Chen Cang is worried now!
He was worried that he didn''t know how long the patient could last and whether he could get to the hospital.
After all, pericardiocentesis
Yes!
Chen Cang suddenly remembered that he had a pericardial skill pack.
[pericardial skill Pack: after opening, you can choose to obtain a pericardial skill.]
As soon as Chen Cang gritted his teeth, he quickly chose pericardiocentesis.
To tell the truth, Chen Cang feels that he can''t afford to learn this skill.
After all, there are all kinds of pericardial operations in the pericardial skill package, including pericardiotomy, pericardial repair and so on
These are grade III operations.
In contrast, pericardiocentesis is only a secondary puncture operation.
Although it is more complicated than the four major punctures of thoracic puncture and abdominal puncture, it is also a puncture skill after all.
But... The situation is urgent. Chen Cang has no time to hesitate and chooses to study directly!
[Ding! Congratulations on learning pericardiocentesis. Do you want to start the training?]
Chen Cang hesitated at this moment and chose to enter directly!
Compared with chest puncture, the biggest danger of pericardiocentesis is that if it accidentally enters the ventricle, it can be a big trouble!
After all, the pericardium is not as thick as expected!
The heart is not as strong as expected.
Maybe... This injection will not alleviate the patient''s condition, but aggravate the symptoms and even lead to death.
In front of Chen Cang, a familiar operating room appeared in an instant.
After entering the training space, he began to continuously simulate, learn and master the applicability of pericardiocentesis and the conditions of pericardiocentesis
Continuous training, puncture under ultrasonic positioning... Assisted puncture... Puncture under ECG monitoring
Until finally, Chen Cang began blind puncture.
This is the most critical step!
That is, pericardiocentesis with a puncture needle without any auxiliary equipment.
After all, this situation on the scene is obvious. There is nothing but blind wear!
As time went by, Chen Cang became more and more proficient.
However, it did not achieve 100% in the end.
This makes Chen Cang feel at a loss.
Puncture training is comprehensive.
It even includes emergency management conditions for pericardiocentesis.
For example, pericardial effusion does not require immediate surgery, but has an accurate scoring standard. Some need emergency puncture, while others need to complete the puncture within 12 to 48 hours.
Not all pericardial effusions are as early as possible.
In the virtual space, Chen Cang constantly learns and popularizes the technologies and knowledge points related to pericardial effusion and pericardiocentesis.
Soon, it''s time for training.
This is the first time Chen Cang feels that the special training time is so short.
He really wants to learn this technology to perfection and practice the success rate of "blind puncture" to 100%. In this way, he can treat patients better and more accurately.
Unfortunately, the past is contrary to our wishes
Soon
After Chen Cang retired from the virtual space, a burst of prompt sound began.
[Ding! Pericardiocentesis: Master level; special effects: accurate; 2. Safe.]
Two special effects are very important for Chen Cang.
This is also the two directions that Chen Cang keeps practicing in the virtual space.
First of all, we must ensure the accurate location of pericardial puncture, and second, we must ensure the absolute safety in the puncture process.
……
At this moment, less than a second has passed outside.
This second is very short, but for patients at this time, it may be the distance between life and death.
Chen Cang quickly used his knowledge to judge the patient''s condition.
Seeing Chen Cang hesitating, Lao Liu hurriedly said, "Doctor Chen, let''s go quickly! Take it to the hospital. Let''s talk about it when we get there!?"
Chen Cang shook his head: "it''s too late. The patient''s current situation is very critical. There are too many effusions in the pericardium, which has seriously affected the blood circulation. If you don''t take them out, it''s estimated that you can''t get to the hospital!
Even in the emergency department, who knows what the situation is, now he needs to do pericardiocentesis! "
Lao Liu shook his head as soon as he heard Chen Cang''s words!
Xiao Chen is too aggressive.
Lao Liu has been a 120 driver for 20 years and knows this very well.
What is pericardiocentesis?
Of course he knows what''s going on.
But it is because of understanding that I am more worried.
What are the site conditions?
Nothing!
No CT effect, no ultrasonic ECG positioning, ECG monitoring can''t be taken up!
What do you do with it?
Blind?!
Don''t think that the drivers of 120 emergency vehicles are just drivers. They have seen no less life and death than doctors, and no less rescue. Therefore, after hearing what Chen Cang said, they were immediately uneasy.
"Xiao Chen, really can''t go to the hospital?" Lao Liu, the driver, is still a little worried.
Chen Cang nodded: "I can''t hold on. At this time, my heart is getting weaker and weaker. If I wait until I go to the second provincial hospital, I may be gone!"
