Rescue had no effect.

Sun Lien was sweating profusely against the wall next to him, feeling as if his legs had been completely hollowed out by something - there seemed to be no bones in them.

The status bar is still faithfully traveling its duties, but this time is different from the past, on Huang Bingxian's status bar, the number of prompts followed by the state of "ventricular fibrillation" is (there are ???? times before defibrillation is successfully lifted).

Continuous chest compressions and defibrillation have been performed for more than thirty minutes, with 30 mg of epinephrine administered along with atropine and continuous chest compressions. Even lidocaine was injected with 30 ml.

But the number of prompts still maintained the state of "????", and there was no wavering at all.

But the rescue that lasted for half an hour still did not stop, and two minutes after Huang Bingxian's ventricular fibrillation attack, Sun Lien gave instructions to use amiodarone, and after 150 mg of amiodarone intravenously, the theoretical onset time was about 30 minutes.

If amiodarone doesn't work, there's really no way around it.

During the rescue process, the use of epinephrine in large doses is originally a reverse indicator. The more epinephrine used in the rescue process, the worse the patient's prognosis. But it is obviously impossible to use epinephrine - as a first-line rescue drug to dilate blood vessels and reduce peripheral vascular resistance, epinephrine plays a very important role in the rescue of ventricular fibrillation.

However, the same is adrenaline, norepinephrine and isoproterenol have a completely different effect from adrenaline...... Well, this is estimated to be tested when practicing medicine. Sun Lien was a little surprised that he could still consider the difference between these three drugs now. He sat on the ground with an extremely complicated mood, watching Yuan Ping'an and Brune continue to rescue.

Norepinephrine is generally used to strongly constrict blood vessels, rapidly raise blood pressure and reduce blood flow to vital organs. Therefore, the most common application scenario is to rescue patients with hemorrhagic shock - intravenous administration is required, although in extreme cases intravenous bolus can also be given, but it is extremely risky and generally does not operate this way. Isoproterenol is commonly used to relieve asthma and relax bronchial smooth muscle, and is mainly given by aerosol or sublingual administration......

Sun Lien looked at Huang Bingxian's hospital bed in a daze, Brune had already done three rounds of chest compressions, and the next one to take over was Dr. Pascal.

"No......" Dr. Pascal did two rounds of chest compressions, and it was Yuan Ping'an's turn to get started again. Sun Lien slowly stood up and looked at the cardiopulmonary monitor that showed a straight line, "It's useless." ”

"The time of death, 3:21 p.m. on January 3. Xu Yourong glanced at the wall clock in the rescue room, "Pull the ECG." ”

Although everyone expected Huang Bingxian's death, his ventricular fibrillation happened a little too suddenly. There was not even a hint of an abnormal electrocardiogram. Moreover, the ventricular fibrillation attack was extremely stubborn, from the onset of ventricular fibrillation at 2:45 minutes to the declaration of death at 3:21, during more than half an hour of rescue, Sun Lien and the doctors of the entire treatment team did not even have a chance to successfully restore sinus rhythm.

In general, other patients can restore sinus rhythm somewhat after timely medication and electrical defibrillation after the onset of ventricular fibrillation. Some may be defibrillated enough to support doctors in treating the condition that caused ventricular fibrillation, while others may have another ventricular fibrillation attack without waiting for treatment or even diagnosis.

But Huang Bingxian's ventricular fibrillation attack was a little too resolute, it was 30 milligrams of epinephrine, 30 consecutive defibrillations. Even if it's a rock, so much adrenaline into it, it's time to move.

"I'll leave the rest to the medical examiner. Dr. Brunn walked up to Sun and sat down on the ground next to him. The Texan bumped Sun Lien on the shoulder, "Your physical fitness is too weak." ”

"My wounds aren't healed yet. Sun Lien glared at Brunn, "Your skills are too bad." ”

Dr. Pascal reached out and dragged Sun Lien up from the ground, and then sympathized, "You shouldn't let him do it, even if you find an intern to sew it more carefully than him!"

Sun Lien nodded seriously, "At least the intern won't pat it with his hands after sewing up the wound." ”

"Hey!" Dr. Brunn was annoyed, "I've stitched it up very carefully!

Sun Lien laughed, "Then suture and charge me a thousand yuan at a time? ”

Suture staples have a more civilized name - disposable skin staplers. However, doctors still like to call it "staples". And the reason why doctors do this is very simple, the name of the staple is more intuitive. Although expensive, disposable skin staplers do work similarly to staplers. By pressing, sterile titanium nails puncture the skin and pull the skin on both sides tightly and close. It is easy and quick to operate, and most importantly, when dealing with relatively large wounds, staplers are much less troublesome than sutures.

