Chapter 2236

"Do you suspect phlegm blockage?" Su Yun asked. He didn't look like him. He was a little confused.

Zheng Ren didn't speak. He took the sputum suction tube and tried twice. The tube was unobstructed, and then sent to the patient's endotracheal intubation.

The sputum suction tube hissed, and only a small amount of secretion was sucked out. It seems that it should not be the cause of sputum blocking the trachea.

Zheng Ren was stunned when he continued to send the sputum suction tube inside.

"Boss, what's the matter?"

"There's something in it. The sputum suction tube can't go in." Zheng Rendao.

"..." Su Yun and the inpatient in ICU were stunned. Lin Yuan stood behind and didn't understand what boss Zheng said for a moment.

This situation is beyond everyone's imagination.

Su Yun immediately recalled the patient's preoperative chest film and chest CT.

There can be no problem. If something happens before the operation, the ventilator will give the same alarm during the operation.

"What have you done?" Su Yun looked at the ICU seriously and asked.

ICU inpatients are always confused.

Nothing was given. The patient was sent back after the operation and had slight agitation. At first, he didn't give any treatment. According to the suggestion of anesthesiologist Lao he, observe for 6 hours and prepare for extubation.

However, with the passage of time, the patient became more and more agitated. Finally, several people couldn't press it, so they gave propofol.

If you continue to calm down, you will prolong the withdrawal time, but you can't do without the patient's restlessness.

The general manager of ICU thought it over carefully and called the nurse to ask, but at this time, Zheng Ren suddenly said in a deep voice: "no! The endotracheal intubation is broken!"

"Er..." Su Yun took a look at the endotracheal intubation, which was enhanced. Broken? Impossible.

The inpatient of ICU was also stunned. She immediately explained: "boss Zheng, enhanced endotracheal intubation..."

"Prepare fiberoptic bronchoscope and bedside chest film!" Zheng Ren did not discuss with them and gave medical advice directly.

"OK." Su Yun didn't hesitate to pull the inpatient in ICU to push the X-ray machine.

Pushing the bedside X-ray machine, Zheng Ren began to film the patient.

Put in position, put the film box and shoot the film, and let Lin Yuan run to the radiology department with the film box to wash the film.

At this time, fiberoptic bronchoscopy is always ready for hospitalization.

Zheng Ren took down the ventilator and pulled out the endotracheal tube.

During extubation, it was found that the endotracheal tube was broken, leaving only about 12cm of the tail of the tube, and the rest must be left in the patient's trachea.

The tracheal foreign body prompted by the pig's hoof is actually part of the enhanced endotracheal intubation!

After looking at this situation, not only Zheng Ren, but also su Yun and the inpatients in ICU were stunned.

What is this? Enhanced endotracheal intubation can be broken?! How did it break? Misoperation when handling patients? How hard will it take to break the reinforced endotracheal tube.

The general manager of ICU carefully checked the location of the broken endotracheal tube and whispered, "boss Zheng, Brother Yun, it doesn't look like a quality problem."

Zheng Ren had already seen the incomplete condition of the broken end of the endotracheal intubation. He guessed in his heart and said in a deep voice, "it's not the trachea that breaks by itself, but the patient's teeth."

“……”

"Urge Lin Yuan to ask the radiology department to upload the film quickly." Zheng Ren squints at the patient's ECG monitoring.

Although there are foreign bodies in the trachea, the endotracheal intubation itself is a pipe, which only causes severe stimulation and will not directly block the lumen, resulting in suffocation and death of the patient.

Soon, the bedside X-ray film was uploaded, and Zheng Ren saw the patient's first-hand information.

The X-ray shows that the anterior endotracheal tube has entered the right bronchus

Looking at the image on the computer, several people sighed.

This "medical accident" came inexplicably and caught people off guard. If you find it, take out the pipe. I hope there will be no more waves.

"Boss, do you remember what the patient's family said that day?" Su Yun suddenly asked.

Zheng Ren recalled that the man squatting on the sidewalk cried bitterly, he said something about the patient, and he said that the patient refused treatment.

At the time of the operation, the patient's face was very ugly. Under the persuasion of the patient's family and Chang Yue, he entered the operating room.

It should be that after waking up from general anesthesia, the patient's subconscious obsession is causing trouble - he refuses to spend money. Instead of spending money for surgery, he might as well die directly.

I didn't expect that Zheng Ren didn't understand so much. After all these years as a doctor, I have seen many strange patients.

However, the strange place of the patients in front of us is also this obsession. Generally speaking, the desire for survival is very strong.

Usually, those old people who say they die when they are old and don't add burden to their children, almost no one will do it on such a day.

There is great terror between life and death. Before that moment, few people can feel how scary the threat of death is.

Generally speaking, few people have such a firm belief that they just want to die.

"Ask Chang Yue... Call her directly... Forget it, take out the tube first. The patient can go offline and watch it. After waiting, let the patient's family and Chang Yue do his work again." Zheng Ren said helplessly.

Su Yun nodded. In the face of such a patient who wanted to die, no one had a good way.

Zheng Ren did not feel much about the vicissitudes of life and the impermanence of things. He began to take the first half of the broken reinforced endotracheal intubation out of the trachea under propofol anesthesia.

Compared with each other, the broken position of endotracheal intubation is more certain to be broken by the patient's own teeth after waking up under anesthesia.

After a good operation, Zheng Ren was unable to laugh or cry. However, it also proves the success of the operation from the side - the patients have the strength to break the reinforced endotracheal intubation with their teeth.

Contact ringer and the medical office, and find Chang Yue and the patient's family members to make it clear.

The operation was successful. It was said that they could go to the ground tomorrow and be discharged one week later. The patient's family members were overjoyed. But after seeing the endotracheal tube broken by his teeth, he was stunned for a long time, filled with tears and apologized to Zheng Ren.

This was handed to Chang Yue. Zheng Ren was afraid that the patient would make any more moths. He simply set up a chair and sat at the head of the patient's bed, staring at him without blinking.

Postoperative tracheal tube rupture is very rare, especially the enhanced tracheal tube rupture has not been reported in clinic. This case is very special. Through the stump of the catheter, it can be confirmed that the catheter was repeatedly bitten and broken by the patient's teeth.

This was discovered early. If it is later, it is estimated that there will be more twists and turns.

Two echocardiographies were performed intermittently. The left ventricular ejection fraction of the patient was increased to about 60%, and the operation effect was completely beyond imagination.

After four hours, the patient completely woke up. Seeing that all indicators were satisfactory, Zheng Ren transferred the patient out of the ICU. Specifically, the patient's family and Chang Yue did the dredging work.

……

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Note: the truth is that a teacher talked about it many years ago. There is a case about the rupture of reinforced endotracheal intubation.