Chapter 2168 Rescue

"Old Mu is undergoing surgery, what's wrong?" Su Yun asked lazily.

"The patient's heartbeat stopped!" the nurse yelled, then turned around and ran back.

Well……

Is it next door?

Su Yunhuo stood up suddenly, and saw Zheng Ren turn around through the leaded glass, without even tearing off the sterile gown, opened the sensor airtight lead door, and strode out.

"Mr. Wu, don't worry, the boss and I will go there." Su Yun strode away, not forgetting to explain to Mr. Wu.

At Mr. Wu's age, I'm really afraid that if he attends the emergency department first aid, he will cause his own heart attack first.

The interventional operating room of the People's Hospital of Pengcheng Development Zone is not large, with only 5 operating rooms. The airtight lead door of the operating room with the red light on during the operation was closed, and panicked voices came from the operating room.

"Push the medicine! Atropine 1mg!"

Zheng Ren walked over quickly, and immediately saw a pale system panel, the diagnosis on it was blurred. Diagnoses such as coronary atherosclerotic heart disease and carotid artery stenosis can be vaguely seen.

The doctors in the circulatory department are doing heart compressions, and the nurses are drawing medicine and preparing for injection.

The surgical screen shows that the carotid artery intervention site is at the bifurcation of the right internal carotid artery, where the baroreceptors are more sensitive, and the reflex adjustment is mainly to respond to pressure sensing in a short time, within a few seconds.

This is to do a coronary stent, and the heart stops when the carotid artery stenosis is opened through preoperative surgery.

Zheng Ren took a glance to see the situation, and went directly into the operating room of the system.

Su Yun quickly followed behind Zheng Ren. Seeing that the nurse was a bit slow in drawing the medicine, he said, "Old He!"

Lao He didn't respond, but walked over directly, silent and firm. He walked to the ambulance, broke open a piece of atropine, drew it into the syringe, opened the three-way connection and injected it directly.

Emergency rescue tests the psychological quality and technical level.

The little nurse was like a recruit who had just entered the battlefield. He was immediately frightened by the roaring cannons. How could he be so proficient as a veteran like Lao He who had experienced countless battles, big and small.

Originally, the technical level was average, and if he panicked again, there would really be nothing left.

"Lao He, intubate." Zheng Ren said suddenly, "Xun Xun, push the ventilator over. Su Yun, go for heart compressions, increase the strength and frequency."

After Zheng Ren finished speaking, he tore off the sterile gown, took off the sterile gloves, and turned to brush his hands.

Without hesitation, Su Yun walked to the operator's side, bumped his shoulder, and pushed the operator away from the position where the heart was pressed outside the chest.

The surgeon was dumbfounded.

But at this time, if a doctor who can confidently take over the rescue appears, she will definitely not stop her.

At the beginning of the operation, the balloon was slightly stretched, and the patient suffered cardiac arrest. It is said that the circulatory department is very good at this aspect of emergency first aid, but after pressing for 30 seconds, the heart did not resuscitate, and I suddenly panicked.

"You, go charge the defibrillator." Zheng Ren went to brush his hands, and Su Yun took over the rescue command.

He is an unscrupulous commander, full of the style of a big director.

Pushing in a shot of atropine, dopamine, and epinephrine, Lao He completed the endotracheal intubation as quickly as possible, and handed the balloon to the assistant doctor.

Zheng Ren brushed his hands and came in, wearing a sterile gown.

"Boss, what should I do?"

"Cervical artery stenosis still needs to be stretched. Where's Lao Mu?" Zheng Ren glanced and saw that Su Yun was doing chest compressions at a frequency of 110 beats per minute. The waveform on the ECG monitoring had not recovered yet, and Just like in the operating room of the system, there is also some urgency.

"Boss Zheng, I'm here." Mu Tao finished the last step of the operation and rushed in.

Seeing Mu Tao coming in, the doctor in the circulatory department said hoarsely, "Professor Mu, the patient's cardiac arrest..."

"Boss Zheng, what should I do?" Mu Tao asked with a frown.

"Go and push the ventilator, I'll remove the brace." Zheng Ren stood on the operator's seat and glanced at Su Yun.

"Look at what I'm doing. I didn't put on the lead jacket. Just hurry up and do it." Su Yun kept his arms straight and continued to do cardiopulmonary resuscitation.

The airtight lead door closed slowly, and Zheng Ren had already started to step on the line at this time.

The position of the balloon changed slightly, Zheng Ren pushed it in again, found the carotid artery stenosis, opened the stenosis, and inserted the CRISTALLO ideale-SE 6-9mm×40mm self-expanding stent.

