Chapter 183: Tracheostomy
Although Liu Dongfang kept performing emergency debridement, the rest of his eyes kept observing the patient's chest undulation.
But just now!
The patient actually stopped breathing!
"Director Liu, what's wrong with him?!" Sun Linlin said anxiously.
Apparently!
She also noticed the abnormality of the patient!
"It is estimated that the airway is trapped due to the strong irritating gas!" Liu Dongfang judged.
"What then?"
"Prepare for endotracheal intubation, ventilator-assisted ventilation!"
Liu Dongfang gave an order, and Sun Linlin hurriedly prepared the supplies!
As the endotracheal tube connected to the guidewire was handed over to Liu Dongfang, Sun Linlin assisted the patient in opening the airway.
That's it!
A shrill sound similar to the crowing of a rooster came from the patient's airway!
"Director?"
Sun Linlin was stunned, and then her face changed suddenly!
"Laryngeal edema?!"
Liu Dongfang's face sank, and a bad premonition hit his heart.
He hurriedly took the video laryngoscope in Sun Linlin's hand and inserted it into the patient's mouth!
Suddenly!
A gray tissue comes into view!
The crystal clear film is even more flushed!
Dropsy!
Extensive edema!
The whole throat was squeezed into a slit by swollen tissue!
And the epiglottis opening is even more imperceptible!
Liu Dongfang took the intubation and tried several times, but to no avail!
At this time, the epiglottis cartilage is like an iron wall, preventing anyone from violating it!
"How so?!"
Sun Linlin was so anxious!
At this time, the injured person's airway is occluded, and the lung ventilation function is lost, which can lead to severe hypoxemia in just a few minutes!
When the time comes, the secondary ischemic hypoxic encephalopathy will be powerless!
"Director, change the number six tracheal tube, do you think it's okay?"
Faced with the inquiry, Liu Dongfang shook his head helplessly.
In the current situation, not to mention the No. 6 catheter, even the No. 5 catheter used by children will not help!
This is a protective measure made by the injured person's body to detect external dangers!
After all, strong acids are seriously corrosive!
In order to prevent the strong acid from burning the airway, the body stressfully closes the pathway!
This caused Liu Dongfang to be unable to perform tracheal intubation!
The clock is ticking!
The condition of the injured has not improved in the slightest, but is gradually getting worse!
Looking at Tie Qing's face, his purple lips and the nail bed, Liu Dongfang knew that he couldn't wait any longer!
"Prepare for tracheostomy!"
"Lidocaine 5 mg, accessory kidney 1 mg, tracheostomy pack, iodophor, oil yarn, gauze!"
Hearing this, Sun Linlin repeated while preparing things according to Liu Dongfang's requirements!
"Lie on your back, pillow under your shoulders, head back!"
Liu Dongfang and Sun Linlin quickly put the wounded in a good position!
Looking at the trachea protruding in the middle of the neck, Liu Dongfang brought iodophor and quickly disinfected it!
Until the entire neck was covered with iodine, Liu Dongfang injected the anesthetic prepared by Sun Linlin into the middle of the wounded's neck to carry out subcutaneous infiltration anesthesia!
At this point, Liu Dongfang took out the silver-white locket from his arms and took out the crystal clear scalpel!
"Now cut open and get ready for negative pressure suction!"
"Okay!"
After that, Liu Dongfang's left thumb and middle finger fixed the larynx of the wounded to prevent the trachea from shifting left and right!
Press your index finger against the Adam's apple, hold the knife in your right hand, and make a median incision from the inferior edge of the cricoid cartilage to the upper edge of the sternum.
As the tip of the knife pierced into the skin, Liu Dongfang's eyes narrowed slightly, feeling the subcutaneous tissue and fascia.
"This is it!"
A glint flashed in Liu Dongfang's eyes!
The strength in the hand is not reduced, and the trend is opened!
Suddenly, a light white tracheal ring appeared in front of me!
However, due to the obvious edema of the wounded, this tracheal ring looms!
