Song Junxing came out of the duty room and asked Lao Xie about the specific situation while putting on his white coat. After asking clearly, he pondered for a moment and then said: "Lao Xie, the reasons you analyzed are all right. Save Wang Chuyi first with the remaining bottles of blood." ――Since it is a queue and the condition is of the same level of criticality, the principle of first come, first rescue should still be followed. As for the injured person with suspected splenic rupture... Let the blood transfusion doctor prepare first, and if necessary, call all the patients present who meet the blood type Healthy people, including you and me, are ready to donate blood."
"Yes!" In fact, these measures are similar to what Lao Xie is already doing, but Xie Yao feels that it is best not to make the final decision on this kind of matter by himself, especially when there is a veteran among the people working with him.
Seeing Xie Yao walking to the emergency room, Song Junxing thought about it and followed him.
At this time, the nurse had helped summon several blood donors, and judging by their attire, they should all be stretcher bearers from the evacuation brigade of Fengchuan Field Hospital.
When the nurse saw them coming, she quickly stood up and said, "Chief Song, Director Xie."
Song Junxing waved his hand to stop talking nonsense: "Can we start?"
"This..." the nurse hesitated and said, "These are the blood donors now, but..."
"If you have any difficulties, please ask!"
"Well...the citrate and the empty bottles are not enough! The remaining blood bottles are only enough to collect three units of blood..."
Song Junxing was stunned: Is there a time when the stock is out of stock?
However, this is considered normal. The traffic in the quasi-security area is far less than that in the rear. In addition, during the martial law period, inspections are strengthened, which often leads to insufficient transportation capacity. Ammunition is sometimes tight, and shortages of medical supplies are common.
“Pick what you can first, and then wait until there is not enough!”
"yes!"
But this is only a stopgap measure. If laparotomy and spleen removal are required, three units of whole blood will probably not be enough - not enough citrate blood bottles mean that blood transfusion surgery is needed. Song Junxing immediately gave the order: "Prepare the equipment. Has the blood transfusion doctor notified you?"
"Chief, I remembered a problem... this surgery... is not easy to handle." Xie Yao suddenly thought of something and said while chewing his teeth.
"how?"
"We don't have a transfusion doctor today..."
"There is no blood transfusion doctor? What's going on?" Song Junxing was a little confused: "The regulations stipulate that the mobile field hospital should have more than two blood transfusion doctors. How come there are not?"
"The rule is that there should be more than two people." Xie Yao was a little helpless, "But now there are vacancies everywhere on the front line, and everyone is looking for people. After the adjustment a few days ago, Lao Li went back to lead the team to train new transfusion workers, and our team is the only one left. Xiao Huang, who fell down because of severe malaria yesterday..."
"Tsk..." Song Junxing frowned more and more, "What should I do? How about you, Lao Xie? Can you do it?"
"I've seen it once in Guangzhou, but I've never done it myself." Xie Yao was a little embarrassed, and he also complained in his heart: Although this scene is tricky, how can you say "What can we do?" from your dignified leader. Say it out of your mouth, the Senate claims to be all-knowing and all-powerful. Now that your generals have no idea, what should we do as soldiers? Doesn't this disturb the morale of the army?
But he just thought about it. He was joking. He, Xie Ke, was not interested in the tea invited by the Political Security Bureau.
"I haven't done it either..." Song Junxing was very honest: "My specialty is dentistry, and I have only seen blood transfusion surgery a few times..."
Lao Xie thought to himself that the chief was not afraid of being exposed, and his impression of him changed a bit, so he continued: "Chief, there is nothing we can do about this matter. We need two knives. If a blood transfusion is necessary, you will do the surgery, and I will do it." Being a helper..."
"Thank you, teacher!" Before he finished speaking, Chen Ruihe ran over in a panic: "Come and take a look!"
"What's going on?" Xie Yao followed him quickly to the bedside of the observation room Wang Chuyi: the blood had been transfused; the wound seemed to be treated well, and the bleeding in the thigh and chest had basically stopped. ; Looking at the things prepared nearby, in order to prevent hemothorax or pneumothorax from not being discovered, even closed chest drainage is prepared. He was a little confused as to why Chen Ruihe was so anxious to bring him here, and looked in the direction of Chen Ruihe's finger.
Unexpectedly, this sight made his pupils shrink suddenly: Wang Chuyi's left leg had begun to turn black, and the traces of a tourniquet could still be faintly seen on the skin of his leg.
"Did you not loosen the tourniquet?" Xie Yao suppressed his anger and asked, "Hey! How did you check your physical examination and ask for your medical history? How come you didn't find this?"
"I...it was already like this when I first found out..." Chen Ruihe was very frustrated.
"You..." Xie Yao was still about to get angry, but Song Junxing, who arrived shortly afterwards, stopped him.
"It's not his fault. It wasn't long after the wounded were brought here, but their limbs were all so black. The tourniquet was definitely not tied by this classmate. It was probably bandaged by the frontline health workers. I guess they didn't tell the stretcher bearers how to stop the bleeding. The belt needs to be loosened every once in a while..."
