Chapter 515

This is the most critical patient Chen Cang encountered in his life!

No one!

The most critical is not the most serious. Many serious patients have no possibility of rescue in front of Chen Cang.

At this time, Chen Cang felt that he had a chance!

In fact, it's most appropriate to take an X-ray at this time, but... Where is the time to go back?

The patient's blood pressure is almost gone. With the rupture of the ascending aorta and cardiac tamponade, it is uncertain whether the heart is damaged. If it develops according to the general situation, the patient may really be gone before being sent to the hospital.

During this time, Chen Cang made up for the diseases of cardiovascular surgery, especially the treatment of emergency.

He clearly remembered that the latest report recorded that the incidence of thoracic aorta in traffic accidents in the United States last year was about 15%, while the rupture of ascending aorta was only 5%, and in the figure of 5%, only 10% had the chance to be sent to the hospital, and only 20% of the 10% could be rescued successfully!

What this means is self-evident!

Chen Cang doesn't know that there is a greater chance of surgical infection in the car?

Can't Chen Cang understand the definite diagnosis under chest X-ray, SCT or EBCT? It's best to do an angiography of the aorta to determine the location of the injury?

However, all this is allowed by the injury.

Now don't talk about CT and angiography, even chest films don't have a chance!

Chen Cang clearly remembers!

According to the latest guidelines, if it is suspected that the aorta is ruptured, the circulation is extremely unstable, and there are signs of direct rupture and secondary penetration (hemothorax, cardiac tamponade), it should be explored and rescued immediately!

Therefore, Chen Cang will now choose direct thoracotomy for exploration and hemostasis.

When you have no choice, the guide is not only your dependence, but also your legal basis!

Doesn't he know that everything he does now will be accompanied by risks?

He knows!

However, what passes at this time is life, where there is time to delay!

Chen Cang said decisively, "Lao Yang, stop ahead."

The driver Lao Yang was stunned:???

Through the rearview mirror, he saw that Chen Cang was going to have an operation, and his face suddenly changed!

But I didn't say a word. Instead, I just found a suitable place. The car is very good.

On the way of 120 ambulance transferring patients, the doctor's words were like a military order, and Chen Cang was the leader of the rescue team.

Chen Cang looked up at the two patients and said, "get off and go to the second provincial hospital."

The two men suddenly changed their faces. The bald man still wanted to talk. It was obvious that Wang Qian didn't give them a chance and sent them down directly.

Chen Cang took a deep breath and was a little nervous.

This is the first time he has handled such a critical patient independently, and it is also the first time he has operated on the ambulance.

Anesthesia in this case requires stable, less or no drugs that inhibit the circulatory system. For critically ill patients, the best is local anesthesia, first carry out relevant operations, and then carry out anesthesia induction or endotracheal intubation.

At this time, limited by the conditions, Chen Cang can only carry out local anesthesia!

The effect of local anesthesia is still very fast, not long.

Chen Cang picked up the scalpel and made a direct incision in the middle of his chest!

Wang Qian said nervously, "there is not much gauze..."

Chen Cang nodded, then carefully pulled away his sternum... Gradually saw the scene of scalp numbness!

This is a sea of blood.

Chen Cang turned to Wang Qian and said, "draw blood!"

Wang Qian also changed his face, but he picked up the syringe and began to draw blood!

Chen Cang's eyes stared directly at the pericardial area. At this time, the pericardium was like a big steamed stuffed bun full of blood. When Chen Cang cut it slightly, a stream of blood gushed out.

"Hemostatic forceps!"

Now the bleeding place has been exposed, which is the starting part of the left ventricular outlet. The position here is relatively fixed, so it is easy to cause rupture after being impacted by violence or sudden deceleration!

Fortunately... The ribs didn't hurt the heart.

This may be the only thing to be thankful for.

The blood pressure was very low and Chen Cang was helpless, but it was a battle without choice. If he didn't work hard, the patient would die.

Chen Cang decisively opened the pericardium and completely exposed the bleeding site.

"Are there any non-invasive hemostatic forceps?"

Wang Qian was stunned and immediately shook his head: "no!"

Who prepared these things in the rescue car?

Chen Cang hesitated. He suddenly picked up his hands, pressed them on them, and pinched the tear with his hands. The blood didn't flow.

Blood pressure has stabilized for the time being

But the patient's life is still like the leaves of this season, swaying in the wind.

Fortunately, after pericardial tamponade contact, the patient's bleeding was also controlled, and the blood pressure was gradually rising.

Chen Cang said to Lao Yang, "go back to the hospital!"

Lao Yang glanced at Chen Cang from the rearview mirror, nodded seriously, started the car steadily, started and drove towards the hospital.

Through his hands, Chen Cang can clearly feel the power of blood flowing out of his hands and clearly touch the traces of life.

A few minutes later, the car stopped directly at the door of the special emergency channel of the second provincial hospital.

Chen Cang dared not move, but Lao Yang, the driver, jumped directly behind him and carefully carried the bed down with Wang Qian.

Li Baoshan, Tao MI and Xia Gaofeng are waiting anxiously!

Chen Cang hurriedly said, "go to the operating room immediately!"

Everyone did not doubt him. In the operating room at this time, Wang Kaian, Zhou Xiaodong and Zhang Wenfu outside their hearts had put on their clothes and were waiting for the arrival of the patient!

Blood transfusion department, laboratory department, medical department, anesthesiologist... All of them are waiting for Chen Cang's return.

With the arrival of Chen Cang, the rescue preparation officially kicked off!

Everyone began to prepare in an orderly way!

Blood drawing, emergency test, blood matching

Contact person of medical department, signature, Authorization

The anesthesiologist is Liu Jian. When he saw that Chen Cang had opened his chest and pressed his hands on his heart, he couldn't help staring.

The cardiopulmonary bypass machine has begun to prepare.

At this time, Wang Kaian looked at Chen Cang with non-invasive vascular forceps: "I'll come!"

Not very loud, but very firm.

Chen Cang nodded and carefully completed the handover.

When Chen Cang went out, Wang Kaian started related work with the three people and the anesthesiologist.

Intravenous intubation!

Establish cardiopulmonary bypass!

Liu Jian started endotracheal intubation and prepared for anesthesia.

This operation needs to be performed with cardiac arrest. When everything is ready, Zhang Wenfu blocks the distal end of the ascending aorta and prevents blood from passing by.

Tao MI and Xia Gaofeng trembled when they saw the tear at the beginning of the patient's ascending aorta, running through the outside and under the pericardium.

This... Is really like what Chen Cang said. It's hard to or go back to the hospital.

Think of Chen Cang and Wang Qian's return covered with blood just now, think of Chen Cang pressing with his fingers to stop bleeding, and return to the hospital all the way

Two people sigh!

Xiao Chen is really a character.