(Thanks to the two book friends of [Falling Embers] and [Rose Spider] for their 1,000 coins reward!)

After confirming the location, Ruan Bin operated the arterial guidewire retrograde through the common femoral artery into the external iliac artery!

"What kind of operation is this, I don't understand?"

"Wouldn't it hurt the injured person by thrusting like this?"

Many onlookers around the melon-eating crowd held their mobile phones and recorded while gossiping.

They don't understand what kind of operation this is at all, and it is estimated that many doctors in third- and fourth-tier municipal hospitals do not know about this kind of surgery!

"It's in!"

One step closer to success!

The urethral sheath is flushed with saline, and then Nguyen Bin is sent through an arterial guidewire into a 30 cm long sheath to create a access platform.

Since this balloon is relatively thin, it is implanted directly through the 7F sheath!

At this point, be very careful with the guidewire or vascular sheath and stop immediately if resistance is encountered. Once the sheath has been successfully implanted and confirmed to be in place, the guidewire and pointed dilator can be removed. Caution should be exercised when drawing blood through the sheath, otherwise be careful that the sheath is not in the lumen or against the wall.

All of this has been perfectly completed by his rich experience and prediction.

And then there's the balloon catheter!

This part of the operation is generally carried out under X-ray fluoroscopy, and at this time, due to the lack of conditions, Ruan Bin is still implanted completely empirically.

A long guidewire arteriosis is implanted through a sheath and sent into the abdominal aorta. In fact, at this time, if it is not performed by X-ray fluoroscopy or ultrasound, it is difficult to ensure that it is still in the thoracic aorta or has entered the splanchnic branch or aortic arch.

It's still a blind exercise!

However, Ruan Bin uses world-class experience to judge how long the guidewire is going in with body surface markers and catheter markers, and at the same time uses rich experience to judge which direction is entering the abdominal aorta!

"I don't know if it's entered the abdominal aorta?" Hu Dongwei saw his little heart fluttering. To be honest, they were more nervous than Ruan Bin at this time.

But he found that the young doctor in front of him didn't even sweat a drop, and the expression on his face was also calm and calm, how big is this person's heart?

At this moment, Ruan Bin had already sent the balloon catheter along the guidewire to the predetermined position, and there was no obstacle at all! That is to say, he was transported smoothly and there was no mistake. If there is a mistake in general, the catheter will be stopped as soon as resistance is encountered!

"It's in the abdominal aorta!" Ruan Bin finally breathed a sigh of relief.

Now we are left with the last step - filling the balloon to embolize and stop the bleeding!

In general, this step is best done by filling the balloon under fluoroscopic monitoring. It is important to maintain the position of the long sheath just below the balloon to provide support and prevent the inflated balloon from being rushed downwards by the bloodstream. The balloon touches the wall of the aorta and the syringe fills when resistance is felt. The guidewire should remain in the balloon catheter to support the catheter and prevent the balloon from dislosing.

But now Ruan Bin still needs blind exercises!

He can't see the bulb inside, he can't see where the artery has ruptured, should he fill at the tail end of the abdominal aorta or go a little further?

At this point, it can only be a temptation.

The patient had a large posterior peritoneal hematoma, which proved that the bleeding point was around this location. Then the place where the abdominal aorta ruptures must be in the pelvic bone, at most the location of the previous point.

Eighty-nine is not far from ten!

On the basis of the position of the pelvic bone, Ruan Bin sent some catheters into it, and then began to fill the sac at a little above the position of the pelvic bone!

"Okay! Send it to the hospital immediately!" Ruan Bin said.

"Stop the bleeding?" Hu Dongwei was stunned, he looked at the time, only 9 minutes had passed since the operation began, and it was terrifying!

"Just look at the blood pressure. Ruan Bin said with a smile.

"Oh my God, my blood pressure has stabilized!

Shocking, shocking!

They didn't expect to witness a pre-hospital (wild) REBOA surgery today!

This is definitely the first case in China!

This doctor in front of me is terrifying, isn't it? This level is completely on par with the doctors of the best emergency team in the world at the moment, or even a little better.

It's all blind exercises!

"This ...... Doctor, this is definitely the first REBOA in China! And it only took 9 minutes, which is simply amazing. Hu Dongwei originally wanted to call the other party's doctor, but suddenly he found that he didn't know the other party's name.

"Okay, it's not important, let's send the patient to the hospital immediately for the next step. Ruan Bin said lightly.

"Okay, okay, okay!" At this time, the two of them came to their senses, although the hemorrhage has stopped now, but they have to be sent to the hospital immediately for surgery to repair the ruptured blood vessels, otherwise there will be no blood supply below the pelvis, and it will definitely be paralyzed by necrosis after a long time!

"By the way, doctor, what's your name? Come with us to the hospital? I'm afraid I'm worried about what will happen to the patient on the road. You'll also need to register your information. Hu Dongwei said in a respectful tone.

"Okay!" Ruan Bin nodded and continued, "My name is Ruan Bin. ”

Since the ambulance was still parked a few hundred meters away, there was still a traffic jam here.

So he carefully put the patient on the stretcher, took a few other patients with minor injuries, and hurried towards the ambulance.

Got in the car.

After several exchanges, Ruan Bin learned the names of these two people.

"Dr. Ruan, do you think the patient will be able to recover his circulation?" asked Lei Jincheng. Although the bleeding has stopped, if the circulation does not resume somewhat, then the situation is also very bad.

"If nothing else, five minutes after the bleeding stops, the circulation should be restored. Ruan Bin said confidently.

"The patient's vital signs are stable at the moment and should be able to survive to the hospital. Hu Dongwei checked it again and said excitedly.

All of this is thanks to Ruan Bin's REBOA!

"By the way, Dr. Ruan, which hospital are you from? It's really amazing! This pre-hospital REBOA will definitely shock the domestic medical community!" At this time, Lei Jincheng regarded Ruan Bin as an idol.

After all, it is the first REBOA in China!

"I am a resident doctor at Wucheng County Hospital, and I am now studying at the First Affiliated Hospital of Modu. "Nguyen Binh D County Hospital...... Resident doctor?" Hu Dongwei and the two were instantly stunned after hearing this. They think that the Ruan Bin in front of them can make the first REBOA in China, and he should be a very famous genius doctor.

But what did the other party say about Wucheng County? They hadn't even heard of the name of this county. Still a resident doctor!

This reversal of the thunder of their burnt inside and tender outside.

Aren't they supposed to be studying the process of first-level surgery and studying for second-level surgery?

"Yes, what's wrong?" asked Ruan Bin.

"Uh, no, nothing. By the way, Dr. Ruan, are you a graduate of medical school?" Hu Dongwei didn't give up, maybe the other party was a high-achieving student?