Skin grafting needs to be performed in the operating room, and the sterility level in the rescue room is actually very low, not as clean as the "debridement room" in anorectal surgery. Although the skin that has been burned into eschar must be cleaned during skin grafting,
Being washed means that the deeply damaged muscle tissue will be directly exposed to the air, which is extremely risky.
The burn department is a very special department, and their work is very different from other departments. The work scope of the burn department includes internal medicine, surgery, plastic surgery, anesthesia, life support, anti-infection, rehabilitation and other directions. And
In the treatment of severe burns, each of these directions requires doctors in the burn department to not only "understand", but also to be proficient.
If the emergency department is the special forces among doctors, then the emergency burn department is a position that can only be filled by the truly experienced battlefield veterans among the special forces.
Severe burns are a condition that needs to be taken seriously in any hospital. From the moment Zhao Weihong was carried to the rescue room and confirmed to be sent to the Fourth Central Hospital, the Burn Department of the Fourth Central Hospital has entered a first-level alert state.
Two of the three doctors on duty entered the operating room at the same time and began to change clothes and wash their hands, while the other doctor on duty came to the emergency room to communicate with Sun Lien and others about the case.
In fact, the case communication should logically involve the patient's family, so that when the emergency department and the burn department conduct handover consultations, the patient's family can also directly know what kind of risks their loved ones will face. Although it is a bit cruel, it does improve
It improves the patient's family's understanding of the patient's condition and can resolve possible risks to the doctor-patient relationship to a certain extent.
But Zhao Weihong's daughter really... made the doctors a little unsure. Now that they had the signature of District Chief Ouyang, everyone was relieved and started to discuss the handover, bypassing the District Chief's wife who was still in the hospital.
.
"In order to achieve the best pain relief, the patient is now in an opiate state." The person who presided over the handover was Xu Yourong. After all, she is a licensed doctor, and she is more confident than a newcomer like Sun Lien who has not yet passed the medical qualification exam.
, and it also facilitates exchange of opinions with the doctors in the burn department. “After admission, we immediately provided advanced airway support to the patient, and at the same time performed jugular vein catheterization. Now more than 500 ml of fluid has been refilled. The heartbeat has dropped from every level on admission.
The 144 beats per minute dropped to 110, the blood pressure began to gradually rise, and the vital signs were stable..." Xu Yourong paused and continued, "When I asked about the medical history just now, the family mentioned that the patient had a small nasal needle knife inserted into the nasal cavity before the burn.
The length of the blade is about fifteen centimeters..."
There was an exclamation in the conference room. The emergency doctors attending the conference had just heard the news. Their eyes widened and they unconsciously shouted out what they were thinking, "What the hell?!"
"Although the patient's burn condition is still the main concern at the moment, I strongly recommend that you consult a neurosurgery department as soon as possible to clarify the patient's brain injury." Xu Yourong waited for the exclamations to subside a little before continuing, "What is certain is that,
The patient's cerebellum and brainstem were not injured, otherwise we would not have been able to stabilize her vital signs. But how much damage has been caused by this... this witch doctor-like treatment method still needs to be clarified as soon as possible."
The atmosphere in the conference room was a bit depressing. After a long silence, the doctors who came to pick up the patient from the burn department looked at each other and nodded, "Give the patient a preoperative injection and prepare to send him to the contaminated operating room.
Let's rub the old lady's back. After the burn wounds are almost treated, we will transfer her directly to the combined operating room and use the MRI there to confirm the brain damage."
Zhao Weihong's transport situation is more complicated than that of ordinary patients. Due to the effect of powerful opioid analgesics, Zhao Weihong's respiratory center is actually completely suppressed. Now she does not have any spontaneous breathing and only relies on breathing.
The machine is working and living. If she is to be transported to the operating room, the breathing problem must be solved. Although with the advancement of technology, life support equipment has shrunk from the previous "entire room" to "one-fifth of the size"
"The size of a room". However, the size of the ventilator is still too large, and it is impossible to put it into the elevator together with the hospital bed. What's more, there are no power sockets in the elevator and corridor for the use of the ventilator, which is simply unrealistic.
"Just press it with your hands." Sun Lien had never transferred a patient who was unable to breathe on his own. After coming out of the conference room, Sun Lien took a chance and went to consult Dr. Cao Yanhua. The answer he got was as expected, "Use it along the way."
It only takes about ten minutes to press the air bag with your hands."
A simple breathing bag, commonly known as a balloon. It is a hollow plastic ellipsoid about half the size of a basketball. Connect the outlet end of the balloon to the interface of the breathing mask or directly insert it into the advanced airway interface, and then squeeze it rhythmically.
It can play the same role as a ventilator. But after all, this kind of squeezing relies entirely on manual force, which is really not suitable for long-term use. But it is more than enough for short-distance transportation.
"I thought there would be some kind of portable rechargeable ventilator in our hospital." Sun Lien smiled sheepishly, "After all, the hospital is a combined operating room and a helicopter platform..."
Dr. Cao Yanhua curled his lips, "You can't pursue everything that is too advanced, wouldn't it become unconventional?" At this point, he suddenly remembered something, and asked mysteriously, "Do you know why our hospital has
Do operating rooms still have spring doors?"
Sun Lien had just been to the operating room in the morning, so he was naturally impressed by the door in the operating room that needed to be pushed with his butt, "I don't know, why?"
"The old dean of Ningyuan Hospital is the dean who retired just before your class entered school. He once studied in France." Dr. Cao Yanhua took the time to gossip, "In France in the 1980s, hospital equipment was very advanced.
Advanced ones. These include the kind of electric surgical door that is similar to the automatic door of a spaceship. There is a pedal at the door, which can be opened by pressing it with your foot."
Sun Lien nodded, "I heard from several friends that their hospitals also have automatic doors like this."
"Then, one day, the old director visited an operation in the operating room." Cao Yanhua continued to smile softly and said, "The patient at that time was an American traveling in France. He had megacolon, and the patient in that operation was
The French doctor who performed the surgery chose electrocautery in order to reduce bleeding.”