Zheng Ren held a 50ml syringe in his hand. After simple disinfection, he inserted a needle 0.5cm above the pubic bone.
With the bladder filled with urine pressing against the abdominal wall, there is no difficulty in inserting the needle. Zheng Ren then began to drain out the urine accumulated in his bladder.
A full tube of 50ml syringe is about 60ml. After 6 puffs, Zheng Ren turned his head to look at the ECG monitor.
As Su Yun performed heart compressions and the urine accumulated in the bladder decreased, atrial fibrillation appeared on the ECG monitoring.
"Continue cardiac compressions, Gu Xiaoran! Prepare for defibrillation!"
"Epinephrine, lidocaine intravenously."
Gu Xiaoran took the defibrillator head from the circulating nurse and asked, "How much energy should I give?"
"200J."
"Mr. He, I'm defibrillated." Gu Xiaoran still greeted Lao He very carefully, but when he saw Lao He holding a syringe in his hand, waiting for him to perform defibrillation first, he felt inexplicably panicked.
It's like a machine that was originally running well, suddenly stalled due to its own reasons.
"Xiao Ran, give it to me, hold on tight." Su Yun knelt on the operating table in an awkward position and performed heart compression, and he said anxiously.
"Oh, oh." Gu Xiaoran immediately handed the defibrillator to Su Yun.
"Bang~"
Under the energy of 200 joules, the patient's ventricular fibrillation improved to a certain extent.
"Continue." Zheng Ren directed the rescue.
As the heart rate appeared, his words were no longer 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, make a cystostomy." Zheng Ren looked at Mr. Yu and said.
"Oh, okay." Mr. Yu stood in the operating area, watching the heart rate and electrocardiogram displayed on the patient's ECG monitor go from normal to disappearing, and then from disappearing to normal again. The process had nothing to do with him, as if he was observing a very standard event. The teaching of emergency rescue is average.
It's just that... I seem to be the magician, and I should be the one standing in the middle to direct the rescue. Seeing Boss Zheng taking command from the center, Mr. Yu felt a little envious.
Zheng Ren took a look at the patient's electrocardiogram, which had stabilized, and finally let out a long breath.
"It's okay. Mr. Yu will make an ostomy first and then take out the nails." Zheng Ren said.
Although the ECG monitoring still occasionally issued two alarms, it gradually returned to normal with the effects of three electric defibrillations and the effects of epinephrine, lidocaine, and atropine.
The most important thing is that the urine in the bladder has been drained out by Zheng Ren.
After observing for a few more minutes, Mr. Yu laid down the sterile drape on the abdomen and started to perform the cystostomy. The patient's vital signs had returned to normal.
"Boss, you are really just like mice and ants." 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 was too awkward.
In fact, it would be enough to stand under the operating table and add a footstool, but at that time, the heart rate suddenly dropped off a cliff, and the electrocardiogram stretched into a straight line. Who has time to think about so many things.
It will definitely come as soon as possible.
"Urine retention in the bladder is caused by stimulating the vagus nerve." Zheng Ren didn't mean to come on stage to help Mr. Yu. It was just a cystostomy operation. By the way, he wanted to check whether the 50ml syringe needle had damaged other organs. This kind of surgery hardly counts. The operation can only be said to be a treatment operation. Zheng Ren would not perform it.
"Again, rich clinical experience?" Su Yun blew out a breath subconsciously, and a stream of hot air could not penetrate the three-layer mask and overflowed along the gap above the bridge of the nose.
"Well, are you sure?" Zheng Ren said directly and frankly, took off his sterile gloves, turned around and sat on the original stool.
"Boss Zheng, Brother Yun, what's going on?" Mr. Yu asked with lingering fear.
Just now, when the patient's heart rate plummeted and the electrocardiogram straightened out, he was confused and didn't know how to be afraid. But now that everything has passed, looking back, Mr. Yu feels afraid.
What the hell! How could a good patient, who walked in by himself, die suddenly after only a few minutes of surgery? !
"I just said that the vagus nerve was stimulated." Zheng Ren said lightly, leaning against the wall, feeling a bit of coolness coming from the wall, and he was a little lucky.
Fortunately, I couldn't find the answer in the end. When I came out of the system operating room, I heard Su Yun chatting with Mr. Yu, saying that the bladder pressure was high and urine might spurt out the moment the last nail was opened.
This thought made Zheng Ren turn around and go back to the system operating room. He first performed a cystostomy and then performed the surgery. The experimental subject did not suffer from cardiac arrest.
The problem was found, but unfortunately, before Zheng Ren could say anything, the patient's heartbeat had stopped.
But it would be good if he could be rescued, Zheng Ren thought in his heart.
Seeing that Boss Zheng was reluctant to talk, Mr. Yu had no choice but to look for the pubic bone and prepare to make an incision on the stocking to make a cystostomy while looking at Brother Yun with questioning eyes.
"Traveling nerves are widely distributed in various tissues and organs throughout the body, and complete various physiological activities in the form of reflex arcs with the central nervous system." Su Yun said and asked: "Have you ever had eye surgery?"
Mr. Yu shook his head.
"Where did you graduate? Didn't you go to the ophthalmology department during your internship and 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 for a look. But when I meet a professor who is so fucked up, he can't even go to the operating room and just writes medical records down there. Yes." Mr. Yu said.
"Don't talk about being a fucking professor. I guess you will soon become the kind of fucking professor you say you are." Su Yun smiled, "Did the boss say that? In the end, you became the most annoying professor you used to be." That kind of person.”
"..." Mr. Yu was startled for a moment, then smiled and said, "I can lend you your kind words, Brother Yun."
It's just that his smile was so stiff at this time, and he hadn't recovered from the sudden change just now.
Accidents in the operating room can happen anytime, anywhere, and God knows where something could go wrong. It's just that this problem appeared and was solved faster, and the rescue was over before Mr. Yu could react.
But... what does it have to do with ophthalmology
"Brother Yun, what's wrong with the ophthalmology department? Keep talking." Mr. Yu asked while incising 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, it will produce a vagus nerve reaction, causing overexcitation of the vagus nerve, leading to arrhythmia and slowed pulse. This is called the oculocardiac reflex."
"Well, no wonder students who don't go to internships come on stage."
"The reflex arc is from the ophthalmic branch of the trigeminal nerve to the pontine nucleus of the trigeminal nerve, and then to the dorsal nucleus of the vagus nerve. Finally, the myocardium reacts, which can lead to cardiac arrest in severe cases. The same is true for this patient. Cardiac arrest caused by vagus nerve reflex, right boss? .”
"Yeah." Zheng Ren nodded.