"Old Mu is performing surgery. What's wrong?" Su Yun asked lazily.
"The patient's heartbeat stopped!" The nurse shouted, turned around, and ran back.
Uh …
The operating room next door?
Su Yun suddenly stood up. Through the lead-lined glass, he saw Zheng Ren turn around. He did not even tear off his sterile clothes. He opened the sensed airtight lead door and strode out.
"Old Wu, don't worry. I'll go over with the boss." Su Yun strode away and did not forget to explain to Old Wu.
At Old Wu's age, he was really afraid that he would participate in the emergency treatment and cause a heart attack first.
The interventional surgery operating room of Shenzhen Development Zone People's Hospital was not big. There were only five operating rooms. The airtight lead door of the operating room with the red light of surgery was closed. A panicked voice came from the operating room.
"Push the medicine! Atropine 1mg! "
Zheng Ren walked over quickly and immediately saw a pale System panel. The diagnosis on it was already blurry. He could vaguely see the diagnosis of coronary atherosclerotic heart disease, carotid artery stenosis, and so on.
The doctor from the circulatory department was doing cardiac compressions. The nurse was drawing the medicine and preparing to push it.
The screen of the surgery showed that the carotid artery intervention was at the bifurcation of the right internal carotid artery. The pressure receptor here was more sensitive, and the reflex adjustment was mainly for a short period of time. It could react to the pressure in a few seconds.
This was to do a coronary stent. When the carotid artery stenosis was opened, the heart would stop.
Zheng Ren glanced at the situation and went straight into the System's operating theater.
Su Yun quickly followed behind Zheng Ren. Seeing that the nurse was a little slow in drawing the medicine, he said, "Lao He!"
Lao He did not answer. Instead, he walked over silently and firmly. He walked to the side of the emergency vehicle, broke open a tube of atropine, drew it into the syringe, opened the three-way, and directly injected it.
Emergency treatment tested one's psychological quality and skill level.
The young nurse was like a recruit who had just entered the battlefield. When she heard the roar of the cannon, she was immediately frightened. She was not as skilled as Lao He, a veteran who had experienced countless battles.
Her skill level was already average. If she panicked, there would really be nothing left.
"Lao He, intubate," Zheng Ren suddenly said. "Go around and push the ventilator over. Su Yun, go do cardiac compressions. Increase the strength and frequency. "
After saying that, he tore off his sterile clothes, took off his sterile gloves, and turned around to wash his hands.
Su Yun did not hesitate. He walked to the host surgeon's side and bumped his shoulder, pushing the host surgeon away from his chest.
The host surgeon was dumbfounded.
However, at this time, if there was a doctor who could confidently take over the rescue, she would definitely not stop him.
At the beginning of the surgery, the balloon was slightly opened and the patient suffered cardiac arrest. Logically speaking, the Circulatory Department was very good at emergency rescue in this area. However, after pressing for 30 seconds, the heart did not beat again, and he immediately panicked.
"You, go charge the defibrillator." Zheng Ren went to scrub in while Su Yun took over directing the rescue operation.
He was a fearless commander, full of the style of a director.
One by one, atropine, dopamine, and adrenaline were pushed in. Lao He completed the tracheal intubation as quickly as possible and handed the balloon to the assistant doctor.
Zheng Ren came in after washing his hands and put on a sterile suit.
"Boss, what should we do?"
"The carotid artery stenosis still needs to be opened up. What about Old Mu?" Zheng Ren took a glance and saw that Su Yun was doing chest compressions at a frequency of 110 beats per minute. The waveform on the ECG monitor had not recovered. Just like in the operating theater, it was also a little urgent.
"Boss Zheng, I'm here." Mu Tao completed the last step of the surgery and rushed in.
When the doctor from the Circulatory Department saw Mu Tao come in, he finally saw his savior. He said hoarsely, "Professor Mu, the patient's heart has stopped …"
"Boss Zheng, what should we do?" Mu Tao asked with a frown.
"You go push the ventilator. I'll go down the stent." Zheng Ren stood in the surgeon's position and glanced at Su Yun.
"Why are you looking at me? If I'm not wearing a lead apron, then I'm not wearing one. Just hurry up and do it." Su Yun's arms were straight as he continued to perform CPR.
The airtight lead door slowly closed. At this time, Zheng Ren had already begun to step on the line.
The position of the balloon changed slightly. Zheng Ren sent it inside again and found the place where the carotid artery was narrowed. He opened the narrowed segment and sent it into the CRISTALLO
6-9mm x 40mm self-expanding stent.
