Nine forty p.m.

Emergency Department.

As the saying goes, emergency rescue is like fighting fire, after receiving the report from the resident doctor, Liu Ziang immediately pulled Zhao Heng and rushed from the brain surgery department to the emergency department.

Why did Liu Ziang pull Zhao Heng, on the one hand, it was a joke, and on the other hand, of course, it was because Zhao Heng was a doctor with extremely high professional and psychological qualities, especially in emergency treatment, the level was even more extraordinary.

When Zhao Heng and Liu Ziang arrived at the emergency room, the patient was already lying in the emergency room, with an endotracheal tube inserted, and all aspects of blood pressure and heart rate were monitored.

As soon as the two entered the emergency room, the attending doctor Li Yang immediately greeted them, and Li Yang was a little surprised to see Zhao Heng and Liu Ziang appear together.

Just over a month ago, Li Yang thought that it would be good if a young doctor like Zhao Heng, who had a solid foundation, could win the assistant director and come to the emergency department.

What Li Yang didn't expect was that the world was changing too fast, and it was only a little more than a month, and Zhao Heng's rapid ascension to the throne made everyone who knew him before feel caught off guard.

This will already be mixed with an old man like Liu Ziang.

"How's the patient doing?"

Liu Ziang asked in a deep voice.

As soon as he heard that it was an acute head injury, Liu Ziang didn't dare to delay, and pulled Zhao Heng to come.

"The patient is a 60-year-old man who was in a severe car accident, suffered acute mechanical trauma, severely damaged his head, had a history of hypertension, breathed 6 breaths per minute, and had a blood pressure of 80/60 mmHg. Suspected subarachnoid hemorrhage with skull plate fracture. ”

Li Yang quickly and professionally introduced the patient's condition.

It can be said that this patient's condition is indeed critical, and there is almost a breath left.

"Subarachnoid hemorrhage? Skull plate fracture? ”

Hearing Li Yang's words, Liu Ziang touched his chin and fell into a short thought.

If the patient has a history of hypertension, it is likely that the acute trauma will cause a sharp increase in blood pressure, causing cerebral blood vessel rupture and hemorrhage.

However, it is also possible that the skull plate fracture has damaged the blood vessels and caused bleeding, and I am afraid that the specific situation can only be known after the acute craniotomy is performed and the skull is opened.

"It seems that a craniotomy is necessary, junior, and the anesthesia will be handed over to you."

After a short thought, Liu Ziang made a surgical plan, he turned around, patted Zhao Heng's shoulder and said.

"Okay."

Zhao Heng readily agreed, the patient in front of him almost only had one breath left, not only the risk of surgery is very high, it is very likely that he will not be able to get off the operating table, and the risk of anesthesia is also very great.

Liu Ziang handed over this matter to him, which is also his trust and recognition.

Although he didn't know why Liu Ziang and Zhao Heng appeared together, Li Yang was still shocked when he saw Liu Ziang hand over the anesthesia of such a critically ill patient to Zhao Heng.

Li Yang knew very well that Liu Ziang's level was unfathomable, if it weren't for Zhao Heng's ability to anesthetize such a critically ill patient, he would not have handed it over to Zhao Heng.

That's it, Li Yang was also shocked by the rapid improvement of Zhao Heng's level.

Next, Liu Ziang and Zhao Heng introduced the patient's condition to the family and explained the risks of the operation.

Although the patient's family felt grief, seeing the patient who only had one breath left, it also indicated that they could accept the risk and signed the preoperative informed consent form.

Once the preparations are made, the patient is quickly sent to the operating room and the emergency surgery is about to begin.

Zhao Heng first came to the operating room to prepare, and as soon as he entered the operating room, Tian Zhen, the instrument nurse, looked at Zhao Heng in surprise.

At this point, didn't Zhao Heng get off work a long time ago? Why did you come back into the operating room?

"Aren't you off work?"

Tian Zhen asked with some confusion.

"Don't talk about it, I was arrested by Director Liu."

Zhao Heng said helplessly, with the situation of this patient, it seems that he will be busy until at least three or four o'clock in the morning.

"That's why he looked for you because of your ability."

Tian Zhen smiled and said.

"Don't talk about this, immediately prepare sufentanil and cis-atracurium besylate, as well as propofol, the amount should be sufficient."

Zhao Heng shook his head slightly, signaling that he didn't want to say why he was arrested by Liu Ziang, but quickly gave instructions to Tian Zhen.

"yes, okay."

Tian Zhen did not hesitate at all, she and Zhao Heng cooperated very tacitly, which was reflected in the previous surgical cooperation.

Zhao Heng was preparing for surgical anesthesia, and after a while, the patient was pushed to the operating room.

As soon as the patient was sent in, Zhao Heng immediately transferred the patient to machine-controlled breathing with Tian Zhen's cooperation, and put on ECG monitoring.

He has done a lot of surgery, but it is the first time he has seen the anesthesiologist and the instrument nurse cooperate so well and have such a tacit understanding.

After making these preparations, Zhao Heng began to examine the patient for preoperative anesthesia.

"The patient's left pale hole has become dilated, and the light reflex is gone."

After checking the patient's signs, Zhao Heng said to Liu Ziang very solemnly.

The child's hole is enlarged and the light reflex is lost, indicating that the patient's oculomotor nerve or midbrain injury is damaged, either way, indicating that the patient is dying and dying.

"I can only give it a go."

Liu Ziang nodded and said in a deep voice.

This situation, in brain surgery, Liu Ziang is not the first time to see it, and the first time to deal with it.

"Let's start, sufentanil 20 mcg, cis-atracurium besylate 10 mg, propofol 80 mg intravenously induced, do it immediately!"

Zhao Heng quickly said to Sun Meng, a roving nurse who was already in place standing on the side.

The roving nurse was not in place just now, so it was the instrument nurse Tian Zhen who gave Zhao Heng a hand, and now that the itinerant nurse is in place, then Tian Zhen has to concentrate on preparing the surgical instruments.

In the operating room, the division of labor is clear.

"Okay."

Sun Meng immediately responded and began to implement Zhao Heng's instructions.

Next, Zhao Heng did invasive blood pressure monitoring for right internal jugular vein puncture and catheterization for right radial artery, and also set up an autologous blood recovery machine.

Seeing Zhao Heng's series of chaotic, fast, accurate and orderly operations, Liu Ziang couldn't help but nod and looked at Zhao Heng with great appreciation.

In his opinion, this series of complex operations, in the entire East Hospital, I am afraid that only Zhao Heng can do it so cleanly.

If the anesthesia is done well, the surgeon will have a bottom in his heart, which are all complementary to each other.

Ten minutes later, the roving nurse Sun Meng said, "Dr. Zhao, blood pressure is 125/60mmHg. ”

"Well, norepinephrine 0.4 mg IV."

Zhao Heng nodded, the patient's blood pressure was pulled back, so it was necessary to continue to maintain it, which was a prerequisite for surgery.

After another ten minutes, Sun Meng said again: "The blood pressure is 140/70mmHg, and the partial pressure of carbon dioxide at the end of breath is 34. ”

Hearing Sun Meng's report, Zhao Heng nodded and said to Liu Ziang, "It's time to start the operation." ”

"Okay, let's get started."

Liu Ziang nodded and said to Xiao Sun, a resident doctor who was already waiting on the side.

Doctor: I'm picking up properties at the hospital.

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