It was a stressful and long night for all the pre-hospital first responders. And for the king pigeon, it was a very difficult night.

Because in the previous twenty hours, he had only slept for two or three hours, and tonight he originally planned to go home and sleep in the dark, but he was dragged back to the hospital by a phone call from Tie and went directly to the accident site of the landslide.

The middle shift drivers who worked from 4 o'clock in the afternoon to 12 o'clock in the evening took advantage of the kung fu to return to the Second Affiliated Hospital of Yaxiang to hand over the shifts one after another, and after the busy work, someone will continue to take over, but the king pigeon cannot.

Originally, he was on duty at twelve o'clock at night, and when he went to the scene, he just went to work in advance, so naturally he couldn't go, let alone sleep, don't even think about it.

In the past few hours, due to the oversaturation of work, there is basically no time to be idle, and Wang Jiaxin's body has such an incident, Wang Ge is naturally sleepy, but he obviously feels that his physical state can no longer keep up.

Because it is not the 24-hour duty system of the emergency department of an ordinary hospital, the ace pigeon who works eight hours a day cannot adapt to not sleeping for more than 20 hours in a row.

His lower back and cervical spine began to ache abnormally, his eyes were unbearably dry, and he felt pain every time he rolled his eyeballs.

His ability to judge things began to decline, and his sense of brakes, clutch and accelerator was no longer sharp. Fortunately, in the middle of the night, as long as you maintain the fifth gear, you basically don't need to step on the clutch to shift gears, otherwise something has to go wrong.

Wang Ge closed his eyes hard, trying to relieve his fatigue, this process only lasted a few tenths of a second, when he opened his eyes again, a black shadow suddenly rushed over in front of the headlights, Wang Ge gritted his teeth, it was definitely not a figure, the accelerator under his feet was not loosened, and he hit the little black shadow directly!

There was a bang in front of the ambulance, and there was a loud bang.

In addition to the roar of the machine from the engine compartment, several wails of animals were heard outside the window. At the same time, the king pigeon felt a jolt in the wheels, as if an ambulance had run over the animal's body.

The noise attracted the attention of the other two medical staff in the car, and the younger Cheng Susu was startled, "Master Wang, what's the situation?

Listening to the muffled sound of the impact, it was indeed very scary, and the body shook slightly, as if it had hit someone.

"It's okay, it could be a wild cat and a wild dog, don't delay. Wang Ge quickly replied, reassuring the two people in the car, but he was very dissatisfied with himself.

If this was in normal times, even at night, and an animal suddenly came out, he would definitely have had time to react. Before closing his eyes, he observed that there was no one around the vehicle and in front of him, so he dared to use the few tenths of a second to lubricate his eyes, but he didn't expect a small animal to suddenly emerge from the side of the road.

The speed at which people come out is not so fast. And who would crash straight into a speeding ambulance except for those who wanted to commit suicide?

Of course, the speed of the ambulance was very fast, and it drove close to 100 kilometers per hour on this road with few vehicles and had not yet entered the city, and the king pigeon naturally could not make a stupid move to slam the steering wheel and cause the body to be unstable in order to save the life of an animal.

At this speed, a slight movement of the steering wheel will have a big impact on the vehicle's path and stability, let alone the act of slamming the steering wheel. The road is slippery, if the vehicle skids, is uncontrolled, or even rolls over, then the death may not be as simple as a cat or dog. The whole car has to be hit, and the king pigeon can't afford this responsibility.

Whether it is training in the ambulance fleet, or the test in the level of B-level driver's license, in the case of high-speed driving, in the event of an emergency, whether there is someone in front, an animal, or a tire burst, there is only one principle: hold the steering wheel, slow down as soon as possible, give way to speed, and leave the rest to God.

Although Wang Ge didn't hear the crisp sound of the front bumper shattering, he still hoped that nothing would happen to the ambulance's bumper. If the bumper is cracked, you will be scolded by Sun Chengde and Tie Roughly, not to mention, and you have to pay money from your salary to repair it, which is really worth the loss.

Fortunately, it was only a small animal that was knocked down, which did not affect the operation of the vehicle, and the patient did not seem to be as dangerous as Dr. He Yunfei said.

