Chapter 564: Stop the scene, false alarm

Author: Fisherman by the River

Chapter 564: Stop the scene, false alarm

Zhou Can carefully examined the patient, hoping to find a way to save the patient.

To be honest, if there is a problem with the lungs, even if the external lung membrane is used, it may not be able to be rescued. ECMO is by no means omnipotent. Its purpose is to temporarily work on the heart and lungs and help patients complete breathing and circulation.

It cannot replace cardiopulmonary work for a long time.

Not to mention the external lung membrane, even if you just use a ventilator, it cannot take too long. Otherwise, the patient's body will easily become dependent and greatly increase the probability of infection.

This type of total lung resection patient will suddenly reduce the lung function after the operation by 50%, and the respiratory and circulatory systems will be under tremendous pressure. It is equivalent to the two people carrying two hundred kilograms together, but suddenly one person escapes, and the remaining one will be exhausted to death.

Therefore, the mortality rate and complications of one side of total pulmonary resection are very high.

Removing part of the lung lobe is relatively less risky.

In addition, the quality of life of patients with total pulmonary resection on one side will be greatly affected. In the past, they easily climbed to the third floor, but now they may be out of breath and exhausted after climbing half a floor.

If the patient is younger, he may not even be able to live a normal life as a couple.

When Zhou Can first formulated the surgical plan for this patient, after careful consideration, there was no other way, so he chose to help the patient with the left lung to save his life.

The patient had the operation two days ago, and today is the third day.

Currently, the face and lips are cyanotic, including nails, which are abnormal cyanotic, which is a clear manifestation of hypoxia.

The patient had difficulty breathing, had a large amount of pink foam-like sputum, and his heart rate was significantly higher than normal. It reached 150 beats/minute.

Blood oxygen saturation has dropped to the bottom and has long fallen below the lowest warning line.

If the blood oxygen saturation is less than 95%, obvious discomfort will usually occur, which will cause the doctor to be alert. The patient's blood oxygen saturation has fallen below 80%, which is the result after various rescue measures.

Zhou Can's face was as deep as water, and several chief physicians in the custody room looked at him with serious expressions. Everyone was really helpless, so they could only hope for him to see if they could think of a treatment solution.

"Sister Yan, please lend your stethoscope to use!"

Zhou Can said to Director Xueyan.

Percussion hammers and stethoscopes should be commonly used by cardiothoracic surgeons. Because these two things may be needed at any time.

However, this place is sterile management, and items outside cannot be brought in easily.

Director Xueyan’s stethoscope should be built in the custody ward.

Although the patient seemed to be dying at any time every breath and looked scary, Zhou Can was as stable as Mount Tai. He held a stethoscope and pressed it to the patient's lungs to auscultate.

"The patient is covered with wet rales and blister sounds, combined with the patient's current symptoms and signs, it must be pulmonary edema. The first day after the operation was cured, indicating that the patient's lung condition worsened yesterday, and it may even be this morning. Show me the infusion and medication list."

Zhou Can's current pharmacological diagnosis has also been upgraded to Level 6. When diagnosing and treating such critically ill patients, he has the ability to start from many aspects.

Including pharmacology, pathology, symptoms, etc.

In the past, when doctors’ advice and medication matters, especially for some patients with complicated medication, they seemed powerless and difficult to get involved.

The deputy chief physician and the chief physician seem to be only half a level apart, but the level is very different.

Especially the two core items of pharmacology and pathology, there is a clear difference.

Before Zhou Can's pharmacological diagnosis was advanced, he was even worse than nurse Jiang Wei in many drug use fields.

Director Xueyan's theoretical level has always been outstanding, and her pharmacological diagnosis has long been level 6. Even now, Zhou Can is slightly inferior to her.

At most, Zhou Can now be qualified to "discuss the truth" with her.

It's equivalent to everyone being at this level, she's just a little stronger.

Although Xueyan, Deputy Director He and others have already checked the patient's infusion and medication, Zhou Can still wants to check it again. Even if no problems are found from it, he can have a clearer understanding of the patient's treatment and medication situation.

What medicines have been used and how effective it will be after use can give Zhou Can a good feedback.

After checking, his originally frowning brows loosened a lot.

"The main rescue measures that have been implemented for patients are mainly oxygen inhalation of face masks and intramuscular injection of sedative drugs."

Maybe everyone dare not take medicine rashly when the diagnosis opinions are not unified.

"Zhou Can, look at your expression, have you found the reason for the patient's pulmonary edema?"

