It's not that difficult to open a hospital in another world, right? Chapter 442: How do I know that a person under general anesthesia is about to faint?
Chapter 442: How do I know that a person under general anesthesia is about to faint?
Grete’s hand is very steady.
His heart is also very peaceful.
Fill the 20ml syringe with normal saline and insert it steadily into the vascular cavity of the stumped brachial artery. Hold the syringe with the index and middle fingers of your right hand, hold the head of the piston with your thumb, and push the injection forward slowly.
In the previous life, the injection needle used for blood vessel flushing should have a flat head to avoid damaging the lining of the blood vessel. However, Gretel did not expect this when he made the needle.
All needles are beveled! Let the gold coins be made and sterilized now, it’s too late! When transplanting a severed limb, you need to race against time to minimize the damage...
He can only use his own steady operation to keep the needle parallel to the longitudinal axis of the blood vessel to avoid inserting the sharp needle into the inner wall of the blood vessel. Then, he slowly and steadily injects the liquid, allowing the physiological saline to enter the artery along the blood vessel cavity, and smoothly
Along the passage of blood vessels, gurgling forward.
It cannot be fast or slow. If it is too fast, the water column will hit the lining of the blood vessel cavity, which will damage the extremely delicate intima; if it is too slow, the physiological saline cannot reach the end of the limb and then flow back along the vein.
The limbs have been severed, there is no heart beating, and there is no arterial constriction. Only the pressure given by the syringe injection can make the normal saline move forward in the blood vessels. It must reach the end to flush out the accumulated metabolites and clots in the tissues and expand them.
Spasm, closed network of small blood vessels and capillaries.
In his previous life, he had never replanted a severed limb, nor had he undergone an organ transplant. He could only try to find out what the appropriate injection speed was based on his own estimation. Well, first of all, there was no pressure during the injection.
It means there are no blood clots nearby, which is fine...
Inject a tube of normal saline, then suck another tube, and continue injecting. Gretel muttered while rinsing:
"Oh, it would be nice if there was a pump... Flushing with a syringe can't always ensure uniform and stable pressure... Heparin saline should be used here..."
"Heparin?" The silver dragon girl suddenly interjected. She was exactly the same as Gretel. She pulled a floating dish as a stool and stood aside to watch. When she heard Gretel muttering, she immediately asked:
"What is heparin? Is it squeezed out of liver?"
"Did you hear that?" A few steps behind the operating table, Elder Brock's voice was loud and his feather crest was vibrating:
"Master Healer needs a liver! Someone go get a piece of liver! I want fresh one!"
Under his heavy gaze, someone immediately turned around and ran out. Grete sweated profusely:
"Don't!"
Although heparin was, um, discovered from the liver, it doesn't mean that you can squeeze out heparin by taking a piece of liver and squeezing it!
Whether it is unfractionated heparin or low molecular weight heparin, the production process is very complicated and precise! If you give me a piece of liver, I will not use it!
Besides, current heparin is mainly extracted from cow lungs or pig small intestinal mucosa, and it has nothing to do with liver...
The elder who ran out made an emergency stop. Cerela sat at the far end of the operating table, staring at the wounds of the severed limbs through her secret eyes, and asked in a low voice:
"What should we do?"
"What can I do? If not, there won't be anything..."
Grete answered dully through the mask. In the final analysis, saline flushing uses physical methods to remove blood clots; while the use of heparin prevents blood from coagulating again.
Well, as long as he connects blood vessels quickly enough and uses enough treatments, he won't be afraid of blood clots!
"Grete, what are these red, blue and yellow things?"
"Ah, these are the blood vessels and nerves I marked...the red ones are arteries, the blue ones are veins, and the yellow ones are nerves..."
"So later on, it's red after red, blue after blue, and yellow after yellow, right?"
"That's right. That's roughly it..."
Grete stared at the wounds of the severed limbs and explained to her in a low voice. The mage's trick was really convenient. If it were in the previous life, silk threads would have been tied on the wounds to mark them. Not to mention the difficulty of the operation, blood vessels and nerves, there would be
How fragile it is, there will definitely be physical damage if you prick it!
Behind the refuge hut, the elders gathered to listen to the lecture breathed a sigh of relief and almost knelt down to worship.
Miss Elf, you are so considerate! The healer answered your question casually, which saved us a lot of research time! Well, when we finish reattaching the broken arm, we must give her gifts! Give her lots of gifts!
Grete replied in a low voice, operating carefully and trying to maintain the stability of his movements. When he saw the red flushing fluid flowing out, he breathed a sigh of relief:
Well, the flushing fluid is starting to flow out of the bone marrow cavity, which is good;
There is flushing fluid flowing out of the cephalic vein, basilic vein, and brachial vein, indicating that the physiological saline has reached the end of the limb and returned along the capillary network;
These three small points have been marked before and should be the radial accessory artery, the middle accessory artery and the superior ulnar accessory artery. The flushing fluid also flows out, great!
Of course, there were indeed bruises and swelling in some places. After all, it had been caught in the mouth of a leopard once. Gretel would clean up what he could. If he couldn't, he could only let him go for the time being.
After flushing the blood vessels, he assessed the situation and turned to Saiwei, who had been watching tremblingly with a broken arm hanging:
"Lie down, I'm going to start picking up!"
