These words deeply touched the female worker, and she finally nodded: "Thank you, doctor, I will go and tell my mother." ”

The female worker left, and Dai Yunyang praised Wu Hao: "Director, you are still thoughtful, transfer to the dividend therapy team of the oncology department, and let her die with dignity, this is the best result." I didn't think about it so deeply, the heart of the healer's parents, this sentence is really appropriate for you. ”

"Haha, when did you learn to pat on the back?"

Soon, the female worker came back and told Wu Hao and Dai Yunyang that her mother was willing to stay and continue the treatment, if she didn't pay for it.

Any patient is like this, as long as it doesn't cost money, of course, they are willing to stay in the hospital, at least when the pain can be relieved by the doctor, and they can die relatively peacefully, which is the best.

Wu Hao then asked them to apply, asked the hospital for medical assistance, and contacted the palliative care team of the oncology department, and there happened to be an empty bed, so he successfully transferred the mother of the female worker to the dividend therapy ward of the oncology department.

Dai Yunyang breathed a sigh of relief, and at this moment, he heard the siren of the ambulance, and several ambulances came to the emergency center.

The nurse on duty at the nurse station shouted in the aisle: "The car accident was injured in the group, there are eight wounded, and the doctors and nurses of all departments are here to help!" ”

Dai Yunyang hurried out, the ambulance arrived soon, and the head nurse Xiong Shengnan led the triage, judged the patient's injury, and assigned it to the specific medical team to be responsible for the rescue.

According to the emergency center's plan for dealing with group injuries, Dai Yunyang and Wu Hao were in a group, and he wore a mask and rubber gloves to follow Wu Hao to deal with patients.

They pushed a patient covered in blood to the emergency room with an ambulance bed, and when they were about to move to the treatment bed, several people needed to move at the same time, Wu Hao commanded everyone: "Listen to my orders!" - One, two, three, up! ”

Several people exerted force at the same time, smoothly transferring the patient from the stretcher bed to the bed in the emergency room. Especially the male nurse Kang Zhuang, who is physically strong, and this kind of rough and heavy work is all on him. If it weren't for the smooth transfer of the patient to avoid secondary injury, he could do it alone.

After Wu Hao's quick examination, he said to Dai Yunyang and Wang Bingbing: "Chest and abdomen injury, difficulty breathing, immediately intubated, handed over to the two of you." ”

Dai Yunyang agreed and began to intubate. He tilts the patient's head back, uses his right hand to help open the mouth from the right corner of the mouth, and uses the left hand to hold the laryngoscope into the mouth from the right corner of the mouth, pushing the tongue to the left and slowly pushing forward to reveal the uvula.

He lifted the lower jaw with his right hand, continued to advance the laryngoscope until he saw the epiglottis, placed the tip of the curved lens between the base of the tongue and the epiglottis, then lifted the laryngoscope up and forward, revealing the glottis, gave topical anesthesia, began the intubation, held the cannula with a pen, entered the mouth from the right side, and inserted the tip of the catheter into the glottis accurately and dexterously.

Immediately, he pulled out the tube core and inserted the tube into the trachea. The dental pad and endotracheal tube are then taped to the victim's cheek.

Then, Dai Yunyang observed the outline of the injured person's chest, which rose and fell symmetrically. I listened to both lungs with a stethoscope again, and I could clearly hear a clear breath sound, indicating that the trachea was indeed inserted into the airway, and then I said: "Intubation is complete." ”

At this time, Ma Feng was also intubating another patient over there, and when he heard him say that it was done here, he hurriedly called him: "Xiao Dai, come and help, this injured person has a difficult airway, I can't handle it." ”

Dai Yunyang hurriedly went over to see, the patient was a young man, very strong, but at the moment his face was full of pain, Dai Yunyang asked, "What's the matter?" ”

Ma Feng said: "The injured person has a cervical vertebra fracture, and if the head is intubated in a normal position, it is likely to cause cervical spinal cord contusion and paraplegia, so it cannot be intubated normally." I just tried to use a fibroscope, a cord, and a laryngeal mask, but they all failed, and it seems that I can only use tracheostomy, so you can try it. ”

Tracheostomy is actually a last resort for anesthesiologists, because tracheostomy can cause trauma to the patient and cause many more complications.

