Before reinforcements arrive, emergency department medical staff need to continue rescuing and treating patients.
"Doctor Xie, do you want me to have an X-ray?" asked the experienced nurse Yang.
This patient 100% needs emergency surgery. X-ray, CT and other examinations are necessary to help the doctor determine the position of the steel bar in the injured body and how to perform the operation.
The problem was that the injured person's vital signs suddenly became unstable, and it was not suitable to send him to the imaging department for examination at this time. The medical staff sent the injured person to the emergency room first.
The data on the ECG monitor showed that the injured had low blood pressure, fast heart rate, and obvious blood volume deficiency.
I hurriedly asked the nurse to go to the blood bank to get blood.
On the other hand, there is only one venous channel on the injured person, which was opened by Dr. Liu and others before. In the current situation of the injured person, two venous channels must be opened to maintain blood pressure. But in such a state of near shock, hypovolemia
, the surrounding veins must have dried up, and the nurse cannot inject the veins.
According to the cases mentioned before, it may be possible to puncture the internal and external jugular veins or the subclavian vein to establish central venous infusion. However, the injured person today is quite special. The clavicle of the neck was injured when he fell from mid-air, which was the result of the above-mentioned vein puncture.
Contraindications. Generally speaking, the subclavian vein, internal jugular vein, etc. are deep vein catheters. Clinically, peripheral veins can be selected.
What should the peripheral venous nurse do if she cannot find the blood vessel? The only option is for the surgeon to step in and perform a phlebotomy.
Blood vessels cannot be found to "disappear" but they do not really disappear. Blood vessels always exist in the human body. Blood-filled blood vessels allow medical staff to feel the pulse through the skin and then puncture them. Now the blood vessels are deflated and cannot be touched, so they can only cut them open.
I went after the skin.
The clinically preferred phlebotomy vessel is the great saphenous vein.
The general direction of the great saphenous vein in the human body is as follows: it starts from the inside of the dorsum of the foot, goes up along the inside of the ankle, goes to the inner side of the calf and thigh, and finally joins the femoral vein.
According to the direction of this blood vessel, the doctor can choose to incise the great saphenous vein at the medial malleolus or the great saphenous vein at the femoral region. You don’t need to think too much to know that the medial malleolus is the preferred location, which is easier to start with.
"Do an incision on the great saphenous vein at the medial malleolus." Xie Wanying ordered.
Nurse Yang and Guo Zihao who were present hurriedly brought the necessary items for the incision.
Every second counts when rescuing patients in shock, and everyone is working hard.
The door of the emergency room is closed. The medical staff are busy rescuing patients at this moment, and the emergency hall outside is almost unattended. Anyway, when emergency patients come again, they will shout for the doctors and nurses.
Someone could take advantage of this moment and just go through the gate security check and quietly walk into the emergency department without anyone noticing.
The two people who got off the taxi and pulled the suitcases did exactly this. They waited for Xie Wanying and the others to send the patient inside, and then walked to the entrance of the Guozhi Emergency Department lobby.
The lights at the entrance of the emergency room shone down, clearly reflecting the appearance of the two people. They were two young people. One of them was wearing a yellow sweater, like a curious baby, stretching his head and looking around inside the emergency room.
The other person wore a blue and white sports coat, hugged the briefcase with both hands like a sleeping pillow, and sat on the suitcase to take a nap.
Who wouldn't want to sleep in the middle of the night? This is probably what people who doze off want.
The man in the yellow sweater didn't think so, so he pushed his shoulder and said, "Hey, Zhiyuan, wake up, sneak in and take a look."