Retroperitoneal bleeding in the pelvis is temporarily stopped by a large amount of gauze tamponade, and even after tamponade, the bleeding does not stop immediately, and the retroperitoneal space will bleed slowly, but the bleeding will gradually slow until it stops.

The pelvic fracture is only one part of the bleeding, and now there are many parts of the patient's body bleeding, and the current situation is very critical, which is also a matter of no choice, and the rescue team has been advancing the operation as quickly as possible.

After hard work, Director Xu finally took out a bloody short steel bar, and then continued to fight, ready to continue to take the second short steel bar, only by taking out all the short steel bars, can the two long steel bars be conveniently separated.

On the side of the thoracic trauma, the pericardium has not yet opened, and the tear in the lung is already bleeding, so the chest surgeon has to give priority to the lungs first, and the lungs cannot stop the bleeding at all, so they have no choice but to perform lobectomy.

Lung tissue is very brittle and more difficult to suture than other tissues, so in this emergency, only lobectomy can be done.

This method of hemostasis is widely used in surgery, such as intrauterine hemorrhage during childbirth, if there is no way to stop the bleeding, the entire uterus can only be cut off to achieve the purpose of hemostasis.

When there are many blood vessels in the uterus, and it is difficult to stop the bleeding one by one, cutting off the entire uterus is undoubtedly the most effective way, because the blood supply and return blood vessels of the uterus are fixed, and there are not many of them, so it is easy to find.

This is equivalent to the bursting of countless water pipes in a house, and there is no way to block them one by one, and the best way is to turn off the main water supply switch of the whole house.

The same is true for lobectomy, the breach cannot stop the bleeding, and the entire lobe is removed to ligate its blood supply and return blood vessels to achieve the purpose of hemostasis.

The pericardium does not dare to wait for a long time, since the steel bar penetrates the pericardium, even if the heart is not damaged, there will be blood vessel damage, temporarily because the steel bar has a certain pressure on the surrounding tissues, this pressure can temporarily squeeze and close the blood vessels to a certain extent.

However, there is more or less blood oozing in the pericardium, and once the amount of bleeding accumulates to a certain extent, it will cause cardiac tamponade, which will cause the heart to be unable to beat.

Director Xu continued to separate the second short steel bar, if the short steel bar was not all removed, it would be difficult to carry out other operations, and it would be impossible for the firefighters to cut the two long steel bars in sections.

The neurosurgeon in charge of the head is still cleaning the hematoma in the skull, and they are careful in their movements, focusing only on their own surgery, regardless of the thoracic and abdominal surgery.

At this time, the doctors of several teams were doing their best to rescue, and the doctors in the audience were also extremely nervous.

Suddenly, I don't know which big blood vessel in the abdominal cavity ruptured, and with a bang, blood spurted out far away, and the blood line of the parabola was more than a meter away.

Several of the doctors who were watching the battle were splattered with blood, and one doctor had a large pool of blood sprayed on his body.

"This patient has four infectious diseases, right?" The blood-splattered doctor immediately became nervous.

After receiving the anesthesiologist's reply, there was no problem, and the doctor who was splashed blood was relieved.

Gauze! Gauze!

Director Xu immediately caught the gauze in the nurse's hand and pressed it to the bleeding place as quickly as possible, but a few pieces of gauze were far from enough, and there were steel bars blocking it, so it was difficult to perform the movement freely, and the tamponade to stop the bleeding was much slower than usual.

"Gauze!"

Director Xu shouted while directing his assistant to suck blood.

"Here!"

The assistant immediately put the suction device into the blood, hoping to create a short clean surgical field so that the main surgeon could find the blood vessels that spurted blood.

However, this was in vain, and a single straw could not remove a large amount of blood from the field.

Everyone is an experienced emergency surgeon, and several straws have been prepared for a long time, and the assistant immediately pulls out the suction tube and directly uses the thick suction head to suck blood.

In this way, with the help of a few straws, he was able to barely create an unstable and instantaneous clean field.

Director Xu relied on this instantaneous field to lock the location of the bleeding in a small range, his hands were full of blood, and the blood flowed down the glove. Director Xu is experienced, he can't manage so much now, and directly grope with his hands to pinch the upper part of the abdominal aorta, and then the bleeding can be stopped.

This kind of manual hemostasis is a basic skill that almost every emergency surgeon must master, and sometimes it can have unexpected effects.

Director Xu judged from experience that the speed of this bleeding obviously came from the aorta, and other blood vessels could not be so violent, so Director Xu pinched the upper part of the abdominal aorta and began to look for bleeding points.

