I invited a doctor from the anesthesiology department to perform a central venous catheter because the mother-in-law of the head of Ouyang District was too seriously injured at that time - after severe burns, a large amount of water in the patient's blood was lost, causing all the veins to collapse, and even the central veins collapsed. It's not that Zhou Jun can't do it, but he is worried that if he fails to do it himself, it may lead to slow rescue progress, and on the other hand, it is not too easy for the anesthesiology department to do this kind of surgery.

Although from the name, the concept of "anesthesiologist" is still stuck in "they are dispensing anesthetics". But in the modern medical system, the work of anesthesiologists in the operating room is almost equivalent to an entire ICU team. It's just that the anesthesiologist needs to think about how to maintain the patient's vital signs under anesthesia, bleeding, and surgery. It can be said that they do not work too long hours (compared to ICU doctors), but at the same time the situations that need to be dealt with and the challenges they face are the greatest.

Because the challenge is huge, the technology is high. But now this patient ...... The challenge is not too difficult. At least so far, Zhou Jun is sure to complete the tube burial operation.

Even if the other person has no blood pressure at all, it can be detected.

The fifth defibrillation has been completed, and the sixth defibrillation has not yet begun. The minute or so in between is the only chance to bury the tube. Although the patient's body is constantly rising and falling under chest compressions, in order to save the other person's life, this chest compressions must not be stopped. Even if you have to stop and make a substitution, you must not take more than five seconds.

"No ultrasound. Zhou Jun was already standing on the top of the patient's head, and the nurse on the side had disinfected the patient's skin in advance, while Zhou Jun said to his colleagues on the side, "You can press as usual, and the intensity will be consistent." ”

The thick needle was pierced into the jugular vein by Zhou Jun's fingers as soon as he moved, and the blood return was normal, which is the so-called hitting the needle. Then the skin expander, which had been pinched by Zhou Jun in his hand, was pressed against the skin of Wang Baoguo's neck along the guide wire. Zhou Jun poked hard with his right hand, and the skin expansion was completed.

The speed of the guidewire into the blood vessel should not be too fast, otherwise it is easy to cause knots or scratch the blood vessel wall due to the physical characteristics of the guidewire itself. But again, the burial must be done quickly. Otherwise, the next time he defibrillates, Zhou Jun can only choose to let go and let the patient receive the electric shock. The catheter is completely unattainable, which can have serious consequences.

In two minutes, the central venous catheter is completed in a patient with no blood pressure who has a fluctuating body, and there is no ultrasound guidance, which is really difficult and frightening.

"The catheter is inserted. Just when Sun Lien was nervously counting the time, Zhou Jun had already stretched out his hand to the nurse, "Bring the needle holder and the leather needle." ”

A total of fifty-eight seconds passed from the time Zhou Jun started the operation until he asked for the leather needle to be sutured.

After Zhou Jun completed the sutures in 14 seconds and tested that the catheter could work smoothly, the doctors who were watching couldn't help but let out an exclamation. There are not many things that can amaze the emergency doctor, but completing a non-ultrasound-guided intravenous catheter in the neck of a cardiac arrest patient undergoing chest compressions in one minute and twelve seconds is definitely one of them.

This can even be called "godlike".

"Keep pressing. Zhou Jun took two steps back, watched the nurses connect and maintain the central venous catheter, and said to the doctors who were exclaiming, "If you are not tired, then come and line up to continue chest compressions." ”

As soon as he said this, Wang Baoguo, who was receiving chest compressions, suddenly made a crisp sound of "click" on his chest. Sun Lien looked at it, and a new prompt was immediately updated in the status bar "Fracture of the fifth rib on the right side (00.00.01)".

