Fentanyl is a controlled substance and is the most strictly controlled drug in hospitals. The doctor who prescribes it needs to use a red prescription slip commonly known as a "red ticket".
Each red ticket has an independent number to facilitate the hospital review department to track the flow of prescriptions and drug usage. Xu Yourong had just joined the treatment team a few hours ago, and the red prescription number she held still belonged to the Department of Neurosurgery.
The red sheets used in the emergency room had not yet been handed over to her. Although she wanted to relieve the patient's pain as soon as possible, Xu Yourong was helpless.
Needless to say, Sun Lien didn't have the right to prescribe. But fortunately, he was smart enough. After seeing Xu Yourong's troubled expression, Sun Lien turned around and rushed out of the emergency room. He grabbed Liu Tangchun who was about to return to the office and said, "Liu Tangchun
Teacher, quickly, prescribe five milligrams of fentanyl!"
For the second time in a short period of time, Liu Tangchun was pulled back by Sun Lien's arm. Poor Director Liu was in his fifties. Although he had been a soldier when he was young, his health was not as good as it was thirty years ago. Sun Lien lost his hand again in desperation.
It was so serious that it made Director Liu stare blankly.
In fact, you can also ask doctors from other emergency departments to issue red orders, and you don't necessarily have to kidnap Director Liu from the hall. But Sun Lien had other ideas. He had already performed the rescue of severe burns in accordance with the requirements in the textbook.
But the state of the corpus callosum rupture made him a little uneasy. Whether it was in the morning or after eating in the evening, Sun Lien did not see this state in Zhao Weihong. Then there is only one possible inference, that Zhao Weihong's corpus callosum rupture occurred after he was discharged from the hospital.
Counting from the time he was discharged from the hospital until he was sent to the ambulance again. During this hour, Zhao Weihong's corpus callosum, which had been functioning normally for 67 years, was severely damaged.
What Sun Lien was afraid of was that the burns were just a tactic, and the damage to the corpus callosum was the real killer. He had to make Liu Tangchun aware of the patient's severe brain tissue damage as soon as possible. What if the burns were to cover up the damage to the corpus callosum...
Sun Lien had no hope in the humanity of Zhao Weihong's family.
Liu Tangchun quickly issued a red ticket. The male intern nurse who had been waiting for a long time took the red ticket and ran towards the pharmacy. The severe pain caused by the burns reacted on Zhao Weihong, and the strong pain stimulated her.
Her brain is constantly secreting dopamine. After these dopamine enters the viscous blood, it directly stimulates her already overwhelmed heart to continue beating rapidly. If the pain is not relieved as soon as possible, it is only a matter of time before the heart stops completely.
If the heart fails, Zhao Weihong will basically be dead. It is absolutely impossible for her to undergo a heart transplant in her current condition. And large-scale burns mean that there will be a lot of waste in the circulatory system that needs to be processed. If the liver and kidneys cannot get enough energy during their over-limit operation,
If there is sufficient blood supply, they will also join the strike ranks one by one.
This is the first step in multiple organ failure from extensive burns.
Three minutes after Zhao Weihong was sent to the emergency room of the Fourth Central Hospital, doctors from the anesthesiology department finally arrived at the scene.
Maintaining the operation of the circulatory system is the specialty of anesthesiologists. Unlike the cardiology and respiratory departments that treat diseases, the main job of the anesthesiology department is maintenance rather than treatment. Therefore, in terms of treatment methods, the anesthesiology department is also much rougher. Except for a few individuals
Except for doctors who like to chant "Da Lang, drink the medicine...", doctors in the anesthesiology department are more likely to be silent. They need to monitor the patient's heartbeat, respiration, and blood pressure, and sometimes even pay attention.
Patient’s urination status
"Is the pain relieved?" The person who came to help was an attending doctor from the anesthesiology department. When he visited Lin Lan's surgery in the morning, Sun Lien had seen him on the sidelines, although his entire face was covered by a mask and surgical cap.
He stood up, but his pair of black framed eyes with white horizontal stripes left a deep impression on Sun Lien.
"A red order was issued for five milligrams of fentanyl. I've gone to get the medicine..." Before Sun Lien could finish speaking, the door to the emergency room was pushed open by a male intern nurse. He was holding a small plastic basket in his hand.
, which contained a glass vial with a blue plastic cap.
"Carry out a B-ultrasound to guide me." The anesthesiologist wearing zebra glasses put on gloves and skillfully took out the tools in the central venous puncture set. After disinfecting the right side of Zhao Weihong's neck, who was lying on his side, he looked at
Using the guidance from the B-ultrasound, I started from the head direction and inserted the needle on the syringe toward Zhao Weihong's neck.
Logically speaking, deep jugular vein cannulation requires the patient to lie down, but the carbonized outer layer of Zhao Weihong's back skin directly made Zebra give up the idea. Fentanyl is still being dispensed, so let Zhao Weihong lie down now.
, she was afraid that she would hurt herself to death. The brave anesthesiologist, who was skilled in art, did not choose the subclavian vein or femoral vein, which were easier to penetrate but also had higher risks. Instead, he still chose the most suitable for large-scale fluid replenishment.
Neck veins.
The catheter placement was very smooth. The seven to eight centimeter long needle was less than halfway inserted, and the dark red blood instantly returned to the syringe. This also marked that the rapid rehydration channel was successfully opened. A guidewire was inserted into the channel next to the needle.
, stop at the position marked by the guidewire scale and pull out the needle. At this time, the skin expander in the puncture set comes in handy.
The skin expander is a very hard hollow plastic tube. The guide wire passes through the hollow part. The plastic tube is close to the position where the needle is inserted. Then Dr. Zebra pressed down hard, and the front end of the plastic tube hardened directly.
It squeezed into the skin, making the already thick pinhole even wider.
Sun Lien, who was observing a deep jugular vein catheterization for the first time, was horrified and sighed in his heart. If he had stayed in the hospital honestly and actively cooperated with the examination, why would Zhao Weihong have suffered like this?
After unplugging the skin expander, Dr. Zebra took out the remaining infusion tube from the suit. After passing through the guidewire, he slowly followed the infusion tube toward the neck vein. It looked a bit like a sewer tube.
Workers are smoothing wire into a blocked pipe.
After going down for about ten centimeters, Dr. Zebra stopped with satisfaction. He slowly pulled out the guidewire, used a syringe to draw a little blood along the tube, and then nodded and said, "It's done, let's start replenishing fluids."
Let's do it." After that, he put down the syringe and went to help the nurses who were still preparing fentanyl to prepare painkillers. This is also one of the jobs of the anesthesiologist.