Chapter 1788

"What do you think at home?" Su Yun squatted and fiddled with the patient's chest tube.

He emptied the fresh blood drained from the chest tube. While timing, he bent a chest tube to observe the drainage speed.

The chest tube is unobstructed and there is not much drainage, which can be confirmed.

What Su Yun did seemed unnecessary, but Zheng Ren knew that he was eliminating problems that might arise in some small details.

Many seemingly serious conditions actually stem from a little accumulation of problems.

"Lao Zhao, where's the second line?" Su Yun asked as he fiddled with the chest tube.

"Professor Zhang..." said Zhao Yunlong.

Su Yun is also very helpless.

It's not like Professor Zhang. Everyone's level is different, and their ability to bear risks and ideas are also different.

Some people are partial to radicalism, others are partial to conservatism.

Each has its own advantages and disadvantages.

As for Professor Zhang, if he goes to school, he will be a good teacher. But in this extremely complex situation, he may not be a good emergency candidate.

"Where are the people?" Zheng Ren asked.

"Soon." Zhao Yunlong said, "Zheng... Boss, please take a look for me and I'll urge the patient's family members."

"Go." Zheng Ren said, "is the catheter room ready for IABP?"

"Ready, director Zhang Lin is coming from home." Zhao Yunlong said.

Zheng Ren nodded. Instead of talking, he turned on the computer and began to look at the patient's medical records.

Zhao Yunlong's narration is too brief. He only said the most important points, and there is no time to elaborate on the rest.

For the patient's situation, Zheng Ren still wants to take a closer look.

The patient was 52 years old and had a history of familial hypertension. His father died of intracerebral hemorrhage. There had been no symptoms before. As Zhao Yunlong said, he came to the hospital two days ago because of chest tightness and shortness of breath.

In the medical record, the patient complained that he had no history of vertigo.

Zheng Ren doubted this. If there is vertigo, it is most reasonable to accompany the occult onset.

The patient's history can not represent everything, but can only be used as a reference, especially for patients with complex current situation.

Admission examination, head CT was abnormal, and cranial MRI was done one day later.

Zheng renneng felt that the patient's family members did not sign for IABP, which may have been a sign long ago - family factors and economic factors are possible.

Test sheets and various inspection reports look the same as Zheng Ren.

He soon had a certain understanding and cognition of the evolution of the patient's condition. Su Yun looked at the medical record and looked back at the patient. His neck was almost broken.

"Boss, the smoke disease shown on the MRI is very serious." Su Yun commented when he saw Zheng Ren insert the nuclear magnetic film into the film reader.

"Well, I'll consider..." Zheng Rengang said here, and the alarm of the monitor was loud.

Didi's voice rang through the room.

Zheng Ren and Su Yun suddenly stood up. Zheng Ren's chair fell to the ground and made a "bang".

"Prepare IABP!" Zheng Ren roared in a low voice.

Su Yun was stunned. He subconsciously wanted to refuse. Do you want to die if you do IABP directly without the signature of the patient's family?

But he heard from Zheng Ren's voice that he could not refuse.

Fuck him! Su Yun's heart was horizontal. Anyway, the sky fell and the boss stood on it. It seems that it is also a good choice for great to resign and work at Massachusetts General Hospital.

"IABP machine and helium for machine are ready!"

"IABP catheter and puncture package are ready!"

"0.9% NaCl 500ml + heparin 5000U, ready!"

"Pressurized bag, maintaining pressure of 300MMHG?"

Su Yun asked.

"Yes." Zheng Ren opened the quilt on the patient, then opened the IABP puncture bag and prepared iodophor.

"Lidocaine." Zheng Ren said in a deep voice while wearing gloves.

Su Yun has turned on the machine, pushed it to the bedside, directly unscrewed a plastic bottle of lidocaine, and put the syringe into the sterile bag.

Zheng Ren picks up the syringe, probes the tip of the needle into the opening of the plastic bottle and draws out lidocaine.

Without dilution, he grabbed a handful of iodophor in his right hand and disinfected the patient's femoral artery, followed by local anesthesia.

The puncture was successful, and the balloon catheter was sent into the patient's femoral artery. Zheng Ren moves very fast. Su Yun just put the electrode piece in front of the patient's chest, and the two ECG monitoring systems operate at the same time.

At this time, Zheng Ren had finished the operation and sent the IABP tube to the descending aorta.

Turn on the counterpulsation pump. Zheng Ren hands the sensor monitoring aortic pressure to Su Yun.

Su Yun connects the sensor to the host.

The flushing system is connected with the sensor, and the central chamber is connected with the pressure conduit.

Zheng Ren's work has been basically completed, and Su Yun is busy flying.

Connecting the helium pipeline, Su Yun looked at it several times and determined that the working pressure of helium met the requirements.

"Sew it." Su Yun definitely said.

Zheng Ren nodded and began to fix the helium pipe.

Su Yun debugs various parameters on the host.

Su Yun is more professional than himself. Zheng Ren knows this. Letting him do it is the most worry-free way.

You don't have to participate at all.

As the IABP system began to work, Zheng Ren breathed a sigh of relief. The patient had no problem in a short time.

The machine feeds the patient's ECG or blood pressure signal into the counterpulsation control device to make the balloon pump act synchronously and reversely with the patient's heart beat.

The moment before heart contraction, that is, when the aorta is open, the balloon deflates, reduces the end diastolic pressure in the aorta and reduces the work of the left ventricle. Reduce afterload and myocardial oxygen consumption.

Immediately before heart relaxation, balloon inflation increases diastolic coronary perfusion pressure and myocardial oxygen supply.

This can reduce the left ventricular anterior and posterior load and reduce the cardiac load. The balloon quickly completes the exhaust immediately before the heart contraction and aortic valve opening, so as to instantly depressurize the aorta, reduce the left ventricular ejection resistance and increase the cardiac output.

IABP has incomparable significance for perioperative support and stable hemodynamic state.

With the start of IABP, the crazy ECG monitoring began to calm down gradually.

"Boss, the patient's family didn't sign." Su Yun debugged various parameters of the machine. See Zheng Ren packing up IABP, but he said.

"No time." Zheng Rendao, "when the patient's family members sign, everyone dies."

"Why hasn't Lao Zhao come back?" Su Yun is nagging, but his eyes are staring at the monitor.

The emergency first aid was successful, but various values and indicators are still not ideal. The patient is still on the verge of death. When not, it depends on his life.

"Boss..." Su Yun said with a frown. "I don't think it's right. The patient's condition is too serious, even heavier than expected."

Zheng Ren also noticed this and thought about what to do next.