Chapter 0139 Cricothyroid membrane puncture

The two rested under a tree on the side of the road.

"Wait until you go back and drive, drive slowly, the key is not to panic. Especially when you see a large number of cars, you should predict the traffic conditions in advance. In case of an emergency, just don't make a mistake with the accelerator and brake. When you were driving just now, the accelerator and brake switched very easily, and you formed a memory when you drove too much. ”

Xiao Su summarized Yang Ping's driving just now, and taught Yang Ping his several years of driving experience and inventory.

Another couple on the side of the road, as if they had rested enough, got into the Honda SUV, and before getting into the car, the man did not forget to look this way.

Yang Ping and Xiao Su rested for a while, and Xiao Su checked the power of the car, which was enough, and it was full when he came out.

The two circled around the university town a few more times, and they practiced almost, and Xiao Su took Yang Ping to practice reversing into the warehouse.

Parallel parking spaces, oblique parking spaces, and vertical parking spaces, Xiao Su found a parking space and asked Yang Ping to practice all of them, and each item was passed.

Yang Ping learns very quickly, every project is mastered at one time, and after practicing a few times, he still has his own experience.

After practicing very skillfully, the two of them found a self-service hot pot restaurant and followed the directions.

The popularity of this hot pot restaurant is relatively high, and the price is not expensive, 100 yuan per person, and the two of them found a booth by the window.

The bottom of the mandarin duck pot was sent up by the waiter, Yang Ping and Xiao Su picked a lot of ingredients, and they were also hungry and ready to have a good meal.

"You're a quick learner, you've become so proficient in one afternoon." Xiao Su poured ingredients into the hot pot.

Yang Ping felt embarrassed: "I was originally shopping with you, and while shopping, it became to accompany me to practice driving." ”

Xiao Su said with satisfaction: "I have been shopping for several hours, enough, you see, I bought and bought, and I ate and ate, I am so happy today!" ”

After Xiao Su filled up all the ingredients, Yang Ping covered the pot, and the two waited for the hot pot soup to boil.

Xiao Su said carefully and considerately: "You go to the consultation on Tuesday, drive my car, wait until you go back to the hospital, I will fully charge the battery, there is an area in the underground parking lot of our hospital, which is full of charging piles." When you go to Attached One, there are charging piles in Area E on the third floor of its underground parking lot. ”

"Are you familiar with Appendix One?" Yang Ping heard her say this, and he even knew where there was a charging pile.

Xiao Su nodded: "If you drive an electric car, you know where there are charging piles in the entire G city, after all, charging piles are not as common as gas stations, and it is inevitable that mileage anxiety will occur." ”

"This pure electric car, it feels like a mobile phone, very interesting, going home is not refueling, but charging, I will buy a pure electric car in the future, environmental protection and health and silent." Yang Ping is interested in this electric car.

"You buy this too, this one comes in black, and there are several colors." Kosu recommends.

Yang Ping shook his head like a rattle: "No, no, this is too expensive, I'll buy a BYD, domestic." ”

"It seems that BYD's battery is safer and can pass the acupuncture test, and the blade battery has recently been released, and the energy density has also kept up." Xiao Su was able to keep up with the topic.

The two chatted while eating, from daily life to surgical operations, Xiao Su asked for some professional knowledge that he didn't understand, such as the use of a certain instrument, why a certain step should be done, Yang Ping patiently answered, and felt that she was really studious, and she was really thinking about the steps of the operation, so as to better cooperate with the main surgeon.

The ingredients were disced, Yang Ping asked Xiao Su what else he wanted, and he wanted to get up to pick the ingredients.

Suddenly, there was a bit of noise in the store, Yang Ping turned his head to look, and following Yang Ping's gaze, Xiao Su also went to look.

Someone had an accident, and in the hall, a girl in her twenties fell to the ground.

Yang Ping and Xiao Su immediately rushed over to see what was going on.

"I was fine just now, but suddenly my face was ugly and I collapsed."

The girl's boyfriend was completely out of ideas, and in a panic asked everyone for help, picked up the phone and dialed 120 again, and stammered when he spoke.

"I'm sorry, let me go, I'm a doctor." A middle-aged man parted the crowd and hurriedly squeezed in.

He made a simple judgment of his condition, felt under the xiphoid process, and began to perform cardiac compressions in the lower sternum, and the technique was extremely skillful, and this proficiency was by no means only received simple training, but should have been achieved after many years of long-term training.

