Normally, when it comes to rescuing patients, the relevant department is responsible for the disease. But this person had a compound injury. Judging from the color of the blood, it was estimated that a large vein was damaged after the rectum was punctured and entered the pelvic cavity. It can be considered that the luck is not bad. If it was a large artery, it would have died of acute total heart failure due to blood loss in such a long time!
Fluid resuscitation is a very necessary method for patients with massive bleeding, but the clinical debate on which type of fluid resuscitation is better has not yet concluded! The principle requires that the electrolyte concentration of the liquid is similar to that of normal plasma; the osmotic pressure and osmotic volume are similar to that of whole blood; and the principle is that the smallest amount of fluid can be used to achieve maximum expansion and optimal oxygenation. Literature in the past 20 years believes that crystalloids are superior to colloids in early fluid resuscitation. The former includes glucose and electrolytes, and the latter includes plasma, plasma substitutes, and whole blood.
To put it simply, during shock rescue, whether to transfuse blood or balanced solution first is a matter of endless debate, not to mention anything else.
This kind of bleeding of internal organs must be performed while rescuing the patient from shock, actively searching for the bleeding point, and then stopping the bleeding. Only by stopping the bleeding first can we hope to save our lives.
Without Ouyang, this operation became controversial. In the past, the director of the anorectal department would not be involved in this kind of thing. It is better to do less than to do more. Anyway, general surgery is responsible for this kind of thing. He was happy to fuck his own hemorrhoids.
But when Zhang Fan underwent a major surgery for rectal cancer in the anorectal department, he couldn't sit still. His authority was almost destroyed by Zhang Fan. If he doesn't get this place back now, he probably won't be able to in the future. Good job. It is now rumored that he is as good as cutting off his butt!
This is unbearable. He was still counting on the doctors below to help him support his wife, "Get ready for surgery!" He looked at the patients being rescued and was the first to speak out. He had thought about it, and he would only perform surgery on the anorectal part of his stomach after he opened it.
The director of general surgery and the director of urology said nothing. He was embarrassed! No one stood up, so the director of the medical office saw that the posture was wrong and quickly contacted Ouyang. The boss is not as good as the second, and there is no strong superior. It is really difficult to control these directors who have eyes above their heads.
While the hospital is rescuing people and preparing for surgery, the injured person's family in Hong Kong has long been upset and looking for someone everywhere. Now they can only rely on connections to find people and find people with energy, otherwise the injured person who is thousands of miles away, There was nothing they could do.
With a big family and a big business, there are many internal affairs. Some people hope that they are alive, some people hope that they are dead, and some people hope that they are half-dead. It’s not surprising that money touches people’s hearts! If you are from a small family, as long as you have the ability, you will definitely use your strength in one direction.
The phone of the patient's bodyguard kept ringing, and the phone of the frontier boss also kept ringing. What a mess! People in the wounded family are playing games! In the game between surgery and hospital transfer, for a boss of this level, his wife may not be able to make the final decision!
Ouyang came down with the phone, and the superiors also said hello, and did not give direct orders. They just said, do your best. This is an attitude. The leader's phone calls are very particular. They must, must, and try their best, which all represent different levels of attention.
After Ouyang entered the emergency department, several directors of the Department of Surgery also spoke up.
"How to do it? Who will come?" Ouyang asked. The leaders' attention levels were different, so she only cared about the doctors' business. She didn't want to put any pressure on the doctors. The patient's identity was not disclosed.
"Dean, this is an anorectal trauma, and I am in charge! However, considering the severe bleeding, I applied for assistance from other departments." said the director of the Anorectal Department.
"Okay!" Ouyang said after looking at him. Then he said to the director of general surgery and urology: "Get ready for surgery." In just two sentences, the matter was confirmed.
The director of the anorectal department was not very popular and his skills were average. He could not ask the directors of general surgery and urology, who were probably just ordinary deputy senior doctors, to assist him. But that's enough. In fact, this operation looks dangerous. As long as you quickly open the abdominal cavity and find the bleeding point, it is not difficult except for the speed requirements. It is not a surgery that requires lymphatic clearance or reconstruction or other very difficult operations.
While they were discussing the operation, the director of cardiology in the emergency department was not idle either. He had to suspend his life before he could perform the operation. What is suspending his life is to first ensure the circulation and the oxygen in the circulation!
Zhang Fan doesn't like gossip, and he won't be curious about the intrigues of several directors. What he cares about is disease and rescue. The director of the heart, an expert from a provincial hospital, was pushed out to a municipal hospital back then, but her shock resuscitation skills ranked her second in the city hospital, and no one dared to admit she was first! This is the qualification!
