Chapter 516 What a Character!

This is the most critical patient Chen Cang has ever encountered in his life!

none of them!

The most critical is not the most serious. For many serious patients, there is no possibility of rescue in front of Chen Cang.

At this time, Chen Cang felt that there was a chance!

In fact, at this time, it is most appropriate to do an X-ray to judge, but...where do you have time to go back to do it?

The patient's blood pressure is almost gone, the ascending aorta is ruptured, accompanied by cardiac tamponade, and it is uncertain whether the heart is damaged or not.

During this time, Chen Cang made up for the diseases of cardiovascular surgery, especially the emergency treatment.

He clearly remembered that the latest report recorded that the incidence of thoracic aorta in traffic accidents in the United States last year was about 15%, and the rupture of the ascending aorta was only 5% of this. Among these 5% figures, only There is a 10% chance of being sent to the hospital, and among these 10%, only 20% can be rescued successfully!

What this means is self-evident!

Doesn't Chen Cang not know that there is a greater chance of infection in the operation on the car?

Doesn't Chen Cang understand that a chest X-ray, SCT or EBCT can be used to make a clear diagnosis? Best to do an aortic angiography to identify the injury site?

However, this is all within the circumstances of the injury.

Now let alone CT and angiography, there is no chance for even a chest X-ray!

Chen Cang clearly remembered!

According to the latest guidelines, if aortic rupture is suspected, the circulation is extremely unstable with signs of direct rupture and secondary penetration (hemothorax, cardiac tamponade), surgical exploration should be performed immediately!

Therefore, Chen Cang will now choose to directly open the chest to explore and stop the bleeding.

When you have no other choice, the guide is your reliance and your legal basis at the same time!

Doesn't he know that everything he does now will be accompanied by risks?

He knows it all!

However, what is passing at this time is life, and there is time to delay!

Chen Cang said decisively, "Old Yang, stop ahead."

The driver Lao Yang couldn't help being stunned: ? ? ?

Through the rearview mirror, he saw that Chen Cang was going to have an operation, and his expression changed suddenly!

But I didn't say a lot, but directly found a suitable place and made the car very good.

On the way of the 120 ambulance to transport the patient, the doctor's words were like military orders, and Chen Cang was the leader of the rescue team.

Chen Cang raised his head and said to the two patients, "Get out of the car, and hurry up to the Second Provincial Hospital."

The faces of the two suddenly changed, and the bald man wanted to talk. Obviously, Wang Qian didn't give them a chance and sent them down directly.

Chen Cang took a deep breath and was a little nervous.

This is the first time he has dealt with such a critical patient independently, and it is also the first time he has performed surgery in an ambulance.

The anesthesia in this case requires stable, less or no use of drugs that inhibit the circulatory system. For the critically wounded, it is best to perform local anesthesia first, and then perform anesthesia induction or tracheal intubation.

At this time, due to the limited conditions, Chen Cang can only perform local anesthesia!

The effect of local anesthesia is still very fast, not long.

Chen Cang picked up the scalpel and made a direct incision in the middle of the chest!

Wang Qian nervously said, "Not much gauze..."

Chen Cang nodded, and then carefully retracted his sternum... Gradually, he saw a scene of numbness on his scalp!

This is a sea of ​​blood.

Chen Cang turned to Wang Qian and said, "Draw blood!"

Wang Qian's expression also changed, but he picked up the syringe and began to draw blood!

And Chen Cang's eyes stared straight at the pericardium area. At this time, the pericardium was like a big steamed bun full of blood. When Chen Cang cut it a little, there was a gushing out of blood.

"Hemostatic forceps!"

Now the bleeding place has been exposed, that is, the starting part of the left ventricular outlet. This part is relatively fixed, so it is easy to cause rupture after being hit by violence or sudden deceleration!

Fortunately...the rib didn't hurt the heart.

This may be the only thing to be thankful for.

The blood pressure is very low, Chen Cang is helpless, but this is a battle with no choice. If he does not work hard, the patient will surely die.

Chen Cang decisively cut open the pericardium, and the bleeding site was completely exposed.

"Are there any non-invasive hemostatic forceps?"

Wang Qian was stunned for a moment, then shook his head: "No!"

Who prepares these things in the ambulance?

Chen Cang hesitated for a while, then suddenly picked up his hands, pressed them on them, and pinched the tear with his hands, the blood stopped flowing.

Blood pressure has stabilized for now...

But the patient's life is still like a leaf in this season, swaying in the wind.

Fortunately, after the pericardial tamponade was contacted, the patient's bleeding was also controlled, and the blood pressure was gradually rising.

Chen Cang said to Lao Yang, "Go back to the hospital!"

Lao Yang glanced at Chen Cang from the rearview mirror, nodded solemnly, started the car steadily, started, and drove towards the hospital.

With his hands, Chen Cang could clearly feel the power of blood flowing out of his hands, and he could clearly touch the traces of life.

A few minutes later, the car parked directly at the entrance of the special channel of the emergency department of the Second Provincial Hospital.

Chen Cang didn't dare to move, but the driver Lao Yang jumped directly behind him and carefully lifted the bed down with Wang Qian.

Li Baoshan, Tao Mi, Xia Gaofeng and others below are already waiting anxiously!

Chen Cang said quickly, "Go to the operating room immediately!"

Everyone does not suspect him. In the operating room at this time, Wang Kai'an, Zhou Xiaodong, and Zhang Wenfu outside their hearts have already dressed and are waiting for the arrival of this patient!

The blood transfusion department, the laboratory department, the medical department, the anesthesiologist... all of them were on standby, waiting for Chen Cang's return.

With the arrival of Chen Cang, the rescue preparations officially kicked off!

Everyone started to prepare in an orderly manner!

Blood draws, emergency tests, blood matching...

Medical department contact person, signature, authorization...

The anesthesiologist was Liu Jian. When he saw that Chen Cang had opened his chest and put his hands on his heart, he couldn't help but widen his eyes.

The extracorporeal circulation machine has been prepared.

At this time, Wang Kaian glanced at Chen Cang with a non-invasive vascular forceps: "I'll come!"

Not loud, but firm.

Chen Cang nodded and carefully completed the handover.

When Chen Cang went out, Wang Kaian took the three and the anesthesiologist to start related work.

Intravenous cannulation!

Establish extracorporeal circulation!

Liu Jian, on the other hand, started tracheal intubation and prepared for anesthesia.

This kind of operation needs to be performed under the condition of cardiac arrest. When everything is ready, Zhang Wenfu blocks the distal end of the ascending aorta and prevents blood from passing through.

When Tao Mi and Xia Gaofeng saw the torn opening of the patient's ascending aorta, which runs through the outside and under the pericardium, they couldn't help trembling.

This... It's really as Chen Cang said, it's very difficult to return to the hospital.

Thinking of how Chen Cang and Wang Qian came back covered in blood just now, thinking of Chen Cang pressing his fingers to stop the bleeding, all the way back to the hospital...

The two were amazed!

Xiao Chen is really a character.