Before Ma Feng came up, Dai Yunyang saw the father of the patient Cai Liya standing there, looking very helpless, so he walked over and asked, "Don't worry, your daughter will be fine." ”

"Thank you, doctor."

"By the way, why did your daughter kill herself? - I don't mean anything else, just ask casually. It's inconvenient to say it's okay. ”

Father Cai shook his head sadly: "It's not inconvenient to say, many people know about it." - My daughter's boyfriend thinks it's great when he has a little money, it's not a thing, he promised to marry my daughter, they all live together, he likes other women again, and he wants to break up, my daughter is angry, so she takes medicine, cough cough cough ......"

At this time, Ma Feng came up and carried the tracheal surgery box.

Dai Yunyang followed Ma Feng into the ward, he saw that Ma Feng didn't even wear a mask, and said, "Director, let's wear a mask, just in case." ”

"Masks?" Ma Feng looked at him suspiciously.

"The ICU is a sterile ward, and you must wear a mask, a round cap, an isolation gown and shoe covers when entering the intensive care unit." Dai Yunyang pointed to the rules of the system hanging on the wall.

"Hey, let's get in and out, it's okay." Ma Feng smiled, turned around and pushed open the door of the ward, "We have to come into contact with so many patients in a day, and we have to wear masks and take off masks back and forth, which is a waste of time." ”

Ma Feng pushed the door in, Dai Yunyang was helpless, he wore a mask in the hospital the whole time, but he didn't have time to change isolation gowns and shoe covers, so he had to follow up like this.

Ma Feng called Fu Quan, the patient's ICU tube bed doctor, over and said, "We will do a tracheostomy on patient Cai Liya later, and I want to take a look at her medical records to make an understanding." ”

Ma Feng is the deputy director in charge of the ICU, and Fu Quan participated in the ward rounds just now, and already knew that Ma Feng was going to do a tracheostomy on Cai Liya, so he immediately said, "No problem." I'll bring it to you. ”

As he spoke, he quickly retrieved the medical record folder.

Dai Yunyang and Ma Feng got together and found a pathogen test sheet, because it was an ICU patient, the physical examination was very comprehensive, and the test sheet showed that influenza virus, parainfluenza virus, adenovirus, respiratory syncytial virus, rhinovirus, human metapneumovirus, SARS coronavirus, mycoplasma, and chlamydia were all negative.

They then looked down and saw a CT of the patient's chest. Bilateral lung infections are shown, with multiple small patches.

Ma Feng asked Fu Quan: "What's the problem with the patient's lung infection?" Got it figured? ”

Fu Quan shook his head: "It's viral pneumonia, but I haven't figured out what the pathogen is." Because of the pathogen detection, all the known viruses have been ruled out, even bacterial pneumonia has been ruled out, and we can't figure out what is wrong. Treatment is now symptomatic and supportive. ”

Ma Feng nodded, handed back the medical records to Fu Quan, and took Dai Yunyang to Cai Liya's bedside to prepare for surgery. Cai Liya has been in a coma because she was intubated and used a sedative.

Dai Yunyang prepares surgical tools and medicines, and Ma Feng mediates the intravenous pump to deepen sedation and analgesia, so as to minimize the patient's irritation and choking reactions.

Dai Yunyang disinfected the skin in and around the patient's neck with 3% iodine tincture and 70% alcohol, spread a sterile towel, and then raised the patient's shoulders and tilted his head back to protrude the trachea forward, fix the head, and keep the head in the midline position.

Then, he looked at Ma Feng: "Okay?" Am I out of charge? ”

"Wait!"

Ma Feng hesitated for a moment, but still turned the scalpel upside down and handed it to him: "The main knife is still you, I am old, this hand is shaking so much, I always feel that the strength is not accurate, if I don't cut too deep and stab the back wall of the trachea or the front wall of the esophagus, it will be miserable." It's still you, I'll be the assistant. ”

Dai Yunyang knew that Ma Feng would not be polite about this kind of thing, he really had this kind of worry when he said this, so he took the scalpel in his hand. The two switched places.

Ma Feng returned the cannula above the incision.

Dai Yunyang held a scalpel and smoothly lowered the knife to cut the skin and subcutaneous tissue along the anterior midline of the neck from the inferior edge of the thyroid cartilage to the suprasternal fossa. Use a hemostat to separate the anterior cervical muscles on both sides along the white thread up and down to the depths.

Ma Feng immediately used a retractor to pull the separated muscles to the sides, revealing the anterior wall of the trachea, the thyroid isthmus, and the inferior thyroid venous plexus.

Dai Yunyang then used a scimitar to pierce the trachea downward under the tracheal ring, raised the handle of the knife, turned the blade upward, and used the tip of the knife to pick open the second and third tracheal rings. Very calm and fast, without the slightest hesitation.

Ma Feng also moved quickly, and he immediately used a tracheal opener to reach in and open the tracheal incision. Dai Yunyang inserted the outer tube of the tracheal cannula, took out the tube core, and put it into the inner tube. Tie the tracheal cannula around the neck with a strap. The incision is very precise and does not require additional sutures.

After connecting to the ventilator, observe that the ventilator is working normally, then use scissors to cut a piece of gauze and insert it between the wound and the cannula, and then use a single layer of sterile wet gauze to cover the outside of the tracheal cannula.

Ma Feng breathed a sigh of relief: "It's done!" Call it a day. ”

The operation was successful, both of them were in a good mood, and after explaining Fu Quan, they left the ward and went downstairs to go back.

In the director's office, Wu Hao was busy in front of the computer, with a cup of coffee next to him.

At this moment, a little nurse ran in nervously and said, "Director, it's not good, Master Dang's breathing difficulties have worsened, and his blood oxygen saturation has dropped to 85%." ”

Wu Hao stood up suddenly, his movement was too big, he hit the table, and with a bang, the black coffee on the table was poured and spilled on the computer keyboard.

Wu Hao ignored it completely and strode out.

When I came to the observation room, the patient's blood saturation on the meter had dropped to 84%, and Dai Yunyang also came, discussing with the head nurse Xiong Shengnan.

Dai Yunyang said to Wu Hao: "Director, why don't you change to a high-flow nasal cannula for oxygen?" ”

Once the oxygen is inhaled by a high-flow nasal cannula, the maximum inspiratory flow rate can be increased by six times, which can quickly correct the patient's hypoxia state.

"Well, that's a solution." Wu Hao agreed.

The head nurse made arrangements, while Wu Hao and Dai Yunyang exchanged views on the side.

Dai Yunyang said: "The data is falling too fast, which is very abnormal. ”

"Yes, this is not an ordinary viral pneumonia, it should be ......" Wu Hao's last few words were very vague, and even Dai Yunyang, who was standing next to him, didn't hear clearly.

"Transfer to ICU?"

"Transfer to ICU!" Wu Hao made a decision, "Make an alveolar lavage solution and send it for testing to check for pathogens." ”

The two exchanged a few words and walked out, and Boss Pang, who was sitting outside waiting, saw the doctor come out, and he already knew Wu Hao's body and hurriedly greeted him and asked nervously: "Doctor, is my dad okay?" ”

"It's not a big problem, the current situation is ......" Wu Hao stepped aside and began to tell Boss Pang about the patient's current condition. He is an old doctor, and he has a lot of experience in dealing with patients' families, and Dai Yunyang saw that he was wrong, so he quietly walked away.

Back in the duty room, the old man's illness made him feel a faint uneasiness, he called up the medical records of the big man, watched the CT, looked at it, and found that it was familiar.