Ji Xiang came to the emergency department of the Second Affiliated Hospital as quickly as possible.

This time, the system mission was not as calm as before, but kept flashing, like an alarm light.

Maybe this is the difference between emergency tasks, Ji Xiang didn't think much about it, threw the bicycle aside, and trotted into the hospital.

"Doctor Koji!" Colonel Wang beckoned, lowered his voice and called Ji Xiang.

"Teacher Wang." Ji Xiang ran over in the crowd, "What's going on?" ”

At this time, the lobby of the emergency department was chaotic, and only the door of the emergency room was slightly quieter.

Several people stood at the door with gloomy faces, and there were people constantly reporting the situation to them.

Among the people who reported the situation, Ji Xiang only knew one - Dean Zhao.

Dean Zhao, who was like the stars and moon that day, is now like the most inconspicuous little star, and he can't rely on it at all.

"Two died on the spot, the others ...... The number of people suffering from explosions, fires, and burns has reached 16. Colonel Wang sighed, and his short and fat body seemed to shrink a little.

Such a serious accident will not be in a good mood when anyone mentions it.

"Is it serious?" Ji Xiang asked a nonsense.

"There were a few minor injuries and moderate injuries that were sent directly to the stage. Now there is a patient with severe burns who cannot establish intravenous access...... People, it is estimated that it is enough to choke. ”

Ji Xiang and the system task were right, knowing that this was the patient who was "waiting for death".

"I'll take a look." Ji Xiang Road.

"Don't go." Colonel Wang sighed, "It's heavier than expected, two have died, and one can't even get a needle in, the anesthesiology department and the nursing department have tried, no, I am about to leave." ”

Ji Xiang was a little puzzled.

Seeing Ji Xiang's stunned face, Colonel Wang knew that this little rookie didn't know what it meant at all, so he explained, "Three people who died in major safety accidents need to be reported, and the city has ordered that the patient must be rescued." ”

"It's better not to save at this time." Mr. Wu was depressed and hung his head and chattered.

Colonel Wang shook his head, "Be quiet." ”

Mr. Wu sighed, Ji Xiang didn't know what kind of thing they had encountered before he would say such a thing.

But the gossip thing can be pushed back, and the most important thing now is indwelling venous access.

You can't just watch people die.

But Ji Xiang didn't even know the most basic situation, he asked cautiously, "Teacher Wang, what is the patient's condition, why can't he even get a needle in?" ”

"Burns all over the body, even the soles of the feet are burned, and only a little bit of the right groin can see the blood vessels." Wang Daxiao said, "But there are rotten skin and blisters, just a blood vessel, and finally Director Xu of the anesthesiology department tried to indwell venous access." ”

"And then?"

"Failed." Colonel Wang sighed again, "The blood vessels of patients with severe burns are very expensive, there was once a burn patient who lived in the sterile room of the burn department, a doctor changed dressings, and the venous access fell off somehow, and the doctor was scolded by the director of the burn department for a week. ”

"......" Ji Xiang was speechless, a rookie like him couldn't feel how grim the situation was that Colonel Wang said.

"Let's take a look at the stage later, you will have to rotate to the burn department sooner or later." Colonel Wang said, "Let's see what a lighter patient looks like first, so as not to be unbearable at that time." ”

There was a strong sense of carrying here, but Ji Xiang was a little anxious, he didn't say anything, and turned around and went to the bathroom.

"No politeness at all." Mr. Wu looked at Ji Xiang's tall back and said disdainfully.

"Came in too much hurry, coupled with nervousness, the sphincter ...... A soak of urine is suffocated, and the gods can't stand it. "Colonel Wang is very tolerant of Ji Xiang.

Ji Xiang found a quiet place and entered the system space with bated breath.

"Teacher, you know the task." Ji Xiang asked with a roar when he came in.

Although the time flow rate of the system space is different from the outside, Ji Xiang, a rookie, has been unconsciously assimilated and immersed in that tense and oppressive atmosphere.

"Yes." The system NPC hunched over his back and said slowly, "You go and see the simulator first, and then say your disposition opinion." ”

It turned out that it was ready, Ji Xiang was not polite to the system NPC, and strode into the operating room.

A burned simulator was lying on the operating table, Ji Xiang glanced at it, and his heart was cold.

Burns all over the body turned out to be like this.

The simulated person is covered in carbonized positions, and the slightly lighter places are red patches and blisters, and there is no intact skin at all, so it's no wonder that the needles can't be pricked.

"Generally speaking, scalp needles and groin indwelling needles are the most common ways to establish venous access for burn patients." The system NPC explained, "But this patient is seriously injured, and only the HY department is basically fine. But there are also a lot of blisters in the groin, you can take a look. ”

Ji Xiang gradually became helpless.

The system task is right, there is no way to indwell venous access, and the patient's whole body is not complete except for the palm-sized position of the lower body.

"Teacher, what is going to be done?" Jixiang asked blankly.

"I'll teach you." The system NPC said lightly, "I showed you the anatomy of the corpora cavernosa on the first day, you can tell me." ”

"A large number of cavernous sinuses behind the corpora cavernosa, equivalent to valves, pump a large amount of blood into the ...... by stimulating local smooth muscle relaxation."

Ji Xiang said, and suddenly understood the meaning of the system NPC.

