Whether the boy really understands, Li Xiyang doesn't know.

But the only one who could save that woman at the moment was him.

Let's hope he can do it!

Zheng Xiaoyu was still a little worried, and instructed the little nurse in the ward to focus on monitoring and report as soon as there was a situation.

After solving this matter, the two went back to the office together.

Li Xiyang is on the night shift today, and while he is not busy at this time, he hurriedly made up the cases.

……

At 9 o'clock in the evening, Li Xiyang was ready to go to the ward round.

At this time, the mobile phone rang, and it was Dr. Huang Ping calling.

"What's wrong, Dr. Huang?"

On the other end of the phone, Huang Ping's voice was very urgent, "Doctor Li, help!" ”

Li Xiyang's expression was solemn, "What's wrong?" ”

Huang Ping said anxiously, "The patient who was suspected of poisoning just sent in, because he was unconscious, he did not support gastric lavage, I have tried to induce vomiting, but the effect is not good."

The patient's heart rate has just plummeted, and he can't hold on! ”

Li Xiyang didn't see the patient, so it was difficult to judge for the time being.

However, according to Huang Ping, it is likely to be pyloric obstruction with a large amount of gastric retention.

If this continues, it will be life-threatening.

So Li Xiyang said quickly, "Where are you?" Is there a gastric lavage room on the third floor? ”

"Yes!"

"Okay, I'll go over immediately, you first prepare 37 degrees of warm boiled water, warm normal saline, 1:5000 potassium permanganate solution, 2% sodium bicarbonate solution."

"Good!"

"Wait a minute, there is also a supine position, close to the bedside, the head is tilted, and the rubber cloth and treatment towel are placed on the neck, back of the shoulders, under the jaw, and on the chest."

Li Xiyang ran to the elevator and quickly gave instructions.

……

When he arrived at the gastric lavage room, Li Xiyang saw Huang Pingzheng fiddling with the patient on the gurney with the nurse, and tried to adjust him to the position ordered by Li Xiyang on the phone.

But because the patient did not cooperate, several people got started together.

Several people were sweating profusely, which caused the patient to lie flat on his back and tilt his head.

Li Xiyang stepped forward, "How's it going?" ”

Huang Ping looked back at Li Xiyang, and then looked at the monitor on the side, "Fortunately, with you, my heart rate has just stabilized." ”

Li Xiyang nodded and asked, "Have you checked the contents?" ”

When the poisoning substance is unknown, a small amount of gastric contents should be taken and sent for testing.

Huang Ping nodded, but there was no result yet.

However, the patient was already ventricular fibrillation when he was first delivered, and the situation was urgent, so he directly induced vomiting, but the effect was not good.

Huang Ping spoke, and Li Xiyang had already done a general examination for the patient.

It is indeed a symptom of poisoning,

Let's wash the stomach!

At this time, the things that Li Xiyang wanted were also ready, and Li Xiyang first took the rubber cloth and spread it on the neck, back of the shoulders, under the chin, and on the chest.

Then reach out and get ready to take the stomach tube.

But Huang Ping shook his head and said, "This patient doesn't cooperate, I'm afraid it's difficult to operate." ”

Li Xiyang lowered his head to look at the patient, and suddenly noticed that the patient's nose was red.

Apparently previous attempts at intubation were unsuccessful.

In particular, the patient's nasal wing is narrow, and the narrowness is somewhat unreasonable.

I touched it and found that this person had made a nose and narrowed the wings of his nose.

At the moment, this adult model of gastric tube is indeed difficult to insert.

After thinking for a moment, Li Xiyang said, "Change to a pediatric urinary catheter." ”

Huang Ping's eyes lit up, this is a good idea.

"But I'm afraid the length of the urinary catheter is not enough!"

Li Xiyang smiled, "This is simple, use two sections of hospital to explain the connection to extend the length." ”

Huang Ping nodded, "Xiao Li, it has to be you!" ”

Soon, Huang Ping found a pediatric urinary catheter and a medical glue connection, and the problems of thickness and length were solved.

Li Xiyang picked up one end and inserted it into the patient's nose smoothly with the filigree tube insertion method.

Because the children's urinary catheter is relatively thin, Li Xiyang motioned to Huang Ping to press the point on the wing of his nose with one hand.

Soon, the catheter was successfully entered into the stomach.

"Prepare 300 ml of injections and gastric lavage."

Li Xiyang spoke, and the little nurse hurried to prepare.