As the carotid artery was opened, Su Yun's movements gradually slowed down.
The compression fluctuations on the patient's ECG monitoring also gradually returned to ventricular tachycardia. After a few seconds, sinus rhythm was restored.
Zheng Ren stopped stepping on the line and said, "Put on the lead apron."
Su Yun looked at the values on the monitor and nodded. He turned around to put on the lead apron with Lao He.
The surgeon from the Circulatory Department stood at the side with a blank expression.
"Little Sun, what's going on?" Mu Tao asked.
"The patient's diagnosis is coronary atherosclerotic heart disease, exertional angina, arteriosclerosis of both lower limbs, and carotid artery stenosis. Originally, I wanted to solve the carotid artery stenosis first and then put down the stent, but I didn't expect the heart to stop just as the balloon was put in. "
Mu Tao nodded.
Significant carotid artery stenosis was an important risk factor for perioperative stroke in patients with coronary artery stents. The stroke rate was as high as 3% to 11%, and it was positively related to the degree of carotid artery stenosis.
The patient's condition was clear. There were no problems with the preoperative diagnosis and surgical indications.
The treatment was correct, and the surgery was normal. The carotid artery stenosis should be solved first. However, the patient's heart stopped for a long time, so he was immediately stunned.
"Boss Zheng," Mu Tao asked softly.
"Tell me about the surgery process," Zheng Ren said. "There shouldn't be any big problems. Don't be nervous."
"The patient's condition is much better. Is he still using the ventilator?" Mu Tao asked.
"He has to." Su Yun came back in his lead apron and said disdainfully, "The patient with coronary artery stenosis had a stroke during the perioperative period because of carotid artery stenosis. The prognosis is very poor, and the mortality rate is about 50%."
Mu Tao was an interventional doctor, not a doctor from the Circulatory Department. If he were to help with the rescue and perform coronary artery stent surgery, he would have no problem. However, when it came to more detailed things, especially pathology and physiology, he would not be able to help.
"Tell me about the process," Zheng Ren reminded him again.
"Preoperative angiography showed 90% stenosis of the proximal right internal carotid artery. I used a super-smooth guide wire to send 8F
MPAI guide tube to the right common carotid artery, SpiderRX
5.0mm to the distal right internal carotid artery, into Sapphire
4.0mm x 20mm balloon, give 15ATM. After five or six seconds, the patient's heart stopped beating. "
The surgeon should be the Circulatory Department Chief of the Shenzhen Development Zone People's Hospital. Under Zheng Ren's pressure, he directly became a junior doctor and began to report the surgery process.
When emergency treatment was basically ineffective, it was undoubtedly a relief for the surgeon to have someone step forward.
In the face of a sudden cardiac arrest, he could still be so firm and full of confidence to command the rescue. Needless to say, his skill level was much higher than his own.
"Yes, it squeezed the carotid pressure sensor," Zheng Ren said. "After balloon dilation, cardiac arrest, ventricular fibrillation, and malignant arrhythmia are common complications."
"Boss Zheng, I thought we would have to give up the surgery," Mu Tao said with a long breath.
"There's no need. The cardiovascular activity center in the brain controls the heart and blood vessel activity through the sympathetic and vagal nerves, so that arterial blood pressure is maintained at a certain level.
"When the balloon dilates, the arterial pressure sensor immediately feeds this information back to the cardiovascular center through the afferent nerve. The cardiovascular center's activity changes accordingly, causing the heart rate to slow down, peripheral blood vessels to dilate, and blood pressure to decrease.
"The pressure in the balloon rises too fast, the diameter is too large, the pressure is too high, the duration of dilation is too long, and the sensitivity of the pressure reflex is too strong. These may be the cause of cardiac arrest.
"It'll be fine after the surgery. He'll recover after a while." Zheng Ren smiled.
"Old Mu, where's Old Wu?" Su Yun suddenly asked.
"The teacher is watching the patient during the surgery …" Mu Tao said.
"That's fine. Prepare for the next surgery. This should be solved soon." Zheng Ren smiled.
"We don't need to use the heart stent, right?" Su Yun asked the surgeon.
"No … No need. Sorry for the trouble," the surgeon said politely in a low voice.
Bringing the patient back at this time was equivalent to bringing himself back. The surgeon felt that it was not enough to express his gratitude.
However, she was still a little confused, still immersed in the nightmare of the patient's sudden death.
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