"Director Zhou......" It was Dr. Cao Yanhua who was pressing, and he said intermittently while pressing, "Maybe...... Broke a rib. ”

"Go on. Zhou Jun frowned and leaned over, groping in the patient's chest under Cao Yanhua's body, "There's no way to press it, keep the rhythm and depth, don't worry about the rest." ”

"I'm worried about ......," Cao Yanhua continued, "don't fucking have an open fracture, if you pierce the alveoli, it will be troublesome." ”

"You're not Guo Yulai. Zhou Jun patted Cao Yanhua on the body, "Don't worry, let's have another group, I'll take over." ”

Sun Lien held the defibrillation board in his hand, and after hearing the prompt sound after the machine was ready, he immediately raised the defibrillation board in his hand and said, "Charging is complete, 160 coules, flash away!"

Zhou Jun, who had just taken over more than a dozen compressions, immediately jumped off the stretcher bed, and Sun Lien quickly pressed the defibrillation button on his hand after confirming that there was no contact with other medical staff at the bedside.

The life-saving sixth defibrillation was issued, with an energy of up to 160 joules of electricity gushing out of the patient's collarbone, causing all of his heart muscle to stop moving, and then entering the second defibrillator board, which was placed at the tip of his heart. Immediately afterward, he entered his body again through the second defibrillator and escaped through the defibrillator at his collarbone.

Two electric shocks with almost no delay stopped all of his heart muscles, and then he was running in an orderly manner again.

Defibrillation effects are evaluated during post-defibrillation compressions. Wang Baoguo is no exception. Zhou Jun went up and did two more sets of compressions before being stopped by the other doctors, who had already seen sinus rhythm appear.

Wang Baoguo's fate was temporarily dragged back.

"Lien, you go and take care of the wound on your arm. Zhou Jun gasped, and the hair on his head was messy. He wiped the sweat from his forehead and said to Sun Lien, "There are too many patients outside, you work hard, and when the injury is dealt with, you will go to the outpatient clinic as soon as you can deal with the injury." ”

Sun Lien nodded, he didn't feel that the injury on his arm was so serious that he needed to rest by himself. However, under the treatment of Wang Baohe and the doctor, Sun Lien saw for the first time how serious the injury to his arm was.

After the blood stain was washed away by normal saline, a five-centimeter-long wound appeared hideously in front of Sun Lien. The depth of the wound is not shallow, at least a centimeter or two. After the skin was pulled apart by its own tension, the skin at the edge of the wound showed an unhealthy grayish white, and Sun Lien could even see yellow granular fat in his own wound.

"That's not a small mouth. Dr. Wang sighed, took a procaine from the tray next to him and said, "You need stitches." I'll give you a little less anesthesia first. ”

"Come on, less. Sun Lien sighed, the dose of local anesthesia is too large, which may cause a certain degree of interference to people's thinking. And the inability to keep the mind sharp is a big taboo in the work process. Although it will hurt, it is better than being groggy and eventually leading to a misdiagnosis.

One bottle of procaine is two milliliters, while Dr. Wang injected less than one milliliter of Sun Lien. It is painful to infiltrate a small amount of anesthetic drugs, but this pain is more painful than suturing without complete anesthesia...... It's simply weak and vulnerable. Sun Lien called for a long time before completing the stitching.

"I gave you six stitches. "Because the anesthesia is incomplete, in the process of trimming the wound and suturing it, Wang Baohe can save money. The five-centimeter wound was stitched with six stitches, all of which were closed with simple intermittent sutures. "You wound...... You may have to scar later. Why don't you come back after work today and I'll sew it for you again?"

"Then I'll wait until I get off work. Sun Lien smiled bitterly in a hoarse voice, "When the time comes, you have to give me more anesthetic...... It hurts me to death. ”

The clothes Sun Lien was wearing had been completely wet with sweat, and there were a lot of blood stains on them. He reluctantly walked to the lounge, and after looking for a long time, he found a clean wash gown to wear on his body, and then put on Xiao Guo's white coat and walked out of the rescue room again.

"Li Huizhen, patient Li Huizhen, please come to the ninth consultation room. "The announcement began to play in the rescue hall. Sun Lien's ninth clinic is up and running.