"Where did Chen Qi go? Look, find someone. ”

When Qi Yunming was hysterical and yelling, all the Chinese doctors went to the camp to find someone, so they almost dug the camp three feet into the ground?

It's not that there are no surgeons in the camp, but such a critically ill patient is obviously not something that ordinary people can afford?

The doctors in the medical team to aid Africa, naturally, like their African counterparts, first thought of the miracle doctor Chen Qi.

From this side, it can be seen that Chen Qi has actually become the core of everyone unconsciously, which is the benefit of technical authority, but also a disadvantage.

The disadvantage is that when Chen Qi is not there, everyone is like a headless fly.

The patient was in danger, but the attending doctor could not be found, which made the Teodoro family who rushed to the hospital almost crazy, along with the black soldiers, and the hospital was in chaos for a while, and the atmosphere became tense.

At this time, the little nurse Chen Li quietly raised her hand:

"Qi, Dean Chen said before that he was going to go outside to find weapons to defend our hospital, so he drove out."

Qi Zhiming patted his head:

"Yes, yes, he said he was going out, I was confused, how could this guy go to find weapons, where to find them? He's definitely going to be lazy again, quick, go to the beach to look for it, he often eats seafood and takes a nap there. ”

Immediately, a group of soldiers drove their cars and separated along the coast as fast as possible to find people.

Qi Yunming commanded again: "The patient is the order, we can't just wait for Dean Chen to arrive, Yi Zewen, Zhang Xing, you will start rescuing the patient immediately." ”

Yi Zewen was a little older in the surgical team, so he immediately took over the temporary command.

"Lao He, you immediately carry out tracheal intubation; Chen Li, immediate vital signs monitoring; Yang Xiuxiu, you immediately open the channel of the pulse, open two first, first 0.9% sodium chloride, and then we will wait for Dean Chen to arrive. ”

Was there a mistake in this command?

That's right, in line with the emergency process, but the problem arises, they are not facing an ordinary patient, but a patient with severe burns, a roast duck, then the problem comes.

The first problem was Chen Li, the little nurse was just about to tie the sphygmomanometer cuff, but it was tied a little tighter, and pieces of skin and flesh fell off.

Chen Li screamed in fright.

I really can't blame her, she is professionally trained, and she doesn't scream under normal circumstances, but it's really a piece of human flesh that falls off easily, and anyone is numb.

It's not just Chen Li who is in trouble, Yang Xiuxiu is also crying:

"Doctor Yi, I, I can't find the veins, look at the hands and feet, where is there still complete skin, there is no way to prick the needle."

In burns, most of the veins on the body surface have been destroyed, especially in the shock period, it is necessary to replenish the amount of fluid in a short time, and it is necessary to build an intravenous channel that can ensure the patency of the flow.

This creates a contradiction.

On the one hand, a large amount of fluid is needed, and one channel is not enough, and two or three infusion channels are often required.

On the one hand, the skin has become black carbon, especially the four feet, because when people escape in the fire, they must use both hands and feet, and the skin is exposed, so the injury and burn are more serious, and they can be pricked with needles.

Yi Zewen was already sweating profusely when he heard the nurse's report, this patient couldn't even monitor his basic vital signs, and he couldn't get the infusion, how could he be rescued?

It is very difficult to rescue burn patients, such as vital sign support, the infection level at the back, and finally the skin grafting and plastic surgery level, the first level is very complex and very life-threatening.

I couldn't pass this first level, Yi Zewen thought to himself that this black soldier must be dead and couldn't be saved.

The house leak happened to rain overnight, and when doctors in China and Cyprus were struggling with how to save them, anesthesiologist He Fule's tracheal intubation also had problems.

"Doctor Yi, the patient's airway can't be opened, and he can't even open his mouth, I, I can't be intubated, what should I do?"

You can't complete the infusion for a while, and you can't die for the time being, but your airway can't be opened, and the patient's airway is blocked and causes suffocation, which means that you will die.

Not to mention Yi Zewen now, even Qi Yunming next to him, the director of Freetown National Hospital, Bagri, Director Momberto, and Piette were also sweating profusely.

The patient's family apparently saw that Dr. Hua Guo was also unbooked, so they began to mourn again.

"Doctor, where's that double director? Why not come to the rescue? Does he need money? We have dollars, we have gold, as long as we can save him, we are willing to support enough reward~~~"

Qi Yunming heard this and yelled:

"Why are you still stunned, go get normal saline, and debride the patient first."

