All kinds of pipelines have been replaced with new ones under the quick action of medical staff, which has eliminated the occasional problem of pipelines to the greatest extent.

The rescue drug has entered the patient's body, and the rescue is being carried out in an orderly manner. There is enough time, Wu Mian has his own judgment.

However, the words of patience put more pressure on the anesthesiologist.

The background "music" is that various instruments are alarming, radial artery puncture is invasive to monitor blood pressure, and the values displayed on the screen are constantly fluctuating, and although the cliff decline is stopped under the effect of large doses of rescue drugs, it can only be maintained at a very low value.

The anesthesiologist was already wet with sweat, and kept tilting a slight angle to the side and back in a weird posture, and a nurse wiped his sweat. But his eyes didn't dare to leave the B-ultrasound screen for a second, and he meticulously executed every word of the unknown teacher behind him.

Although I don't know who the person behind me is, I didn't rush in various professional words and rescue sequences, especially at the beginning, but first made a differential diagnosis and found a correct path, so that anesthesiologist Ren Haitao felt more confident.

It's definitely a big bull, otherwise who would dare to do this. Although there is a big bull directing the rescue, Ren Haitao is not sure that the rescue can be successful.

Just give it your all, he's really doing his best. Anesthesiologists are professionally sensitive, and they subconsciously have to look at them when they hear alarms from monitors, ventilators, and other instruments.

But he knew where his responsibility was.

"The maximum and minimum diameters of the Sono Acoustic Phased Array probe P21, in M mode, are placed approximately 2 cm from the right atrium-inferior vena cava junction. ”

"The IVC is distinctly slender and < 1 cm in diameter, suggesting volume depletion and volume reactivity. ”

Anesthesiologists are nervous, and generally doing this will have a rather complicated calculation formula.

Mechanically ventilated respiratory variability – IVC inspiratory dilation rate = (IVC max-IVCmin)/IVC min. Usually let yourself do the math, and it takes at least 2 or 3 minutes to hold a pen and paper.

Now, 2 or 3 minutes can mean the difference between life and death for a patient.

Quite a complex calculation formula, quite a cumbersome calculation process, quite ...... Thinking of this formula, Ren Haitao had a headache.

This is not the college entrance examination, but it is more difficult than the last big question of the college entrance examination, which is countless times more difficult.

However, the voice of the big bull behind him did not say any value, but continued after adjusting the infusion amount.

The anesthesiologist was slightly stunned, he didn't think that the calm and calm command of the rescue bull behind him didn't even know this formula, and the various remote controls before proved that he had studied e-FAST very deeply.

It must be the big cow who calculated the result, and the infusion guided by this result is in ...... The anesthesiologist was only stunned for a moment, and Wu Mian's voice behind him became stern, poking at Ren Haitao's back like a knife.

"Anesthesiologist, concentrate!"

He didn't scold, but the anesthesiologist felt that he was more scared than he was scolding himself.

Under the pressure of the technical level, the anesthesiologist has developed an emotion called fear in his heart.

"The probe is placed at the apex, 1~2cm medial to the midclavicular line of the 5th intercostal space on the left side, slightly tilted upward, and the direction sign points to the patient's left shoulder. ”

"Slide...... The probe is placed on the long axis of the left ventricle parasternal and slides the probe toward the apex. Well, well done. ”

"Pay attention to the interventricular septum, pay attention!"

"When the ventricular septum has just disappeared, rotate the probe 90 degrees clockwise...... Turn!"

"Press the tip of the probe down slightly and tilt the probe so that the ultrasound beam is directed towards the right shoulder. Yes, that's all. ”

The ultrasound probe is constantly moving back and forth between the heart and the inferior vena cava, and the infusion sequence is carefully adjusted according to the images provided by the ultrasound.

Under the guidance of cardiac B-ultrasound, a large number of rapid expansion, the colloidal fluid was changed to succinyl gelatin, and crystals were interspersed in the middle. Elevate the lower limbs by 15° to increase the amount of blood returning to the heart in position.

Sometimes the crystals are given at full speed, sometimes the gel behind is advanced, and sometimes the infusion speed is reduced.

At first, there were people who pondered and thought about it, such as the anesthesiologist who was being rescued.

Soon, everyone's thinking couldn't keep up with Wu Mian's speed, and it was too late to do it with all their might, let alone think.

Everyone turned into puppets, at the mercy of the hand behind them.

As time passed, the patient's precipitously falling blood pressure stabilized and slowly rose. The values gradually returned from critical values to the lower limit of the normal level.

Lactate was measured 3 times, KCl4g and calcium gluconate were pumped, and 250ml of sodium bicarbonate was instilled intravenously to correct body acidosis and electrolyte balance disorders.

I don't know how long it has passed, but the urging voice gradually weakens.

1 second ......

10 seconds......

60 seconds......

The clear command voice did not appear, and some people thought in a trance, was the rescue successful?

Something impossible is happening right in front of your eyes, no matter how real it is, it can make people feel unbelievable.

2 minutes ......

5 minutes ......

"Teacher Wu......"

"Prepare to give mannitol. ”

Director Xu and Wu Mian of the anesthesiology department said at the same time.

"......" Director Xu of the anesthesiology department buzzed in his head.

The patient's blood pressure returned to 70/45 mm Hg, which was considered a temporary escape from a fatal state of shock. In Director Xu's view, at this time, he will accept the patient and send the patient to the ICU for recuperation for a few days.

The next troublesome thing is how to explain to the patient's family and strive for the understanding of the patient's family.

This kind of shock that comes and goes without a trace, no one wants to be not.

But Mr. Wu Mian actually gave mannitol!

Mannitol is a very common and commonly used drug that is a good diuretic, reducing intracranial pressure, intraocular pressure and treating kidney medicines, dehydration drugs, sugar substitutes, and also used as an excipient for tablets and a solid and liquid diluent.

The patient is still in a state of shock, so he should be in a hurry to give mannitol, what if he can't control the shock?

But blaming Teacher Wu Mian's doctor's order in person, Director Xu can't do this kind of thing.

It's not that I can't, but I don't dare.

Not to mention Wu Mian's previous series of glorious history, but also to say that the rescue process just now clearly tells everyone how strong this Teacher Wu is.

"Give it, I know it. Wu Mian smiled slightly and said, "Generally, patients with anaphylactic shock will be accompanied by complications of increased intracranial pressure, and if brain tissue edema is not controlled in time, there is a 2.23% chance that serious consequences will occur." ”

Severe consequences are brain death, and the patient becomes vegetative, which is well known.

But mannitol...... Low blood pressure...... Shock......

The combination of these contradictory terms makes people feel confused. Just after the rescue was successful, the patient got rid of the hypotensive state, what if it was given mannitol, what if he went into shock again?

"Teacher Wu, is 250ml enough?" Director Xu hesitated for a few seconds and asked in a low voice.