In the clean room, the chirping sounds of the three cardiopulmonary monitors sounded a bit chaotic. Sun Lien and Director Huang were in the room, and for a moment they felt a little uncomfortable because it was too quiet here.
In the room, several hospital infection control staff wearing P4 protective clothing were continuing the installation of respiratory lines, while other medical staff were waiting outside the clean room, preparing to wait until Sun Lien or Director Huang became unwell and could no longer persist.
Go to replace.
Dr. Yuan Pingan and Dr. Cao Yanhua each brought two nurses to wait, and Dr. Brun and Dr. Pascal also decided to prepare to wait together.
"You wait inside for two hours and then come out to change shifts." Yuan Pingan said rudely to his team leader, "Wear a mask for more than an hour. If the patient develops a situation that requires chest compressions, then you should quickly step back.
When we go in to do compressions, Nicole, please don’t take off your mask inside, it’s the plague!”
"I know, I know." Sun Lien agreed with a guilty conscience. When Yuan Pingan met him for the first time in the Fourth Hospital, he met Dean Song who scolded him for wanting to skin him. He probably heard a lot in this month.
My original "heroic feat" was why I was so nervous.
"You were the one who took off the mask to rescue the patient in the clean room last time?" Director Huang was really shocked now. He didn't expect that Dr. Sun was still a ruthless person.
Sun Lien coughed awkwardly, and when he was about to say something, he suddenly heard a sharp alarm sound.
The monitor next to Tang Xingde screamed. Sun Lien was already familiar with the waveform of ventricular fibrillation at this sound!
"Push the defibrillator, prepare two intravenous injections of lidocaine, hurry!" Sun Lien rushed to Tang Xingde's side and started chest compressions. Wearing an N95 mask, chest compressions were very laborious, but he had just put it on.
How long will it take for my current physical strength to hold on?
Sun Lien glanced at the status bar above Tang Xingde's head. Sure enough, a new status was added: ventricular fibrillation (there are still 8/8 times before the defibrillation is successfully released).
It took eight defibrillations to calm down, but this at least meant that the person could be saved. Sun Lien felt a little more relaxed, and while doing chest compressions with all his strength, he quickly wondered in his mind why Tang Xingde suddenly suffered from ventricular fibrillation.
In addition to electric defibrillation, correcting the cause of ventricular fibrillation is also one of the important means to relieve ventricular fibrillation.
There are currently five known status columns, "Significant increase in white blood cell levels," "High fever," "Severe pneumonia," "Sinus tachycardia," and "Reduced fibrinogen concentration." A significant increase in white blood cell levels means that the patient is in a serious condition.
Bacterial infection. Bacterial infection may cause bacterial emboli to appear in the blood and block the coronary arteries, resulting in ventricular fibrillation.
High fever? This is one of the evidences that the body is fighting bacteria. In order to control the collateral damage caused by high fever, doctors from the Fourth Hospital have used ice blankets to cool down the three people. None of them inhaled depolarizing muscle relaxants.
, this kind of hyperthermia is naturally not caused by malignant hyperthermia. On the other hand, if the core temperature is too high, it may indeed cause a large number of cells to die, thereby releasing too much potassium. When this potassium enters the blood, it will cause blood potassium
If it is too high, it can quickly cause ventricular fibrillation and cause death.
Needless to say, severe pneumonia can be seen together with sinus tachycardia. Pneumonia can lead to insufficient oxygen content in the human body. The heart rates of these three people are frighteningly high. The heart cannot get enough oxygen under high-intensity load.
Oxygen, the result is the continuous accumulation of lactic acid, leading to ventricular fibrillation.
The decrease in fibrinogen concentration directly increases the possibility of DI. If a patient suffers from DI, the coronary arteries may indeed be blocked by thrombus and cause ventricular fibrillation.
Five states, four completely different causes of ventricular fibrillation. Each one has a high possibility, and the treatment method for each one is different. Sun Lien must immediately find out the real cause of the patient's ventricular fibrillation and treat it
Treatment. Otherwise, even if Tang Xingde restored sinus rhythm after eight defibrillations, he might have to tremble again within a few minutes.
The first ventricular fibrillation requires eight electric defibrillations. According to general experience, subsequent defibrillations will be more and more difficult. Sun Lien even feels that if this defibrillation is successful, Tang Xingde will
If he trembles again, he may not be able to be saved.
Think quickly, think quickly! Sun Lien pressed Tang Xingde's chest hard while shouting to Yuan Pingan who rushed into the clean room, "Come here and help!"
The moment the monitor alarmed, Yuan Pingan rushed in with nurses Xiao Guo and Zhong Yu. Yuan Pingan was waiting one step beside Sun Lien, ready to take over and perform chest compressions at any time, while Xiao Guo rushed to five meters away in three consecutive steps.
Next to the rescue vehicle, he rushed back with the defibrillator and turned it on to charge. Zhong Yu pulled out the drawer under the rescue vehicle, took out lidocaine from it and began to inject it intravenously.
Sun Lien got out of the way, and then Yuan Pingan took over the chest compressions. He quickly took two steps back. After confirming again that there was no other status bar above Tang Xingde's head, he began to think quickly about countermeasures.
The possibility that Yersinia pestis can cause bacterial embolism is extremely low. When bacteria invade the tissues in the human body, the mixed parts of necrotic tissue and bacteria fall off and float in the blood, forming bacterial embolism. But when Tang Xingde's family was infected with plague
They are all too short and should not be enough to cause bacterial embolism.
Hyperkalemia? This is possible, but the three patients have been in an extremely high temperature state for a short time, and although there are indicators of acute kidney injury, the human body’s organs have the ability to compensate. Only Tang Xingde’s current kidney function indicators and body edema
Judging from his condition, his kidneys are far from failure. The possibility of hyperkalemia is not too high either.
dic? This is easy to rule out. Sun Lien took a look at the intravenous infusion needle on Tang Xingde's arm. There was no trace of blood leaking out. This can also be ruled out.
"Acidosis is most likely, Nurse Zhong, give ten milliliters of 5% sodium bicarbonate, intravenous injection!" Sun Lien identified the most suspected cause. That's not to say that hyperkalemia is completely impossible. In comparison, 5% of
Sodium bicarbonate is the fastest to infuse, and even if the judgment is wrong, it will not cause direct danger to the patient. Moreover, sodium bicarbonate itself has a therapeutic effect on patients with hyperkalemia.
"Fourth defibrillation, 220j, get out of the way!" Xiao Guo completed the third defibrillation, but the effect was still not satisfactory. Yuan Pingan continued to perform chest compressions, but there was already a layer of sweat on his head.
, it seems that I probably won’t be able to hold on for much longer.
"I'll take over. You're going to let Dr. Cao in." Sun Li'en stood next to Yuan Pingan, "Switch hands with me after the fifth defibrillation!"
High-quality chest compressions are an important factor in improving the success rate of defibrillation. The so-called high quality means that the doctor's chest compressions must have sufficient strength and frequency. This is an amazing consumption of physical strength, so in the chest
It is very necessary to change people in time during external compression.
"I'll do it." Brun came in wearing a mask and protective equipment. His big beard looked a little ridiculous under the N95 mask. "You young doctors don't have enough physical strength. Don't you usually eat meat?"
?”
For the first time in his life, Yuan Pingan felt that American red-necked motorcyclists were really cool.