With his distinctive sideways movements, Kraft immediately recognized the patient's identity. Before the two punctures, this man was still sitting in the consulting room, asking if there was any possibility of treatment.
He murmured and tried to squeeze out a few words in the short and rapid breathing space. Although he endured the pain and tried his best, the breath he exhaled was still as thin as a gossamer, and it was difficult to even complete the correct articulation.
Kraft hurried to his side and listened carefully to what was said. However, what struck his ears was not the description of the illness, but the words "church" and "cemetery".
"I need you to tell me what happened and how I feel now!" the confused doctor shouted, trying to bring the person back from his unknown mental state.
"No cemetery..."
Now that he finally knew what he was talking about, Kraft, dumbfounded, asked the young man who helped him to help him, and moved him to half-lying on the bed, so that this guy who had prematurely asked about the real estate issue after his death could calm down.
"Who are you?" The other person's enthusiastic look doesn't sound like they are just meeting each other, they should at least know each other.
"This is my father. He suddenly became like this on the road just now." The young man looked at the doctor anxiously. He was at a loss for words. He pressed the side of his chest to imitate what he saw. It seemed that the patient had sudden chest pain while walking.
No matter how far you went, you were sent back again.
[Hell, I’m not doing emergency medicine]
He once again urgently recalled the posture of the patient when he met him. He subconsciously tilted to protect his right side, which was consistent from front to back. It seemed like the changes in the original disease were getting worse.
"A lot of hemoptysis?" David asked from the side. He opened the patient's lips and found no blood filling the mouth.
It doesn't look like it. Even if one of the blood vessels involved happens to be broken at this moment, it shouldn't be like this. Kraft simply fished out the knife from the box, cut open the top and tore it off, tearing off the obstruction.
Pendant, observe the condition of the entire upper body.
The chest cavities on both sides are obviously not symmetrical. The right side that should have been restricted in breathing is now fuller. The trachea is not in the middle, but slightly curved and offset to the left. The jugular veins on both sides are full and bulging under the skin.
In most areas of most of the lung fields on the right side under the earpiece, the breath sounds have completely disappeared, just like after puncture and air infusion, but the range is much larger, and there is no room for the lungs to relax.
"pneumothorax."
"But didn't we perform artificial pneumothorax on him?"
"Then guess why it's called 'artificial' pneumothorax."
The chest is a closed space. In addition to piercing the chest wall from the outside to allow air to enter, of course there can also be another situation - air leakage from the inside.
"His lungs were broken." The lungs, which had been eroded by tuberculosis, formed various lesions, structural damage and damage, and even invaded the pleura in this case, like an aging skin bag.
When a patient exercises vigorously, such as walking for a long distance suddenly, and takes a large breath, the weak spot can no longer withstand the increased air pressure and suddenly bursts, and the air inhaled into the lungs flows into the chest along the breach, and in turn,
Compresses the lungs.
The case at hand was obviously not an ordinary pneumothorax in terms of speed of progression and severity. A large amount of gas accumulated in the chest cavity in a short period of time, reaching the point where it was about to be fatal.
【Tension pneumothorax】
When the breach is ventilated but not completely ventilated, a very special valve structure may be formed.
The air can enter the chest when inhaling, but cannot be squeezed out along the opening when exhaling. It operates like a one-way valve, causing it to only go in but not out.
This process of inflating the chest is uncontrolled. As we all know, people will die if they don't breathe. Each breath is aggravating the condition, making breathing more difficult, and the pressure in the chest gradually increases.
The increased pressure compresses not only the lungs, but also everything else in the chest, including the heart. Blood that cannot return fills the blood vessels, causing visible bulging veins.
"Needle, leather tube." Kraft took out the remaining half of the bottle of alcohol, poured it onto the right side of the patient's chest without hesitation, and poured clean water into the empty bottle.
David handed over the leather tube with the needle connected and watched as he inserted the other end of the tube into the water bottle, "Do you want anesthesia?"
"Hold him!" Congratulations to this patient for becoming the second person to challenge anesthesia-free chest puncture. I hope he can have the willpower of the old Duke and now he has no time to slowly inhale anesthesia with an ether bottle.
Of course, taking into account the emotions of the patient's family, Kraft kept explaining with both hands, "Your father has air in his lungs, which is now pressing on his heart and lungs. I have to use a needle to release it. This will be a little bit...
pain."
The young man who hadn't realized what Kraft was about to say was already frightened by the sudden illness and nodded in agreement.
In the next second, Kraft's hand was pressed to the desired position, fixing the skin, and the needle penetrated, "Don't be nervous, it will be fine soon."
Obviously, not everyone in this world can bear pain calmly, especially the pain of a thick needle piercing the chest wall. The patient struggled reflexively, but luckily Kupp lived up to his expectations and suppressed him without letting the needle deflect.
shift.
The puncture this time can be much bolder. The lungs have been compressed very small, and the air under the chest wall is full. With skilled techniques, the puncture can be done quickly and accurately.
The water inserted into the catheter boiled and a series of large bubbles appeared. The high pressure in the chest found an outlet, and the gas surged out along the catheter.
Just as quickly as the onset of symptoms, the patient's condition improved visibly within a few minutes.
His breathing gradually turned from depressed and rapid to steady, his consciousness also recovered from the state of ignorance due to lack of oxygen, and he felt around his neck.
Craft found the pendant next to the pillow, an old-fashioned double-winged ring, and thrust it into his hand. The patient holding the amulet spoke his first complete sentence after waking up.
"I don't want to be buried there."
"No, you're lucky to have survived." Kraft wrapped the puncture point with a wet cloth to seal it, and handed it to David to fix it.
It's really lucky. If a blood vessel were broken by the way and it evolved into a hemopneumothorax, there would really be no place to cry. No one has the ability to open the chest to find the bleeding point and stop the bleeding. Kraft may be able to find the bleeding point by cheating.
But there is nothing we can do.
"Then... when can I pull this out?" Seeing my father turn back from the door of heaven with an iron needle stuck in his chest, it was a bit scary.
"It's very early. Before he stops leaking, this thing has to be stuck. Once removed, it will be like before. I suggest you be hospitalized... Well, stay here for a few days for observation." Now
Artificial pneumothorax was done when it was time to do it, and it was time to fix the pneumothorax on your own when it was not time to do it.
To be honest, Kraft didn't think the patient's prognosis would be good. He might develop pleurisy, empyema, trauma and infection within a few days. There was nothing anyone could do. He could only keep it under his nose and take advantage of it every day.
"David, please give me black elderberry juice, three times a day. Make it thinner and let the family members feed it slowly. Don't choke."
During this period of time, he had no choice but to gain some understanding of "primitive internal medicine" and was able to skillfully prescribe the medieval version of isatis root, perhaps with a little vitamin C.
The situation had almost calmed down. Before leaving, Kraft became a little curious about the cemetery issue that was on the patient's mind. "What did he mean when he said 'church' and 'cemetery' just now?"
The young man explained: "My father has been devout all his life and wants to get closer to the Lord, but now it seems... it is probably more difficult."
"Does it matter?"
"It's like this, professor, you may not be aware that it is difficult for us tuberculosis patients to be buried in church cemeteries and ordinary cemeteries." David came closer and explained.
"Why?"
David avoided the crowd and lowered his voice: "The church's view is that the Great Plague will be passed down. They believe that people with severe infectious diseases, such as tuberculosis and syphilis, are unclean and can generally only be placed in specific cemeteries.
Compared with the church, the conditions are indeed a bit worse."
"All infected people?"
"Most of them, if you have a special status, you can be accommodating."