Chapter 266

In general, the relevant department is responsible for the rescue of patients, but this person is a compound injury. Judging from the color of the blood, it is estimated that he has damaged a large vein after puncturing the rectum and entering the pelvic cavity. It can be said that the luck is not bad to the top. If the main artery, acute total heart failure would have lost blood and died for such a long time!

Fluid resuscitation in patients with massive hemorrhage is a very necessary means, but what kind of fluid resuscitation is best? The clinical debate has not yet yielded results! In principle, the electrolyte concentration of liquid is similar to that of normal plasma; Osmotic pressure and osmotic volume were similar to those of whole blood; And it can achieve the maximum expansion with the least liquid volume and the best oxygenation. In recent 20 years, the literature believes that early liquid resuscitation crystal liquid is better than colloidal liquid. The former includes glucose and electrolyte, and the latter includes plasma, plasma substitutes and whole blood.

To put it simply, it is a controversial issue whether to transfuse blood or balance fluid first when rescuing shock at present, no matter what else.

This kind of internal organ bleeding must be operated while rescuing shock, actively looking for bleeding points, and then stop bleeding. Only by stopping the blood first can there be hope to save life.

In the absence of Ouyang, this operation is controversial. In the past, the director of anorectal department would not participate in this kind of thing. It's better to do more than less. Anyway, this kind of thing is carried by ordinary foreigners in front. He was happy to dry his hemorrhoids.

But when Zhang Fan had a major operation for rectal cancer in the anorectal department, he couldn't sit still. His authority almost knocked Zhang Fan out. If he didn't find the site now, it would be difficult to do it in the future. Now it has been whispered that he is the level of cutting his ass!

I can't stand it. Still counting on the doctor below to adopt a wife for him, "prepare for the operation!" He looked at the rescued patient and made a sound first. He thought well and opened his stomach. He only operated on his anorectal part.

The director of general surgery and the director of Urology didn't say anything. He was embarrassed! No one set up a platform. The director of the medical department saw that the posture was wrong and hurriedly contacted Ouyang. The boss doesn't have a bird, and he doesn't have a strong superior. He really can't hold these directors with eyes on his head.

In the hospital for rescue, when preparing for the operation, the families of the wounded in Gangwan had already turned the world upside down and looked for people everywhere. Now they can only trust the relationship, find people and find energetic people, otherwise they have no way for the wounded thousands of miles away.

The family is big and the business is big. There are many internal things. I hope he lives, he dies, and he is half dead. It's not surprising that money moves people! If you are a small family, as long as you have the ability, you will definitely move your strength in one direction.

The phone of the patient's bodyguard kept ringing, and the phone of the border boss kept ringing. What a mess! The wounded family are playing games! The game between surgery and transfer, the boss of this level, his wife may not be able to decide!

Ouyang came down with the phone. The superior leaders also said hello and didn't give orders directly. In a word, do your best. This is an attitude. The leader's phone calls are very particular. They must be, certain and try their best. They all represent different degrees of attention.

After Ouyang entered the emergency department, several directors of the Department of surgery also spoke.

"How? Who's up? " Ouyang asked, with different levels of attention from the leaders, she cared about the doctor's business. She didn't want to put any pressure on the doctors. The identity of the patient was not disclosed.

"Dean, this is anorectal trauma. My main knife handle! However, considering the massive bleeding, I applied for assistance from other departments. " The director of anorectal Department said.

"OK!" Ouyang said after looking at him. Then he said to the director of general surgery and Urology, "prepare for the operation." In two simple words, the matter was confirmed.

The anorectal director's face is not big and his level is average. Please do not move the director of general surgery and Urology, which is estimated to be an ordinary deputy high school to assist. But that's enough. In fact, this operation looks dangerous. As long as you quickly open the abdominal cavity and find the bleeding point, it's not difficult except for the speed requirements. It's not a very difficult operation such as lymph node dissection and reconstruction.

When they talked about the operation, the director of the emergency department was not idle. He had to hang his life before he could have the operation. What is hanging his life is to ensure the circulation, the oxygen in the circulation!