"Alas!" Xie Yao squatted on the ground angrily: "It's just a back-and-forth today... nothing is satisfactory!"
"Lao Xie..." Song Junxing didn't know what to say. The level of frontline health workers was limited, so it was not uncommon for them to do this kind of thing, but he could understand Xie Yao's depression.
After seeing the true level of medicine in the Senate, the seemingly understandable thing of "low level" was almost a crime in their eyes - Wang Chuyi's leg could not be saved, the tourniquet was too tight Typical dry gangrene that has been caused for a long time, and now the limb is about to be amputated...
"Thank you!" Song Junxing seemed to have finally thought of what he should say: "Get up quickly! The wounded are still waiting to be rescued!"
"Yes..." Xie Yao stood up and went to prepare the equipment full of opinions - although the blood transfusion operation usually doesn't take too long, it's hard to tell when these two novices were on stage; there was another patient waiting for a laparotomy next door. ’s... This moment of effort has added a lot of workload.
"Lao Xie, don't cause trouble." Song Junxing reminded him when he saw that he was in a bad state.
"I know it well." Xie Yao nodded and said nothing more.
"Director Xie! The blood pressure of the patient with abdominal trauma dropped sharply and his pulse was weak! Do you want a laparotomy?" Before he could finish speaking, a voice came from the observation room.
"Send to the emergency operating room! I'm coming!" Xie Yao shouted back, then turned to Song Junxing and said, "Chief, what about this blood transfusion surgery..."
Song Junxing closed his eyes and said with some pain: "Then let me do it. You should quickly prepare for a caesarean section."
Before citrate could be mass-produced, the method of blood transfusion adopted by the Senate was blood transfusion. However, because the Senate is very clear that ex vivo blood collection is the future of blood transfusion technology, it did not make the fancy improvements in blood transfusion techniques and instruments in history, but simply and roughly equipped some connectors and pipelines. Even if there are This is what happened - as long as the fermentation industry comes together, the cost of citric acid will not be that high. Even in modern times, the ACD preservation solution used for blood collection is nothing more than citric acid + sodium citrate + glucose. Therefore, for the Senate, the technology used for blood transfusion is either an in vitro blood collection technology backed by citric acid and cold storage, or a simple emergency blood transfusion, eliminating those transitional procedures that once appeared in the history of blood transfusion. technology.
The so-called blood transfusion refers to the technology of blood transfusion by directly connecting the blood vessels of the blood donor and the blood vessels of the blood recipient or indirectly connecting them through pipelines. This technique does not require ex vivo storage of blood, but does require surgical anastomosis of blood vessels and/or transfusion lines.
Since the Senate did not put into production special staplers and blood transfusion connectors, blood transfusions under field conditions could only be completed manually: one end of the blood transfusion tube was sutured to the donor's blood vessel, and the other end was sutured to the blood recipient's blood vessel. Come on, done. The dangers of this technology can be imagined, and the simple pipelines provided by the Senate cannot solve the problem of blood coagulation and blocked tubes. The tubes often need to be replaced and re-anastomized. In addition, the in vitro blood storage technology is very safe and convenient. Therefore, neither the elders nor the naturalized doctors like blood transfusion surgery very much. Generally speaking, only if the "immediate blood transfusion has a high probability of saving the patient" and "not immediate blood transfusion will definitely save the patient" are met. Only the wounded in large-scale injuries who meet these two conditions and the situation is very urgent can undergo this operation. Therefore, blood transfusion has gradually cooled down after its initial popularity and only exists as a technical reserve. .
However, a new situation emerged in the Guangdong and Guangxi strategy: this operation is not as good as Qimu Island and Jeju Island. After Lingao and Guangzhou have established modern or even modern hospitals, those who use low-level medical security to meet the needs of refugees are used. Yu Jun obviously cannot satisfy the veterans who lead the troops, but the limited logistics capabilities are obviously not enough to support hospitals of the level of Lingao and Guangzhou. Even if the refugees cannot receive blood transfusions, no one will blame them. However, with the blood station in Guangzhou becoming popular, the frontline soldiers do not have access to blood transfusion technology, which will make people scratch their heads. .
In such a non-embarrassing conflict, blood transfusion made a comeback.
Although blood transfusion obviously has some problems, and the survival rate is not very good, there are two different things between technical limitations and not using it if you have a way - at least it is suitable for blocking the mouths of the inspection team.
The Senate was initially equipped with modified paraffin threaded tubes for blood transfusions: paraffin can prevent blood coagulation in the tube to a certain extent, and the threads at both ends of the tube can be used to fix sutures and prevent the connecting tube from moving within the blood vessel. In terms of the selection of connectors, the improved blood transfusion connector developed by American scholar Unger in the early 20th century was used: first, a syringe was used to collect blood from the blood donor's blood vessel, and at the same time, physiological saline was infused into the blood recipient; then the valve direction was adjusted to The blood drawn into the syringe is transfused to the recipient, and the direction of the physiological saline infusion is changed to the blood donor to prevent clotting of the tube to a certain extent.
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Next update: Volume 7 - Guangzhou Governance Chapter 432
