Chapter 2611 Vagal Nerve Reflex

Zheng Ren held a 50ml syringe in his hand, and after simple disinfection, he inserted a needle at a position 0.5cm above the pubic bone.

With a urine-filled bladder against the abdominal wall, needle insertion is not difficult. Immediately, Zheng Ren began to pump out the urine accumulated in his bladder.

The 50ml syringe needle was filled with a tube of about 60ml, 6 pumps, Zheng Ren turned his head to watch the ECG monitor.

As Su Yun's heart was pressed and the urine accumulated in the bladder decreased, atrial fibrillation appeared on the ECG monitor.

"Continue to press the heart, Gu Xiaoran! Prepare for electrical defibrillation!"

"Epinephrine, lidocaine IV."

Gu Xiaoran took the defibrillation head from the roving nurse and asked, "How much energy do you give?"

"200J."

"Mr. He, I've defibrillated." Gu Xiaoran still greeted Lao He very carefully, but he saw Lao He holding a syringe in his hand and waiting for him to defibrillate first, and he was inexplicably panicked.

It's like a machine that was working well, suddenly froze for some reason.

"Xiao Ran, give it to me, hurry up." Su Yun said anxiously while kneeling on the operating table in an awkward position, doing heart compressions.

"Oh, oh." Gu Xiaoran immediately handed the defibrillator to Su Yun.

"Boom~"

Under the energy of 200 joules, the patient's ventricular fibrillation improved to a certain extent.

"Continue." Zheng Ren directed the rescue.

With the heart rate appearing, his words are not as dense as they were at the beginning.

After Zheng Ren drew out 600ml of urine, he took out the needle of the syringe.

"Mr. Yu, do a cystostomy." Zheng Ren looked at Mr. Yu and said.

"Oh, good." Yu Zong stood in the operation area, watching the heart rate and ECG displayed on the patient's ECG monitor go from normal to disappear, and then from disappear to normal again. The process has nothing to do with him, as if he was watching a very standard The teaching of emergency rescue is average.

It's just... I seem to be the performer, and I should be the one standing in the middle directing the rescue. Seeing Boss Zheng commanding in the center, Mr. Yu was a little envious.

Zheng Ren glanced at the patient's electrocardiogram, which had stabilized, and finally let out a long breath.

"It's okay, Mr. Yu will make a fistula first, and then take out the nails." Zheng Ren said.

Although the ECG monitoring still occasionally issued two alarms, it has gradually returned to normal after 3 times of electrical defibrillation and the drug effects of epinephrine, lidocaine, and atropine.

The most important thing is - the urine in the bladder has been pumped out by Zheng Ren.

After observing for a few more minutes, Mr. Yu laid down the sterile drape on the abdomen and began to perform cystostomy, and the patient's vital signs had returned to normal.

"Boss, you are really like a mouse or an ant." There were sweat stains on the front of Su Yun's sterile cap, not because of nervousness, but because the posture of half-kneeling on the operating table for emergency chest compressions just now was too awkward.

In fact, standing under the operating table and adding a footstool would be enough, but at that time, the heart rate suddenly dropped precipitously, and the electrocardiogram was pulled into a straight line. Who has the time to think about so many things.

It must come as soon as possible.

"Urinary retention in the bladder stimulates the vagus nerve." Zheng Ren didn't intend to go on stage to help Mr. Yu, it was just a cystostomy operation, and by the way, he wanted to check whether the needle of the 50ml syringe had damaged other organs. The operation can only be said to be a disposal operation, Zheng Ren will not be able to do it.

"Another rich clinical experience?" Su Yun subconsciously blew a breath, a burst of hot air could not pass through the three-layer mask at all, and overflowed along the gap above the bridge of the nose.

"Well, sure." Zheng Ren said directly and frankly, took off the sterile gloves, turned around and sat on the original stool.

"Boss Zheng, Brother Yun, what's the matter?" President Yu asked with lingering fear.

Just now, when the patient's heart rate dropped precipitously and the electrocardiogram straightened into a straight line, the person was dumbfounded and didn't know how to be afraid. But now that everything is over, thinking back, Yu Zong feels afraid.

This is hell! A good patient, who walked in by himself, died suddenly after a few minutes of surgery? !

"I just said about the stimulation of the vagus nerve." Zheng Ren said lightly, leaning his back against the wall, feeling a bit of coolness coming from the wall, he was also a little thankful.

Fortunately, I couldn't find the answer in the end. When I came out of the operating room of the system, I heard Su Yun chatting with Mr. Yu. They said that the bladder pressure was high, and urine might spurt out the moment the last nail was opened.

This thought led Zheng Ren to turn around and go back to the operating room of the system. He performed cystostomy first and then underwent surgery. The experimental subject did not suffer from cardiac arrest.

The problem was found, but it was a little regrettable that the patient's heartbeat had already stopped before Zheng Ren could say anything.

But it's good to be saved, Zheng Ren thought to himself.

Seeing that Boss Zheng was not willing to talk, Mr. Yu had no choice but to look for the pubic bone, prepare to incision on the stock holdings, and perform cystostomy, while looking at Brother Yun with a questioning look.

"The nerves are widely distributed in various tissues and organs of the whole body, and complete various physiological activities with the central nervous system in the form of reflex arcs." Su Yun said, and asked, "Have you ever had eye surgery?"

Mr. Yu shook his head.

"Where did you graduate from? Didn't you go to an ophthalmology department during your internship or internship?"

"I've been there, but the professor will definitely not let me do it. It's good to go to the operating room and stand aside to take a look. When you meet a professor who is a fucking professor, you can't even go to the operating room. You just write medical records below. Already." Mr. Yu said.

"Don't talk about being fucked, I guess you will soon become the kind of fucking professor you said." Su Yun smiled, "Did the boss say that, in the end, you became the most hated professor you used to be?" the kind of person."

"..." Mr. Yu was stunned for a moment, then smiled and said, "I would like to borrow your good words, Brother Yun."

It's just that his smile is so stiff at this time, and he hasn't recovered from the sudden change just now.

Accidents in the operating room can happen anytime and anywhere, and God knows where there will be problems. It's just that this problem appeared quickly and was resolved even faster, and Mr. Yu didn't realize that the rescue was over before he realized it.

It's just... what does it have to do with ophthalmology?

"Brother Yun, what's wrong with the ophthalmology department, you continue to talk." Mr. Yu asked while cutting the skin and separating it layer by layer.

"There is a rare condition in eye surgery, called the oculocardiac reflex. When the eye muscles are stretched, a vagus nerve reaction will occur, causing the vagus nerve to be overexcited, resulting in arrhythmia and slow pulse, which is called the oculocardiac reflex."

"Uh, no wonder students who don't do internships come on stage."

"The reflex arc is from the ophthalmic branch of the trigeminal nerve to the pontine nucleus of the trigeminal nerve, then to the dorsal nucleus of the vagus nerve, and finally the myocardium responds, which can lead to cardiac arrest in severe cases. The same is true for this patient, cardiac arrest caused by vagal reflex, right, boss .”

"Yes." Zheng Ren nodded.