Chapter 304： :emergency rescue!

Chen Cang is worried now!

He was worried that he didn't know how long the patient could persist at this time and whether he could reach the hospital.

After all, the pericardial puncture ...

Yes indeed!

Chen Cang suddenly remembered that he had a pericardial skill pack.

[Pericardial Skill Pack: After opening, you can choose to acquire a pericardial skill. 】

When Chen Cang gritted his teeth, he quickly chose [pericardial puncture].

To be honest, learning this skill, Chen Cang feels inadequate.

After all, there are various pericardial surgeries in the pericardial skill pack, including pericardiotomy, pericardial repair, etc ...

These are all tertiary surgeries.

In contrast, pericardial puncture is only a secondary puncture operation.

Although compared with thoracic puncture, abdominal puncture ... These four major punctures are a bit more complicated, but they are also puncture skills after all.

But ... the situation is urgent, Chen Cang can't hesitate to choose to study directly!

【Ding! Congratulations, learn to perform pericardial puncture, do you start training? 】

Chen Cang was hesitant at this moment and chose to enter directly!

Compared with chest puncture, the biggest danger of pericardial puncture is that if you accidentally puncture into the heart chamber, this is a big trouble!

After all, the pericardium is not as thick as expected!

The heart is not as strong as you think.

Maybe ... this needle goes in, instead of reducing the patient's condition, it exacerbates the symptoms, and even leads to death.

In front of Chen Cang, a familiar operating room appeared.

After entering the training space, I began to continuously simulate, learn, and grasp the applicable symptoms of pericardial puncture and the conditions of pericardial puncture ...

Continuous training, puncture under ultrasound positioning ... puncture with assistance ... puncture under ECG monitoring ...

Until the end, Chen Cang began to perform blind wear.

This is the most critical step!

The pericardial puncture is performed using a puncture needle without any auxiliary equipment.

After all, this situation was very obvious at the scene, there was nothing, only blind wear!

As time passed, Chen Cang continued to become proficient.

However, after all, not 100%.

This makes Chen Cang's heart very low.

Puncture training is comprehensive.

It even includes emergency management conditions for pericardial puncture.

For example, pericardial effusion does not require immediate surgery, but has an accurate scoring standard, some require emergency puncture, and some require puncture within 12 to 48 hours.

Not all pericardial effusions are as early as possible.

In the virtual space, Chen Cang continuously learns and popularizes the techniques and knowledge points about pericardial effusion and pericardial puncture.

Soon, the training time is up.

This was the first time that Chen Cang felt that the special training time was so short.

He really wants to learn this technology to perfection and practice the "blind penetration" success rate to 100%. In this way, he can better and more accurately treat patients.

Unfortunately, things often go against ...

quickly……

After Chen Cang exited from the virtual space, a prompt sounded.

【Ding! Pericardial puncture: master class; special effects: precision; 2. safety. 】

Two special effects are very important for Chen Cang.

These are two directions that Chen Cang is constantly practicing in the virtual space.

First, the position of the pericardial puncture must be ensured, and secondly, absolute safety during the puncture.

...

At this moment, less than a second has passed outside.

This second is very short, but for the patient at this time, it may be the distance between life and death.

Chen Cang quickly used his knowledge to judge the patient's condition.

Seeing Chen Cang hesitant, Old Liu said quickly: "Doctor Chen, let's go! Send to the hospital, let's talk when we get there !?"

Chen Cang shook his head: "It's too late. The patient's current situation is very critical. There is too much fluid in the pericardial cavity, which has seriously affected blood circulation. If you don't draw it out, you may not reach the hospital!

Even if he arrived at the emergency department, who knows what the situation is, now he needs to have a pericardial puncture operation! "

Old Liu shook his head when he heard Chen Cang's words!

This little Chen is so impulsive.

Old Liu has been a 120 driver for 20 years and knows this situation very well.

What is pericardial puncture?

He naturally knew what was going on.

But it is because of understanding that I become more worried.

What are the conditions at the scene?

Nothing!

Without the influence of CT, without the positioning of the echocardiogram, ECG monitoring is not available!

What do you do?

Do it blindly? !!

Don't think that the driver of the 120 ambulance is just the driver. They have seen less life or death than doctors, and the rescues they have seen are not a few, so after hearing Chen Cang's words, they were immediately disturbed.

"Xiao Chen, really can't go to the hospital?" The old driver Liu was still a little worried.

