Chapter 2764 Three Generations of Explorers of Flying Immortals

The key to the operation of the bag-mask ventilation technique is to seal and open the airway.

If the ventilation is unsatisfactory during single-person operation, two-person pressurized assisted ventilation should be considered, and the airway should be opened with manipulation, and the oropharyngeal or nasopharyngeal airway should be used at the same time. This technique is mainly used when the patient is at risk of aspiration and reflux, while compressing the cricoid cartilage.

Even the laryngoscope and light stick guidance techniques have been used, and the basic operation of the single-person balloon mask has been ruled out by Zheng Ren and will not be considered.

However, two-person balloon-mask ventilation with small tidal volume and high-frequency high-pressure oxygen supply revealed that the chest rise and fall of the patient was not obvious.

"Laryngeal mask!" Zheng Ren roared in a deep voice.

At the same time, he had already put on sterile gloves, and his eyes moved back and forth between the ECG monitoring and the patient, but he did not perform a tracheotomy immediately.

In the patient's current condition, tracheotomy is a high-risk tracheotomy, and Zheng Ren tried it in the operating room of the system. Even if there is a halo of luck, even if there is a reward bonus of +10 for the completion of the operation, even if it is just a small operation, the final completion of the operation is only 65%.

This means that patients who are assisted by a ventilator may not be able to go offline, or even get off the operating table at all.

Zheng Ren has tried many times, and the success rate of 65% is already the highest.

In fact, patients with high-risk tracheostomy are not uncommon.

The main symptoms are short neck, obesity, upright sitting position, inability to tilt the head back, agitation, wide or space-occupying thyroid isthmus, high mediastinum, tracheal deviation, tongue falling back, severe dyspnea, and simultaneous oral intubation or oral intubation. Patients with intubation but no spontaneous breathing, poor coagulation function, sudden asphyxia before operation, and patients with unclear cervical and thoracic bone and cartilaginous landmarks belong to the high-risk tracheotomy population.

Under normal circumstances, it can be remedied by means, but the patient in front of him is in a special situation, Zheng Ren is very helpless, this time he encountered a particularly difficult matter.

Fortunately, the oxygen supply effect of the mask is good, and it has been tested in the operating room of the system.

An anesthesiologist quickly opened the laryngeal mask and handed it to Zheng Ren.

After receiving it, Zheng Ren pulled the patient's jaw with his left hand, and was about to put the laryngeal mask in when he was surprised to see that it was a second-generation laryngeal mask!

Strange, the third-generation laryngeal mask is obviously used in the operating room of the system. What's going on?

There is a big difference between the second-generation and third-generation explorer laryngeal masks. Even the third-generation laryngeal masks are only 98% complete. Zheng Ren dare not be careless.

"Three generations of explorers!" Zheng Ren said immediately.

Director Xu was taken aback, three generations of explorers... Laryngeal mask?

The patient's blood oxygen saturation has dropped to 70%, why is Boss Zheng still picky about the second-generation and third-generation laryngeal masks...

Just as he was about to explain something, Feng Xuhui stood outside the operating room and immediately said loudly, "Mr. Zheng, wait a minute!"

Holding the mobile phone in his left hand, he made a call and answered it almost instantly. Feng Xuhui said in a loud voice, "Emergency first aid kit!"

While speaking, Feng Xuhui quickly walked to the door of the operating room with "booming" steps.

Opening the door of the operating room, Liu Xiaojie, who was more than ten meters away, pushed the box over. The heavy trolley case slid on the marble floor and arrived in front of Feng Xuhui almost the moment he opened the door.

After receiving the box, the door is closed, and the whole process takes 3.2 seconds.

Director Xu has been following behind Feng Xuhui, and he remains calm. After all, he is the director of the Department of Anesthesiology, and he has seen too many similar situations.

It's just that today's patients are a little more special, and it would have been done with a more ordinary laryngoscope.

Boss Zheng did not perform a tracheotomy for a long time, and Director Xu also knew that this was a high-risk patient, and once the tracheotomy was performed, he might face more troubles. This kind of trouble is not all from the family members of the patients, but more from the patients themselves.

It is not uncommon for patients to get worse after high-risk tracheotomy, so he also prefers to use a laryngeal mask.

It’s just that the 912 laryngeal mask is not bad. That model has been used for many years, and Boss Zheng wants the third generation of explorers. This kind of laryngeal mask has only been heard at academic conferences, and the anesthesia department of 912 has not yet evolved to this point.

The small consumables dealer who has been following Boss Zheng seems to be... the manager of the consumables manufacturer, what did he just yell at? First aid kit? !

Director Xu saw a medium-sized trolley case "flying" in, and the small consumables dealer immediately squatted on the ground to open the case.

A wide variety of emergency and first aid consumables are neatly placed in the trolley case.

He didn't even look at it, and stretched his hand in, as if he knew where dozens of consumables were.

Feng Xuhui immediately grabbed a sterile packaged bag. Seeing Director Xu standing not far away and looking at him, Feng Xuhui threw the bag in his hand.

"Director Xu!"

You don't have to be polite when you are in the emergency department, and there is no time to be polite. Every minute, every second is extremely precious.

Director Xu took the aseptic package, and the target was a third-generation Explorer laryngeal mask.

"..."

What the hell, director Xu felt that his face was hot invisibly.

But before he had time to think about it, he turned around and ran, tearing off the outer packaging of the laryngeal mask while running.

Zheng Ren took over the laryngeal mask and inserted it using the conventional blind detection method.

Pull the mandible with the left hand to widen the oral cavity, and hold the laryngeal mask with the right hand, with the mouth of the mask facing the patient's mandible, insert it along the midline of the tongue against the posterior pharyngeal wall until it can no longer be advanced.

After the laryngeal mask was placed, positive pressure ventilation was performed, and Zheng Ren observed that the degree of chest rise and fall returned to normal. He picked up a stethoscope and auscultated symmetrical and clear breath sounds on both sides, and there was no air leakage murmur in the front of the neck.

Even though he had performed more than 10 operations in the operating room of the system, even if he came out with a halo of luck, Zheng Ren still checked carefully for any errors.

After the laryngeal mask was removed, Zheng Ren placed a gastric tube to exhaust the gas under the guidance of the laryngeal mask to solve the problem of the diaphragm rising due to the large amount of gas in the stomach and the lung volume reduced.

"Propofol 40mg!"

"Midazolam 2mg!"

"Dexamethasone 10mg!"

Zheng Ren watched the patient's ECG monitoring, and kept giving medication instructions.

"Intravenous infusion of aminophylline 0.25g + 5% glucose 250mL!"

The patient's blood pressure fluctuated at 184-110mmHg/98-55mmHg, and heart rate fluctuated at 60-98 beats/min.

"Nitroglycerin 0.05mg, Urapidil 15mg." Zheng Ren said in a deep voice.

Seeing the continuous rise in blood pressure, heart rate and blood oxygen saturation, the air in the operating room eased a little.

Boss Zheng's doctor's order was perfectly executed without any doubts, even for Director Xu.

If he wasn't there, Director Xu would be ready to take off the laryngeal mask next step, but as Boss Zheng stood there, Director Xu felt very at ease for no reason, rather than just being robbed of his position in the emergency department to make him feel that his authority had been compromised. challenge.

At this time, speaking of technology, coupled with the throat mask of the third-generation explorer who is like a flying fairy, Director Xu has long since lost his mind.