete. This took only a few minutes. p>
"Doctor, can I survive?" The patient's voice was already very weak, his face and lips were pale, his eyes were closed, and he opened them a little bit with great effort.
The fluid has been opened as fast as possible, with three channels simultaneously infusing colloid fluid and crystalloid fluid into the body.
Yang Ping held his hand tightly, which was cold.
"Yes! It must be possible!"
The patient gasped and wanted to speak, but could not speak several times.
"No need to talk anymore, it will be fine, hold on!" Yang Ping held his hand and put a little more force on it to show encouragement.
The patient still squeezed out a few words: "Save--me--, the child--is in--junior high school--poor--"
A few intermittent words, no more words can be squeezed out.
This kind of emergency vehicle is already very advanced, but after all it is just an emergency vehicle. It can only provide the most basic life support such as rehydration.
In the short term, fluids can maintain volume, but ultimately blood transfusions are needed to replenish red blood cells and maintain oxygen transportation. Blood transfusions can only be done in the hospital.
The heart rate has risen to 120 beats/min, the blood pressure has dropped to 80/40mmhg, and the blood oxygen level is barely maintained at 90% by inhaling oxygen.
I don’t know if the ever-expanding splenic capsule has ruptured. If it does, I will definitely die. This can only depend on luck. Sometimes, I have to admit that there is such a thing as luck.
Dr. Lu can no longer do color ultrasound, as the squeeze of the ultrasound probe is also risky. Even if a rupture is seen, nothing can be done for the time being.
"Hurry up!"
Yang Ping told the driver in front of him that he was holding the patient's hand and keeping his fingers on the radial artery. His pulse was weak and he felt that it would dissipate at any time.
"It's already the fastest!" the driver shouted, but he still pressed the accelerator deeper.
The nurse changed another bag of liquid. Dr. Lu was anxious and his face was covered with sweat.
The siren of the ambulance was blaring rapidly, and the driver was weaving in and out of the traffic. Some cars in front of him took the initiative to avoid and give way, but more cars ignored him. The driver was a retired automobile soldier with very good skills. He turned the steering wheel calmly and kept overtaking.<
/p>
The biggest uncertain factor in urban traffic is traffic jams.
This chapter is not over yet, please click on the next page to continue reading!
Everyone prays in their hearts, never get stuck in traffic, never, never!
The patient was already in a state of confusion. He shouted loudly, but his eyelids only moved.
The ambulance got on the viaduct. Suddenly, the car in front braked, slowed down, and stopped slowly.
The ambulance followed the car in front and slowed down to stop. Because the distance between the cars was well maintained, the ambulance stopped smoothly and no patient caused too big a bump.
"What's going on?" Xiao Wu asked.
The driver shook his head: "I'll go down and take a look."
A long dragon formed immediately behind me. Looking ahead, I saw it was also a long dragon.
The driver pulled the handbrake, pushed open the door, got out of the car, looked around, and walked a dozen meters further to inquire about the situation.
He came back and said: "I heard that the truck in front broke down and there was a traffic jam!"
Damn it! Everyone cursed.
At this time, there is a traffic jam, and there is no way to do it. There are cars all over the front, back, left, and right, and there are also cars stuck in the convoy. It is so jammed that it is impossible to move forward or back.
Yang Ping's heart was ashen, and there was only a faint breath left in the pulse in his hand, like a candle in the wind, it would be extinguished at any time.
The fire of life is sometimes very tenacious, but sometimes it is extremely fragile. It will be extinguished by any disturbance.
Dr. Lu opened the back door of the ambulance and put up a pergola with his hands. Looking forward, he could not see the long queue at the end. Looking back, he still saw a long and winding queue.
He walked back and forth behind the car, banging the fist of his right hand on the palm of his left hand, anxiously.
Time passes minute by minute.
The patient's consciousness was completely blurred and he was told not to move his eyelids.
The heart rate is getting faster and faster, and the pulse is as fleeting as a gossamer.
After looking at the traffic for several times, there was no movement at all. Dr. Lu raised his head and shouted heartbreakingly: "Help, the people in the car are waiting for help!"
Helicopters, even if it is too late to call a helicopter now, not everyone has the opportunity to use a helicopter. The hospital has two helicopters, one is under maintenance, and the other is hired by a high-end insurance company to pick up patients.
The piercing siren and flashing lights of the ambulance, as well as the hysterical shouting of the doctor, alarmed the nearby car owners who got out of the car to get some air. A man wearing sunglasses moved over in the narrow gap between the cars and asked: "
What's going on?"
"The people in the car are waiting for help and are dying!" Dr. Lu was helpless and wiped the sweat with his sleeves.
Yang Ping and Xiao Wu were in the car, Xiao Wu stared at the ECG monitor, and Yang Ping kept holding the patient's hand.
The eldest brother touched his head, took off his sunglasses, looked inside, and then looked at the queue of cars.
Open your Northeast accent voice:
"Quick, quick, quick! Come and help, help, it's urgent!"