Chapter 2720 the Sword Is Not Old

"Find someone to do transesophageal echocardiography!" Director Miao continued.

Su Yun had already picked up the phone, and the call was made to Lao He's phone. Lao He was already getting ready to leave work, humming a ditty, and sitting in the duty room smoking a cigarette.

After receiving Su Yun's call, Lao He didn't ask what happened. He only knew that it was a urology operation, and he needed to undergo transesophageal echocardiography immediately.

Lao He's B-ultrasound level is quite high, and he is one of the few doctors who can use ultrasound to judge pneumothorax. This kind of technique is one of the few techniques that can be boasted in front of Boss Zheng. He didn't expect to think of himself when he saved the stage.

Pushing the bedside echocardiography machine, Lao He trotted into the operating room.

The operating room was busy, and the strange thing was that Lao He didn't see Boss Zheng and Brother Yun. Director Liu of the Department of Urology was holding the mobile phone in his hand, constantly changing the angle, and the voice of Director Miao directing the rescue came from the mobile phone.

I'll go... Lao He was stunned for a moment, and then his heart became clear, and he immediately realized what happened.

This is Director Liu being confused!

It has been a habit formed for many years. When encountering a problem, I can't solve it by myself, so I immediately find the chief director.

At the moment of life and death crisis, Director Liu has forgotten that Director Miao has retired. He has changed from a clinical first-line director to an old man who dances square dance every day and takes care of himself for the elderly.

Director Miao's voice from the phone was still steady, full of domineering and unquestionable aura.

Where are Boss Zheng and Brother Yun? Lao He pushed the bedside echocardiography machine to the patient's head and took the opportunity to look around.

no one!

Forget about it, Brother Yun said to do transesophageal echocardiography.

Lao He quickly sent the transesophageal ultrasound probe into the patient's mouth, avoiding endotracheal intubation, and overcame the interference of Mr. Yu doing chest cardiac compressions, and sent the probe into the esophagus.

"Mr. Yu, stop for 20 seconds!" Lao He roared loudly.

"Less than, stop for 20 seconds, and the anesthesiologist will perform an echocardiogram." Director Miao's voice came, and the memory contained in the total body made him stop the chest compressions immediately.

"Gas was found in the right heart! Gas was also found in the left heart!" Lao He quickly scanned and saw the gas in the heart, reported it to Director Miao in the mobile phone video, and took out the probe.

"Put a small sponge pad on the right side!" Director Miao's voice came, "Continue to press, intermittent cardiopulmonary resuscitation. Central venous catheter..."

"Director Miao, I'll do this part." Boss Zheng's voice came out in the video.

Lao He was clear in his heart, but he didn't think too much about why Boss Zheng was at Director Miao's house. Instead, he quickly pushed the bedside echocardiography machine aside, found the central venous puncture kit in the cabinet, and quickly came to the patient.

The patient's head was already crowded with many people, and Lao He didn't explain it, and broke open the world abruptly. At this time, the mobile phone rang. Before the puncture, he took out the mobile phone, turned on the hands-free, and put it aside.

"Old He, do a central venipuncture." Boss Zheng's deep and steady voice came.

Lao He calmed down, and while preparing to puncture, he said, "Right now, 22 seconds!"

He used the improved subclavian central vein puncture method. The best puncture point was found at the intersection of the vertical line of the right clavicle center and the horizontal line of the sternoclavicular joint, and the needle tip pointed to the lower edge of the thyroid cartilage for puncture.

After entering, the central venous catheter is extended down, all the way into the right heart. Lao He is quite confident in his skills, 22 seconds, exactly.

"There is an air lock effect, and you can feel the pressure when you inhale after entering." Boss Zheng's voice came from the phone.

Although what he said was known to Lao He, his heart became a little more stable for no reason.

"It has entered the right atrium." Lao He said, "I am pumping air."

Keep trying, because of the air lock effect, the syringe does not twitch smoothly.

The air lock effect, also known as the air lock phenomenon, is a blocking phenomenon caused by the gas in the flowing liquid due to different pressures in the liquid. This phenomenon usually occurs at the high point between the pipelines, which is the reason why the general centrifugal pump cannot pump liquid.

Lao He tried a little bit, and suddenly the syringe in his hand moved slightly, moving a short distance, about 5ml.

"Boss Zheng, pump out 5ml of gas." Lao He quickly pumped out the blood and gas while reporting to Zheng Ren.

"Go on, I just watched the echocardiogram, and there is still air in the ventricle."

Zheng Ren said while holding the phone.

"Boss, it's normal to have air in the atrium. I have never thought about why there is air in the ventricle." Su Yun asked while standing aside.

Although he was not in the operating room, he could still feel the breath full of adrenaline and dopamine.

Zheng Ren shook his head, and said, "There are too few cases, and I don't know much about them. The existing cases show that most of them are double-cavity pneumatosis, and there is no congenital disease of right-to-left shunt."

Paradoxical air embolism is gas absorbed into the venous system that eventually enters the arterial system

It usually occurs in patients with a right-to-left shunt of the heart, in which gas that accumulates in the right atrium or right ventricle enters the left heart system through a right-to-left pathway, causing coronary or cerebral artery embolism

This is a question. Now that they are in the emergency department, the two of them have a tacit understanding and do not continue to discuss this issue.

Lao He's operation has passed the test, and even overflowed a lot. Soon the gas in the left side of the heart was also pumped out, and the problem that caused the cardiac arrest was resolved.

After about 20 minutes of continuous chest compressions and intermittent defibrillation, the patient's hemodynamics and respiratory function stabilized

Director Miao let out a sigh of relief, put the phone aside, and leaned against the back of the sofa. Looking at his expression, Zheng Ren didn't feel tired, only the relief and joy of nervous and excited emergency rescue.

"Director Miao, are you tired?"

"Not tired." Director Miao said with a smile, "It's the first time that I, an old man, have come across a cell phone to direct the rescue."

"The treasured sword is not old!" Su Yun stretched out his thumb and praised.

"Gas embolism caused by laparoscopy was encountered once before. At that time, I was stunned and pondered while rescuing. But that time I made an operation error, and it was easy to think that carbon dioxide entered the blood vessel. After symptomatic treatment, the patient had no complications after surgery. Symptoms, he was discharged from the hospital in a few days."

"How many years ago?" Su Yun asked.

"The end of the last century." Director Miao said.

"At that time, you just started laparoscopic surgery, and you encountered gas embolism? Why didn't you write a case report?" Su Yun asked curiously.

"The case report... I wrote it." Director Miao said, "I thought this case should be rare, and I didn't even submit to a journal with the Chinese prefix, so I went directly to The Lancet. Unfortunately, my English is average, and the format is not good. It’s too clear, and it’s all over in the end.”

So it was like this, Zheng Ren smiled.

"Director, how is your health?" Director Liu's voice came from the phone.