Holding the surgical retractor, Zhang Shuping carefully helped Teacher Xie pull the surgical incision while holding his breath with the assisting emergency nurse.
I just remember what the textbook said, if you try to touch the pericardium immediately if you try to reach it at the wrong angle, you may encounter obstacles or it may be awkward to operate. If external pericardial compression is unsuccessful, you will need to disconnect the third and fourth ribs for intrapericardial compression.
By that time, it will be a dead horse and a living horse doctor.
The best, the best is to succeed in the first attempt. Zhang Shuping felt deeply that the hot breath he breathed was going to burn him to death.
The current situation is really a hot potato for him and Teacher Xie.
It's impossible to save him even if you don't want to, but the success rate of treating a dead horse like a living horse is really low.
This is the same reason why clinical routine advocates external chest cardiac compression while intrathoracic cardiac compression is extremely rare.
According to medical statistics, there is no advantage in the success rate of intrathoracic heart compressions compared to external chest heart compressions. Therefore, there are special prerequisites for doctors to perform intrathoracic heart compressions on patients. For example, in the current case, as seen in Shouer
Emergency rescue of patients who have undergone thoracotomy with the chest cavity not closed after surgery.
Well, surgeon Xie’s gloved right hand reached into the surgical incision.
She has never done this kind of surgery independently, but she must have done intra-chest heart compression, otherwise she would never dare to do it if she thanked the surgeon. She once remembered the one performed by the immortal brother when she was a child in Shou, which made her crazy.
Perform heart compressions on the little baby with bare hands.
After experiencing such a worse encounter, her mentality is undoubtedly very stable now.
Thanks to Brother Shenxian, a group of "cruel and ruthless" mentors, for leaving her with all kinds of painful experiences and lessons.
After touching the patient's heart wrapped by the pericardium, the first step is not to press, but to further clarify the diagnosis: is the patient's heart completely stopped, or is the patient's heart just weak, that is, the heart beats weakly and with little strength, or is it ventricular fibrillation?
If the heartbeat is weak, 0.1% epinephrine or 10% calcium chloride should be injected into the cardiac chamber to stimulate the myocardium and then cardiac compressions should be performed. At the same time, a doctor should be ordered to ask the nurse to inject dopamine and other drugs into the intravenous channel to assist in maintaining blood pressure.
If it is ventricular fibrillation, it is not necessary to perform electric defibrillation immediately. Instead, after performing heart compression for a certain period of time, wait for the myocardial tension to improve before performing defibrillation. It can be seen that the most professional medical heart compression technique is not as simple as teaching laymen pre-hospital on-site rescue.
Compression alone must be combined with precise first aid measures such as administering rescue medication.
After carefully touching the patient's heart, Xie Wanying confirmed that it was asystole.
Is complete arrest scary? It seems to be the worst of the above three situations. But no matter which situation it is, for doctors, unless the heart completely returns to normal beating, none of them is necessarily good. The patient's heart
The situation is changing rapidly, and the three situations may be interchangeable.
What doctors have to do is to carry out routine operating procedures step by step and follow the valuable clinical experience left by countless medical predecessors to their descendants.
The gloved right hand immediately further prepares the compression posture.
There are three methods of intrathoracic heart compression, the single-hand method and the sternum compression method.
The single-hand method is to touch the front of the patient's heart with the thumb and thenar eminence, and place the remaining four fingers behind the patient's heart. The purpose is to press the left and right ventricles evenly, forcefully and rhythmically.
The left and right ventricles are the main pumps of the heart and are responsible for pumping blood. When the heart stops beating, the ventricles lose their ability to pump blood, causing the heart itself and other organs of the human body to lose blood nutrients and die. This is exactly the problem that heart compression is intended to solve.