At this time, if you don''t discharge liquid, the load on the heart is so large. No matter what method you use, there''s no way.
Relieving cardiac compression is the patient''s only chance of survival.
But at present, the patient''s condition is limited, and it is impossible to carry out puncture positioning and cardiac structure exploration. What should we do?
If there is no ultrasonic positioning, it can only rely on the doctor''s hand feeling and experience. It is likely that the puncture will fail or even aggravate the condition. Moreover, because the cause of bleeding is unknown and the internal damage of the heart is not known, will the bleeding continue due to heart rupture after puncture? Or lead to ineffective puncture and catheterization, or even accelerate the death of patients?
If the traditional emergency thoracotomy is used, is the hemostasis time allowed?
This is not a question of permission or not, but that the conditions are not available at all!
It''s too late!
Chen Cang was faced with a lot of thorny problems, and the patient''s life was in danger. He could not think twice. The opportunity to regain his life from the God of death was fleeting. Only this time!
Emergency pericardiocentesis!
Chen Cang made up his mind that he must seize every minute to save a glimmer of life.
If the patient doesn''t have pericardiocentesis, let alone whether the rescue can be successful, he can''t get to the hospital at all.
Let alone check and understand what went wrong.
Pericardiocentesis and catheterization can quickly solve the life-threatening first pass of pericardial tamponade, which is very important. It is also a crucial step to win time for follow-up rescue.
Chen Cang opened the rescue box. There was no pericardial puncture needle, but there was a thoracic puncture needle.
It works.
Lao Liu looked at Chen Cang with an uneasy face: "Dr. Chen... What do you want..."
"Blind wear?"
Chen Cang nodded. He didn''t wear blind at this time. Is there any other way?
No,
It has to pass through.
After cutting the clothes and disinfecting them, Chen Cang began his own operation.
Chen Cang now suddenly hopes that his eyes can see through. How good should that be?
Not for anything else, when you puncture for yourself, you can have more chances of success!
Uneasy!
Uneasy!
All the emotions filled Chen Cang''s heart.
Only one chance.
Chen Cang took a deep breath, and the puncture needle went deep slowly. He wanted to feel the touch, the sense of failure to break through the pericardium.
Chen Cang moved forward slowly.
Everyone around dared not say a word.
Lao Liu stood still and dared not disturb him at all.
Whispered in my heart.
Has he seen this kind of blind penetration?
Yes!
But it all fucking failed!
Shit.
Thinking of this, Lao Liu was afraid.
Chen Cang watched carefully for fear that something might happen.
Xiao Chen... How brave!
The muggy environment makes people breathless.
But Chen Cang felt a cold sweat behind him!
Don''t have an accident.
Suddenly, Chen Cang''s hands felt a sense of failure from the puncture needle. After he felt it, he stopped quickly.
His dexterous hands made him react very quickly.
Chen Cang said to Lao Liu, "help me smoke a little and I''ll see what liquid."
Lao Liu nodded hurriedly, "how much do you smoke?"
Chen Cang shook his head: "you first try to draw a few milliliters back. I''ll see what happens."
After Chen Cang said it again, he shook his head: "I''ll do it myself."
Lao Liu smiled awkwardly and was a little embarrassed.
Chen Cang doesn''t mind. Lao Liu is not a doctor, and he has skills in pumping back. Don''t smoke too hard and get the heart
Chen Cang pulled back slowly without resistance.
Don''t worry
After five milliliters came out, Chen Cang saw that it was all blood.
Suddenly his face changed.
That''s not good news.
Blood vessel rupture? Or a broken heart?
All this is possible.
Chen Cang continued to smoke.
He felt the resistance from the syringe and pulled away slowly.
After about 100ml, Chen Cang dared not smoke any more.
Pull out the puncture needle, pick up the stethoscope and start auscultation. I feel that the heart sound has recovered and the beating of the heart is gradually stable.
Chen Cang was immediately excited.
succeed!
Pericardiocentesis was successful.
Chen Cang felt the gradual recovery of the patient''s vital signs and was delighted.
At least the patient took the first step!
In other words, kill the first boss who hinders the successful treatment of patients!
Pericardial tamponade!
However, this does not mean that the patient is out of danger.
Because the cause of pericardial effusion is not clear, we must hurry to the hospital for the next rescue.
"Lao Liu, get ready to carry it to the car and go to the hospital!"
As soon as Lao Liu heard this, he immediately understood what was going on. He quickly and Chen Cang carefully raised the stretcher and carried it to the 120 ambulance.
……