The China-Cyprus Friendship Hospital was immediately busy......

Chen Qi was found on a hillside by the sea.

It's hard not to find out, because his Lamborghini LMA002 civilian armored car is so conspicuous that it can be seen from a distance when parked on a mountain road.

Chen Qi was sleeping soundly when he suddenly heard the sound of cars, motorcycles, and a group of people commotion.

When he opened his eyes, he almost beat his heart out of fright, because all around him were armed men with real guns and menacing faces.

"This, what's going on? The rebels have already reached Freetown? Well, I am a doctor, a Chinese doctor, we are neutrals, we are here to serve the great people of Serrarian and to serve the friendship between the two countries. ”

Chen Qi was stunned, and he almost took out the small flags of the two countries and waved them a few times.

Since ancient times, I thought that Qiu Ba was all killed, and if he didn't come over, his little life would be confessed here, and he would really die in a foreign country.

Just when Chen Qi was thinking about how to get out, a Chinese doctor crawled from the foot of the mountain:

"Chen, Dean Chen, come on, there is a big man in our Friendship Hospital, his whole body was burned to charcoal by an incendiary bomb, and now he is still alive and needs emergency treatment, everyone is waiting for you."

"Burns?"

"Yes, at least more than 80% of the body has extensive burns, almost all of them are 2 or 3 degrees deep."

"Hey, you can still survive like this, the chosen one, the protagonist's aura, let's go, save people."

Chen Qigang ran a few steps, turned back to the soldiers and said, "This super large steamer has to be taken away for me, if you lose it, you can't buy it in your country." ”

"Ah, Dean Chen, when are you still thinking about eating, but you are the commander of the army, a big man."

The place where Chen Qi took a nap is actually not far from the China-Cyprus Friendship Hospital, the straight-line distance is only 3 kilometers, and the car accelerator pedal is only 7 or 8 minutes away.

Chen Qi jumped out of the car and ran to the emergency room, and saw that the patient who was undergoing debridement also had a toothache.

Don't forget that Chen Qi was a hepatobiliary surgeon in his previous life, and he also majored in hepatobiliary surgery for his master's degree and doctorate.

Now that such a serious illness has come, Chen Qi said that it is impossible not to pressure, not to mention that this is still an important political figure on the Serbian side.

Yi Zetian really wanted to kneel down when he saw Chen Qi running in, and shouted anxiously:

"Dean Chen, hurry, hurry, the patient urgently needs tracheal intubation, and Lao He and I can't handle it."

Deep burns, especially those of the head and face, in which the mouth appears to be swollen and protruding, are called the "fish-mouth sign".

It is also accompanied by a deep burn of the neck with annular or semi-annular eschar, which can affect endotracheal intubation.

The most terrible thing is that it can also cause severe internal laryngeal burns, and severe glottis edema leads to laryngeal obstruction, which is also an important reason why He Fule and Yi Zewen, an anesthesiologist and a surgeon, cannot be intubated.

Chen Qi became popular when he saw it:

"Insert a fart tube, you see, the patient has obvious respiratory distress, and the black person can't see the face, if it is a yellow or white person, it will already be blue and purple at this time, and he will be suffocated to death soon, since he wants to rescue him, he must have the courage to take risks."

"Ah, it's so serious, what if you don't intubate?"

"What to do, of course it is a direct tracheal incision, although the risk of surgery is higher, but this is the only way, Lao He, you will do local anesthesia immediately, regardless of general anesthesia, it's too late, I'll talk to the family."

As soon as Chen Qi arrived, everyone was like a precision machine running immediately.

Chen Qi found the commander-in-chief's wife who was crying and howling:

"Madam, the situation is critical now, I need to cut this part of the patient, otherwise he will not be able to breathe, and it is estimated that he will not survive for half an hour."

Lady Teodoro was already six gods at this time, and Teodoro's father, Chief Raodoro, nodded firmly:

"Doctor, you can come as you like it, we have no opinion, our only hope is to save my son."

Doctors like this kind of courteous and easy to communicate with the patient's family, and if they really want to meet those tangled family members who are looking forward and hesitant, and when they make up their minds, it is estimated that they are cold.

The family said yes, but without saying a word, Chen Qi took the scalpel from the instrument nurse, felt the lower edge of the thyroid cartilage to the suprasternal fossa, and cut it along the anterior midline of the neck.

At the moment when the trachea was cut, the blood in the trachea gushed out like a beautiful blood mist.

The family members next to him screamed, smacked, and fainted twice.

