Yang Ping doesn't care at all about things other than saving people. Those are the leaders' business. He just concentrates on the operation.
Saving one is just one, there is no other better way.
Yang Ping can almost understand the anatomy of the human body with his eyes closed. Yang Ping is very fast.
The image of this boy's CT scan was immediately converted into information that directly guided the operation in the brain.
Where is the injury, where is the bleeding, how fast is the bleeding, where is life-threatening, and where is the highest priority, a clear order will naturally be formed.
Open your heart without hesitation.
As skillful and easy as cutting skin.
The bleeding in the mediastinum was stopped, the pericardial tamponade was relieved, and the damaged lungs were repaired if they could be repaired, and resected decisively if they couldn't be repaired.
Everything is for the purpose of saving lives, any other superfluous things are discarded, and every operation is straightforward.
The ribs are fixed with memory alloy clips to restore the normal thorax.
Next, open the pelvic cavity, which will require taking great risks.
If it were anyone else, they would definitely not dare to open the pelvic cavity at this time. They would first consider interventional embolization to stop the bleeding, then fix the pelvis with an external fixator, wait for the blood pressure to stabilize, and then consider whether to open the pelvic cavity.
At this time, the pelvic cavity is opened, the closed volume space is opened, the pressure in the retroperitoneal space is instantly reduced, and the blood immediately sprays stronger driven by the pressure difference, and the wounded person will die immediately due to the instantaneous increase in bleeding.
However, if the bleeding is not stopped immediately and completely, the blood pressure will not be stable at all, and the wounded will have no hope of survival. This is the only bridge to victory, there is no other way.
No matter how great the risk is, it is still necessary to open the pelvic cavity and try conservative measures such as interventional embolization, which will only waste time.
The sound of the suction device made a squeaking sound, and the blood tide had not receded. The tip of the vascular clamp on Yang Ping's hand had already penetrated into the blood, reaching the bleeding point.
Clamping and ligation are done in one go, and all actions are completed in the blood.
The blood tide receded, and when a clear surgical field appeared, Yang Ping had already completed hemostasis of several major blood vessels.
Song Zimo looked confused. What the hell kind of technology was this? There was blood everywhere. Before he could see clearly, he had successfully ligated blood vessels in the blood.
The blood vessel ligation completed by Yang Ping blindly showed that each ligation position was precise.
Can his eyes see through?
Otherwise, how could you have such a strong blind ability?
The several blood vessels that were ligated in the blood are all the most fatal bleeding points. Some of these broken blood vessels have retracted. Even with a clear surgical field, it is not easy to operate under direct vision. p>
"You can see the distribution of blood accumulation on CT films, and deduce which blood vessels have been damaged. If you are proficient in anatomy to a certain extent, you can also find the bleeding point with your eyes closed. After all, there are very few variations."
Yang Ping explained while operating, so that Song Zimo would not look like a magic trick.
It’s a reasonable explanation. It’s like typing. If you are extremely proficient, you don’t need to look at the keyboard or think about which words you want to type. Your hands will naturally press which keys.
When Song Zimo was hesitating, Yang Ping tied several more blood vessels.
As the bleeding from the venous plexus around the sacrum ceased, the pelvic bleeding was completely controlled and all organs were explored.
After repairing the damaged organs, reduction and internal fixation of the pelvic acetabular fracture began.
Various reconstructive steel plates were nailed to the pelvis, and the separated pubic symphysis was also fixed by steel plates. The shattered and deformed pelvis returned to normal.
"The blood pressure is up, 85/48mmHg." Fatty Liang reported his vital signs regularly.
Finally, the blood pressure began to rise slowly, which indicated that the reversal was beginning to occur.
After life lingers at the critical line for a long time, it begins to recover and then gradually moves away from the critical line.
Bilateral femoral shaft fractures, closed reduction and interlocking intramedullary nail fixation, reduction, opening, guide wire insertion, marrow reaming, nail insertion, locking nail insertion, all steps are consistent and completed in one go.
The whole body trauma surgery was successfully completed in one go, and the vital signs were stable within the normal range.
"90/62mmHg——"
Fatty Liang continued to report his blood pressure.
If the blood bank can keep up with the follow-up AB blood supply, this child will definitely be able to survive the danger.
Sixteen years old is in full bloom and should not be reset!
"How was it?"
Lao Han shuttled back and forth between several operating rooms to keep abreast of the progress of each operation.
"It should be pulled back." Yang Ping raised his head.
