Doctor: I picked up attributes in the hospital

Chapter 129 Patients with Acute Traumatic Brain Injury

Nine forty at night.

Emergency Department.

As the saying goes, putting out an emergency is like putting out a fire. After receiving the report from the resident doctor, Liu Ziang immediately dragged Zhao Heng from the brain surgery to the emergency room.

Why did Liu Ziang pull Zhao Heng? On the one hand, it was just a joke. On the other hand, of course, it was because Zhao Heng was a doctor with extremely high professional and psychological qualities, especially in emergency response. .

When Zhao Heng and Liu Zi'ang arrived at the emergency room, the patient was already lying in the emergency room, with a tracheal tube inserted, and monitoring of blood pressure and heart rate all in place.

As soon as the two entered the emergency room, Li Yang, the doctor in charge, immediately greeted them. Seeing Zhao Heng and Liu Ziang appearing together, Li Yang was a little surprised.

Just over a month ago, Li Yang thought that if a young doctor with a solid foundation like Zhao Heng could win over the director assistant, it would be great to come to the emergency department.

What Li Yang didn't expect was that the world was changing so fast. In just over a month, Zhao Heng's rapid rise to the position caught everyone who knew him before being caught off guard.

This time, they have already mixed up with big shots like Liu Ziang.

"How is the patient?"

Liu Ziang asked in a deep voice.

As soon as he heard that it was an acute craniocerebral injury, Liu Ziang didn't dare to delay, so he dragged Zhao Heng along.

"The patient is a 60-year-old male who suffered a serious car accident, suffered acute mechanical trauma, and suffered severe brain damage. He had a history of hypertension, spontaneous breathing 6 times/min, and blood pressure 80/60mmHg. Suspected subarachnoid hemorrhage and skull plate fracture."

Li Yang quickly and professionally introduced the patient's condition.

It can be said that the patient's condition is indeed critical, and he is almost dying.

"Subarachnoid hemorrhage? Skull plate fracture?"

Hearing Li Yang's words, Liu Ziang touched his chin and fell into a short thought.

If the patient has a history of hypertension in the past, it is very likely that during acute trauma, the blood pressure will rise sharply, causing cerebral blood vessel rupture and bleeding.

But it is also possible that the fracture of the skull plate caused blood vessels to cause bleeding. I am afraid that the specifics of this can only be known after an acute craniotomy is performed and the skull is opened.

"It seems that a craniotomy is necessary, junior, and I will leave the anesthesia to you."

After thinking for a while, Liu Ziang made up his operation plan. He turned around, patted Zhao Heng on the shoulder and said.

"it is good."

Zhao Heng readily agreed. The patient in front of him was almost breathless. Not only was the operation risky, but he might not be able to get off the operating table. The risk of anesthesia was also great.

Liu Ziang handed over this matter to him, which is also his trust and recognition.

Although he didn't know why Liu Ziang and Zhao Heng appeared together, Li Yang was shocked to see Liu Ziang handing over the anesthesia for such a critically ill patient to Zhao Heng.

Li Yang knew very well that Liu Ziang's level was unfathomable. If Zhao Heng hadn't really possessed the ability to anesthetize such a critically ill patient, he would not have given it to Zhao Heng.

That's it, Li Yang was also surprised by how quickly Zhao Heng's level improved.

Next, Liu Ziang and Zhao Heng introduced the patient's condition to the family members and explained the risks of the operation.

Although the patient's family members felt grief, they also showed that they could accept the risk and signed the preoperative informed consent form when they saw the patient with only one breath left.

After the preparations were made, the patient was quickly sent to the operating room, and the emergency operation was about to begin.

Zhao Heng first came to the operating room to prepare. As soon as he entered the operating room, Tian Zhen, the equipment nurse, looked at Zhao Heng in surprise.

At this point, shouldn't Zhao Heng be off work long ago?Why are you in the operating room again?
"Aren't you off work?"

Tian Zhen asked with some doubts.

"Stop talking, Director Liu has arrested him."

Zhao Heng said helplessly that with the patient's condition, it seemed that he would be busy at least until three or four in the morning.

"That's because you are capable, so he came to you."

Tian Zhen said with a smile.

"Let's not talk about this, immediately prepare sufentanil, cisatracurium besulphonate, and propofol, the amount must be sufficient."

Zhao Heng shook his head slightly, indicating that he didn't want to talk about why Liu Ziang arrested the young man, but quickly gave Tian Zhen an order.

"okay."

Tian Zhen didn't hesitate at all. She and Zhao Heng cooperated very well, which was reflected in the previous operation cooperation.

Zhao Heng was preparing anesthesia for the operation, and after a while, the patient was pushed to the operating room.

As soon as the patient was brought in, Zhao Heng, with the cooperation of Tian Zhen, immediately switched the patient to machine-controlled breathing and put on ECG monitoring. This set of procedures, the cooperation of the two was extremely proficient and fast, and he watched Liu Ziang was a little surprised.

He has done a lot of surgeries, but it was the first time he had seen the anesthetist and the equipment nurse cooperate so well and in such a tacit understanding.

After completing these preparations, Zhao Heng began to check the patient for preoperative anesthesia.

"The left pupil of the patient has been dilated, and the light reflex has disappeared."

After checking the patient's signs, Zhao Heng said to Liu Ziang very solemnly.

The dilated pupils and loss of light reflex indicate that the patient's oculomotor nerve injury or midbrain injury, no matter what it is, indicates that the patient is dying and dying.

"Just let it go."

Liu Ziang nodded and said in a deep voice.

This is not the first time Liu Ziang has seen this kind of situation in brain surgery, and it is the first time he has dealt with it.

"Let's start, sufentanil 20 micrograms, cisatracurium besylate 10 mg, propofol 80 mg intravenous induction, execute immediately!"

Zhao Heng quickly said to Sun Meng, the itinerant nurse who was already in place at the side.

The patrol nurse was not in place just now, so Tian Zhen, the instrument nurse, was helping Zhao Heng. Now that the patrol nurse is in place, Tian Zhen has to concentrate on preparing the surgical instruments.

In the operating room, the division of labor is very clear.

"Ok."

Sun Meng responded immediately and began to carry out Zhao Heng's orders.

Next, Zhao Heng underwent catheterization of the right internal jugular vein and catheterization of the right radial artery for invasive blood pressure monitoring, as well as an autologous blood recovery machine.

Seeing Zhao Heng's series of complex but not chaotic, fast, precise and orderly operations, Liu Ziang couldn't help nodding, and looked at Zhao Heng appreciatively.

In his opinion, this series of complicated operations, in the entire Eastern Hospital, probably only Zhao Heng can do so neatly.

If the anesthesia is done well, the surgeon will have confidence in his heart, and they all complement each other.

Ten minutes later, Sun Meng, the itinerant nurse, said, "Dr. Zhao, blood pressure is 10/125mmHg."

"Well, norepinephrine 0.4 mg intravenously."

Zhao Heng nodded. The patient's blood pressure has been pulled back, so it must be maintained continuously, which is a prerequisite for the operation.

After another 10 minutes, Sun Meng said again: "Blood pressure 140/70mmHg, end-tidal carbon dioxide partial pressure 34."

Hearing Sun Meng's report, Zhao Heng nodded and said to Liu Ziang, "The operation can begin."

"Okay, let's start."

Liu Ziang nodded, and said to the resident doctor Xiaosun who was already waiting at the side.

(End of this chapter)