Chapter 2719

"Find someone to do transesophageal echocardiography!" Director Miao continued.

Su Yun has picked up his cell phone and called Lao he's cell phone. Lao he was getting ready for work, humming a tune and sitting in the duty room smoking.

After receiving Su Yun's call, Lao he didn't ask what happened. He only knew that it was a urological operation and that he needed to do transesophageal echocardiography immediately.

Lao he's B-ultrasound level is quite high. He is one of the few doctors who can judge pneumothorax by ultrasound. This technology is one of the few that can be blown in front of boss Zheng. He didn't expect to think of himself when saving Taiwan.

Pushing the bedside echocardiography machine, Lao he ran into the operating room.

The operating room was busy. It was strange that Lao he didn't see boss Zheng and Brother Yun. Director Liu of urology department was holding a mobile phone, constantly changing the angle, and the voice of director Miao commanding the rescue came out of the mobile phone.

I went to... Lao he was stunned for a moment, then his heart was bright, and he immediately realized what had happened.

This is director Liu's ignorance!

The habit formed over the years can't be solved after encountering problems. Find the senior director at the first time.

At the time of life and death crisis, director Liu forgot that director Miao had retired, and changed from the first-line clinical director to an old man who danced square dance every day and provided for the aged leisurely.

Director Miao's voice from the mobile phone is still calm, full of domineering and indisputable breath.

What about boss Zheng and Brother Yun? Lao he pushed the bedside echocardiography machine to the patient's head and took the opportunity to look around.

No one!

Forget it first. Brother Yun said to do transesophageal echocardiography.

Lao he quickly sent the transesophageal ultrasound probe to the sick population, avoided endotracheal intubation, overcome the interference of Yu always doing extrathoracic cardiac compression, and sent the probe to the esophagus.

"Yu Zong, stop for 20 seconds!" Lao he shouted loudly.

"Less than, stop for 20 seconds, and the anesthesiologist will do echocardiography." Director Miao's voice came, and the memory contained in the total body made him stop the action of extrathoracic heart compression for the first time.

"Gas is found in the right heart! Gas is also found in the left heart!" Lao he quickly scanned, saw the gas in his heart, reported it to director Miao in the mobile phone video, left an image, and took out the probe.

"Put a small sponge pad on the right!" Director Miao's voice came, "continue pressing, intermittent cardiopulmonary resuscitation. Central venous catheter..."

"Director Miao, I'll come this time." Boss Zheng's voice came out in the video.

Lao he was clear in his heart, but he didn't think too much about why boss Zheng was at director Miao's house. Instead, he quickly pushed the bedside echocardiography machine aside, found the central venous puncture kit in the cabinet and quickly came to the patient.

The patient's head has been crowded with a lot of people. Lao he doesn't explain. He forcibly bumps into the world. At this time, the mobile phone rings. He takes out the mobile phone before puncture, turns on the hands-free and puts it aside.

"Lao he, do a central venipuncture." Boss Zheng's thick and steady voice came.

Lao he was steady in his heart. While preparing for puncture, he said, "now, 22 seconds!"

He adopted the improved method of subclavian central vein puncture. He found the best puncture point at the intersection of the vertical line of the center of the right clavicle and the horizontal line of the sternoclavicular joint, and the needle tip pointed to the lower edge of the thyroid cartilage for puncture.

After entering, the central venous catheter extends downward to the right heart. Lao he is quite confident in his technology, 22 seconds, no difference.

"There is an air lock effect. You can feel the pressure by suction after entering." Boss Zheng's voice came out on his mobile phone.

Although Lao he knew what he said, he was more stable in his heart for no reason.

"Has entered the right atrium." Old he said, "pumping gas."

Keep testing. Because of the air lock effect, the syringe does not twitch smoothly.

Air lock effect, also known as air lock phenomenon, is a blocking phenomenon caused by different pressures in the liquid in the flowing liquid. This phenomenon usually occurs at the high point between pipelines, which is the reason why general centrifugal pumps can not pump liquid.

Lao he tried a little. Suddenly, the syringe in his hand moved slightly and moved a short distance, about 5ml.

"Boss Zheng, draw out 5ml of gas." Lao he quickly drew out the blood and gas and reported to Zheng Ren.

"Go on. I just saw the echocardiography. There is still air in the ventricular cavity."

Zheng Ren said with his mobile phone.

"Boss, it's normal to have gas in the atrium. I haven't wondered why there is gas in the ventricle." Su Yun asked, standing aside.

Although not in the operating room, I can still feel the breath of adrenaline and dopamine.

Zheng Ren shook his head and said, "there are too few cases, and I don't know. The existing cases show that most of them are double chamber gas accumulation, and there is no congenital disease of right to left shunt."

Abnormal air embolism is the absorption of gas into the venous system and finally into the arterial system?

It usually occurs in patients with right to left cardiac shunt. The gas accumulated in the right atrium or right ventricle enters the left cardiac system through the right to left channel, resulting in coronary artery or cerebral artery embolism?

This is a question. Now in the emergency rescue, both of them have a tacit understanding and do not continue to talk about this issue.

Lao he's operation passed the customs and even spilled a lot. Soon the gas in the left heart was also pumped out, and the problem of cardiac arrest was solved.

After about 20 minutes of continuous chest compression and intermittent defibrillation, the patient's hemodynamics and respiratory function tend to be stable?

Director Miao took a breath, put his mobile phone aside and leaned back on the back of the sofa. Zheng Ren looked at his expression, not tired, only nervous and excited relief and pleasure after emergency rescue.

"Director Miao, are you tired?"

"Not tired." Director Miao said with a smile, "it's the first time I've met this old man who commands rescue through my mobile phone."

"The sword is never old!" Su Yun stretched out his thumb and praised.

"There was a gas embolism caused by laparoscopy once. At that time, I was confused and thought about it while rescuing. But that time, I made a mistake and easily thought of carbon dioxide entering the blood vessels. After symptomatic treatment, the patient had no complications after the operation and was discharged in a few days."

"How many years ago?" Su Yun asked.

"The end of the last century." Director Miao said.

"At that time, you had gas embolism just after endoscopic surgery? Why didn't you write a case report?" Su Yun asked curiously.

"The case report... Was written." Director Miao said, "I thought this case should be very rare. I didn't even invest in Chinese prefix journals, so I directly looked for the lancet. Unfortunately, my English is general, and the format is not very clear. In the end, it's over."

So it was. Zheng Ren smiled.

"Director, how are you?" Director Liu's voice came from his mobile phone.