Lao Han is relieved, he saves one by one.
"Let the ICU pay attention to fat embolism and pulmonary embolism!"
Yang Ping said a few words and took off his surgical gown. Without taking a break, he immediately ran next door and participated in the rescue of the female driver.
Director Ouyang, along with Dr. Jin and two deputy chief physicians from the Department of General Surgery and the Department of Thoracic Surgery, were nervously operating. Just as the chest was opened, the female driver's heart had already stopped.
The female driver’s life is currently maintained by an artificial heart-lung machine.
They were performing intrathoracic cardiac compressions. The thoracic surgeon held the heart in his hand, squeezed it rhythmically, and then injected epinephrine into the heart with a syringe, but there was still no response.
The heart in his hand was like a ball of dead flesh without any sign of beating.
When this woman was so drunk that she rushed the Maserati into the crowd, I wonder if she ever thought about how she would end up.
——
In the emergency room, the female driver's father, a man in his fifties, was constantly calling someone to find someone. He didn't know whether to find someone to save his daughter or to find someone to help resolve the accident.
The jeweled woman, the mother of the female driver, looked anxious and knocked hard on the door of the emergency operating room from time to time.
Surrounding them were several entourages in suits and ties, as well as lawyers who rushed over with briefcases.
The door to the operating room opened, and Director Han, Director Sun, and Director Zhao came out and stood at the door without calling their names.
The woman rushed up and asked, "How is my daughter?"
"The heartbeat and breathing have stopped. Rescue is being carried out. There is little hope." Director Zhao sighed.
The woman immediately grabbed Director Zhao's chest, cried loudly, and asked how and why it happened like this.
The man put down his cell phone and grabbed the woman's hand. The security guard also rushed up and separated the woman. Director Zhao adjusted his collar.
"The injury is too serious. We are doing our best and we must be mentally prepared."
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The objectivity of medicine is as cold as iron. Director Zhao can only report the condition objectively.
As a father, the man felt dizzy. This precious daughter had caused so many troubles in the past and he had been able to resolve them one by one. Now for the first time, he felt scared, truly scared.
The heartbeat stops, which means - dead.
The man shuddered and touched his forehead, trying to calm down. The hot phone he was holding in his hand almost dropped.
"Please, doctor, save her, she is still young." The man begged.
"We are trying our best, but the injury is too severe." Director Zhao was very calm.
With many years of experience as a director of the Medical Department, this kind of scene is common.
The boy who had just been rescued by Yang Ping was pushed out and sent to the trauma ICU.
Before his family members arrived, the principal and teachers followed him: "How is it?"
"The operation was successful. The vital signs are currently stable, but we are not out of danger now. We need to be sent to the intensive care unit for continued monitoring and treatment." Xiao Wu and Zhang Lin escorted the patient.
Another student was pushed out of the operating room. His right calf was damaged and had to be amputated.
As the flat car rolled out, looking at the empty limbs, the student's mother cried heartbreakingly, and her father hugged her and kept comforting her.
They were fine a few hours ago, but now they are missing a leg due to an unexpected disaster. No matter what, they cannot face it.
Compared with the student who died at the scene due to craniocerebral injury, he was much luckier, at least he was able to survive.
Students, family members, and teachers who were still undergoing surgery stared anxiously at the door, feeling uneasy.
The third student came out and underwent splenectomy, partial liver resection, and partial intestinal resection.
There was a mess at the entrance of the emergency operating room, and the government staff responsible for comforting kept comforting the family members.
The female driver's parents sat back on the blue plastic chairs. Her father picked up the phone several times, but he didn't know who to call at this time.
These students were pushed out one after another, and the female driver's parents didn't even raise their eyes, let alone go up to understand the condition, as if the whole thing had nothing to do with them.
After learning that they were the parents of the female driver, the mother of the amputee student lost control and rushed over crying to demand an explanation.
At a distance of three meters, the staff grabbed the grieving mother.
The noble lady stood up subconsciously, took two steps back, and tugged on her clothes in disgust, fearing that the people rushing towards her would stain and mess up her clothes.
The disdain and contempt on his face is enough to make anyone angry.
——
Yang Ping has taken over the operation of the female driver, and Song Zimo has also stepped into the position of first aid.
Director Ouyang and Dr. Jin, deputy chief physicians of general and thoracic surgery, took the initiative to get out of the way.
"Defibrillation!"
Defibrillate the heart directly into the chest.