But...... Puncture infusion from the corpora cavernos? Ji Xiang had never heard of this kind of way.

"Teacher, you mean infusion through cavernous bodies?" Ji Xiang was afraid that he had misunderstood, so he asked tentatively.

"Hmm." The system NPC nodded.

Ji Xiang couldn't cry or laugh.

The corpora cavernosa is not a blood vessel!

But logically, it seems ...... OK.

However, looking at the helpless expressions on the faces of Colonel Wang and Mr. Wu outside, it is estimated that even the old cannon of urology has never done anything like this.

"The basic principle is this, I'll do it once you watch." The system NPCs put on sterile gloves and begin to operate.

Prepare the skin in the simple surgical area and clean the remaining hair roots again.

The system NPCs then begin to disinfect the skin around the stem.

Hold it with your index finger and thumb to fix the corpora cavernosa behind it, and take the right side of the corpora cavernosa without a subcutaneous vein on the side.

"Be careful to avoid damage to the dorsal neurovascular bundle and the ventral urethra."

The system NPC told Ji Xiang when he did this.

Ji Xiang nodded, he understood the operation of the system NPC, the difficulty is not high, it is just a matter of mindset.

He wondered if it would work.

After all, through the cavernous infusion, Ji Xiang has never seen it, never heard of it, and never even thought about it.

The system NPC uses a No. 6 infusion needle to penetrate the cavernous body about 2cm through a 45° angle on the side, and inserts the needle about 0.5cm after penetrating the tunica albuginosa.

"There is a saying about the needle of the infusion set, don't talk about it specifically, you will feel it carefully in the future." The NPC of the system explained, "45° on the side is the best angle, and in the case of the patient, 2cm into the needle, when the needle pierces the tunica albugina, there will be a sense of failure." ”

"Puncture the white membrane by 0.5cm, and you can stop when you feel a sense of frustration."

The system NPC inserts the needle and opens the infusion channel.

The liquid is boiled to the maximum and drips in a drip pot.

Ji Xiang's heart was pounding, so simple?!

The liquid symbolizes vitality, and if it could, the patient would probably have a chance!

Ji Xiang immediately helped the system NPC fix the needle with a dressing, and the system NPC adjusted the infusion rate to 50ml/min.

"It is difficult to rehydrate after extensive burns, which is a very head-scratching thing in the clinic.

Because the effective circulating blood volume drops sharply after extensive burns, immediate and rapid fluid replacement is the fundamental measure to rescue shock.

However, after extensive burns, the skin is severely damaged, the blood vessels on the body surface are severely damaged, and there are not many veins available for infusion, or even nowhere to wear, even the remaining skin is a valuable donor area that needs to be protected. ”

After the system NPC did all this, he looked at Ji Xiang and said lightly.

Ji Xiang referred to the gloomy expressions of the people outside the emergency rescue room and the helpless expressions of Colonel Wang and Mr. Wu, and vaguely understood the consciousness of the NPCs in the system.

Indeed, a big living person can't establish intravenous access, so it's hard for doctors to accept it.

"Deep venipuncture or incision requires the operator's skilled operation technology, requires local strict aseptic conditions, and is difficult and time-consuming, and it is impossible to replenish a large amount of fluid in a short period of time, which affects the timing of rescue and the effectiveness of treatment."

"Teacher, is there any other way?"

"Bone marrow cavity puncture is possible." "However, extensive burns are contraindications to bone marrow puncture and are not suitable at this time. Reluctantly, infections and so on after are big problems. ”

"The corpora cavernosa has its own advantages, first of all, the location is more hidden, it is not easy to burn, the skin is relatively intact, the anatomical position is relatively fixed, and it is easy to puncture.

The cavernous body is composed of many cavernous trabeculae and cavities, the cavities are actually sinus spaces that communicate with blood vessels, and the blood sinus cavities are large and extensive, which flow back into the deep dorsal veins and into the pelvic venous plexus, which can directly enter the systemic circulation.

And there is another advantage - the cavernous body is surrounded by a tough buffy membrane, so that the sinusoids are still open even in the case of volume depletion, which is a relatively independent and complete tissue structure, so that the puncture can be fast, accurate, and has a high success rate. ”

Ji Xiang's vague cognition gradually became clear with the explanation of the NPC in the system.

This is especially better than veins, especially the cavernous body is wrapped with a white membrane, which is an independent tissue structure, and will not fail to rescue due to hemorrhagic shock and the blood vessels throughout the body are deflated and cannot be pierced.

"Teacher, why don't you promote it on a large scale?"

"It's rare to have no blood vessels at all." The system NPC said, "Secondly, this operation may have side effects, and it cannot be used unless it is absolutely necessary." ”

Ji Xiang nodded.

"Here you go."

The simulator changed one, Ji Xiang put on gloves, and began to learn the needle pricking process of the system NPC step by step.

……

"Leader, this is Gu Lao from the imperial capital, a member of the health care team." President Chen of the Second Affiliated Hospital and the leaders of the city introduced.

I happened to meet this person, although he is not an emergency intensive care person, but the name of the health care team is loud enough.

The patient could not be saved, and Dean Chen just wanted to tell the leaders in all ways that it was not that the hospital was not dedicated, but that the injury was too serious.

Of course, Dean Chen knew how many consequences there were for the death of three people.