Zhou Jun stitches five stitches on a patient, which takes about a minute. The stapler takes about two minutes. In the case of smaller wounds, doctors actually stitch faster. But if Zhou Jun wanted to stitch up the seventeen stitches on Sun Lien's body, it would take at least ten minutes. Because when manually suturing with multiple needles, not only should the suture technique be considered, but also the tension of the suture should be constantly adjusted to ensure that the wounds on both sides have enough tension to be combined. If the pull is too small, the wound will not heal, and if the pull is too great, it will leave a centipede-like scar.

The stapler sutures seventeen times in a row, which takes about five minutes. And since each titanium nail is independent of each other, and the tensile force provided is constant. Therefore, the probability of severe scarring is also lower - if the stapler that can be used once for 1,000 yuan does not work well, then no one will use it.

"You internists, you're so ignorant. Dr. Brunn muttered, "It only took me 20 minutes to get seventeen stitches by hand on my chest and abdomen, and there was no need to withdraw the stitches or fail in between!"

Sun Lien blinked, and decided not to use Zhou Jun to fight Brune - after working in Ningyuan for a year, Brunn's stitching speed would definitely become much faster.

The number of patients in China's large hospitals is much higher than in the United States.

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In large emergency center hospitals, there is always no shortage of trauma patients of all kinds.

It was as if a knife had been stabbed in the Fourth Courtyard today, and since half past four in the afternoon, on average, every thirty minutes or less, at least one unlucky ghost hurried to the Fourth Courtyard with his head or arm or something else. In two hours, there were eight scalp tears and cuts alone. The cleaning aunts of the property wiped the floor at a speed that could not even keep up with the speed at which the floor was stained with blood.

"I just complained that there were so few patients who needed stitches. Dr. Bruun stretched his arm with difficulty, trying to relieve the pain caused by the cramps in his fingers, "There's no need to bring so many people at once, right?"

Sun Lien didn't reply, "When you get off work, Lao Bu, you go to find Dr. Cao Yanhua." ”

"Dr. Cao?" Brunn asked, frowning, "what are you looking for him?"

"Go to him for an emergency education – never be too easy. After Sun Lien completed the last stitches, he put down the arm in front of him and said to the owner of the arm, "It's okay, remember not to let the wound get wet, don't move too much, and from tomorrow onwards, come to the hospital every day to change dressings." Lasts a week. ”

The young man looked at his arm very depressedly and asked, "What if the clinic is closed?"

"If you don't want to toss, it's okay to go to your community hospital to change your dressing. Sun Lien lowered his head again and again to prescribe medicine, and instructed over and over again, "If you have to come to the fourth hospital to change the medicine, then you can come to the emergency department during the outpatient vacation." However, the emergency department cannot be handled in order, and you may have to wait a while if you come to change the dressing. ”

"You know, the emergency department has to deal with the critical illness first. The young man sighed, put on his clothes and left, "Thank you, doctor." ”

"Alright, I don't see any more patients at the door who need to be debrided. Yuan Ping'an took off the gloves on his hand and squinted at Dr. Brunn, "Lao Bu, I beg you, don't talk nonsense about some things." ”

Dr. Brune was confused, "What did I say? I mean the patient who needs stitches recently......" Before he finished speaking, Yuan Ping'an directly blocked his mouth with his hand, "That's it, that's it!"

"A little less. Brunn still mumbled the last few words, "What's the matter? I'm telling the truth!"

Yuan Ping'an covered his face in pain, "Brunn, your uncle!"

"Jingle bell!" The phone at the duty desk rang suddenly, and Xu Yourong picked up the phone, "The rescue room of the Fourth Hospital." ”

"Got it. After a short silence, Xu Yourong hung up the phone, "Ningyuan 120 forecast, a male patient, steel bars inserted from the thigh, stabbed out of the left shoulder, and served in 15 minutes. ”

After a brief silence in the emergency room, many doctors fell silent, and then a sentence burst out neatly, "Brune, your uncle!"

Brune, who was scolded, scratched his head, "Such an evil sect?"

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This kind of prediction of severe trauma patients means that the entire emergency room will have to be busy. No, it's not just the emergency room, orthopedics, general surgery, hepatobiliary surgery, blood transfusion medicine, imaging, and even thoracic and neurosurgery can't run. The specific departments that will be busy mainly depend on how many organs the patient who has been pierced by steel bars has injured.

It's not that the Fourth Hospital hasn't been in contact with such patients before, but it's just like the intuitive feeling of ordinary people - this situation is dangerous. Piercing through the right leg and exiting the left shoulder means that almost all organs in the abdominal cavity can be injured. At the same time, the spine, aortic aortic veins, and even the respiratory system, including the diaphragm, can be damaged.

And the fifteen minutes of the advance forecast are the best time left for Sun Lien and them to call for support.

Hey, Brother Pheasant, Dongxing's rotten boy has made a big deal!