Doctor: I picked up attributes in the hospital

Chapter 165 To make matters worse-brain stem glioblastoma discovered!
"Doctor Zhao?"

Wang Li, a nurse in the emergency department, stood by, waiting for Zhao Heng's order.

As a nurse in the emergency department, it can be said that this kind of scene is staged several times a day.

"Sodium nitroprusside 4 units, esmolol load 0.5 statically pushed for 1 minute, and maintained for 10 minutes."

Seeing the dazzling red blood pressure number on the life monitor, Zhao Heng quickly made a decision.

Sodium nitroprusside is the drug of choice for hypertensive crisis. It is a short-acting antihypertensive drug. Its nitroso gene decomposes to produce NO, which causes vasodilation, which can expand arteries and veins at the same time.

As for esmolol, as a selective β-receptor blocker, it is mainly used for tachycardia and hypertension during induction of anesthesia, tracheal intubation, operation, recovery from anesthesia, and postoperative tachycardia.

The reason why Zhao Heng chose the combination of sodium nitroprusside and esmolol was, on the one hand, to quickly lower blood pressure, and on the other hand, to stabilize the patient's heart rate and prevent arrhythmia.

It can be said that if it is not a senior emergency doctor who has worked in the emergency department for decades, he would not be able to come up with such a complete emergency blood pressure reduction plan.

"Okay, Doctor Zhao."

Hearing Zhao Heng's order, Wang Li immediately responded.

However, in Zhao Heng's body at this moment, Wang Li unexpectedly saw a calm demeanor that can only be found in the chief doctor.

After a while, Wang Li prepared two medicines and began to inject the patients.

After the drug enters the patient's vein, it works immediately.

230/120
200/100
. .

After 3 minutes, the blood pressure dropped to 140/80mmHg. This blood pressure is at the borderline high blood pressure and has already left the hypertensive crisis.

"Senior, you can start the operation."

Seeing that the blood pressure dropped steadily and safely, Zhao Heng couldn't help heaving a sigh of relief, and said to Liu Ziang.

"okay."

Liu Ziang nodded.

Liu Ziang never doubted Zhao Heng's ability to deal with emergencies.

Every time, Zhao Heng never let him down.

"let's start."

Liu Ziang said to Li Yang and the two firefighters.

Next, Li Yang wrapped the two ends of the steel bar with a towel, and then he and Liu Ziang held the two ends of the steel bar with both hands.

As for the two firefighters, one fireman fixed one end of the steel bar with a hydraulic demolition pliers, and the other fireman held an angle grinder and used the angle grinder to cut the steel bar little by little, constantly sending out sparks , and buzzing.

After a while, the exposed part of the steel bar on the migrant worker's head was cut off.

This process looks very thrilling.

As the part of the exposed head was cut off, the migrant worker was immediately sent to the CT examination room for examination of his brain.

10 minute later.

CT examination room operating table.

At this moment, the uncle migrant worker's head has been wrapped with thick gauze, and he is lying on the examination table, ready for brain CT examination.

On the other hand, Zhao Heng and Liu Ziang stood behind the console, watching the real-time images of the brain appearing on the electronic screen.

"Director Liu, this patient is very lucky. The steel bar is only 0.5mm away from the middle cerebral artery."

Xu Jin, the chief physician of the imaging department, looked at the brain CT image displayed on the electronic screen and said in amazement.

"Of course I'm lucky, otherwise I wouldn't be able to wait to be sent to the hospital."

Liu Ziang nodded and said.

In fact, every year, there are many accidents on the construction site, and it is not uncommon for workers to have their bodies penetrated by steel bars.

There are always a few lucky people who survived the steel bar piercing through the abdomen, chest and even the head.

At this moment, Zhao Heng discovered that something was wrong with the image on the electronic screen.

"Mr. Xu, can you enhance this piece?"

Zhao Heng pointed to a place on the screen where the density of the brain tissue area was significantly reduced.

"This piece?"

Xu Jin was a little puzzled, and then looked in the direction Zhao Heng pointed.

"This... this is where the brainstem is."

Just looking at it for a while, Xu Jin, who has rich experience in imaging diagnosis, was a little surprised.

The function of the brainstem is mainly to maintain the life of the individual, and a series of important physiological functions including heartbeat, respiration, and digestion are all related to the brainstem.

Therefore, under normal circumstances, lesions rarely occur in the brainstem.

And once the disease occurs, the situation will be extremely serious.

"However, in the case of this low-density shadow, sometimes brainstem degeneration will also appear, which may not necessarily have clinical significance."

Xu Jin thought for a while and said again.

"No, this is not brainstem degeneration, this is brainstem glioblastoma!"

Liu Zi'ang looked at the place Zhao Heng was pointing at, and said with a serious expression.

"Isn't it?"

Xu Jin was a little surprised by Liu Ziang's judgment. This brainstem glioblastoma is very rare.

"It is very likely that the worker who brought the patient said that the patient fell from a scaffold that was two meters high. For experienced workers, two meters is not a very high height. Therefore, the patient is extremely It may be because of sudden dizziness that he fell down. What's more, in the late stage of brain stem glioblastoma, cranial nerve palsy, symptoms of unsteady gait and ataxia may also occur. These are all possible It was what caused the patient to fall directly."

Zhao Heng thought for a while and said.

In the emergency room just now, Zhao Heng was a little surprised at the injury of the migrant worker uncle.

For those who have been working on construction sites for a long time, two meters is not a very dangerous height.

Many operations are carried out at a height of several meters or even tens of meters.

The height of two meters can only be said to be very ordinary. Moreover, once the height of such a height becomes unstable due to an accident, the person himself has a certain emergency response ability, and it will not be like facing backwards and falling straight upside down. He fell down and got stuck in the head by a steel bar.

"..."

At this moment, Xu Jin is already a little down.

With a penetrating head injury, he can still be sent to the hospital, which is already saving his life.

Now a brainstem glioblastoma has been discovered!
Brainstem tumors were considered a "forbidden area" for surgery in the past, because the brainstem has many nerve nuclei, conduction bundles, and reticular structures concentrated in a small area.

Brainstem tumors are mostly glioblastomas with infiltrative growth, so surgery is difficult, and it is easy to cause damage to important structures in the brainstem, resulting in high surgical disability and mortality, and poor prognosis.

Adding the two together, Xu Jin didn't know how to do this operation.

"Student, are you sure about anesthesia?"

Liu Ziang said to Zhao Heng with a solemn expression.

In this patient's case, it was tricky enough to safely remove the rebar from the head.

Not to mention, the tumor in the brain stem must be removed at the same time.

The more difficult situation is that the brainstem is an important part that controls the human body's breathing and heartbeat. When surgery is performed on the brainstem, the patient may experience respiratory and cardiac arrest at any time. In this case, the patient should be anesthetized to maintain a normal life One can imagine how difficult the signs are.

(End of this chapter)