"Do you suspect that the sputum is blocked?" Su Yun asked. He did not look like it and was a little puzzled.
Zheng Ren did not say anything. He took the sputum suction tube and tried it twice. The tube was unobstructed. Then, he sent it into the patient's tracheal intubation.
The sputum suction tube made a hissing sound. Only a small amount of secretion was sucked out. It seemed that it was not the sputum blocking the trachea.
As he continued to send the sputum suction tube in, Zheng Ren was suddenly stunned.
"Boss, what's wrong?"
"There's something inside. The sputum suction tube can't be sent in," Zheng Ren said.
"…" Su Yun and the ICU chief resident were stunned. Lin Yuan stood behind and did not understand what Boss Zheng meant in an instant.
This situation was beyond everyone's imagination.
Su Yun immediately recalled the patient's preoperative chest X-ray and chest CT scan.
It was impossible for there to be a problem. If there was something before the surgery, the ventilator would have also sounded the alarm during the surgery.
"What did you do?" Su Yun looked at the ICU chief resident very seriously and asked.
The ICU chief resident was stunned.
He did not give anything. When the patient was sent back after the surgery, he was slightly agitated. At first, he was not given any treatment. According to the anesthesiologist Lao He's suggestion, the patient was observed for six hours and prepared to be extubated.
However, as time passed, the patient became more and more agitated. In the end, a few people could not hold it down, so they gave propofol helplessly.
Continuing to calm down would prolong the time of extubation, but the patient's agitation could not be denied.
The ICU chief resident thought about it carefully and called the nurse over to ask. However, at this moment, Zheng Ren suddenly said in a deep voice, "No! The tracheal intubation was broken! "
"Uh …" Su Yun glanced at the tracheal intubation. It was an enhanced type. Broken? That was impossible.
The ICU chief resident was also stunned. She immediately explained, "Boss Zheng, the enhanced tracheal intubation …"
"Prepare the fiberoptic bronchoscope and bedside chest radiograph!" Zheng Ren did not discuss with them and directly gave the order.
"Okay." Su Yun did not hesitate and pulled the ICU chief resident to push the X-ray machine.
Zheng Ren pushed the bedside X-ray machine over and began to take the patient's radiograph.
He set up the position, projected the radiograph box, took the radiograph, and asked Lin Yuan to take the radiograph box to the radiology department to develop the radiograph.
At this time, the chief resident had already prepared the fiberoptic bronchoscope.
He removed the ventilator and the tracheal intubation tube.
When he extubated the tracheal catheter, he found that the tracheal catheter was disconnected, leaving only about 12cm of the end of the catheter. The rest must have been left in the patient's trachea.
The foreign body in the trachea that the System had hinted at was actually part of the enhanced tracheal intubation!
Even Su Yun and the ICU chief resident were dumbfounded when they saw the situation.
What the hell was going on? Even the reinforced tracheal intubation could be broken?! How did it break? Did he make a mistake while moving the patient? How much force would it take to break a reinforced tracheal intubation?
The ICU chief resident carefully checked the location of the broken tracheal intubation and whispered, "Boss Zheng, Brother Yun, it doesn't look like there's a quality problem."
Zheng Ren had already noticed that the broken end of the tracheal intubation was incomplete. He had a guess in his heart, so he said in a deep voice, "The trachea did not break on its own. The patient broke it with his teeth."
"…"
"Hurry Lin Yuan and ask the radiology department to upload the radiographic films as soon as possible." Zheng Ren narrowed his eyes as he looked at the patient's ECG monitor.
Although there was a foreign body in the trachea, the tracheal intubation itself was a tube. It would only cause intense stimulation and would not directly block the lumen, causing the patient to suffocate to death.
Soon, the bedside X-ray was uploaded, and Zheng Ren saw the patient's first-hand information.
The X-ray showed that the front tracheal catheter had entered the right bronchus …
Looking at the image on the computer, the few of them sighed.
This' medical accident 'came out of nowhere and caught them off guard. If they found it, they would take out the tube. They hoped that there would be no more trouble.
"Boss, do you still remember what the patient's family said that day?" Su Yun suddenly asked.
Zheng Ren recalled that the man squatting on the curb was crying bitterly. He remembered that he had said something about the patient's situation and that the patient had refused treatment.
When he was undergoing surgery, the patient's expression was very ugly. He only entered the operating theater after the patient's family and Chang Yue persuaded him.
It should be because after he woke up from general anesthesia, the patient's subconscious obsession was causing trouble. He was unwilling to spend money. Instead of spending money on surgery, it was better to just die.
He did not expect the obsession to be so strong. Zheng Ren could understand it. After being a doctor for so many years, he had seen many strange patients.
However, the strange thing about the patient in front of him was the same obsession. Generally speaking, the desire to live was very strong.
Old people who usually said that they would die when they were old and not be a burden to their children would not be able to do so when the day came.
There was a great fear between life and death. Until that moment, very few people could feel the threat of death.
Generally speaking, unless they were at the end of their rope or had no one to care about them, very few people would be so determined to die.
"Ask Chang Yue … Just call her … Forget it, take out the tube first. The patient can go offline and watch. After that, let the patient's family and Chang Yue do their work, "Zheng Ren said helplessly.
Su Yun nodded. There was no good way to deal with such a patient who wanted to die.
Zheng Ren did not lament the vicissitudes of life. Under propofol anesthesia, he used a fiberoptic bronchoscope to remove the front half of the broken tracheal tube from the trachea.
Comparing the location of the broken tracheal tube, it was more certain that the patient had broken it with his teeth after waking up from the anesthesia.
Zheng Ren did not know whether to laugh or cry at the unexpected turn of events in the end. However, it also proved the success of the surgery — the patient had used his teeth to break the strengthened tracheal tube.
He contacted Lin Ge and the medical administration division, then called Chang Yue and the patient's family over to explain the matter.
The surgery was successful. It was said that the patient could walk the next day and be discharged a week later. The patient's family was overjoyed. However, after seeing the tracheal tube that had been broken by teeth, he was stunned for a long time and apologized to Zheng Ren with tears in his eyes.
Zheng Ren was afraid that the patient would cause trouble again, so he simply got a chair and sat at the patient's bedside, staring at him without blinking.
Postoperative tracheal tube rupture was extremely rare, especially the strengthened tracheal tube rupture, which had not been reported clinically. This case was extremely special. Through the remains of the catheter, it could be confirmed that the catheter had been repeatedly broken by the patient's teeth.
This was discovered early. If it had been a little later, it would have probably been more twists and turns.
After two intermittent echocardiograms, the patient's left ventricular ejection fraction increased to about 60%. The effect of the surgery was completely beyond imagination.
Four hours later, the patient was fully awake. Seeing that all the indicators were very satisfactory, Zheng Ren transferred the patient out of the ICU, leaving the patient's family and Chang Yue to do the rest.
…
…
Note: It's true. I heard from a teacher that it happened many years ago. Regarding the rupture of the reinforced tracheal intubation, he had only heard and encountered one case.
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