With the opening of the carotid artery, Su Yun's movements gradually slowed down.

The squeeze fluctuations on the patient's ECG monitoring gradually returned to ventricular tachycardia, and after a few seconds, the sinus rhythm returned.

Zheng Ren stopped stepping on the line and said, "Put on lead clothes."

Su Yun glanced at the value of the monitor, nodded, and turned to put on lead clothes with Lao He.

"..." The surgeon in the circulatory department stood beside him with a blank expression on his face.

"Xiao Sun, what's going on?" Mu Tao asked.

"The patient's diagnosis is coronary atherosclerotic heart disease, exertional angina pectoris; arteriosclerosis of both lower extremities; carotid artery stenosis. I wanted to solve the carotid artery stenosis first, and then install the stent, but I didn't expect the heart to stop just after the balloon was inserted. gone."

Mu Tao nodded.

Significant carotid artery stenosis is an important risk factor for perioperative stroke in patients with coronary artery stents. The incidence of stroke is as high as 3% to 11%, and it is positively correlated with the degree of carotid artery stenosis.

The patient's condition was clear, and there were no problems with the preoperative diagnosis and surgical indications.

The treatment is correct, and the operation is normal. The carotid artery stenosis should be solved first. It's just that the patient's cardiac arrest lasted a little long, so he was immediately stunned.

"Boss Zheng." Mu Tao asked softly.

"Tell me about the operation process." Zheng Ren said, "There should be no major problems, so don't be nervous."

"The patient's condition is much better, is the ventilator still on?" Mu Tao asked.

"It must be used." Su Yun came back wearing a lead suit, and said contemptuously: "Patients with coronary artery stenosis have a stroke due to carotid artery stenosis during the perioperative period. The prognosis is very poor, and the mortality rate is about 50%."

Mu Tao is an interventional doctor, not a circulatory doctor. If he followed up with rescue and coronary stent surgery, he would be fine. But if it really involves some more detailed things, especially pathology and physiology, he is beyond his power.

"Tell me about the process." Zheng Ren reminded again.

"Preoperative angiography showed 90% stenosis in the proximal end of the right internal carotid artery. I used an ultra-smooth guide wire to send an 8F MPAI catheter to the right common carotid artery, SpiderRX 5.0mm to the distal end of the right internal carotid artery, and a Sapphire 4.0mm×20mm ball sac, give 15atm. After 5 or 6 seconds, the patient's heartbeat stopped."

The surgeon should be the director of the circulatory department of Pengcheng Development Zone People's Hospital. Under Zheng Ren's coercion, he directly became a small doctor and began to report on the operation process.

Emergency first aid, when someone comes forward when there is basically no effect, it is undoubtedly a relief for the surgeon.

Facing the situation of sudden cardiac arrest, it is needless to say how much higher the technical level is than myself in order to be so firm and confident in commanding the rescue.

"Well, the pressure sensor of the carotid artery was squeezed." Zheng Ren said, "Carotid arrest after balloon inflation, followed by ventricular fibrillation and malignant arrhythmia are common complications."

"Boss Zheng, I thought I would give up the operation." Mu Tao said with a long breath.

"No. The cardiovascular activity center in the brain controls the activity of the heart and blood vessels through the sympathetic and vagus nerves, so as to maintain arterial blood pressure at a certain level."

"When the balloon is inflated, the arterial baroreceptor immediately feeds these information back to the cardiovascular center through the afferent nerve, and the activity of the cardiovascular center will change accordingly, causing heart rate to slow down, peripheral blood vessels to dilate, and blood pressure to drop. "

"The pressure in the balloon rises too fast, the diameter is too large, the pressure is too high, the duration of dilation is too long, and the sensitivity of the baroreceptor reflex is too strong, which may be the cause of cardiac arrest."

"It will be fine with surgery, and it will recover after a while." Zheng Ren smiled.

"Old Mu, where's Mr. Wu?" Su Yun asked suddenly.

"The teacher is watching the patient in the operating room..." Mu Tao said.

"Alright, that side is preparing for the next operation, and this side should be resolved soon." Zheng Ren smiled.

"Don't we need to install the heart stent?" Su Yun looked at the surgeon and asked.

"No...no need, I'm sorry." The operator said politely in a low voice.

Bringing the patient back at this time is equivalent to bringing himself back, and the surgeon feels that he can't express his gratitude too much.

It's just that she is still a little confused now, still immersed in the nightmare of the patient's sudden death and has not recovered.