Seeing this, Liu Dongfang said in a deep voice: "Hemostat!"
"Good!"
Hearing this, Sun Linlin opened the tracheotomy bag, took out a small hemostat from it, and handed it to Liu Dongfang!
"By separating the sternohyoid and thyroid muscles on both sides, you can expose the trachea!"
The index finger and ring finger of Liu Dongfang's right hand drove the hemostat and quickly squeezed the muscle tissue to both sides!
"Linlin, I need your help!"
After the blunt separation, it is time for the most critical tracheostomy!
However, due to the patient's stimulation for too long, the muscles are in a state of tension all the time.
Liu Dongfang needs someone to help him pull the hook!
Fortunately!
Sun Linlin had already brought disposable surgical gloves.
"Director, what do you want me to do?"
Faced with the inquiry, Liu Dongfang glanced at the thyroid retractor not far away.
The latter understood and directly placed it on the organization that Liu Dongfang separated.
"Hold this position, don't move, I'll be quick!"
"Yes!"
Sun Linlin blushed slightly, and this posture made her a little difficult.
After all, the retractor tests a person's precision and willpower!
At this time, Sun Linlin leaned over and bowed her waist, and her upper body had begun to tremble.
Seeing this, Liu Dongfang didn't dare to delay, and with a strong push, the tip of the knife suddenly pierced into the trachea ring!
Whew!
With a strong air flow spewing out, the impurities in the ginseng trap splashed all over them!
But at this time!
The two people in the room did not have the slightest disgust, but were extremely excited!
Because, this airflow means that the patient's airway is open again!
I saw that the wounded, who had closed his eyes tightly and was about to faint, suddenly opened his eyes.
With the re-undulating chest, a cool breath drilled into the lungs of the wounded, making him feel like he had been reborn!
"Director Liu, it's okay!"
Sun Linlin's eyes were shining, and she was extremely happy with the scene in front of her!
You know, this is the first case of illness that has been rescued since she participated in the rescue!
"It's not over yet!"
However, Liu Dongfang's words were like a basin of cold water, splashed on Sun Linlin.
"Check the patient's airway and prepare for endotracheal cannula replacement!"
Tracheostomy is just the first step for Liu Dongfang!
The next step is to ensure that the patient's trachea is open!
With a No. 6 azure casing handed to Liu Dongfang!
He checked the integrity of the airbag and inserted it into the incision!
Unbiased, just right!
Even!
The size of the incision is exactly the same as the tracheal cannula, leaving no gaps!
"Director Liu, this?!"
Now, it's Sun Linlin's turn to be shocked!
You must know that tracheostomy is the strong point of otolaryngology!
But even then, there are all sorts of problems!
And anastomotic leakage is one of them!
But Liu Dongfang made this operation seamless, not to mention the fistula, not even a trace can be seen!
Sun Linlin has never seen such a technology!
"It's okay!"
Liu Dongfang checked the incision, and then said helplessly: "It's just that this kind of minor surgery has been done less recently, and the hand is a little raw, otherwise it wouldn't have taken so long!"
The speaker has no intention, but the listener has the intention!
Faced with Liu Dongfang's chagrin, Sun Linlin was completely blinded!
"That's slow?!"
Sun Linlin looked up at the clock hanging on the wall!
From the time the wounded entered the debridement room to start the debridement timer, to the completion of the tracheostomy, it took less than 20 minutes!
In the otolaryngology department, a simple tracheostomy takes more than half an hour from preparation to completion!
In such a comparison, Liu Dongfang even thought he was too slow!
Is there still a heavenly principle?!
Just when Sun Linlin was in shock and had not yet returned to her soul, a cold metallic sound suddenly sounded in Liu Dongfang's mind.
[Immediate task: Complete tracheostomy surgery, 20 cases!]
[Current Completion: 5%]
[Mission time limit: 90 minutes]
[Reward: Scalpel XP +100, Lucky Wheel Spins +1]