Chen Cang nodded: "I can't stick to it. At this time, my heartbeat is getting weaker and weaker. If you wait until the Second Provincial Hospital, you may be gone!"

At this time, no fluid is drained, and the load on the heart is so great. No matter what method you use there, there is nothing you can do.

Relieving cardiac compression is the only frontline vitality for patients.

However, at present, the patient's conditions cannot be used to perform puncture positioning and heart structure exploration, what should I do?

If there is no ultrasound localization, it can only rely on the feel and experience of the doctor. It is very likely that the puncture fails and even worsens the condition. Because the cause of the bleeding is unknown, the internal damage of the heart is unknown. Will there be more bleeding due to heart rupture after puncture? ? Or cause the puncture and placement of the catheter to be ineffective, or even accelerate patient death?

Is hemostasis allowed if a conventional emergency thoracotomy is used?

This is not a matter of allowing or disallowing, but the conditions are not met at all!

Time is running out!

A bunch of thorny questions are in front of Chen Cang, and the patient's life is dying, and he cannot afford to think again and again, and the opportunity to regain life from the death is fleeting, only once!

Emergency pericardial puncture and catheterization!

Chen Cang made up his mind and decided that he must fight against time to rescue the front line.

If the patient does not have a pericardial puncture, let alone whether the rescue is successful or not, the hospital cannot be reached at all.

Not to mention check and understand what went wrong.

The pericardial puncture cannula can quickly solve the life-threatening first stage of pericardial tamponade, which is very important, and it is also a crucial step to win time for subsequent rescue.

Chen Cang opened the rescue box. There was no pericardial puncture needle, but there was a thoracentesis needle.

Can be used.

Old Liu looked anxious, looking at Chen Cang: "Doctor Chen ... you want ..."

"Blind through?"

Chen Cang nodded, not blindly at this time, is there any other way?

No!

Must pass on.

After cutting his clothes and disinfecting them, Chen Cang started his own operation.

Chen Cang now suddenly hopes that his eyes can be seen through. How good?

When you pierce for nothing else, you can have a better chance of success!

perturbed!

disturbed!

All emotions permeated Chen Cang's heart.

There is only one chance.

Chen Cang took a deep breath, and the puncture needle slowly penetrated deeply. He had to feel that touch of touch, the kind of feeling of breaking through the pericardium.

Chen Cang moved forward slowly.

Everyone dared not to say a word.

Lao Liu was even motionless and did not dare to bother.

Whispered in my heart.

Has he seen this kind of blind penetration?

Have seen!

But his mother's failure!

His mother.

Thinking of this, old Liu was afraid for a while.

Followed Cang Cang carefully, for fear of something.

This little Chen ... so brave!

The stuffy environment makes people breathless.

And Chen Cang, but felt the cold sweat behind!

But don't get into trouble.

Suddenly, Chen Cang's hands felt a sense of miss coming from the puncture needle. After he felt it, he stopped quickly.

His dexterous hands made him react very quickly.

Chen Cang said to the old Liu, "Pump a little for me, what liquid do I look at?"

Old Liu nodded quickly: "How much to smoke?"

Chen Cang shook his head: "You go back and pump a few milliliters first, and I'll see what happens."

After Chen Cang said it, he shook his head again: "I'll do it myself."

Old Liu smiled awkwardly, a little embarrassed.

Chen Cang doesn't mind. Other old Liu is not a doctor, and it is also skillful to draw back, but don't draw too hard.

Chen Cang slowly withdrew without resistance.

not worried……

After the five milliliters came out, Chen Cang saw all the blood.

Suddenly his face changed.

This is not good news.

Blood vessel rupture? Or a broken heart?

All this is possible.

Chen Cang continued to pump.

He felt the resistance from the syringe and slowly pulled away.

After pumping about 100ml, Chen Cang did not dare to pump again.

Pull out the puncture needle, pick up the stethoscope and start auscultation, and feel that the heart sounds have recovered and the heart beats gradually.

Chen Cang immediately became excited.

Succeeded!

Pericardial puncture was successful.

At least the patient has taken the first step!

In other words, it killed the first boss on the way to the patient's success!

Pericardial stuffing!

However, this does not mean that the patient is out of danger.

Because the cause of the minimum pericardial effusion has not yet been clarified, it must be rushed to the hospital for the next rescue.

"Lao Liu, get ready to go to the car and go to the hospital!"

As soon as the old Liu heard this, he immediately understood what was happening. He and Chen Cang carefully lifted the stretcher and moved towards the 120 ambulance.

...

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