Just when he was glad that there was no death chasing after him, the condition of the young female patient in the car suddenly deteriorated, because Wang Ge clearly heard the sound of a long beep from the central electrical monitoring equipment of the ambulance.

When He Yunfei first got into the car, he and Cheng Susu worked together to perform thoracentesis and drainage on the patient, releasing all the blood and fluid in the chest cavity, reducing the possibility of pulmonary edema and making the patient's breathing smoother.

This treatment is so effective that the patient's breathing deepens almost at the same time as the blood is released through the catheter. But now, the patient is suddenly in crisis again.

Doctors and nurses can never predict what will happen to a patient in the next second, let alone with little to no examination.

"My heart has stopped!" He Yunfei certainly knew what was going on. But in this case, CPR is definitely not possible.

Almost at the same time, the king pigeon noticed that death was already approaching in the back of the ambulance!

"It's fast enough!" Although the ambulance had already passed the Orange Island Bridge and actually entered the city center, the accelerator under the feet of the king pigeon did not let go at all, but stepped on it more and more.

There is no need to think about it, the speed of the Grim Reaper behind him must be very fast, and the patient's condition is a danger within danger. He didn't expect the patient to get better on his own, and the Grim Reaper would give up. All he can do is to leave death behind as much as possible, give the patient more time, let the doctor make decisions, and save the patient's life.

He Yunfei panicked for a moment.

According to his judgment, the patient's ribs were broken and the broken bone section was inserted into the patient's lung like a knife.

Moreover, He Yunfei could not tell whether the patient's broken rib had pierced the heart. If the ribs do penetrate the heart, CPR must not be done, otherwise the patient will die faster.

If the ribs have not yet penetrated the heart, the strong pressure on the chest cavity will also cause the ribs to displace, posing a great threat to the heart.

Can't move, absolutely can't move!

"Doctor, what should I do?" Cheng Susu also glanced at the vital signs monitoring equipment, his pulse was almost non-existent, his blood pressure could not be measured, his lips were blue, and his breathing rate was gradually decreasing. She rolled the patient's eyelids. "The pupils began to dilate. ”

"One milligram of epinephrine, intramuscularly. He Yunfei changed a pair of gloves for himself and put on a mask. "Master Wang, how long will it take for you to get to the hospital?"

"About fifteen minutes. The king pigeon replied.

"The heart stopped beating for fifteen minutes, and the gods couldn't save it. He Yunfei gritted his teeth and stomped his feet and said to Cheng Susu.

"Nurse Cheng, after using up the medicine, assist me in opening my chest. ”

"Open the chest?" Cheng Susu performed the injection action, and raised his head to look at He Yunfei. "In the ambulance?"

He Yunfei has already made his own judgment. "Well, open the chest, do direct intrathoracic heart compressions. ”

Without cardiac compressions, the patient will surely die. There is also a risk of death with chest compressions.

There is a last option in the case of cardiac arrest, chest compressions are not available, or chest compressions are ineffective.

That's intrathoracic cardiac compressions.

One inside, one outside, the risk is not only one point greater.

Intrathoracic cardiac compression refers to the direct use of a scalpel to cut open the patient's chest, cut the ribs, and perform cardiac massage directly with the hands through the pericardium in an emergency. If it doesn't work, then you need to put in a thoracotomy to completely open the chest cavity, cut the heart bag, and directly apply your hand to the heart for heart compression.

In terms of ambulance, although the medical supplies are relatively complete, there is no scientific and technological equipment to assist, and He Yunfei only has one assistant Cheng Susu, so the risk is still very great.

"Doctor, I can't speak...... It's too risky. If the ribs really pierce the heart, it will not be effective for you to open your chest and perform intrathoracic cardiac compressions. Once a patient dies, what will the family members think when they see the chest cavity that has been opened? If you die, you won't leave a whole corpse? You're going to have a lawsuit!" Cheng Susu said, but in his hands, he was cutting the patient's coat and bra with scissors.

