He walked briskly back to the bedside, held his breath and picked up the scalpel, cut the skin and subcutaneous tissue along the anterior midline of the neck, separated the pretracheal tissue, and then used the tip of the knife to pick up the two tracheal rings from the bottom up.

Ma Feng clumsily used a tracheal incision dilator to open the incision, inserted the tracheal cannula, extracted the tube core, inserted the inner tube, connected the ventilator, and treated the wound.

When they were done, they both breathed a sigh of relief.

Dai Yunyang's goggles began to fog up again, and he said to Wang Bingbing: "Fortunately, you thought of this method. ”

Wang Bingbing sighed: "If only I could find a way to keep the goggles from fogging." ”

Ma Feng said: "It's just that it's not a big problem in normal times, as long as it doesn't affect walking." But the operation must keep the vision absolutely clear, any bit of fogging is fatal, we have to find a way to deal with it! You can't run to the refrigerator every time, and if you touch something else and cause pollution, it will be troublesome. ”

Wang Bingbing said: "I'll call and ask the teachers at our school after the shift change to see if they have any solutions." ”

Dai Yunyang nodded and told Wang Bingbing: "When nursing Ma Laohan, pay attention to frequent phlegm suction, patting the back, and using phlegm-reducing drugs. ”

Wang Bingbing nodded in agreement, thought about it, and said: "The most troublesome thing about sputum suctioning is that you can't reach the phlegm plug in the small airway, and you can't clean it up. ”

Dai Yunyang nodded: "That's right, can you use a fiber bronchoscope to suck sputum?" Flexible bronchoscopes can penetrate deep into the small bronchial tubes to suck out viscous sputum and promote recruitment of the lungs. ”

Wang Bingbing stuck out his tongue: "This technique is too difficult, the risk is too high, I don't dare to do it, it will kill people." However, I'll talk to the head nurse to see if she has the skills. ”

………………

Afternoon.

Dai Yunyang and Wang Bingbing had to change shifts to eat. Dai Yunyang is now in the emergency intensive isolation area half the time and half of the time in the outpatient clinic. I won't be able to go home until late at night today.

Dai Yunyang went to the cafeteria for dinner, came to the outpatient clinic to hand over to the doctor, and then sat down and began to receive patients.

The fever clinic and emergency department are all level 1 protection, wearing isolation gowns, work caps, rubber gloves and surgical masks, but no goggles and certainly no integral hoods. And there is only one layer of protective clothing and gloves, which is relatively much easier.

He was busy with his work, Wang Bingbing ran in excitedly after making a phone call, and said to him: "Nurse Xiong said that she doesn't have that technique, and she uses a bronchial microscope to do small airway suction." So, you can't implement your idea. However, Dr. Dai, our teacher said a way, use the gel we used for disinfection to rub it on it and it will not fog up, I tried it just now, it's still true, you can try it next time. ”

"Okay, then you put a notice in the locker room to remind everyone to put on the gel when wearing goggles. - Great, that's a big invention. ”

Wang Bingbing was a little embarrassed, and said shyly: "The teacher also criticized me, saying that he had taught these basic skills in previous lectures, but we didn't take it seriously at the time." I didn't expect that small tricks can be of great use, and when I really wore protective clothing, I found that these small things were a big problem. ”

As soon as I said this, I heard the nurse at the medical guidance desk outside shouting and greeting. Wang Bingbing hurriedly ran out, listened for a while, and came back and said to Dai Yunyang: "There was a woman who was injured in a traffic accident who was transferred to the hospital, named Tan Yuanyuan, who was a big fat man with a big belly and weighed more than 200 pounds. Doctors from obstetrics and brain surgery and thoracic surgery have already arrived. ”

The negative pressure operating room is a special operating room for the treatment of infectious diseases. The exhaust air volume is greater than the supply air volume, so that the indoor air pressure is lower than that of the outside, forming a pressure gradient, and the air flows from the outdoor clean area to the indoor semi-polluted and polluted area, and then discharges it outdoors after being treated by the high-efficiency filter of the return air outlet, so as to avoid infection.

Of course, a similar negative pressure ambulance is used to transport new crown pneumonia patients.

The mother is not under Dai Yunyang's tube, so he doesn't have to go over to help and continue to treat patients.

But soon his errand came, and a nurse ran over anxiously: "Doctor Dai, Director Li asked you to come over, saying that the maternal trauma that just came has a difficult airway, and she is too fat, it belongs to a difficult airway, respiratory distress syndrome, and wants you to go for surgery and intubation." ”

When Dai Yunyang heard this, he was a little dumbfounded: "New crown mother, big fat man, or traumatic difficult airway?" What's going on? ”

The nurse said: "The pregnant woman was sent in a traffic accident, and the fetus is more than seven months old. The pregnant woman was driving with her mother's family and was involved in a traffic accident. Multiple injuries to the head, chest, and neck in pregnant women, acute respiratory distress syndrome. When the family was sent to a nearby emergency hospital, it was determined that the new crown was highly suspected to be a case and transferred to our hospital. ”

Dai Yunyang chuckled in his heart, this is a difficult intubation. - The patient is not a pregnant woman, or the new crown is suspected to be a patient, and the most troublesome thing is the big fat man, plus the traumatic difficult airway. It is the first time for Dai Yunyang to deal with a patient of such difficulty.

Dai Yunyang rushed to the negative pressure operating room.

At the door of the operating room, Li Yanling told Dai Yunyang about the patient's situation, and then said in a deep voice: "The patient was seriously injured in a car accident and had to undergo an emergency cesarean section, and it is a highly suspected case of the new crown." Endotracheal intubation in critically ill patients is a high-risk operation, hemodynamic instability, hypoxemia, metabolic acidosis, increased intracranial pressure, and coagulation dysfunction determine that it is significantly different from ordinary endotracheal intubation. According to relevant foreign reports, more than half of the airway-related events in the ICU are related to death or permanent nerve damage, and the proportion in the operating room reaches 20%. So, you have a lot of responsibility. ”

Dai Yunyang looked at Li Yanling a little dumbfounded, do you know that you are still pushing me up? Aren't you clearly wronging me?

Li Yanling smiled, and continued: "It should have been an anesthesiologist, but now the situation is different, in the face of the new coronavirus, you can only take three levels of protection, after wearing a protective suit and three layers of gloves, it feels very bad, especially the patient's condition needs to be quickly intubated in a short time after oxygen withdrawal, once successful, the anesthesiologist feels that he can't take it and asks for support." I had no choice but to call Dean Shen for advice. Dean Shen decided to send you on. The leader is optimistic about you! ”

Dai Yunyang had a black line in his head, thinking that I was also the first time that a big girl got on the sedan chair. Why do you have to choose me?

Thinking about it, who made himself the champion of the post training technology competition in the hospital, I don't have to say, who is he not on? Dean Shen, who was in charge of the emergency center, personally ordered the generals, and it was useless to say it, so the words came to his mouth and swallowed again.