Dai Yunyang looked at the patient and said, "Try it with retrograde airway intubation, and then cut it if it doesn't work." ”

Generally, normal intubation is to insert the tube into the airway from the mouth or nose, while retrograde airway intubation is the opposite, using a puncture needle to puncture the cricothyroid membrane, the guide tube is inserted into the respiratory tract through the puncture needle, and then the guide tube can pass through the glottis to the oral cavity or the patient's nasopharyngeal cavity, and then use forceps to pull it out of the nostril, and finally put the endotracheal tube sleeve into the guide tube, and use this as a guide to effectively pass the tracheal tube into the glottis and insert it into the trachea.

This method can be said to be Dai Yunyang's unique skill, and it is precisely because he knows this that Ma Feng did not directly cut the trachea, but asked Dai Yunyang to help. nodded immediately: "It's up to you!" ”

Nurse Wang Bingbing disinfects the anterior cervical area. Ma Feng anesthetized the skin, subcutaneous, cricothyroid membrane, trachea and other layers of the injured at the cricothyroid membrane.

Dai Yunyang used the central venous catheter puncture needle to tilt it cephalad to make it at an oblique angle to the skin, and inserted the needle into the anesthesia on the surface of the cricothyroid membrane, confirmed that the puncture needle entered the trachea, put the J-shaped guidewire into the trachea, used a laryngoscope to find the J-shaped guidewire in the injured person's mouth, and then dragged it out of the oral cavity with intubation forceps J-shaped guidewire.

Ma Feng hurriedly helped hold the guidewire. Dai Yunyang slid the suction tube into the trachea through the J-shaped guidewire, and at this time, the patient's airflow sound was heard flowing out of the suction tube. Immediately connect the end-tidal carbon dioxide monitor.

When the end-tidal carbon dioxide waveform and value are displayed, it can be concluded that the suction tube has been placed in the trachea without error. He asked Ma Feng to loosen the guide wire and hold the central venous catheter puncture needle, Dai Yunyang held the endotracheal tube tightly with his left hand, and dragged the sputum suction tube and the guidewire out of the endotracheal tube with his right hand.

He then routinely examines the endotracheal tube to confirm that it has been inserted into the trachea correctly. Intubation is complete.

Ma Feng was amazed and said, "Awesome! ”

At this time, I heard the sound of sirens in the distance, from far and near.

Nurse Xiao Juan ran in and said to Dai Yunyang: "The ambulance sent a transferred patient with spontaneous pneumothorax. At the strong request of the patients, the lower level hospitals were transferred to our hospital. ”

Spontaneous pneumothorax belongs to the scope of emergency internal medicine, and Dai Yunyang immediately walked out quickly, followed by Zhao Guang and Wang Bingbing.

The patient was lying on a transfer bed, had gotten out of the ambulance and was wheeled into the emergency room.

The doctor of the hospital who sent the patient handed over to Dai Yunyang: "The patient's name is Luo Pan, male, 35 years old, who suddenly had a violent dry cough last night, and then felt chest pain, chest tightness, and difficulty breathing, and came to our hospital to see an emergency. On examination, the trachea is displaced to the unaffected side, the chest on the affected side is full, respiratory movements are diminished, percussion is overechoed, tremors, and breath sounds are reduced. The patient was informed of a previous history of bronchial asthma. Therefore, we judged that bronchiectasis was causing spontaneous tension pneumothorax, and X-rays were taken. The patient strongly requested to be transferred to a higher-level hospital for treatment, so I sent it to you. ”