Then he took the syringe handed by the nurse and injected the gastric lavage with a needle along the catheter interface on the other side.

After half a minute of safe injection, Li Xiyang held the needle in his hand and clearly felt a gust of air resistance.

He subconsciously looked towards the other end of the catheter, only to see a small opening bulging on one side of the interface, and gastric lavage gradually penetrated out of the interface of the medical tape.

Li Xiyang hurriedly asked people to strengthen the catheter, but no gastric juice came out.

Li Xiyang frowned, it should be because the urinary catheter is too thin and the air pressure is too small.

"Let's pull it out first!"

If the pressure is continued, it will cause impact trauma to the patient's respiratory tract.

There is no choice but to withdraw the catheter from the patient's nostrils first.

"Dr. Li, what now?"

Huang Ping noticed that the patient's heart rate decreased again, and he immediately became anxious.

Li Xiyang thought for a while and said, "Prepare the opener and tongue tongs." ”

Hearing these two things, Huang Ping instantly understood that Li Xiyang was planning to insert a catheter from his mouth.

Thinking of this, Huang Ping hurriedly went to prepare.

Soon, the gastric lavage tube was reinstalled,

Li Xiyang supported the patient's mandible with one hand, and took the opener with the other hand, forcing the patient's mouth to open.

Then Huang Ping cooperated on the other side and gently pulled out the patient's tongue with tongue forceps,

"Gastric lavage funnel!"

Li Xiyang opened his mouth, and the little nurse on the side hurriedly handed it over.

Li Xiyang took the funnel and slowly inserted it into the patient's throat, and then inserted the gastric lavage tube into the stomach little by little.

During the process pay attention to raise the gastric lavage funnel, which should be 30 to 40 cm above the mouth at a height,

Slowly pour 500 ml of gastric lavage into the funnel, and when it is about to finish, raise your hand to place the funnel below the stomach level.

In this way, the liquid in the stomach can be drained out by siphoning through the funnel.

In the process, he encountered several poor drainage, and whenever this happened, Li Xiyang pinched the ball with his hand to strengthen the siphon to drain outward.

If the perfusion speed is too slow, he will pinch the ball with his hand to speed up the perfusion.

Gastric lavage is not a surgery, but there are a lot of details that need to be paid attention to.

First of all, gastric lavage is mostly used for acute poisoning, and it is required to highlight the word "fast".

Because delaying time will increase the absorption of poisons, which will threaten lives, so it is necessary to buy time, and every second counts.

As a general principle, gastric lavage is most effective within 4~6 hours after taking poison. However, some patients present for more than 6 hours and may still consider gastric lavage.

For example, the patient's gastrointestinal function is poor, so that the poison stays in the stomach for a long time; Or some poisons are absorbed slowly, such as the poison itself with a capsule shell, etc.

In addition, the catheter inserted into the stomach should be gentle, agile and skillful, and the lavage should be started only after confirming that the catheter has entered the stomach, and the catheter should not be mistakenly inserted into the respiratory tract for lavage.

Severe cough, tachypnea, or cyanosis during catheter placement indicate misentry into the airway and should be quickly withdrawn and reintubated.

Patients who are comatose and intubated with vomiting are susceptible to aspiration pneumonia and should be vigilant for prevention.

In addition, gastric lavage is most commonly used in warm boiled water, which is effective and safe, and 2% sodium bicarbonate solution is often used for organophosphorus pesticide poisoning, but it should be noted that it should not be used for trichlorfon, salicylate and strong acid poisoning;

In addition, 1:5000 potassium permanganate solution has oxidative and detoxifying effects on alkaloids and muscarinic substances, but it is forbidden to be used for gastric lavage in parathion poisoners.

Therefore, the choice of gastric lavage should be considered according to the different poisons.

The most important thing to note is that gastric lavage for strong corrosive poisons will cause certain damage, and it may cause perforation during intubation, which is generally not suitable for gastric lavage, and it is easy to cause gastric perforation and tear when a large amount of liquid enters.

In particular, intubation of comatose patients can easily lead to aspiration pneumonia, gastric lavage should be cautious, and gastric lavage should be done to lie flat on the pillow with the head tilted to one side to prevent and prevent aspiration and cause asphyxia.

In this way, repeated perfusion and aspiration, the gastric juice flowing out of the catheter slowly became clear.

Finally, it is similar to the gastric lavage in a transparent package.

At this point, gastric lavage is considered to be successfully completed.