The principles and methods of early fluid resuscitation are important, that is: early, rapid, and sufficient volume expansion is the key to successful rescue of shock.
Ren Li stood calmly in front of the hospital bed, folded her hands, hugged her arms, and gave oral medical instructions without thinking, "Establish four intravenous infusion channels, quickly infuse 1500ml of balanced salt solution, 500ml of dextran 70 (medium molecule dextran), use infusion The pump speeds up the infusion.”
Then he looked at the ECG monitor and directly ordered: "Measure blood pressure manually! Hurry." The nurse was overwhelmed and a little busy. Zhang Fan stepped forward and took the blood pressure monitor and quickly started measuring blood pressure. Speed is important at this time. This is not a time for grace.
"70/30mmhg. Thick and fast pulse." Zhang Fan reported while measuring. "Blood transfusion, pressurized intravenous whole blood and rapid intravenous infusion of 300ml. Put dexamethasone into the pot." Ren Li continued, and Ren Li also tried her best! This rescue method is a bit dangerous! Once you don’t get it right, it’s a big deal!
This kind of person is not short of money. He spent over 100,000 yuan when he was admitted to hospital! awesomeness.
"The blood pressure has risen, but the pulse is still rapid. Director, the surgery is ready!" Zhang Fan said to Ren Li.
"Okay, the rest is up to your surgeon." The principle of this first aid is also very simple. In layman's terms, there is a fish in the bowl, and there is a hole in the bottom of the bowl. Water must be added at a certain speed, not only to ensure that the fish The amount of water required must be maintained so that it cannot overflow all at once! Then continue to maintain this balance, waiting for surgical hemostatic treatment.
This is skill!
The nurse pushed the bed and carried the fixed liquid rack, quickly left the emergency department and ran to the elevator dedicated to surgery. The director of the anorectal department went out in high spirits and was about to enter the operating elevator.
"Who is the chief surgeon?" A lady who looked like an assistant stopped the director of the Anorectal Department.
"Um?"
"Which one of you is the chief surgeon?" the bodyguard translated. In Hong Kong, people with powerful families don't necessarily choose assistants for office work. Moreover, they are an old-fashioned family that prefers the British, and they reject Mandarin the most.
They either speak English or local dialect! And he also flaunts a certain status by speaking English!
"This is our chairman, the chairman with a net worth of more than 4 billion, are you sure?" This woman didn't know whether it was intentional or not, but with just one sentence, the director of Anorectal was so overwhelmed that he immediately didn't dare to enter the elevator! I guess this woman is an undercover agent!
I don’t know if others are anxious or not, but the boss of Frontier must be anxious and can’t figure out what’s going on in the business world, but I can tell by looking at his expression that the relationship is not small or the interests involved are not small.
"Dean Ou, I am a friend of the secretary-general. Please help me! I'll help you later!" The frontier boss was frightened to death. At this time, threatening the doctor with such words was clearly just to ruin things!
Ouyang, who was about to get angry, stopped his anger and looked at the boss of the border area. The boss was a man over 1.8 meters tall. He was half-bent, looking down at the old lady who was a little over 1.6 meters tall in a pleading manner.
Ouyang looked at the stunned director of the anorectal department and said, "Go on, tell her loudly!" Ouyang couldn't bear to let a woman be frightened before surgery!
"Me! Me!" The director of the Anorectal Department was a little incoherent! The pot in Ouyang's stomach is boiling. It's so disappointing! Isn’t it great to have more money?
People who came from their generation are very contradictory. Currently, many of the old-fashioned wealthy consortiums in China belong to their generation, but the ones who can really say they look down on the wealthy are also their generation!
Ouyang glanced at the director of the anorectal department with disdain, then looked back at the group of doctors who had just come out of the emergency department and said: "Whoever is sure, come forward! Don't let others look down on you! I can't afford to embarrass this person!"
"Me!" Director of Urology!
"Me!" The director of general surgery.
"Me!" Deputy Director of Urology.
"Me!" Deputy Director of General Surgery!
"Dean! No need to trouble directors, I can just go up!" Zhang Fan stood at the edge of the crowd and said loudly.
"Okay, it's up to you! Let the young doctor come in!" Ouyang said!
When the frontier boss heard that he asked the youngest doctor to take the job, he immediately softened! Paralyzed! Thousands of llamas fly through my heart!
. m.