Under the stimulation of the electric current, the heart finally began to beat weakly, and the rapid friction of the cart wheels against the ground was heard in the corridor. The AB blood type that was subsequently urgently collected was finally in place.
As long as the pulse can be restored, there is still a glimmer of hope. This is the last chance.
The cart rushed into the operating room, and the blood delivery nurse gasped. The circulating nurse immediately checked the blood type, hung the blood bag on the infusion stand, and the blood transfusion set with the heating and pressure device quickly injected the suspended red blood cells into the human body. p>
The operation continues! It must continue!
From the chest cavity to the abdominal cavity, then to the pelvic fracture, the femoral head inserted into the pelvic cavity is pulled back into place, and finally the limbs are fractured.
Methodical and step-by-step.
Trauma should be dealt with in a step-by-step principle, saving lives first, then saving limbs, and finally considering function.
According to conventional principles, for this kind of patient, the thoracoabdominal and pelvic injuries should be treated to eliminate the life threat, and the comminuted fractures of the limbs can be left for later surgery.
But this is a principle set for ordinary people. Yang Ping has his own principles.
At Yang Ping's speed, it doesn't take much time to fracture the limbs. Moreover, these comminuted fractures have active bleeding, and the amount of bleeding is very large.
The bleeding volume of a pelvic fracture is generally 500 to 5000 ml, and the bleeding volume of one side of the femoral shaft is 200 to 2000 ml.
This kind of high-energy comminuted fracture will cause the amount of bleeding to be higher.
Blood accounts for 7%-8% of body weight. For an adult weighing 50-60 kg, the blood in the whole body is only 4000 to 5000 ml.
A severe pelvic fracture can deplete a body's blood supply without supplemental blood transfusions.
Acute bleeding reaches 30% of the total blood volume, which has reached the human body's compensation limit and threatens life.
30%, that is, 1200 ml to 1500 ml, if the rescue is not timely, it will cause death.
If the speed of the operation allows, of course it would be best to resolve all these fractures, as any place is a leak of blood.
The reason is that the operation speed of ordinary people cannot meet the requirements of completing the operation in one step.
Yang Ping did not take steps, but completed the operation in one go.
Two deputy chief physicians from the Department of Thoracic Surgery and General Surgery stood on the stage, just observing with admiration.
They just watched silently. This young man who performs multi-professional surgeries has a level of thoracoabdominal trauma surgery that far exceeds their own. In the past, they had only heard about or observed surgeries, but had never actually performed on the same stage.
Now I'm on the same surgery stage, seeing it with my own eyes, so close at hand, I'm convinced, I can only worship.
The supplemented blood of the same type carries oxygen and circulates throughout the body, rejuvenating cells. However, some cells also die due to lack of oxygen.
Even if this patient is saved, he will still have serious sequelae, such as brain dysfunction.
Professor Huang Zhong from the Department of Traumatology and Orthopedics of the First Affiliated Hospital arrived at Sanbo Hospital by helicopter with the directors of the Department of Thoracic Surgery and General Surgery, and they hurried to the emergency department.
The female driver's father finally saw the savior: "Professor Huang, thank you for your hard work. I'm afraid they can't handle it."
Professor Huang waved his hand, signaling not to disturb him.
Director Han came out to greet him and said, "Is Xiao Yang busy inside?"
Huang Zhong was very respectful to Director Han, shook hands with Director Han, turned to the family of the female driver and said: "Dr. Yang represents the highest level of surgery in the medical field. I am here to observe and learn."
The tone is sincere and not casual at all.
"Professor Huang——?" What did the female driver's father want to say.
Huang Zhong waved his hand again: "If Dr. Yang can't save him, then you have to accept your fate."
Huang Zhong is so frank and direct.
After listening to this, the lady raised her head and fell back, but two people beside her supported her.
The female driver's heart still keeps a weak beat, and it has been relieved of all the work.
The artificial heart-lung machine next to her, ECMO, has been running, replacing the functions of her heart and lungs.
"The heart beat is weak, continue to use ECMO."
The last pair of vascular forceps was thrown on the bending plate.
On the monitor, the curve symbolizing life has been maintained.
Save one, it’s one.
This one has been saved for the time being.
"How was it?"
Director Han came over again.
"It should be pulled back!"
Yang Ping stared at the data on the monitor.
Then he turned to Song Zimo and said: "Close your chest!"
I haven't dared to close my chest just now, for fear that my heart will stop beating again.
