The laryngeal mask is used a lot in neonatal resuscitation, and most practicing doctors can think of it. The problem of the baby in front of me is not a problem of establishing an artificial airway at all.
When a newborn baby has a slow heart rate and is unable to breathe, there is basically only one reason: the airway is blocked. The blockage may be mucus, meconium, or something else.
Because the baby's heart rate quickly dropped to the dangerous limit, the doctor had no choice but to perform neonatal cardiopulmonary resuscitation to maintain the baby's heart beat during the rescue. Then he chose an opportunity to solve the airway problem.
Positive pressure ventilation to establish an artificial airway using a laryngeal mask, etc., is best done on the basis of a clear airway. Otherwise, each ventilation may push obstructions into the airway. Therefore, they are very careful when using the breathing bag
In the beginning, Song Xuelin did not use the breathing bag, but used his own mouth to blow air. In fact, he was trying to suck it in to see if he could suck out the contents of the baby's airway.
The obstetrician had to clear the obstruction in the mouth and nose when he received the baby for the first time. When he took over the baby, Song Xuelin quickly checked and found that there was indeed no obstruction in the baby's mouth and nose for the time being. It showed that the situation was very helpless, and the obstruction was expected to be in the baby's mouth and nose.
The deeper parts of a child's trachea are difficult to come out of, resulting in a dangerous situation for today's children.
To put it bluntly, if you want to use a laryngeal mask for intubation, it is better to use a tracheal intubation. If the tracheal intubation is successful, at least make sure that the tube is in the trachea. You can put a suction tube in the tracheal tube and connect it to a negative pressure suction device, and carefully suction it.
Can the obstruction in the trachea be aspirated?
This is not a hospital site and there is no negative pressure suction device. The national association ambulance and emergency department will not have spare tracheal intubation for neonatal departments. Neonatal intubation is technically difficult. The emergency doctors on duty in tertiary hospitals are not professional pediatric hospital doctors.
, I didn’t have the technical ability to perform tracheal intubation on such a young child, so I had to send him back to the hospital to find a neonatologist.
What should I do? It is right to try to revive the baby's heartbeat. CPR compressions are performed on the chest, which to a certain extent is equivalent to giving force to the trachea.
However, these rescue measures are insufficient so far, and doctors may need to take a gamble. The rigor of medicine makes doctors first choose mild measures, and they will only take further risks if the patient fails. Any invasive medical operation requires both sides.
Blades have good and bad qualities. When they are good, they can save lives; when they are bad, they can make them lose their lives faster.
When faced with gambling, the doctor first had to calculate whether the previous measures would give the human body enough time to react. Song Xuelin raised his head and asked the time: "How many minutes have we been doing this?"
After receiving his question, Lin Hao and Li Qian looked at their watches and clocks and tried their best to recall and estimate: "Maybe seven or eight minutes——"
"It's been four minutes since I participated, and the time it took Dr. Song for you to take the baby out was five minutes. The total is estimated to be about nine minutes and ten seconds." Xie Wanying said.
Lin Hao and Li Qian listened to every precise time point she spit out, and sighed in their hearts: It turns out that time flies so fast. As someone said, classmate Xie is no different from the old doctor, and they can only lag behind in this regard.
Song Xuelin's slightly narrowed brown eyes flashed with light. He felt most comfortable partnering with Dr. Xie. Dr. Xie could always live up to expectations at critical moments.
"Dr. Song, let's change hands and I'll give it a try." Xie Wanying suggested on her own initiative.