"What are you thinking about at home?" Su Yun squatted and fiddled with the patient's chest tube.
He emptied the fresh blood drained from the chest tube, and while timing, he bent a section of the chest tube to observe the drainage speed.
The chest tube is clear and there is not much drainage, which can be confirmed.
What Su Yun did seemed unnecessary, but Zheng Ren knew that he was eliminating problems that might arise in some small details.
Many seemingly serious conditions are actually caused by the accumulation of little problems.
"Old Zhao, where is the second line?" Su Yun asked while fiddling with the chest tube in his hand.
"Professor Zhang..." Zhao Yunlong said.
Su Yun was also helpless.
This does not mean that Professor Zhang is the same. Everyone’s level is different, and their ability to bear risks and ideas are also different.
Some are more radical and some are more conservative.
Each has its own advantages and disadvantages.
As for Professor Zhang, if he goes to school, he will be a very good teacher. But in this extremely complex situation, he may not be a good emergency first aid candidate.
"Where are the people?" Zheng Ren asked.
"He'll be there soon." Zhao Yunlong said: "Zheng...Boss, please keep an eye on me, and I'll go and hurry up the patient's family."
"Go ahead." Zheng Ren said, "Is the cath lab ready to do IAPp?"
"Get ready, Director Zhang Lin is coming from home." Zhao Yunlong said.
Zheng Ren nodded and did not continue talking. Instead, he turned on the computer and started to look at the patient's medical records.
Zhao Yunlong's narrative was too brief, only talking about the most important points, and there was no time to elaborate on the rest.
Regarding the patient's condition, Zheng Ren still wanted to take a closer look at it himself.
The patient is 52 years old and has a family history of hypertension. His father died of cerebral hemorrhage. I had no symptoms before. As Zhao Yunlong said, he came to the hospital two days ago because of worsening chest tightness and shortness of breath.
In the medical record, the patient reported no history of vertigo.
Zheng Ren expressed doubts about this. If there is vertigo, it is most reasonable to have an insidious onset.
The patient's medical history is just like this. It does not represent everything and can only be used as a reference, especially for patients with complex conditions like this.
During the admission examination, a head CT scan showed abnormalities, so a cranial MRI was performed one day later.
Zheng Ren could feel that the patient's family members did not sign and agree to iabp, which may have been due to family and economic factors.
The test sheets and various inspection reports all looked the same to Zheng Ren.
He quickly gained a certain understanding and understanding of the evolution of the patient's condition. Su Yun looked at the medical records beside him and looked back at the patient's condition. His neck was almost broken.
"Boss, the moyamoya disease shown on the MRI is quite serious." Su Yun commented as Zheng Ren inserted the MRI film into the reader.
"Well, I'm thinking about it..." As Zheng Rengang said this, the monitor's alarm sounded loudly.
The sound of beeping echoed through the room.
Zheng Ren and Su Yun stood up suddenly, and the chair Zheng Ren was sitting on fell to the ground with a "bang" sound.
"Prepare iabp!" Zheng Ren roared in a low voice.
Su Yun was stunned for a moment, and he subconsciously wanted to refuse. Doing iabp directly without the signature of the patient's family members is a death wish
But he could hear the determination in Zheng Ren's voice that he could not refuse.
Leave him alone! Su Yun's heart skipped a beat. Anyway, if the sky falls, the boss will hold it up. It seems that quitting his job and working at Massachusetts General Hospital is a good choice.
"The iabp machine and its helium supply are ready!"
"IABP catheter and puncture kit are ready!"
"0.9% nacl 500ml + heparin 5000u, ready!"
"Pressure bag, maintain pressure 300mmhg?"
Su Yun asked.
"Okay." Zheng Ren lifted the quilt off the patient, then opened the iabp puncture pack and prepared iodophor.
"Lidocaine." Zheng Ren said in a deep voice while putting on his gloves.
Su Yun had already turned on the machine, pushed it to the bedside, unscrewed a plastic bottle of lidocaine, and put the syringe into the sterile bag.
Zheng Ren picked up the syringe, inserted the needle tip into the opening of the plastic bottle, and drew out the lidocaine.
Without diluting it, I grabbed a handful of iodophor in my right hand, disinfected the patient's femoral artery, and then performed local anesthesia.
The puncture was successful and the balloon catheter was inserted into the patient's femoral artery. Zheng Ren moved very quickly. Su Yun had just put the electrode pads on the patient's chest, and the two sets of ECG monitoring systems were running at the same time.
At this time, Zheng Ren had completed the operation and sent the iabp tube to the descending aorta.
Turning on the counterpulsation pump, Zheng Ren handed the sensor for monitoring aortic pressure to Su Yun's hand.
Su Yun connected the sensor to the host.
The flushing system is connected to the sensor and the central chamber is connected to the pressure conduit.
The work that Zheng Ren needed to do was basically completed, and Su Yun was very busy.
After connecting the helium pipeline, Su Yun looked at it several times to make sure that the helium working pressure met the requirements.
"Sew it up." Su Yun said firmly.
Zheng Ren nodded and began to fix the helium pipe.
And Su Yun debugs various parameters on the host.
Su Yun is more professional than himself on this point, and Zheng Ren knows it. Letting him do it is the most worry-free way.
There is absolutely no need for you to participate.
As the iabp system started to work, Zheng Ren breathed a sigh of relief. The patient would be fine for a short time.
The machine feeds the patient's ECG or blood pressure signal into the counterpulsation control device, causing the balloon pump to move in reverse synchronized with the patient's heart beat.
Just before the heart contracts, when the aorta opens, the balloon deflates, lowering end-diastolic pressure in the aorta and reducing left ventricular work. Reduce afterload and reduce myocardial oxygen consumption.
The moment before the heart relaxes, the balloon is inflated to increase diastolic coronary perfusion pressure and increase myocardial oxygen supply.
Doing so can reduce left ventricular preload and postload and reduce cardiac load. The balloon is quickly deflated immediately before the heart contracts and the aortic valve opens, causing instantaneous decompression in the aorta, simultaneously reducing left ventricular ejection resistance and increasing cardiac output.
For perioperative support and stable hemodynamic status, iabp has unparalleled significance.
With the activation of iabp, the screaming ECG monitoring began to gradually calm down.
"Boss, the patient's family didn't sign." Su Yun said helplessly when he saw Zheng Ren packing up the iabp's things after adjusting various parameters of the machine.
"We don't have time," Zheng Ren said. "By the time the patient's family members finish signing, they will all be dead."
"Why hasn't Lao Zhao come back yet?" Su Yun muttered, but his eyes were fixed on the monitor.
This emergency first aid was considered a success, but various values and indicators were still not ideal. The patient is still on the verge of death. As for when he will die, it depends on his fate.
"Boss..." Su Yun said with a frown. "I don't see something right. The patient's condition is too serious, more serious than imagined."
Zheng Ren also noticed this and was thinking about what to do next.