Embolism is a disease named after fat, blood clots, etc. block blood vessels, causing ischemia of the corresponding organs. The most common fat embolism is a super dangerous disease. This disease is really a race against death at the same time. Every second is longer and every second is shorter, and the outcome is often different.
A doctor who can rescue embolism patients often has to work in relevant departments of the hospital for at least ten years before he can take effective rescue measures.
Amniotic fluid embolism is a BOSS-level disease among embolisms. Because this embolism is related to the complex components of amniotic fluid, various hormones and factors once enter the circulation system.
The first thing that happens is allergies, large-scale allergies, and then because these foreign bodies stimulate the blood vessel walls, the blood vessels start to tremble like a cow avoiding a gadfly. This is the blood vessel spasm. Once spasmed, the orderly pulsation of the blood vessels changes. became disco.
The blood vessels begin to throb, which directly results in the inability of blood to flow smoothly, followed by multiple organ ischemia.
Once multiple organs are ischemic, the heart begins to beat harder until heart failure. A series of problems lead to a complete breakdown of body functions.
Just like dominoes, if doctors can stop the deterioration of body functions in a timely and effective manner at an early stage, they may be able to correct it. If once organ compensation fails and organs begin to fail, then the gods will not be able to do anything.
The disease's progression is not only rapid but violent, like a flood that has burst a dam.
Zhang Fan quickly put on the surgical gown. The chief surgeon in Istanbul glanced at Zhang Fan gratefully. Although he did not speak, the gratitude in his eyes could be seen.
He took the initiative to get out of the way of the surgeon. By this time, doctors from China had taken over from the medical team in Istanbul.
"Add oxygen under positive pressure, and cut open the organs directly if necessary. Lao Cheng, I'll leave the breathing and circulation to you." Zhang Fan and Dr. Xiang have already begun to explore the uterus, but Zhang Fan has to do two things at once. Not only does he have to do surgery, Also preside over rescue operations.
The sweat on his forehead has slowly seeped out.
"Brother, give 40mg of dexamethasone directly intravenously. The intravenous channel is hooked up to the intravenous drip of hydrocortisone for maintenance." The purpose of injecting hormones is to suppress allergies. Allergies must be suppressed, otherwise there will be no need to rescue allergy all over the body. , even allergies can kill people.
"Yes!" During medical rescue, after the superior doctor issues an order, the subordinate doctor or the executing doctor must give feedback as soon as possible whether he heard it clearly and whether he can do it.
"Head nurse, 1 mg of atropine plus pap(a)verine is injected intravenously every ten minutes. Take aminophylline through the upper limb channel and add 250 mg of 25% glucose!"
"Yes!" Although the head nurse usually seems to be flirting with her, which is not a way to survive in the workplace, but she can become the head nurse of a major operating room in a tertiary hospital. Not only is she technically proficient, but she is also very agile.
At the critical moment, the patient whose blood pressure could not be measured, this plump woman, inserted the needle into the blood vessel without even mentioning one more time. This is the skill, this is the technique!
"Dextran, dopamine in the pot, 20 drops/minute, walking in the lower limb channel."
"yes!"
"Linocoside C, 0.4 mg mixed with 50% sugar, give it intravenously!" This is a traditional Chinese medicine extract, which is used to treat heart failure with fast effect and low toxicity.
"Frusemide 40 mg, intravenously administered to the upper limbs."
"Yes!" This is a diuretic, not only to prevent pulmonary edema, but also to protect kidney failure. Because once the body is ischemic, the body will supply contracted blood directly to the brain, and the kidneys are very easy to fail due to ischemia.
Therefore, doctors often have a very difficult choice. The choice is too difficult! Which organ is unimportant, the liver? kidney? Or brain, none of them are unimportant.
"5% sodium bicarbonate 250ml, lower limbs walking."
"Yes." This is a weak alkaline solution. If the body is ischemic, carbon dioxide will be stored and the pH value in the body will become acidic, causing acidosis, which is an electrolyte disorder.
Once this thing is disordered, the internal environment of the body will collapse. The body's body fluids and circuits all work in a neutral environment. Once the acid-base balance is imbalanced, something will go wrong. It is important to correct the shock, and it is also important to correct the acid-base balance. Often these two brothers come in front and back.
Everything must go hand in hand here, no one comes first, that is to say, no matter whether it is respiratory circulation, shock or electrolyte imbalance.
They must be corrected as soon as possible. Once one problem is not solved, everything is in vain. This is the bucket effect of the human body.
"Antibiotics, dual combination of ornidazole and cefixazole, given in large doses." The amniotic fluid not only contains nutrients, but also bacteria. I didn’t suppress it with antibiotics for the first time, but when the shock, circulation, and electrolytes were all resolved, I looked back and saw an infection, and then my body collapsed again.
Really, amniotic fluid embolism is ridiculous.
While Zhang Fan was giving the doctor's orders loudly, he and Doctor Xiang took the time to explore the uterus in the abdominal cavity.
At this time, there was only one voice in the operating car, and that was the surgeon Zhang Fan.
Three or four doctors and nurses from Istanbul went out to summon the herdsmen to take blood tests. The surgeon in charge looked at Zhang Fan blankly, listening to words he didn't understand.
There was regret in his eyes. Doctors, no doctor wants his patients to die unexpectedly. Otherwise, he would never be able to bear the title of doctor.
That is to say, the chance of amniotic fluid embolism is very low. Otherwise, the number of humans would never be so high. Many doctors may not encounter this problem even once after working in obstetrics for a lifetime.
However, if you encounter it once, you will probably never forget it. The surgeon in charge in Istanbul is a professor in the Department of Hepatobiliary Surgery at their national hospital. At this time, he had long regretted it in his heart, but there was no regret medicine in the world.
Fortunately, this amniotic fluid embolism occurred after the child had been taken out, otherwise the risk would have doubled.
After the drug was injected into the patient's body, Zhang Fan also started the hysterectomy. The bleeding could no longer be controlled. Although the patient had entered a state of shock, the uterus must be removed as soon as possible to achieve complete hemostasis.
According to current medical statistics, about 1,600 pregnant women die every day around the world, and about 500 of them die due to hemorrhage.
Amniotic fluid embolism is uncommon, but postpartum bleeding is all too common. Now that the patient's body is in a state of ischemia, Zhang Fan must perform a hysterectomy quickly and with as little bleeding as possible to save the patient's life.
"No. O Vicryl line, shorten the turnaround line!" Zhang Fan said to the equipment nurse immediately.
Although the uterus needs to be removed, because she had a caesarean section, the uterus must be closed first to reduce the bleeding before hysterectomy can be performed.
Zhang Fan took the nurse's needle holder and quickly started suturing. The suturing at this time does not involve layer-by-layer suturing. The only requirement is that the bleeding must be stopped quickly and firmly at the first opportunity.
