Chapter 305 Emergency Rescue!

Chen Cang is very worried now!

What he is worried about is that he doesn't know how long the patient can last at this time, and whether he can last until the hospital.

After all, pericardiocentesis...

Yup!

Chen Cang suddenly remembered that he had a pericardial skill pack on his body.

[Pericardial skill pack: After opening, you can choose to obtain a pericardial skill. 】

Chen Cang gritted his teeth and quickly chose [pericardiocentesis].

To be honest, to learn this skill, Chen Cang felt that it was a huge loss.

After all, there are various pericardial surgeries in the pericardial skill pack, including pericardiotomy, pericardial repair, etc...

These are all tertiary surgeries.

In contrast, pericardiocentesis is only a secondary puncture procedure.

Although compared with thoracentesis, abdominal puncture... these four major punctures are a bit more complicated, they are still puncture skills after all.

But... the situation was urgent, Chen Cang had no time to hesitate and chose to study!

【Ding! Congratulations, you have learned pericardiocentesis, do you want to start training? 】

Chen Cang was hesitant at this moment and chose to enter directly!

Compared with thoracic puncture, the biggest danger of pericardiocentesis is that if you accidentally puncture into the ventricle, this is a big trouble!

After all, the pericardium is not as thick as expected!

The heart is not as strong as I thought.

Perhaps... the injection of this needle, instead of alleviating the patient's condition, aggravated the symptoms and even led to death.

Chen Cang's face changed, and a familiar operating room appeared in an instant.

After entering the training space, I began to simulate, learn, and master the applicable symptoms of pericardiocentesis and the conditions of pericardiocentesis...

Continuous training, puncture under ultrasound positioning... puncture with assistance... puncture under ECG monitoring...

Until the end, Chen Cang began to blindly pierce.

This is the most critical step!

That is, pericardiocentesis is performed using a puncture needle without any auxiliary equipment.

After all, the situation on the scene is obvious, there is nothing, only blind wear!

Time passed by, and Chen Cang continued to become proficient.

However, it was not 100% in the end.

This made Chen Cang feel at a loss.

Piercing training is comprehensive.

Even emergency management conditions for pericardiocentesis are included.

For example, pericardial effusion does not require immediate surgery, but has an accurate scoring standard, some require urgent puncture, and some need to complete the puncture within 12 to 48 hours.

Not all pericardial effusions are better sooner rather than later.

In the virtual space, Chen Cang continued to learn and popularize the techniques and knowledge points about pericardial effusion and pericardiocentesis.

Soon, it's time for training.

This was the first time Chen Cang felt that the special training time was so short.

He really wants to learn this technique to perfection and practice the success rate of "blind penetration" to 100%, so that he can better and more accurately treat patients.

Unfortunately, things often backfire...

soon……

After Chen Cang exited from the virtual space, a beep sounded.

【Ding! Pericardiocentesis: master; special effects: precision; 2. safety. 】

Two special effects are very important to Chen Cang.

These are also the two directions that Chen Cang keeps practicing in the virtual space.

First of all, it is necessary to ensure that the location of the pericardial puncture is accurate, and secondly, it is necessary to ensure the absolute safety of the puncture process.

...

At this moment, only less than a second passed outside.

This second is very short, but for the patient at this time, it may be the distance between life and death.

Chen Cang quickly used the knowledge he had learned to judge the patient's condition.

Seeing Chen Cang's hesitation, Old Liu said quickly, "Doctor Chen, hurry up! Take it to the hospital, let's talk about it later!?"

Chen Cang shook his head: "It's too late, the patient's current condition is very critical, there is too much fluid in the pericardial cavity, which has seriously affected blood circulation, if it is not taken out, it is estimated that he will not be able to reach the hospital!

Even in the emergency room, who knows what the situation will be, and now he needs to have a pericardiocentesis operation! "

When Old Liu heard Chen Cang's words, he immediately shook his head!

This little Chen is too impulsive.

Lao Liu has been a 120 driver for 20 years and is very familiar with this situation.

What is a pericardiocentesis?

He naturally knew what was going on.

But it is precisely because of understanding, will be more worried.

What are the conditions on site?

Nothing!

There is no CT influence, no echocardiography positioning, and no ECG monitoring can be obtained!

What are you doing?

Do it blindly? !

Don't think that the driver of the 120 ambulance is just the driver. They have seen life and death no less than the doctors, and they have seen a lot of rescues, so after hearing Chen Cang say this, he suddenly became uneasy.

"Xiao Chen, really can't go to the hospital?" The driver, Lao Liu, was still a little worried.

Chen Cang nodded: "I can't hold on anymore, my heartbeat is getting weaker and weaker at this time, if I wait until I go to the Second Provincial Hospital, maybe the person will be gone!"