Saiwei's face turned pale. Although he had been mentally prepared, it still felt quite scary to actually lie down and be knifed. Especially, what he was given to lie down on was not a table, but three connected disks.
Slippery, translucent, and it moves when you press it...
The situation was stronger than his own. The elders of his tribe winked, and a group of spellcasters stared at him. He could only climb up and lie down. After a confinement spell fell, he could not speak or move, and he froze there.
.
"Well, it's not necessary..."
Gretel really wanted to say this, but when the words came to her mouth, she swallowed them back:
For replantation of amputated limbs in the arm, theoretically, it is enough to anesthetize the brachial plexus. However, considering the patient's acceptance of the surgery, in order to prevent the patient from jumping off the operating table and running away halfway through the surgery, general anesthesia is better
Go under general anesthesia!
No worries!
Anyway, magical anesthesia is not drug anesthesia. There are no problems such as the metabolism of anesthetic drugs and the burden on the liver and kidneys. It is just numb...
He threw the silver skull and manipulated the skull to cut through Sevi's skin, stretch the muscles, and clamp the proximal blood vessels. Then, he raised the broken arm and gestured forward with the trimmed broken bone.
Alas, it is easier to reconnect if it is broken in the upper arm. There is only one humerus. If it is broken in the forearm, there are two bones: the radius and the ulna. A colleague who worked in the orthopedics department once cried and complained that the two bones were restored together and the radius was fine.
The ulna is crooked, the ulna is healed, and the radius is misaligned again...
How can one cry when one hears it, and saddened when one sees it.
Gretel had his own hands, the silver skeleton's hands, plus five or six mage hands, flying up and down, busy non-stop. Clamping blood vessels, trimming the shape of broken bones, holding rongeurs, clicking, clicking, clicking...
During the previous debridement, Grete had already trimmed the broken bones. But now, after incising the proximal skin and seeing the broken bones with his own eyes, he trimmed them extra carefully, smoothing them as smooth as possible so that they could fit together.
"Is it okay? Can I throw healing spells?"
Serila poked her head around, eager to try. A ball of white light had condensed between her fingers, ready to press at any time. Well, Gretel is just a fifth-level priest with only a little mental power. He should save his mental power.
Come down and do more important things!
I'll do the treatment or whatever!
"Shh!"
Grete whispered to her to be silent. Ah, it feels so unaccustomed to not make the cross section into a trapezoid, to bite each other, and to fix it without Kirschner wires or screws...
But if it is built into a trapezoid shape, the bones, and the entire arm, will be significantly shortened. And here, the bone healing does not take too long, so there is no need to use a trapezoidal bite, and internal and external fixation will increase the strength...
He calculated and operated. The heavy rongeur was as light as nothing in the hands of the silver skeleton. Click, click, click, and compared it to a perfect fit. Then, he re-covered the previously peeled periosteum on the bone stubble.
.
be careful!
Be more careful!
It is best not to injure the soft and fine periosteum! Only when it is covered by periosteum can broken bones grow back easily. Although the treatment method is powerful, if you can save a little, just save a little...
"Okay! Cerela!"
"coming!"
A ball of white light condensed like a substance descended. Gretel stared closely at the cross section of the humerus, watching the periosteum tightly wrapping the broken bone, and watching the gaps in the bones gradually close.
Lying down a little further, I took a photo with Cerela's headgear and looked at the bone seam at the far end that was bitten by the black clouded leopard. It was filled with the healing spell, and there were no more cracks...
sharp!
Excellent therapeutic skills!
Miss Silver Dragon competes high!
This healing spell is already stronger than the treatment of moderate injuries, and it is enough to treat serious injuries! It completely landed on a bone. No wonder the bones immediately fit together tightly, exactly the same as before they were injured!
Grete beamed with joy, raised his thumb to Cerela, and continued working. Well, the bones are fixed, and the next step is the blood vessels. If the blood vessels can be successfully anastomotic, the arm will be alive, and the only question left is how much function it can recover.
.
Gretel put away the silver skull, closed his eyes, and concentrated his mind. Then, he circled the thumb and index finger of his right hand in a circle and gestured to Miss Silver Dragon:
Magic magnifying glass, come~
"Too close! Move further! Further away!"
"Bigger magnification! No, I'm not asking you to make the magnifying glass bigger, I'm asking you to make the magnification bigger!"
"Crooked! Crooked! Raise the left side a little higher!"
"If you raise it a little higher, your hands will touch it! It will contaminate the lens!"
Facts have proved that the tacit understanding between Gretel and Miss Silver Dragon still needs to be cultivated...
Up and down, stumbling. The magnifying glass was finally adjusted to a comfortable position for Grete. Grete concentrated on it and began to anastomose the blood vessels. The brachial artery, cephalic vein, and basilic vein. With one movement and two rests, the anastomosis of the three blood vessels was completed, and he was ready to open the blood vessel clamp.
"Celera, prepare a healing spell! If he is dizzy, palpitating, or his eyesight goes black, cast a spell immediately!"
The blood volume has not been replenished and the blood pressure has not risen. Once the arteries are opened after the severed limb is reconnected, the patient's blood pressure will easily plummet!
At this time, you can only rely on healing skills to support the scene!
"...but he is imprisoned there, how do I know that he is dizzy and palpitating?"
"..."
"..."
This is a good question... If a person is under general anesthesia, you won’t know if he faints!
It’s better to remove the blood pressure monitor as soon as possible!
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