I searched from top to bottom along the aorta, and soon, Director Xu found the gap, and he was very puzzled: "Why is there a breach here?" ”

Just as he was about to ask the vascular surgeon to treat the breach, he found that because of the presence of steel bars, it was not easy to do it at all.

Director Long just heard Yang Ping's prediction in advance, and couldn't help but admire it very much, if Professor Yang had done this surgery, there would definitely not have been this kind of blood spurting just now.

"Aortic clamp!"

Director Xu had to block the aorta in advance, which is a very good way to stop bleeding, but the time of blockade is limited, once the limit time is exceeded, the organs below the blocking plane will die due to ischemia and necrosis.

Therefore, as a first-class emergency surgeon, Director Xu put aortic occlusion as a last resort, but he didn't expect it to come so quickly at this time.

After blocking the aorta, Director Xu checked the blood vessels, fortunately, I don't know why there is a break here, it should be very small, maybe the pressure of the blood vessels is too large, and suddenly the small mouth is torn into a longitudinal large mouth, and the vascular surgeon feels that it can be repaired after seeing it.

However, it is necessary to solve two short steel bars before repairing, otherwise the stitches are not easy to start, and the break is just behind one steel bar and is covered by steel bars.

Director Xu hadn't recovered from his breath, and he didn't know where a big bleeding point had appeared, bubbling out like a spring.

"Atractor, here, hurry up, give some vision."

Director Xu estimated that the bleeding blood vessels came from the liver or pancreas, but some of the blood vessels of the liver and pancreas were on the back side, and if it was a blood vessel on the back side, it would be very tricky, so Director Xu could only lock the approximate location of the bleeding point for the time being.

He was an experienced emergency surgeon and responded calmly, and with the assistance of an assistant's suction device, he finally determined the source of the bleeding, which could be the blood vessels of the third hepatic portal behind the liver.

He reached out to the liver and touched it, as if he had found something, and then pinched it, and the bleeding actually decreased, indicating that his judgment was correct.

A short steel bar just passed through the liver, and the liver had to be cut anyway, so it was better to cut it now.

"Vascular clamp!"

Director Xu used vascular forceps to complete the hemostasis of this blood vessel under the feeling of both hands, which is a real skill practiced by many years of emergency surgery experience, and it is difficult for ordinary people to do it.

But after treating the blood vessels here, the bleeding only decreases, not stops.

Judging from the direction of the bleeding, the remaining bleeding should be on the side of the pancreas, and Director Xu tried to feel the back of the pancreas, which is relatively troublesome, because its blood vessels often mutate, and the anatomy is not very stable.

And the pancreas was pressed by the steel bar, and his hand couldn't dig too deep, whether from above or from below, Director Xu groped several times, but found nothing.

This battle is very passive, but Director Xu has no choice, this is the emergency surgery team of Xiehe, if it was in a general hospital, this kind of case would have disappeared a long time ago.

Several groups of doctors were very fast, but there were too many parts of the bleeding, and the speed of bleeding was also fast, and there were many steel bars.

It is impossible to do it in so many places at the same time, and the abdominal cavity is so large that it can only be dealt with one after another.

Blood pressure has begun to show signs of unstable and begin to drop.

The pancreas has not yet been treated, and the vascular surgeon is waiting to deal with the large blood vessels, but it is impossible to deal with the large blood vessels in the case of such a loud and bleeding pancreas, and if two people are treated at the same time, there is not enough space.

The anesthesiologist is highly concerned about the patient's blood pressure, and it is clear that the blood pressure is now on a downward trend, and he intends to increase the pressure of the blood transfusion, but finds that the blood transfusion pressure is already the maximum and cannot be increased.

''Blood pressure is a little unstable!'' ”

The anesthesiologist immediately informed the surgeon of the vital signs he had observed.

I can't help it, and now there are so many bleeding points, it's like a fire is out of control, and the fire brigade is exhausted.

The neurosurgeon has cleaned up the intracranial hematoma and slowly began to separate the tissues around the rebar to create a safe passage for the rebar to be removed.

"The blood vessels of the pancreas are mutated, you see, this is the bleeding blood vessels of the pancreas now, the bleeding is quite violent, this is the blood vessels that must be controlled first, not only these blood vessels, but also here, you see, these blood vessels must be controlled quickly."

Yang Ping pointed out several major blood vessels on the film, which he thought must be controlled first, but they have not been controlled.

