423 Abnormal blood gas
"Check one, check one. Director Liu suppressed his irritability, waved his hand and said, "It's okay, let's leave quickly, there are a lot of people here, which violates the principle of sterility." ”
He was quite impatient, and he didn't shy away from letting Ren Haitao know about his impatience.
This person has a lot of things, considering that there may be mental illnesses, what are you doing here, fooling around.
But for the sake of Mr. Wu's face...... Then check a blood gas analysis, it's not a big deal.
"Old Ren, it's too much!" Li Zhong said with a frown.
"Forget it, Director Li. The deputy director of the anesthesiology department sighed and said, he was also a little disgusted in his heart, what is the matter, he has to do a blood gas analysis. As for whether Mr. Wu answered the call, he had a very dark guess in his heart.
"Alas. Li Zhong saw that Ren Haitao insisted, and moved out of Mr. Wu to endorse the book, but he couldn't persuade him anymore.
"Director Li, who in your medical team has the final say. The deputy director of the anesthesiology department said half-jokingly, half-seriously.
"The facts speak for themselves, and the strength has the final say. Ren Haitao watched intently as the anesthesiologist collected blood, and replied stiffly.
Li Zhong sighed, Lao Ren's temper on this dog day, no wonder Director Xu didn't treat him so much when he was in the Second Hospital of the Medical University. It's really a poor person who must have something to hate, so I met Mr. Wu, who has a good temper and is used to this nerd.
How old are you, and you're still so willful, you can't think about what other people think?
Strength has the final say, and he is paralyzed! In a word, the choked person can't breathe. But even if the strength has the final say, it is Mr. Wu who has the final say, when will it be his turn......
Li Zhong had countless slanders in his heart, thinking of Ren Haitao in pieces, and even felt bored for a while when he looked at his wrinkled old face.
But at this moment, the anesthesiologist's assistant ran back with a report sheet that had just been printed.
It is not uncommon for the anesthesiology department to have its own intraoperative examination equipment, but there is usually only one operating room, and it is not necessary to have it in every operating room.
This time, looking at what Lao Ren said, Li Zhong slandered in his heart.
But......
Why is the anesthesiologist's little assistant looking wrong? The action was a little flustered, and he didn't notice that his shoulder hit the airtight door, and ran in in a panic.
Li Zhong was a little puzzled, instinctively saw this GIF, and he knew that there was a high probability that there was a problem with the blood qi analysis.
But after taking another look at the ECG monitoring, the blood oxygen saturation is 100%, no!
"Master. The assistant said hurriedly.
"Hmm, what's wrong?" the anesthesiologist asked in a deep voice, realizing that something was wrong.
"PaO2 38.8mmHg, SaO2 80.6%, K+2.76mmol/L, Lac<1.0mmol/L, carboxyhemoglobin 1.1%. ”
"......" There was silence in the room.
Even the ventilator and monitor remained silent and still did not call the police.
The anesthesiologist took the test sheet suspiciously, glanced at it from top to bottom, then stood up and replaced the patient's oxygen clip with one finger.
It may be a problem with the oxygen clip induction, but the problem is usually a decrease in the oxygen saturation, not a constant oxygen saturation between 99-100%.
Sure enough, after changing a finger, the blood oxygen saturation is still 100%, without the slightest change.
"Is arterial blood taken?" the anesthesiologist asked.
"Master, yes...... Probably. The little assistant couldn't eat it, he didn't dare to bite it. This is a very critical question, if it is venous blood, everything is explained. But if it is arterial blood, there are many suspicions.
"I'll pick another one. The anesthesiologist began to prepare things, and his assistant was busy in front and back.
The chest doctor was just about to open the skin when something went wrong and their movements stopped.
"Lao Lin, what's going on?" asked the head of the chest department.
"It may be that the blood was collected and venous blood was collected. The anesthesiologist said, "You go ahead, I'll take an arterial blood." ”
"Hmm. The head of the chest department nodded and continued the operation.
The radial artery took blood, and the anesthesiologist used all his skills to hit the nail on the head, determined that it was the radial artery, and then sucked back.
The color of the blood...... Something odd, not bright red, but dark red. It's not like arterial blood, but like venous blood, and you can tell there's something wrong at a glance.
The anesthesiologist froze, he took the syringe, hesitated.
"Stop the operation and change to dual-chamber ventilation. Ren Haitao's waist straightened, he was not joking, but under the instinctive urging of the instinct, he began to command the rescue very seriously.
Li Zhong wanted to say something, but his lips moved under the sterile mask, and finally he didn't make a sound.
He somewhat believed that it was Teacher Wu who asked him to collect the blood qi analysis, but what was the problem? Everything was very calm, and there could be no problem.
"Teacher Ren, what's going on?" the deputy director of the anesthesiology department also asked in surprise.
"Execute the doctor's order, and send a second blood sample for testing. Ren Haitao's waist is straight, his eyes are sharp, his old state is gone, and his voice is calm and cannot be refused.
The deputy director of the anesthesiology department made a gesture, and the anesthesiologist communicated with the thoracic surgeon to stop the operation immediately and switch from single-chamber ventilation to double-chamber ventilation.
"Intravenous infusion of methylprednisolone 80mg. ”
"Potassium chloride 3g micropump pumped in. ”
"Prepare a cooling blanket, ecmo ......" Ren Haitao blurted out a series of medical orders, and it was obvious that he had a comprehensive plan before this.
It's just that before that, Ren Haitao didn't know what happened to the patient.
A phone call to Mr. Wu, although he only said a few words, after he got Wu Mian's verbal medical advice, he added infinite confidence out of thin air.
Coupled with the fact that the blood gas analysis value is the same as imagined, Ren Haitao is more confident. At this moment, he is like Mr. Wu standing in the operating room of Bajingzi Traditional Chinese Medicine Hospital to direct the rescue, and his aura is fully open.
Ren Haitao was very cautious in administering hormones to the patient to prevent hypoxic brain injury, and at the same time made full preparations to avoid rushing in the event of an accident.
At this time, the numerical return of the second blood gas analysis was the same as the first one, Ren Haitao felt more confident, and the voice of commanding the rescue became more and more calm.
Several rescue drugs were given, and the patient lay quietly on the operating table, unable to see any changes in his appearance, exactly the same as when Ren Haitao walked into the operating room at the beginning.
After 3 minutes, Ren Haitao saw that the patient's vital signs were stable, and there was no sudden cliff-like change or progress as he imagined, and he was even uncontrollable.
He let out a sigh and said, "Take another arterial blood...... A portion of venous blood is also taken. ”
This is a very rigorous and careful approach, for fear that arterial blood will be treated as venous blood when the blood is collected.
As long as there is a comparison, there is nothing wrong with it.
Soon, the test results returned.
Arterial blood: PaO2 85.8mmHg, SaO2 98.8%, K+2.78mmol/L, Lac 1.0mmol/L, COHb 0.8%.
Venous blood: PaO2 39.7 mmHg, SvO2 80.7%, K+2.69 mmol//, Lac 1.4 mmol/L, COHb1%.
The difference is huge, and this time the oxygen saturation of arterial blood has risen to 98.8%.
Ren Haitao let out a sigh of relief and said, "Let's continue the operation." ”