Tao Le can hear it now, and Deputy Director An has no bottom in his heart.

So now is not the time for modesty at all.

"Don't worry, leave it to me." Her voice was not high, but it was gentle and powerful.

Director An nodded and didn't say anything more, because the operating room had already arrived.

The family was outside the door of the operating room, and the mother was already crying, and for some reason, she refused to agree to have a tracheotomy.

"Now there's another option. There is no need to do a tracheostomy or a general anesthetic with medication. Our Dr. Tao is proficient in acupuncture and is able to perform local anesthesia and then perform non-invasive fiberoptic bronchoscopic exploration. ”

Deputy Director An put the informed consent form in front of the family: "The time is urgent, if you don't sign it, you don't need to sign it." ”

I don't know if it was the magic of acupuncture and anesthesia, or the last words of Deputy Director An that moved the family, they quickly signed it, and there was no more grinding before.

Tao Le entered the operating room, brushed his hands, and changed into a surgical gown.

The preparation for the operation has been made, Director Shen Suqian of the Department of Pediatrics, Director Wen Xiaoyu of the Pediatric Outpatient Department, and Xin Feng, the head inpatient officer, plus the head nurse Chen, the instrument nurse, and the itinerant nurse in the operating room, and a large room of people are looking at her with burning eyes.

Tao Le opened the golden finger, and the interface was already endangered purple, and every value was terrifying:

Age: 4 years old. Health: 18.

Etiology: inflammatory plastic bronchitis 55%, severe pneumonia (Acinetobacter baumannii infection) 45%.

Body temperature 39.4 degrees Celsius, blood pressure 110/90, breaths 65 breaths per minute, heart rate 166, blood oxygen saturation 60%,

Complications: respiratory failure, right atelectasis, hypoxemia, sepsis.

Below the interface, there is a holographic image of the child from the trachea to the right lung.

The image shows that the entire bronchial tree of the child's right lung is full of jelly-like sputum plugs.

As a rare critical illness in children, this is the scary thing about plastic bronchitis.

Foreign bodies such as sputum secreted in the trachea form sputum plugs when coagulated, which will block the entire bronchial tube.

In the golden finger space, Tao Le has also done many cases of this surgery.

The sputum plug removed with fiber bronchoscopic biopsy forceps and suction device can be completely pieced together into a bronchial tree-like structure, just like shaping with a mold, hence the name.

Plastic bronchitis is a dangerous condition, develops rapidly, and is easily misdiagnosed as lobar pneumonia, resulting in a very high mortality rate.

"Tao Le, you come to do acupuncture anesthesia." Director Shen motioned for Tao Le to come to the stage: "Be prepared, once the anesthesia fails, you must immediately perform a tracheostomy, and the bronchofiberscope must be lowered from the incision." ”

The situation is urgent. Tao Le didn't even bother to speak, he stood directly on the upper right side of the child, and quickly and accurately pierced the needle that had just been taken out and disinfected into the relevant acupoints.

She recognized the acupoints quickly and accurately, and her technique seemed to be like flowing water, and the onlookers were touched.

Although I don't know what the effect is, from the perspective of the technique, it has the posture of an old Chinese medicine doctor, which makes people unconsciously convinced.

But after a short while, Tao Le took the needle.

"The anesthesia was successful." As she spoke, she gave up her position to Director Wen, who served as the first assistant.

"Three minutes and twelve seconds." The second assistant, Xin Feng, reported the time of anesthesia.

The child fell into a coma, proving the effectiveness of the acupuncture.

"Let's get started." Director Shen stood at the head of the child and received a 5mm inner diameter fiber bronchoscope from Director Wen, who served as a helper.

Tao Le did not leave the operating table, but consciously stood aside and served as the third assistant.

She has dealt with every next step and possible problems many times, and she knows them all.

The body of the bronchoscope has been coated with lubricant, and the tip of the objective lens is coated with a layer of warm soapy water to prevent fogging.

Director Shen held the mirror in his left hand and the fiber bronchoscope lens through the oral cavity with his right hand, along the posterior pharyngeal wall to the larynx, and then through the lower part of the epiglottis cartilage to the glottis, and quickly inserted it into the trachea from the back of the glottis along the breath.

The effect of acupuncture anesthesia was shown in this process, and the child did not respond at all, still sleeping deeply and soundly, but the blood oxygen saturation still could not be raised.

Whether it was Director Shen, Director Wen and Xin Feng, they all nodded secretly in their hearts.

Pediatrics, in fact, there are many examinations and treatments that require anesthesia but are not willing to be examined, and Tao Le's hand is too useful here!

Director Shen's hand was very steady, and the tracheoscope quickly descended to the opening of the right main bronchus.

Everyone could see clearly from the external display that the opening was barely nowhere to be found, and it was clogged to the brim with a yellowish jelly-like blockage.

Director Shen immediately reacted that this was an extremely rare pediatric condition - plastic bronchitis.

It turned out to be it. It is no wonder that hypoxemia cannot be corrected in the case of ventilator-assisted ventilation.

The bronchial tubes of the entire right lobe are clogged, and no matter how hard the ventilator tries, oxygen can't get in.

Wen Xiaoyu was also aware of this, and immediately handed over the suction device.

Director Shen slowly poked the suction device down the fiber bronchoscope........ Then I found that I couldn't suck it.

The sputum plug is made of mucus protein and cellulose, just like jelly, the suction device power has been raised to 0.04MPa, and the colloid is still motionless.

"You can't increase the pressure any more, otherwise it will damage the tracheal mucosa." Director Shen stretched out his hand, but he grabbed it.

She raised her head and looked at Director Wen, who was slightly stunned, and was just about to speak, when she saw Tao Le handing over something.

It was a syringe filled with saline.

"Well done." Director Shen glanced at her and nodded appreciatively.

Although the little thing he did was insignificant, Tao Le's mood was still very happy.

Some people's beauty has transcended the boundaries between men and women, and even the smiling glance can make people feel refreshed.

Seeing Tao Le's movements, Director Wen also quickly understood what Director Shen was going to do.

He immediately found an extremely thin plastic tube from the accessories of the fiber bronchoscope and handed it over.

Director Shen inserted a thin plastic tube along the mouth of the jaws, then took the syringe and injected about 5 ml of normal saline.

Negative pressure suck-back is much better than dry suction. Visible to the naked eye, a milky yellow jelly-like object was sucked out.

The opening of the right main bronchus is just the beginning.

Next, Director Shen kept repeating the previous process, injecting normal saline, negative pressure respiration—injecting again, and then sucking back.

There is also a particularly stubborn sputum plug in the middle, which is blocked inside the bifurcation of the bronchi, and it can't be sucked out, so Director Shen uses biopsy forceps to take it out directly.

The operation lasted for nearly two hours, and the child showed signs of waking up in the middle, so Tao Le rushed over to make up for the injection, which ensured the normal operation of the operation.

The sputum plug in the right lung was completely removed, and the child's oxygen saturation visibly rose to 90%.

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