From the location of the injury and the speed of blood pressure drop, Yang Ping can make a rough prediction, which is some of the trauma theories in his published paper, judging the rate of blood loss from the damaged blood vessels, and then adding the speed of blood transfusion, so that you can predict how long the patient can support from the perspective of circulation, if you add factors such as age, then the accuracy is even higher.

According to his own theoretical predictions, this patient will not last long if he continues at this rate.

"You have to hurry, or the patient won't last long." Yang Ping was very worried.

Director Long looked at the situation on the stage, and his heart began to get anxious.

''Blood pressure is still dropping!'' "Anesthesiologists' concerns are now more pronounced.

"Keep pressurizing!"

Director Xu ordered.

But now that it's the ultimate pressure, there's no pressure left to add.

"It's already the biggest pressure."

Said the anesthesiologist.

Director Xu looked up at the bags of blood hanging on the infusion stand, no, the speed of bleeding is so violent, the injury is so complicated, not to mention that the steel bar has damaged so many blood vessels, and there is so much bleeding from fractures, and the amount of bleeding is very huge.

At this time, Director Xu began to feel that his confidence was low, this case was indeed beyond his previous experience, and it was very difficult to deal with.

I don't know what's going on, maybe one of the blood vessels broke through the blood clot formed by the body's self-coagulation function, and the blood bubbled out again.

Where is this bleeding again?

The enemy in front of you can't handle it, and now there are new enemies.

Director Xu felt a little nervous, but this is only a technical level, emotionally Director Xu is still calm as usual, he is a senior emergency surgeon, not a rookie who has just taken a knife.

Not every patient can be saved, just do your best.

Originally, the anatomy here is complicated, otherwise the combined pancreaticoduodenal resection would not be a super-large operation.

The short steel bar has not been pulled out yet, and now it is necessary to dissect the pancreas, and it is impossible to be busy, even if it is three heads and six arms.

A dead horse is a live horse doctor, and that's the only way.

"Director Xu! The one that bleeds the most is behind the head of the pancreas! ”

"Take a big bend, open the forceps a little, insert it from the underside of the pancreatic head, the curve is to the right, the direction of the forceps is straight up, and reach into the clamp at the position of the forceps to the hub."

"Show me the big bend, and I'll show you."

Yang Ping shouted loudly, Director Xu immediately stopped, turned his head to look at Yang Ping, Qiu Nuo gave Yang Ping a clean large curved blood vessel, and he immediately used his hand as a pancreas to show Director Xu.

After the demonstration, Yang Ping approached the operating table and prepared to instruct Director Xu to stop bleeding.

Director Xu hesitated a little and immediately did so, but even with a demonstration, Director Xu couldn't do it so accurately, so he carefully reached into the vascular forceps.

Everyone gave up their positions, and Yang Ping didn't care about any sterile principles, he tried to get as close to the operating table as possible, and looked inside:

"A little to the right, yes, a little more in, a little more, don't be afraid."

"The opening of the pliers is smaller, a little bigger."

"Rotate the pliers a little clockwise, yes, stop!"

"Hold this position, move forward a little, don't move!"

"Clip!"

Under the remote command of Yang Ping, Director Xu finally completed the action, he obviously felt that he was clamping some tissue, and after the suction device cleaned up the bleeding in this part, something magical happened, really, there was no more bleeding here.

"Clamp the upper teeth first!"

Yang Ping could only tell Director Xu like this, because it was impossible for Director Xu to ligate the blood vessels by hand in the next step.

Director Xu complied, put teeth on the vascular clamp, and then let go of the vascular clamp, feeling relieved.

If you don't change to someone else, even if Yang Ping is remotely controlled, it is impossible to complete the hemostatic action, because it requires rich experience.

Next, under Yang Ping's remote control, Director Xu actually completed the hemostasis of several blood vessels, and these were all tricky bleeding sites just now.

After the hemostasis of several relatively large blood vessels was completed, the situation in the operation area improved significantly, and Director Xu breathed a sigh of relief.

You can't always let people do their own surgery like this, right?

Director Xu said to Yang Ping: "Or? Do you brush your hands to help out on stage? ”

Yang Ping was also not polite, how could there be so much pulling when saving people, so he immediately went out to brush his hands.

When you go out, don't forget to say: "Qiu Nuo!" Brush your hands! ”

The waiting operation was very fast, and the instrument nurse on the table could not cope with it, and he needed a nurse who could adapt to his own pace.

PS: I wish you all a happy new year, good health, a happy mood and all the best! Thank you for your support over the year, salute!