Chen Qi was on fire: "Kick out all the irrelevant people, the most feared thing about burn patients is infection, so many people want him to die." ”

Dean Bagri and Momberto, the two giants of the Sierra Health System, also acted as assistants and security guards, driving non-medical personnel out of the emergency room.

The tracheotomy makes a creepy tubular breathing sound at the incision, but the respiratory distress caused by suffocation disappears immediately.

Yi Zewen immediately took the tracheal incision dilator to open the tracheal incision, and Chen Li immediately handed over a tracheal cannula.

Chen Qi quickly inserted the outer tube into the tracheal incision, immediately removed the tube core, and then put it into the inner tube, sucked up the secretions, and began to check whether there was bleeding.

Zhang Xing tied the strap on the tracheal cannula around his neck and tied it into a dead knot to fix it firmly.

The surgical team cooperated tacitly, the division of labor was clear, and finally the first difficulty was overcome, and before Chen Qi could breathe, Yang Xiuxiu shouted again:

"Dean Chen, the patient's superficial veins are almost burned out, I, I can't find the blood vessels needed for venous access, what should I do?"

Chen Qi sighed in his heart, thinking that in the 80s, whether it was a grassroots doctor or a nurse, he lacked high-end medical care knowledge too much, and his level was really not enough.

"Zhang Xing, you go and push the ventilator I brought back from the moldy country and give it to the patient, Yi Zewen, you work with me to open the venous access by surgical means."

The main pathophysiological basis of burn shock is deep-induced fluid loss and abnormalities in cardiac and vasomotor function.

Large amounts of plasma-like fluid leak from the blood vessels into the wound and interstitial spaces, resulting in a drastic decrease in effective circulating blood volume and microcirculation disorders, as well as dysfunction and structural damage of vital tissues and organs.

Therefore, patients with severe burns need a large amount of rapid infusion of crystalloid solution and colloid fluid to implement fluid resuscitation, and need to be transfused with antibiotics, high-energy nutrient solutions, life support drugs, etc. to maintain clinical treatment.

If you can't even find the venous access, there is no way to save it.

Chen Qi looked the patient up and down, no wonder the little nurse couldn't find a place to prick the needle, where are there a few pieces of good meat on the body, especially the burns on the hands and feet are particularly serious.

Then you can't go the regular route.

"Chen Li, you immediately prepare a sterile bag for me to puncture the needle, in addition, call all the young doctors over, I will teach you a few tricks today, it can save lives at a critical moment."

As soon as I heard that Dean Chen was going to teach on the spot, I was in an uproar, and the doctors and nurses who were wearing surgical gowns and had done simple disinfection work surrounded them.

"Yang Xiuxiu, Chen Li, and Yi Zewen Zhang Xing, why do you focus on the names of the four of you, because you are a member of my surgical team, even if I am not there, your handling today is still quite out of points, and you have to criticize.

I can't find the superficial veins on my hands or feet, what should I do? Simple, there are deep veins in the human body, the blood vessels are thicker, and the flow is more guaranteed, which is conducive to rehydration administration. Look, learn a little, I'll do a strong external venous puncture for you first. ”

Chen Qi selected 1/3 of the connection line between the lower jaw and the midpoint of the upper clavicle margin as the puncture point, fixed the skin on the left, and advanced the needle at 15° with the skin on the right, and the needle tip entered the skin obliquely and then went to the puncture tube along the tube.

After returning to the back, fix the puncture needle cannula on the left, pull out the needle on the right, and then quickly connect the end of the catheter connector with the guidewire to the puncture cannula, slowly insert the catheter, and remove the detachable connector.

Fix the catheter on the right, exit the puncture cannula from the end of the catheter on the left, and finally remove the guidewire to quickly connect the catheter to the infusion set.

Chen Qi explained while doing a puncture, and then chose to demonstrate a deep venous puncture in the femoral vein and subclavian vein.

In this way, the three venous channels were quickly established, laying the most solid foundation for rescuing patients.

It is rare for the young doctors and nurses in Huaguo to observe deep venipuncture at such a close distance, and roughly understand the selection site, operation process, precautions, etc., and the rest is a drill.

Medicine can't be lazy, you can only keep rehearsing, and in the end, practice makes perfect.

As a result, the intravenous access was opened, but I encountered a very headache question, that is, what kind of fluid should be injected? What is the dose?

This involved a very complex set of calculation formulas, which almost broke Chen Qi......

(End of chapter)