Director Xueyan has worked with him for a long time and has a deeper understanding of some of his behavioral habits.

Seeing Zhou Can's brows loose, her heart felt much more relaxed.

This is a kind of trust built by long-term cooperation.

Zhou Can only show this expression when he feels more confident in the rescue work.

"That's right!"

Zhou Can nodded.

"Actually, after we discussed it just now, we also thought that the patient was likely to have pulmonary edema, but when he saw pink sputum and the pathological mechanism was unclear, he did not dare to act rashly. The rescue measures were also conservative."

Deputy Director He’s words are somewhat of a sign of saving face.

After all, in the field of external chest, he is considered a veteran in the department.

For a long time after Director Hu Kan's death, he regarded himself as the boss in the external field.

It is undeniable that Deputy Director He is indeed very strong and has extremely rich experience.

Pink sputum indicates hemorrhagic effusion or bleeding in the lungs.

Except for Director Xueyan, others really don’t know how the operation was performed at that time. However, everyone is quite confident about Zhou Can’s surgery level.

"I did the surgery, and I am indeed more familiar with the patient's situation. You and several directors called me over to deal with it, which was very steady."

Zhou Can praised the other party and continued.

"I just looked at the medication for the past three days and there was no problem. The sudden pulmonary edema of the patient should be related to the total resection of his left lung. To put it bluntly, this postoperative complication cannot be avoided. After the entire side of the lung is removed, due to the decrease of the lung blood vessels, the hydrostatic pressure in the blood vessels will increase, and the permeability of the capillaries will also increase. A large amount of water seeps into the alveoli from the lung capillaries, which will eventually lead to acute pulmonary edema."

Zhou Can explained his pathological analysis to the doctors and nurses present.

When everyone rescues various critically ill patients, it is also a process of learning and progress together.

Everyone has different medical knowledge, clinical experience, clinical application of knowledge, and ideas. Listen to other people's opinions more to learn from others' strengths and weaknesses. Next time you encounter similar cases, it will play a good reference role.

Even better doctors can give different diagnosis and treatment opinions in this operation and work together.

Avoid misdiagnosis and misdiagnosis.

Sometimes, when a patient in a department has problems, more than a dozen doctors and nurses surround him. The family members don’t understand and think it’s like they are here to fight.

Actually, it's not.

In the hospital, the doctor felt that it was dangerous and would definitely not confront the family with more than a dozen doctors.

Unless the family is already committing an offense and hitting someone, the doctor will stand side by side in order to protect the female doctor and the female nurse to prevent the family from continuing to commit atrocities.

When rescuing critically ill patients, a large group of doctors and nurses are all at once, which is the importance of the patient's life.

On the other hand, we also want to gather the wisdom and strength of the group to save lives together.

This can also ensure a higher rescue success rate.

"Then how are you going to solve it now?"

Director Xueyan thought that he almost used the external lung membrane to save his life, and couldn't help but feel a slight fever on his face.

Emergency will lead to chaos.

Chaos are unknown.

Not long ago, she saw the patient's condition suddenly deteriorating and she looked like she might die immediately. She was indeed frightened.

Other chief physicians were also very anxious.

If an ordinary patient wears an oxygen mask and does not work, you can also consider going to a ventilator. The patient's condition is very special, and everyone agrees that it is the safest to go to the external lung membrane.

At least that was the case at that time.

Even now, if Zhou Can didn’t calmly analyze the patient’s situation to everyone and tell them that there is no abnormal bleeding in the patient’s lungs and heart. It’s just acute pulmonary edema, they may still be as nervous and anxious as before.

All the doctors present had rich rescue experience.

They know very well how fragile the lives of patients are.

Sometimes, the previous second is fine, but it can be gone in the next second.

"I think the patient's heart rate is still a little too fast. I will give 10 mg of morphine to sedation, and then use cardiotropic and diuretic drugs to treat acute pulmonary edema. Also, the input of crystal liquid must be reduced, which is also related to the patient's sudden acute pulmonary edema."

When Zhou Can said this, he looked at the head nurse.

The doctor's order is prescribed by a doctor, and the nurse has the responsibility and obligation to review the medicine when taking the medicine.

If you can be more meticulous about the patient during the nursing process, and if you find something wrong, you should report it to the doctor at the hospital immediately, which should not lead to sudden acute pulmonary fluid.

Of course, the nurse must not be blamed.

Zhou Can couldn't say such words directly.

"Okay, I will pay special attention to this patient in the next care."
To be continued...