Chapter 152 Craniotomy hematoma removal
"Brain activity is almost gone!"
"Try the brainstem reflex!"
"Weak spontaneous breathing, intubation immediately!"
"Is the operating room ready?! A craniotomy is required! ”
The ICU ward has become a pot of porridge, and a group of doctors and nurses are busy.
Seeing her husband Yingqin being surrounded in the middle, family member Xu Zhen could only cover her mouth and let the tears hang down!
At this time, Xu Qiaoen hurriedly ran in and shouted, "The operating room is ready, has the chief surgeon confirmed it?" ”
"I have already informed Director Liang of the Department of Brain Surgery, and several experts from the Department of Neurosurgery are also rushing over." Someone replied.
Xu Qiaoen hurriedly said: "Then hurry up and send it over, it can't be delayed...... By the way, this is a freshly made film, you can also watch it. ”
"Don't you see we're busy, you say it."
"Through brain CT, it was shown that the cranial congestion of the injured person had disappeared by one-third compared with when he was first admitted to the hospital, and the bleeding points had basically stopped." Xu Qiaoen quickly reported: "But there are a few pieces of bruising, which have metastasized and compressed the main cranial nerve center......"
"Drip ......"
As if to fulfill Xu Qiaoen's statement, the ECG monitor let out a piercing chirp!
"Cardiac arrest! Defibrillator ready! ”
Someone shouted frantically.
Just as the scene was more chaotic, a figure rushed in from the outside, and without saying a word, pulled away from the crowd and jumped onto the hospital bed.
"Song Che?!"
When everyone just calmed down and saw the person clearly, Song Che was already sitting on the hospital bed, and at the same time tore off the collar button of the patient's duty, then put his left hand on the patient's heart, clenched his right hand into a fist, and knocked it on the back of his hand!
Tip zone percussion!
Everyone was stunned.
Rescuing critically ill patients, who they have not experienced.
But as wild as Song Che, few of them have witnessed it!
Lunatic!
Cardiac arrest caused by obvious ventricular fibrillation, at this time, even percussion in the apical area of the heart, isn't this to aggravate ventricular fibrillation?
However, given Song Che's extraordinary strength, everyone didn't stop it.
Everyone then put on the oxygen and defibrillator step by step.
After Song Che performed the apical percussion, he immediately began cardiac resuscitation with extracardiac compressions.
Now that the patient has fallen into a deep coma and is not breathing on his own, he has suffered a cardiac arrest, and it is useless to take some drastic medicine.
After pressing for a full three minutes, Song Che put his ear to the patient's left chest, listened for a moment, and then began the endotracheal intubation.
A series of skillful and sophisticated techniques made everyone's originally disordered mood involuntarily settle down a little.
It seems that subconsciously, everyone has a tacit understanding: as long as Song Che makes a move, there is no incurable disease that cannot be solved.
"It didn't touch the front teeth or squeeze the patient's lower lip, and the depth of the throat was just right, so it was flawless!"
At this time, a sentence came from the corner of the ward.
Xu Qiaoen followed the sound and saw a handsome man at the door at some point, so he stepped forward and said, "I'm sorry, I'm rescuing patients here, if you have nothing to do, go out first." ”
"I've got something." The man smiled: "I am an assistant invited by Expert Song. ”
"Who are you? Which department? How come I haven't seen you. Xu Qiaoen wondered.
"My name is Lin Wendong, I am from the United States, and I am currently a professor in the Department of Medicine at Stanford University."
“……??!!”
Xu Qiaoen was stunned for a moment, and couldn't figure out where Song Che had brought a medical professor at Stanford University to be an assistant.
At the same time, Song Che also completed the intubation process, and when the nurse connected the oxygen catheter, the intravenous access was also completed.
"Epinephrine 1 mg, injected every five minutes, defibrillator, 300j."
Song Che picked up the defibrillator while giving the order, and it landed firmly on the patient's chest!
Looking at the wavy lines on the ECG monitor, Lin Wendong also took a step forward and said, "Try 5% sodium bicarbonate intravenous drip." ”
"No, it's likely that the patient has respiratory acidosis and the extracellular fluid is in a state of alkalosis. Moreover, the patient's respiratory insufficiency, instilling sodium bicarbonate at this time will inevitably produce a large amount of carbon dioxide! Song Che shook his head and said, "Open another intravenous channel and inject 80 mg of lidocaine!" ”
Soon, the lidocaine injection began, and the conductive ointment was applied again.
Preparation! Get out of bed!
Defibrillation again!
In an instant, the electric current lifted the patient's whole body.
Then everyone breathed a sigh of relief.
The ECG monitor shows that the heartbeat has been restored.
But Song Che still had a grim face, and said, "Send it to the operating room immediately for craniotomy hematoma removal!" ”
"I'll be your assistant." Lin Wendong said: "I majored in neurosurgery and brain surgery, and my skills have not been left behind. ”
Song Che nodded silently.
At this time, the experts in brain surgery and neurosurgery don't know when they will arrive, but the patient can't afford to wait for an extra second!
"Doctor Song, please, save him...... My children can't live without their fathers! Xu Zhen grabbed this gap, stepped forward to hold Song Che's arm, and said with tears in his eyes.
Song Che didn't swear an oath, but just reached out and gently patted the back of Xu Zhen's hand.
Xu Qiaoen also came up to support Xu Zhen at the right time.
A few minutes later, the cart rushed into the operating room.
Lin Wendong, who changed into a surgical gown, looked at the brain CT film that had been hanging on the projector, and said, "The extent of the congestion has been controlled, and there are signs of fading, how did you do it?" ”
"Eat earthworms."
Song Che replied directly, and then confirmed with the anesthesiologist, then grabbed the sharp scalpel with one hand and rubbed the patient's brain with the other, as if measuring the ripeness of a watermelon.
"The first step is to make a horseshoe-shaped incision and bite off the skull!" Song Che said decisively.
Lin Wendong was stunned and hesitated: "Don't you make a shaped bone flap?" ”
"Making a bone flap, of course, can be more fully revealed, but it is too time-consuming, now I basically grasp the location of the bruising, plus it is close to brain death, it is better to solve it quickly."
Song Che didn't allow Lin Wendong to discuss, so he took a knife and began to cut open the cortex.
Lin Wendong saw the process in his eyes, and the surprise in his eyes became even stronger.
It can be said that in craniotomy, cortical incision is undoubtedly the first difficulty.
Don't look at only such a thin layer of skin, the process of entering the knife must not only avoid damaging the blood vessels and nerves, but also make an appropriate deep incision to reach the hematoma cavity.
As the so-called difference is at stake!
However, as time went by, Lin Wendong didn't see a trace of blood oozing out of the incision!
It is as if this brain tissue has been presented in the mind of the knife holder!
The cortex, subcutaneous layer, aponeurosis layer, and periosteal layer by layer are uncovered, like a cow.
Then, Lin Wendong took a specific skull drill and handed it to Song Che's hand, while holding his breath and witnessing the whole process of the skull being opened......