Time was no longer measured in days, nor in hours, but in seconds.
As the seconds ticked by, the patient's invasive arterial blood pressure steadily decreased. His heart rate stopped at 150 beats per minute.
However, this kind of tachycardia was already very scary. No one knew when it would fall off a cliff, and the patient could be declared dead.
The oxygen saturation had dropped to around 66%. The anesthesiologist had already started to change to a 100% pure oxygen ventilator.
Under the effect of pure oxygen, the blood oxygen saturation rose briefly and then steadily fell.
"Director Liu, it's a gas embolism." The anesthesiologist was a little flustered. All the possibilities he could think of had been eliminated, and the only diagnosis left was the high mortality rate.
If it was a gas embolism, the anesthesiologist's voice was trembling when he said this.
Chief Surgeon Liu took a look. The Hem-o-lock was placed at the bifurcation of the renal vein, completely clamping the renal vein. There was no possibility of a large amount of carbon dioxide entering the blood circulation through the pressure difference when a pneumoperitoneum was established.
He denied the anesthesiologist's statement, but he still cautiously stopped filling the abdominal cavity with carbon dioxide and pulled out Tropica to relieve the pneumoperitoneum.
However, there was still no change in the patient's condition. The emergency medication had been given, and the vital signs shown on the monitor were still declining.
"Call Chief Miao," Chief Liu said in a deep voice.
The circulating nurse was stunned. Time seemed to have returned to half a year ago. No matter what happened, as long as he called Chief Miao, it could be solved.
However, she did not hesitate. She did not care that Chief Miao had retired. Instead, she immediately dialed Chief Miao's number.
…
…
Chief Miao sat at home and gossiped with Zheng Ren and Su Yun.
They chatted about all sorts of things, but not about medical treatment. He had been doing this for a lifetime, and now that he had retired, he should just let it all go far away.
"Chief Miao, my mother also dances square dancing at home. I just don't understand what's so good about it. Tell me, what's so good about it? "Su Yun said." Why is it that the wind and rain are not delayed? The old man and the old lady are so proud of this thing. "
"Everyone is here to join in the fun," Chief Miao said with a smile. His voice was full of energy. He had basically completely recovered. Apart from the slight problem of walking due to the fracture, everything else was fine.
"I don't have much to do at home, so I'm just idling around."
"I have a dog at home. Why don't you walk it for me when you're free? While I'm at it, I'm at it. Hei Zi's legs were broken during the earthquake relief, so he can't run fast. Don't worry, he's faster than you, "Su Yun asked with a smile.
Chief Miao was about to scold him when the phone rang.
He leaned back on the sofa and leisurely picked up his phone. He glanced at it and saw that it was a call from the operating theater. He immediately sat up straight, and the smile on his face disappeared, leaving only dignity and solemnity.
"What's wrong, Chief Miao?" Su Yun asked.
Chief Miao waved his hand and did not answer Su Yun's question. Instead, he picked up the phone.
"What's wrong?" Chief Miao asked in a deep voice.
Loud and hurried noises could be heard coming from the other end of the line. Both of them could hear bits and pieces of it.
Uh … the patient's condition isn't good?!
The two of them looked at each other. If they were in the 912, they would have already rushed to the operating theater at this time.
However, they were now at Chief Miao's house. By the time they arrived at the hospital, the cucumber would have turned cold.
In the Department of Genitourinary Surgery, there would be a laparoscopic nephrectomy in the afternoon. Did he touch a blood vessel that was not supposed to be touched?
"Video. I'll take a look at the patient's condition," Chief Miao said in a deep and serious voice after listening to the simple introduction.
The phone hung up. Chief Miao saw that Zheng Ren and Su Yun were staring at him, so he explained, "He was performing a laparoscopic nephrectomy. Suddenly, his blood pressure and heart rate became unstable, and his blood oxygen saturation dropped rapidly."
That was really the case!
"Did he touch a blood vessel?" Su Yun asked.
"It shouldn't be. If he touched a blood vessel, it would be over," Zheng Ren said. "It's probably an inexplicable situation. Is it caused by the vagus nerve reflex? "
Chief Miao shook his head slightly. "It's rare for the vagus nerve to cause cardiac arrest during nephrectomy. It's usually fine with medicine."
Just as he said this, the sound of a WeChat video call rang. Chief Miao picked up the video request.
"Chief, the patient …" Chief Liu's voice came from the video. He held his phone and pointed the screen at the television screen of the laparoscope. "There's no bleeding. The patient's blood pressure and heart rate …"
"The heart stopped! CPR! "the anesthesiologist shouted loudly.
Zheng Ren and Su Yun quickly surrounded Chief Miao and looked at the screen.
The heart rate dropped like a cliff, and the blood oxygen saturation was 52%. The alarm on the ventilator and monitor kept ringing. Even when they saw this scene at home, the three of them naturally secreted a large amount of dopamine, adrenaline, and glucocorticoids.
"Anesthesiologist, adjust the operating table. The head is low and the feet are high," Chief Miao said.
However, the screen was in a mess. The anesthesiologist was pushing the medicine, and Chief Yu was doing cardiac compressions. Because they had not found the problem, everyone panicked.
"Anesthesiologist! Xiao Liu, adjust the bed. The head is low and the feet are high! "Chief Miao raised his voice and said unquestionably.
Soon, the bed was adjusted to an angle and changed its position according to Chief Miao's instructions.
Epinephrine, isoproterenol, and sildene came out of Chief Miao's mouth one after another. The other side of the video carried out the doctor's orders.
It was as if an invisible hand had turned back time and returned to the past again. At this moment, Chief Miao was standing in the operating theater and presiding over the rescue.
"Chief Miao, what are you thinking about …"
"The establishment of a pneumoperitoneum caused a gas embolism," Chief Miao said with certainty.
If Zheng Ren was present, he could use the System panel to make a judgment. If Chief Miao was not there, Zheng Ren would probably have to ponder for a while before he could be sure.
After all, the establishment of a pneumoperitoneum caused a gas embolism was so rare. At the very least, Zheng Ren had never encountered a similar situation when he performed laparoscopic surgery in the General Surgery Department.
Laparoscopic nephrectomy. Zheng Ren quickly searched for similar information in his mind.
For patients with kidney disease, laparoscopic nephrectomy was a minimally invasive, safe, and effective surgical treatment. However, because of the need to establish a pneumoperitoneum, there was inevitably the risk of gas embolism.
The incidence of gas embolism was very low, about 0.002% to 0.02%. However, once it occurred, the fatality rate could be as high as 50%.
Reviewing the literature, so far, there were only five reports of gas embolism during laparoscopic nephrectomy.
The older, the spicier. Chief Miao had probably encountered a similar situation before. He knew what had happened at a glance.
After all, Chief Miao was one of the first surgeons in the country to use laparoscopes to perform surgery. He had encountered all kinds of situations.
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