The process of manual cardiopulmonary resuscitation follows the latest guidelines completely, as soon as you go up, you will judge consciousness, breathing, and carotid pulse in a few seconds, and then start compression, and only open the airway after compression.

Forehead and jaw lift manipulation to open the airway, check if there is anything in the mouth that needs to be cleaned, and then mouth-to-mouth artificial respiration twice, and then heart compression, compression to artificial respiration, the ratio of compression to artificial respiration, 30 to 2.

This person should be a doctor, and it should be an emergency physician or an ICU doctor, and the rescue is decisive and smooth, completely out of excellent professionalism.

Yang Ping also squeezed up, knelt on one knee on the ground, touched the carotid artery and nostrils, checked the skin of his neck and limbs, the carotid artery had a faint pulse, and his heartbeat had not stopped. In this case, compressions are perfectly fine, and compressions can help a weak heart pump blood, not necessarily that the heart has stopped beating completely.

There are some hives on the skin, allergic reactions! It's an allergic reaction! Not sudden cardiac death. Acute laryngeal edema caused by an allergic reaction, resulting in asphyxia.

When Yang Ping first obtained the system, he underwent first-aid training, and later received physical examination training from the system's super training program, and he was very confident in his judgment.

"Allergic reaction! Acute laryngeal edema! Open the airway urgently! Yang Ping calmly reminded the middle-aged doctor.

"I'm already open." The middle-aged doctor is confident.

"Cricothyrodocentesis or tracheostomy is required immediately!" Yang Ping looked at him.

The middle-aged doctor did not stop pressing his hand, and his eyes could see that he was hesitant.

In this emergency, whether it is cricothyroid membrane puncture or canal incision, it is invasive, and once the judgment is wrong, it will bring adverse consequences, or the patient may face trouble.

Although the law stipulates that this kind of first aid will be exempted, many things --, are not as simple as imagined, and I have seen many things after being a doctor for so many years.

The doctor and Yang Ping exchanged glances and wanted to vacate the position for Yang Ping, but Yang Ping immediately stopped: "You continue to press, I will do cricothyroid puncture!" ”

Compression can help the heart pump blood, put the residual oxygen in the blood into important organs, and maintain the perfusion of vital organs, especially brain tissue, which can only tolerate hypoxia for four minutes, and if the respiratory circulation is not restored within ten years, the brain will be irreversibly damaged.

"Quick, knife and clean straw! A sharp knife, small scissors will do; Straws, the general size is fine. Yang Ping shouted at the crowd.

Originally, I wanted alcohol or high-strength wine, sterilize the knife with flame, and disinfect the throat area, but it takes time to find these things, this acute laryngeal edema, resulting in complete blockage of the respiratory tract, and death within a few minutes, in order to save time, the disinfection link is eliminated.

Knives and straws are easy to find, there is one in the crowd, carry a Swiss Army knife, pull out the sharp knife, and immediately hand it over, the service desk in the store has a straw, and the waiter took a handful, of different sizes.

Xiao Su took the knife, picked out the straw, and squatted beside Yang Ping, being an assistant at any time.

scissors, someone handed Xiao Su a small pair of scissors again.

The manager of the hot pot restaurant was so anxious that he was sweating profusely, and if something happened, it would be troublesome.

Yang Ping touched slightly to confirm the position, between the thyroid cartilage and the epiglottis cartilage, the soft part, the position of the cricothyroid membrane.

Xiao Su handed over the knife, Yang Ping accurately stabbed the tip of the knife, and a sense of failure appeared, and the tip of the knife entered the trachea and immediately stopped and pulled out, and gently inserted the straw into the trachea.

The straw has been trimmed with the soda, the tip has been removed, one end is reserved for the right length, and the straw is folded at an angle in the bending area.

When Yang Ping placed the straw, it was very convenient, and it was put in along the trachea, and it would not cause damage to the inner wall of the trachea.

Edema of the larynx is blocking the airway, and now the blockage is punctured underneath to re-establish an artificial pathway for air.

Ventilation successful! The sound of air flowing in and out, neighing softly like a whistle, Yang Ping touched the carotid artery, and then looked at the patient's face and lips, pale and slowly turned red.

Seeing this, the middle-aged doctor also stopped the heart compressions.

"Acute laryngeal edema caused by allergies, let her lie flat, don't move her, and wait for the ambulance to come." Yang Ping did all this and waited by the side.

