Zheng Ren held a 50ml syringe in his hand. After a simple disinfection, he inserted the needle 0.5 cm above the pubic bone.
The bladder filled with urine was against the abdominal wall. It was not difficult to insert the needle. Then, Zheng Ren began to extract the urine that had accumulated in the bladder.
The 50ml syringe needle tube was about 60ml. After six aspirations, Zheng Ren turned his head to look at the ECG monitor.
As Su Yun's heart compressions and the urine accumulated in the bladder decreased, the heart rate of atrial fibrillation appeared on the ECG monitor.
"Continue the heart compressions, Gu Xiaoran! Prepare for defibrillation! "
"Epinephrine and lidocaine intravenously."
Gu Xiaoran took the defibrillation needle from the circulating nurse and asked, "How much energy?"
“200J。”
"Teacher He, I'm defibrillating." Gu Xiaoran still carefully greeted Lao He. However, when he saw that Lao He was holding a syringe in his hand and was waiting for him to defibrillate first, he felt an inexplicable panic in his heart.
It was like a machine that was originally running well suddenly lagged because of him.
"Xiaoran, give it to me. Hold on tight," Su Yun said anxiously as he knelt on the operating table in a very awkward position and did cardiac compressions.
"Oh, oh." Gu Xiaoran immediately handed the defibrillator to Su Yun.
"Bang ~"
With 200 joules of energy, the patient's ventricular fibrillation improved to a certain extent.
"Continue." Zheng Ren directed the resuscitation.
As the heart rate appeared, his words were no longer as dense as they were at the beginning.
After Zheng Ren extracted 600ml of urine, he took out the needle of the syringe.
"Chief Yu, do a cystostomy," Zheng Ren said as he looked at Chief Yu.
"Oh, okay." Chief Yu stood in the operating area and watched the patient's heart rate and electrocardiogram on the ECG monitor go from normal to disappearing, and then from disappearing to normal. The process had nothing to do with him. It was as if he was watching a very standard emergency rescue.
However … he seemed to be the surgeon. He should be the one standing in the middle to direct the rescue. Chief Yu was a little envious as he watched Chief Zheng command in the middle.
Zheng Ren glanced at the patient's electrocardiogram. It had stabilized and he finally let out a long sigh.
"It's okay. Chief Yu, do a fistula first and then take out the nail," Zheng Ren said.
Although the ECG monitor still occasionally emitted two alarms, it gradually returned to normal after three rounds of defibrillation and the effects of epinephrine, lidocaine, and atropine.
Most importantly, the urine in the bladder had been extracted by Zheng Ren.
After observing for a few more minutes, Chief Yu spread the sterile sheet on the abdomen and began to perform cystostomy. The patient's vital signs had returned to normal.
"Boss, you're really like a mouse and an ant." There were some sweat stains on the front of Su Yun's sterile cap. It was not because he was nervous, but because his posture of half-kneeling on the operating table while performing emergency chest compressions was too awkward.
In fact, it was enough to stand under the operating table and add a footstool, but at that time, the heart rate suddenly dropped like a cliff, and the electrocardiogram was stretched out in a straight line. Who had the time to think about so many things?
He had to come as fast as he could.
"Urinary retention in the bladder stimulated the vagus nerve." Zheng Ren had no intention of going on stage to help Chief Yu. It was just a cystostomy. At the same time, he wanted to check if the 50ml syringe needle had damaged other organs. This kind of operation could not be considered a surgery. It could only be said to be a disposal operation. Zheng Ren would not do it.
"Rich clinical experience again?" Su Yun subconsciously blew. A gust of hot air could not pass through the three layers of mask and flowed out along the gap above the bridge of his nose.
"Yes, are you sure?" Zheng Ren said directly and frankly. He took off the sterile gloves and turned back to sit on the original stool.
"Boss Zheng, Brother Yun, what's going on?" Chief Yu asked with lingering fear.
Just now, when the patient's heart rate dropped like a cliff and the electrocardiogram directly stretched into a straight line, he was stunned and did not know fear. Now that everything was over, looking back, Chief Yu felt fear in his heart.
What the hell?! The patient walked in on his own. How did he suddenly die after a few minutes of surgery?!
"I just said that the vagus nerve was stimulated," Zheng Ren said lightly. He leaned his back against the wall, feeling a trace of coolness coming from the wall. He was also a little glad.
Fortunately, in the end, he could not find the answer. When he came out of the System's operating theater, he heard Su Yun and Chief Yu chatting. They talked about high bladder pressure and the moment the last nail was opened, urine might spurt out.
This thought made Zheng Ren turn around and return to the System's operating theater. He first performed a cystostomy before the surgery. The simulation mannequin did not have a cardiac arrest.
The problem was found, but it was a little regretful that before Zheng Ren could say anything, the patient's heart had already stopped.
However, it was good that he could be saved, Zheng Ren thought to himself.
Seeing that Boss Zheng was not very willing to speak, Chief Yu could only look for the pubic bone and prepare to cut it open to perform a cystostomy while looking at Brother Yun with a questioning gaze.
"The vagus nerve is widely distributed in various tissues and organs in the body and completes various physiological activities with the central nervous system in the form of a reflex arc," Su Yun said and asked, "Have you done eye surgery before?"
Chief Yu shook his head.
"Where did you graduate from? Have you never been to the ophthalmology department during your internship and internship?"
"I have, but the professor definitely won't let me do it. It's already good enough to go to the operating theater and stand on the side to take a look. If I meet a f * cking professor, I can't even go to the operating theater. I can only write medical records downstairs, "Chief Yu said.
"Don't say f * cking first. I reckon you will soon become the kind of f * cking professor you mentioned." Su Yun smiled. "Boss said that in the end, you will become the kind of person you hated the most in the past."
"…" Chief Yu was stunned for a moment, then smiled and said, "Thank you for your auspicious words, Brother Yun."
However, at this time, his smile was so stiff that he had not recovered from the sudden change just now.
Accidents in the operating theater could happen anytime and anywhere. God knows where the problem could be. However, this problem appeared quickly and was solved even faster. The rescue was already over before Chief Yu could react.
But … what did it have to do with the ophthalmology department?
"Brother Yun, what's wrong with the ophthalmology department? Continue," Chief Yu asked as he cut open the skin and separated the layer by layer.
"There is a very rare condition in ophthalmology surgery called the oculocardiac reflex. When the eye muscles are pulled, it will produce a reaction from the vagus nerve, causing the vagus nerve to become over-excited, causing arrhythmia and slow pulse. This is called the oculocardiac reflex.
Uh, no wonder the interns don't go on stage.
"The reflex arc is from the ophthalmic branch of the trigeminal nerve to the pontine nucleus of the trigeminal nerve, then to the dorsal vagus nerve. Finally, the heart muscle responds, and in serious cases, it can lead to cardiac arrest. This patient also has the same principle. Cardiac arrest caused by the vagus nerve reflex, right, boss? "
"Yes." Zheng Ren nodded.
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