The key to operating the balloon mask ventilation technique was to seal and open the airway.
If the ventilation was not satisfactory during a single operation, two people with pressurized assisted ventilation would be considered, working together to open the airway, oropharynx, or nasopharynx simultaneously. This technique was mainly used when the patient was at risk of aspiration or reflux while applying pressure on the cricoid cartilage.
Even the laryngoscope and optical rod guidance techniques were used. The basic operation of a single balloon mask had been eliminated by Zheng Ren and was not considered.
However, the two-person balloon mask ventilation, low tidal volume, and high-pressure oxygen delivery found that the patient's chest did not rise and fall significantly.
"Laryngeal mask!" Zheng Ren growled.
At the same time, he had put on sterile gloves and his gaze moved back and forth between the ECG monitor and the patient, but he did not immediately perform a tracheotomy.
The patient's current condition was considered a high-risk tracheotomy. Zheng Ren had tried it in the System's operating theater. Even with the Lucky Halo and the + 10 surgery completion bonus, even if it was a small operation, the final surgery completion rate was only 65%.
This meant that the patient could not be taken off the ventilator or even get off the operating table.
Zheng Ren had tried many times and a 65% success rate was the highest he could achieve.
In fact, high-risk tracheotomy patients were not uncommon.
They were mainly short-necked, obese, sitting upright, unable to tilt the head back, agitation, large thyroid isthmus or space occupying, high mediastinum, tracheal deviation, tongue prolapse, severe dyspnea, inability to intubate through the trachea, poor blood coagulation, sudden preoperative asphyxia, and unclear cervical and thoracic bone and cartilage were all high-risk tracheotomy patients.
Under normal circumstances, it could be remedied through surgery, but the patient's condition was special. Zheng Ren was helpless. This time, he had encountered a particularly thorny problem.
Fortunately, the oxygen delivery effect of the mask was good and had been tested in the System's operating theater.
An anesthesiologist quickly opened the laryngeal mask and handed it to Zheng Ren.
Zheng Ren pulled the patient's jaw with his left hand and was about to insert the mask when he saw it was a second-generation laryngeal mask!
Strange, the third-generation laryngeal mask was clearly used in the System's operating theater. What was going on?
There was a huge difference between second-generation and third-generation laryngeal masks. Even the third-generation laryngeal mask's final completion rate was only 98%. Zheng Ren dared not be careless.
"Third-generation explorer!" Zheng Ren said immediately.
Chief Xu was stunned. Third-generation explorer … laryngeal mask?
The patient's blood oxygen saturation had dropped to 70%. Why was Boss Zheng still picky about the second and third generation laryngeal masks …
Just as he was about to explain, Feng Xuhui, who was standing outside the operating theater, immediately shouted, "Chief Zheng, please wait!"
He held the phone in his left hand and dialed a number. The call was picked up almost instantly. Feng Xuhui quickly said, "Emergency first-aid kit!"
As he spoke, Feng Xuhui strode quickly to the door of the operating theater.
After opening the door of the operating theater, Liu Xiaojie, who was more than ten meters away, forcefully pushed the box over. The heavy suitcase glided across the marble floor, and the moment Feng Xuhui opened the door, it was already in front of him.
Zhang Xuan took the box and closed the door. The entire process took 3.2 seconds.
Director Xu had been following behind Feng Xuhui the whole time. He remained calm. After all, he was the department director of the Department of Anesthesiology. He had seen too many similar situations.
However, today's patient's condition was a little special. If it was a normal laryngoscope, it would have been done.
Boss Zheng still refused to perform a tracheotomy. Chief Xu also knew that this was a high-risk patient. Once the tracheotomy was done, he might face more trouble. This kind of trouble did not all come from the patient's family, but more from the patient himself.
It was not uncommon for the patient's condition to worsen after a high-risk tracheotomy, so he was also inclined to use a laryngeal mask.
However, the 912's laryngeal mask was not bad. That model had been used for many years. Boss Zheng actually wanted a third-generation explorer. This kind of laryngeal mask had only been heard of at academic conferences. The 912's Department of Anesthesiology had not evolved to this stage.
The small medical consumables who had been following Boss Zheng seemed to be … the manager of the medical consumables manufacturer. What did he just shout? A first-aid kit?!
Chief Xu saw a medium-sized suitcase 'fly' in. The small medical consumables immediately squatted on the ground to open the suitcase.
The suitcase was neatly arranged with a dazzling array of emergency medical consumables.
He did not even look at them. He stretched his hand inside, as if he knew where the dozens of medical consumables were.
A sterile bag was immediately grabbed by Feng Xuhui. Seeing Chief Xu standing not far away looking at him, Feng Xuhui threw the bag in his hand over.
"Chief Xu!"
There was no need to be polite during the emergency treatment, and there was no time to be polite. Every minute and every second was extremely precious.
Chief Xu caught the sterile packaging and was surprised to see a third-generation explorer laryngeal mask.
"…"
Damn it. Chief Xu felt that his face was burning.
However, he did not have time to think about it. He turned around and ran. As he ran, he tore open the outer packaging of the laryngeal mask.
Zheng Ren took the laryngeal mask and used the conventional blind probe method to place it.
His left hand pulled the lower jaw to widen the oral space. His right hand held the laryngeal mask. The mouth of the mask was facing the patient's lower jaw. It was placed down along the middle line of the tongue against the back wall of the pharynx until it could no longer be pushed forward.
After placing the laryngeal mask, positive pressure ventilation was performed. Zheng Ren observed that the degree of chest undulation had returned to normal. He grabbed a stethoscope and listened to the breathing sounds on both sides. They were symmetrical and clear. There were no leakage murmurs in the front of the neck.
Even though he had done this more than ten times in the operating theater of the System, and even though he had the Lucky Halo after coming out, Zheng Ren still carefully checked if there were any errors in the operation.
After putting on the laryngeal mask, Zheng Ren placed a gastric tube under the guidance of the laryngeal mask to solve the problem of the diaphragm rising due to the expansion of a large amount of gas in the stomach, which reduced the lung capacity.
"Propofol 40mg!
"Midazolam 2mg!
"Dexamethasone 10mg!
Zheng Ren looked at the patient's ECG monitor and kept giving medication instructions.
"Intravenous infusion of 0.25g of aminophylline and 250mL of 5% glucose!"
The patient's blood pressure fluctuated between 184-110mmHg/98-55mmHg, and heart rate fluctuated between 60-98 beats per minute.
"Nitroglycerin 0.05mg, urapidil 15mg," Zheng Ren said in a low voice.
The atmosphere in the operating theater calmed down a little when the blood pressure, heart rate, and oxygen saturation continued to rise.
Boss Zheng's medical advice was perfectly executed without any doubt. Even Chief Xu was the same.
If not for him, Chief Xu's next step was to remove the laryngeal mask. However, with Boss Zheng standing there, Chief Xu felt at ease for no reason. He felt that his authority had been challenged by someone else who only knew how to perform emergency resuscitation.
At this time, with the help of the third-generation explorer's laryngeal mask, Chief Xu was no longer in the mood for anything else.
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