The carotid pulse is now palpable, and the blood pressure is at least measurable, indicating that the symptoms of acute laryngeal edema are severe and the symptoms of shock are not very severe.

"What else can I help with?" The middle-aged doctor said that he was full of admiration for the performance of his peers.

Yang Ping said: "It's okay, wait for the ambulance." ”

"I've already called 120!" The girl's boyfriend said while crying that he was also a young man who had not experienced anything, crying like a child.

The middle-aged doctor's face was a little hot, this young doctor was so bold, he judged accurately and acted decisively just now, and he did a cricothyroid puncture, and he didn't blink his eyes. It's the years that have worn away the passion, and the courage has been frightened.

Seeing that Yang Ping was very calm throughout the whole process, without a trace of panic, and rescued the patient, the doctor's professional sanctity and sense of honor involuntarily came to his heart.

This sense of professional sanctity and honor, middle-aged doctors have been absent for a long time, and now they are looking for it again.

Once upon a time, this sense of mission was only experienced when I first entered the school gate and took the oath of medicine.

"Thank you, I'm familiar with cricothyroid membrane puncture, but my judgment is inaccurate; Even if the judgment is correct, I dare not use it; Even if I did, I wouldn't be as experienced as you would be with a knife and a straw, and I would definitely be looking for a needle, or at least a ballpoint pen or a fountain pen or something. The doctor said guiltily.

"You're right, with this invasive method of rescue, sometimes it's hard to make a decision." Yang Ping understands that not everyone has their own self-confidence.

"This doctor is amazing!"

"The one I admire the most is the doctor."

"If it weren't for the doctor eating just now, this girl would have been in trouble, good luck."

"yes, why is it like this all of a sudden."

"This man, I don't know what's going to happen."

The crowd whispered, east and west, and some of them began to return to the table and continue eating.

Yang Ping checked the patient again, and there were indeed a lot of hives on the skin, how could he be allergic

There have also been reports of people who are allergic to penicillin accidentally eating foods such as chicken and fish with penicillin residues, but this is rare.

As for what causes allergies, it is still left to the doctor of the follow-up treatment hospital to judge, after all, this will affect the reputation of other stores, and you can't jump to conclusions.

Yang Ping just analyzed it in his heart and didn't say it.

The doctor of 120 finally came, the doctors and nurses, as well as the first responder, carrying a stretcher, under the guidance of the clerk, came to the place of the accident.

"What's the situation?" The doctor on call asked immediately.

"Acute laryngeal edema, you see, there is urticaria all over the body, may have been exposed to some kind of allergen, causing type 1 allergic reactions, just did cricothyroid membrane puncture, placed a straw, opened the airway, and the whole operation process was not disinfected."

Yang Ping gave a brief introduction to the situation, and the visiting doctor examined the patient and said, "Okay, leave it to us!" It should be an allergic reaction! Adrenaline--"

The doctor on call immediately instructed the nurse to administer medicine, and the nurse had just established intravenous access and hung up a bottle of saline.

After the injection of epinephrine, the patient was transferred to a stretcher, the first aid person carried the stretcher, and the doctor on call said to Yang Ping and the middle-aged doctor: "Thank you, hard work!" ”

The person was picked up by ambulance, and I don't know who called 110, the police also came, and the manager of the hot pot restaurant, several witnesses, as well as Yang Pinghe and the middle-aged doctor were all questioned by the police. He also left a phone number to cooperate with the investigation at any time.

The police sealed all the hot pot that the patient had eaten and brought it back for testing to rule out food poisoning.

When everyone saw this, most of them didn't dare to eat it, and they didn't think it was at first, thinking that it was just a sudden illness.

Now the police have taken away all the leftover food from the patient's hot pot, where do they dare to eat, some people even feel a little dizzy, and some people feel the need to go to the hospital to see.

Everyone dispersed, Yang Ping and Xiao Su should also go back, Yang Ping drove, Xiao Su was in the passenger seat, back to the hospital.

Back at the hospital, coming out of the underground parking lot, when the two separated, Xiao Su handed a bag in his hand to Yang Ping, which was the clothes that Xiao Su said he bought for his family.

"It's hard work today, the reward is for you, wear it for Tuesday's consultation." Xiao Su's face was flushed, full of shyness.

Yang Ping took the bag, a little surprised, didn't he buy it for her family?

"How do you know my size?" Yang Ping asked stupidly.

"Learn from you!" Xiao Su turned around.

Turning around and waving his hand to Yang Ping: "Rest early!"