Zhang Fan doesn't like gossip, let alone curious about the intrigues of several directors. He cares about disease and rescue. The director in her heart, an expert of the provincial hospital, even if she was upset to the municipal hospital, but her shock resuscitation was recognized as the second in the municipal hospital, and no one dared to recognize the first! This is qualification!

The principles and methods of early fluid resuscitation are particular, that is, early, rapid and sufficient volume expansion is the key to the success of rescuing shock.

Ren Li calmly stood in front of the hospital bed, crossed her hands, held her arms, and gave oral medical advice without thinking, "establish four intravenous infusion channels, quickly deliver 1500ml of balanced salt solution and 500ml of dextran 70 (medium molecular dextran), and speed up the infusion with an infusion pump."

Then he looked at the ECG monitoring and directly ordered: "measure blood pressure manually! Come on. " The nurse was busy. She was a little busy. Zhang Fan came forward and took the sphygmomanometer and quickly began to measure blood pressure. At this time, she paid attention to speed, not demeanor.

“7030mmhg。 Fine pulse speed. " Zhang Fan reports while measuring“ Blood transfusion, intravenous whole blood pressure, rapid intravenous infusion of 300ml. Dexamethasone into the pot. " Ren Li continued. Ren Li also fought! This rescue method is a little dangerous! Once you don't grasp it well, it's a big deal!

This kind of person is not short of money. He released more than 100000 when he was admitted to the hospital! overbearing.

"The blood pressure is rising and the pulse is still slow. The director can operate! " Zhang Fan said to Ren Li.

"Well, the rest depends on your surgery." The principle of this first aid is also very simple. Generally speaking, there is a fish in the bowl and a hole is broken at the bottom of the bowl. You must keep adding water at a certain speed, not only to ensure the water demand of the fish, but also to keep it from overflowing all at once! Then continue to maintain this balance, waiting for surgical hemostasis.

This is skill!

The nurse pushed the hospital bed with a fixed liquid rack out of the emergency department quickly and ran to the special elevator for surgery. The anorectal director went out in high spirits. He was ready to enter the operating elevator.

"Who is the chief surgeon?" An assistant woman stopped the director of anorectal department.

"Huh?"

"Which of you is the chief surgeon." In Gangwan, people with great family power do not necessarily choose assistants for office, and they tend to the old-fashioned family in Britain, which most repels Mandarin.

They either speak English or local dialect! But also to speak English to flaunt a certain identity!

"This is our chairman, the chairman with a fortune of more than 4 billion. Are you sure?" The woman didn't know whether it was intentional or unintentional. Anyway, it was just a word. The anorectal director didn't dare to enter the elevator immediately! I guess this woman is undercover!

Others don't know whether they are worried or not. The frontier boss must be worried. He doesn't understand things in the business field, but he also knows from his expression that the relationship is not small or the interests involved are not small.

"President ou, I am a friend of the Secretary General. Please help me! Make up after love! " The frontier boss was scared to death. At this time, he said such words to threaten the doctor, which clearly came to smash the field!

Ouyang, who was about to get angry, stopped his anger and looked at the boss of the border area. The boss was a man in his eighties. He half bent down and looked down at the old lady who was a little over one meter six.

Ouyang looked at the director of anorectal department who was a little stunned and said, "say it, tell her loudly!" Let a woman be frightened before the operation. Ouyang can't bear it!

"Me! Me! " The director of anorectal department is a little incoherent! Ouyang's belly is boiling. It's too disappointing! Is it great to have more money!

They are very contradictory when they came from. At present, many of the old-fashioned rich consortia in China are their generation, but it is their generation that can really say that they despise the rich!

Ouyang looked contemptuously at the director of the anorectal department, looked back at a group of doctors who had just come out of the emergency department and said, "who is sure, stand up! Don't be looked down upon! I can't afford to lose this man! "

"Me!" The director of Urology!

"Me!" Director of general surgery.

"Me!" Deputy director of urology.

"Me!" Deputy director of general surgery!

"Dean! No labor, directors, I can go! " Zhang Fan stood at the edge of the crowd and said loudly.

"OK, just you! Let the young doctor go! " Ouyang said!

When the frontier boss let the youngest doctor go, he was soft! Paralyzed! Ten thousand camels fly by in my heart!