The unique organs on the chest of the young female patient popped out, and what should have been beautiful became unappreciated. Her chest was completely swollen due to multiple fractures and visceral damage, as well as blood in her chest, and her skin was purple due to soft tissue contusions and subcutaneous hemorrhage.

After cutting off the clothes, Cheng Susu began to prepare for the sterilization of the surgical site.

"Then what do you want me to do? Watching her die?" He Yunfei said helplessly, as a doctor, he would never allow this to happen. No matter how complicated and dangerous the rescue work is, and how much risk he has to take, the most difficult thing to do in the face of a life is to give up.

"If you don't have a patient because you're afraid of carrying a black pot, can you be considered a doctor?" He Yunfei smiled at Cheng Susu.

He is only a doctor in a county-level people's hospital, and he has participated in limited rescue, has done limited surgery, and has never used heart compressions directly with his hands in the rescue of county-level people's hospitals. And today is the first time he has performed this operation, fortunately, the learning and operation of being a doctor must be solid, and the knowledge from school is still in his head, not to mention that he is still an emergency doctor.

"Sterilize, I'll carry the pot on my back, it's nothing to do with you. He Yunfei made up his mind, hoping that the broken rib did not pierce his heart, otherwise he would really have no surgery.

Cheng Susu completed the action of disinfection of the patient's chest very quickly, He Yunfei held a scalpel, made an arc-shaped incision along the patient's left side from the left edge of the sternum to the front of the axilla, entered the chest through the fourth intercostal space, and used tools to cut off the fourth rib, but fortunately this rib was not broken. The right hand is inserted into the chest cavity and the first thing to discern is the beating of the heart.

"It stopped beating completely, and the broken rib pierced into the pericardium. He Yunfei had disappointment in his eyes, but he was still unwilling. "Thoracotomy device, help me open my ribcage!"

At this point, Cheng Susu no longer had any words of objection. The chest has already been opened, it is nothing more than a bigger opening, and a few more stitches when stitching. If a person is dead, when the family letter sees the corpse, it will not care how big the opening on the chest is, let alone whether the pericardium has been cut and stitched up, and it cannot be seen from the outside.

If a person is rescued by He Yunfei because of this, let alone a scar on his chest, He Yunfei will be understood by his family no matter what kind of rescue method he carries out.

He Yunfei wants to open the pericardium, which is definitely not unreasonable. Based on the probe, he judged that the length of the severed rib was enough to pierce the pericardium, but it did not seem to be enough to actually hurt the heart.

The cause of cardiac arrest is likely to be caused by effusion in the pericardium.

The movements of the two people were very quick, completely opening the patient's chest, Cheng Susu was busy sucking away the blood that kept flowing out with an instrument, so as not to hinder He Yunfei's observation and judgment, this bit of blood is nothing compared to internal bleeding in the lungs, and now it is important to save lives, first snatch the heartbeat back, without heartbeat, no matter how much blood in the body is useless.

He Yunfei squinted his eyes, held surgical scissors, and cut the pericardium longitudinally in front of the phrenic nerve, and the fluid in the pericardium suddenly flowed out.

A smooth heart unfolded in front of him. He Yunfei's eyes were even glowing, as he expected, the surface of the heart was not injured by the broken ribs, not even a scratch.

The bright red heart looked very healthy and the heart muscle was strong, but there was no beat. He Yunfei knew that now the muscle cells of this heart were dying in large numbers. In order to avoid myocardial perforation or injury, He Yunfei used the knuckles of the knuckles to perform a heart massage, and the movements were exactly the same as those in the textbook.

At the speed of eighty times per minute, He Yunfei pressed for a minute, and his heart still did not improve.

"Five milliliters of calcium chloride, intracardiac injection! Such a healthy heart has already achieved this level, it is impossible to be without a pulse. Girl, don't let me carry your black cauldron!" He Yunfei said to the patient, paused the compressions, and injected the patient with his own hands.

After the injection was completed, he continued to press the motion. "Take your pulse and look at your pupils. He Yunfei's face was beaming, as he had already seen that the patient's lips were turning from purple to less noticeable rosy.

"The pulse is strong, the pupils are constricted. Cheng Susu checked according to He Yunfei's instructions, and was overjoyed, "Doctor, it's useful!"