If you don't drain the fluid at this time, the load on the heart is so great that no matter what method you use, there is nothing you can do.

Relieving cardiac compression is the patient's only lifeline.

However, due to the current patient conditions, puncture positioning and cardiac structure exploration cannot be performed. What should we do?

If there is no ultrasound positioning, you can only rely on the doctor's feel and experience. It is very likely that the puncture will fail or even worsen the condition. Moreover, because the cause of the bleeding is unknown, you do not know the internal damage of the heart. After the puncture, the bleeding will not stop due to the rupture of the heart. ? Or lead to ineffective puncture and catheterization, or even accelerate the death of patients?

If the traditional emergency thoracotomy is used for hemostasis, is the hemostasis time allowed?

This is not a question of permission and disallowance, but that the conditions are not met at all!

Time is running out!

A bunch of thorny problems were placed in front of Chen Cang, and the patient's life was at stake. He couldn't bear to think about it again and again. The chance to regain his life from the god of death was fleeting, and it was only once!

Emergency pericardiocentesis!

Chen Cang made up his mind and decided that he must race against time to save the chance.

If the patient does not undergo pericardiocentesis, let alone whether the rescue can be successful, he will not be able to reach the hospital at all.

Not to mention checking and understanding exactly what went wrong.

The pericardiocentesis cannula can quickly solve the life-threatening first level of cardiac tamponade, which is very important and a crucial step to gain time for subsequent rescue.

Chen Cang opened the first aid kit. There was no pericardiocentesis needle, but a thoracentesis needle.

can be used.

Old Liu looked uneasy and looked at Chen Cang: "Doctor Chen...you want to..."

"Blind wear?"

Chen Cang nodded, not wearing blindly at this time, is there any other way?

No!

It must be passed on.

After cutting the clothes and disinfecting them, Chen Cang started his own operation.

Chen Cang now suddenly wants to see through his eyes, how good would that be?

When you pierce yourself for nothing else, you can have a higher chance of success!

perturbed!

disturbed!

All the emotions filled Chen Cang's heart.

There is only one chance.

Chen Cang took a deep breath, the puncture needle slowly penetrated, he wanted to feel the slightest touch, the feeling of failure that broke through the pericardium.

Chen Cang moved forward slowly.

Everyone around didn't dare to say a word.

Old Liu was even more motionless and did not dare to disturb him at all.

Heart whispered softly.

Has he seen this kind of blind wear?

seen!

But it's a fucking failure!

motherfucker.

Thinking of this, Lao Liu was afraid for a while.

Following Chen Cang, he watched carefully, for fear that something might happen.

This little Chen... is really courageous!

The sultry environment makes it hard to breathe.

As for Chen Cang, he felt a cold sweat on his back!

But don't let it happen.

Suddenly, Chen Cang's hands felt a sense of emptiness from the puncture needle. After he felt it, he quickly stopped.

His dexterous hands allowed him to react very quickly.

Chen Cang said to Lao Liu, "Help me pump a little, I'll see what the liquid is."

Old Liu nodded quickly: "How much?"

Chen Cang shook his head: "You first try to draw a few milliliters back and let me see what the situation is."

After Chen Cang said it again, he shook his head again: "I'll do it myself."

Lao Liu smiled awkwardly, a little embarrassed.

Chen Cang doesn't mind either. Old Liu is not a doctor, and he is also skilled in pulling back, but don't pull too hard, it will hit the heart...

Chen Cang pulled back slowly without resistance.

not worried……

After the five milliliters came out, Chen Cang saw that it was full of blood.

His face suddenly changed.

This is not good news.

Broken blood vessel? Or broken heart?

All this is possible.

Chen Cang continued to smoke.

He felt the resistance from the syringe and slowly pulled away.

After smoking about 100ml, Chen Cang did not dare to smoke any more.

Pull out the puncture needle, pick up the stethoscope and start auscultation, and feel that the heart sounds have recovered, and the beating of the heart has gradually stabilized.

Chen Cang suddenly became excited.

It worked!

Pericardiocentesis was successful.

Chen Cang felt the gradual recovery of the patient's vital signs, and was overjoyed.

At least the patient has taken the first step!

In other words, it killed the first boss that hindered the patient's successful treatment!

Cardiac tamponade!

However, this does not mean that the patient is out of danger.

Because the cause of the least pericardial effusion has not been clarified, it must be rushed to the hospital for the next step of rescue.

"Lao Liu, prepare to carry it to the car and go to the hospital!"

As soon as Lao Liu heard this, he immediately understood what was going on, and he and Chen Cang carefully lifted the stretcher and carried it towards the 120 ambulance.

...