bookpower Chapter 411
Chapter 411
stethoscope
Lin Feng used a stethoscope to listen to both lungs of the female patient.
Listen,
Breath sounds, symmetrical left and right!
"Pneumothorax can be ruled out..."
Because of the pneumothorax, generally only one side of the lung (left and right lungs) appears, if the pneumothorax, then this side of the lung is not inflated (compressed by air), auscultation is not able to hear breath sounds, or breath sounds are very low, the other side is a strong breath sound.
Therefore, the breath sound of pneumothorax is not called.
If symmetrical, breath sounds can be ruled out.
But!
Lin Feng's brows furrowed tightly!
Crackles, very heavy!!
"Severe pneumonia?"
To be honest, Lin Feng had never heard such a wet crackle in his eyes!
This shows that there is a lot of fluid in the lungs!
But
Why so much liquid?
Is pneumonia such an exaggeration?
Now the patient can't move, can't do CT, because I am afraid of dying in the CT room at any time, if I have to move, I should also send it to the ICU, not the CT room.
If there is no way to CT, there is no way to determine why there is so much liquid.
Moreover, there is so much fluid in the lungs,
Lin Feng thought of a sick ———— drowning!!
What does drowning mean?
That is, the lungs are full of water, the alveoli are in the water, the air cannot go in, and the patient is deprived of oxygen!
So
Why is the patient's oxygen saturation so poor!
It must be because there is too much fluid in the lungs, so that the air cannot enter!
At this time,
Only an efficient ventilator pours itchy air and pumps oxygen into the lungs.
Lin Feng looked at the patient's ECG monitor at this time, and the blood oxygen saturation had dropped to 85%...
"What about ventilators? Why hasn't it come yet? "
Lin Feng shouted.
A nurse quickly explained: "Dr. Lin, the ventilators have run out, there are 3 to send patients to the ICU, and before they come down, I have arranged a few people to go to other departments to borrow..."
Lin Feng: "..........................."
Pit ah!
There were not enough ventilators!
"Draw her blood and send her for a test..."
Lin Feng ordered several examination items, the most basic of which was naturally blood routine.
The nurse quickly drew blood and sent it for testing.
Lin Feng: "Have the families been contacted?" "
Another nurse: "I have been contacted, but they are not in the imperial capital, they are from other provinces, the patient is a student, studying in the imperial capital..."
Lin Feng: "Have you told your family about the situation here..."
Nurse: "Said, the family said that everything came according to the doctor's orders..."
Lin Feng thought for a while: "If you don't sign it, you can't be sure, who may still have a dispute, contact the medical office, let them come through a rescue procedure..."
Nurse: "Yes!" "
The procedures carried out by the medical office can be carried out without the consent of the family, which is for emergency use.
And at this moment,
The ventilator is finally here.
"Dr. Lin, got the ventilator..." the nurse and two interns said panting, sweating profusely.
Pushing a ventilator, it was pushed in from the outside.
Lin Feng urged: "Hurry up and intubate..."
The nurse hurriedly arranged for the patient to be intubated...
Before intubation, Lin Feng arranged a sedation:
"Intravenously pushed 5mg of midazolam..."
Sedation is necessary, otherwise it will be difficult to insert the endotracheal tube smoothly.
(In fact, sedatives also have side effects, if they are overly sedated, they will suppress breathing, patients may die of lack of oxygen because they stop breathing, and sedatives can also cause low blood pressure.) Therefore, the amount of sedative should be determined by the doctor (usually an anesthesiologist). ）
The sedative is pushed in, and when the effect is out, then the trachea is taken and intubated.
Outcome!
One intubation!
Big problem found!!
"Not good, Doctor Lin, a lot of blood!"
The nurse exclaimed.
It was the first time she had encountered this situation.
All the people around were shocked!
When Lin Feng heard this, he was also shocked, and then walked over quickly.
Take a look!
That position of the throat is all blood!
And it's still bright red!
Lin Feng's face changed!
No way!
Ordinary people, if there is blood in the airway and esophagus, it will definitely vomit blood and cough up blood.
But the patient did not?!
"What's going on?"
However, what needs to be done now is not to find the cause, but to quickly suck the blood out, insert the trachea, and itch the air!
"Suction suction! Fast!! "
This is a common device in rescue rooms.
The nurse moved quickly and inserted the suction tube into the patient's oropharynx.
Suction sucks ~~~~~
Blood is constantly being drawn out of the suction tube!!
While inhaling, Lin Feng considered the cause.
Process: The patient has difficulty breathing - rescue - the mask is not invasive and breathing is not enough - blood is found in the throat...
"Heart failure, pulmonary edema?"
The function of the heart is to pump blood, if the heart fails, the blood cannot be pumped out, or it is difficult to pump out, then excess blood will accumulate in the heart, the space of the heart is limited, and the excess blood also flows backwards from one of the channels - the pulmonary vein, leaking out of the alveoli, and even crowding the alveoli.
This blood and water spurts out along the trachea in the form of sputum.
But
Lin Feng quickly shook his head.
"Not heart failure!"
Why is that judged?
Because heart failure patients cough up blood: pink foamy sputum (a mixture of red blood cells and water).
And now, the patient's airway is full of blood, it is bright red!!
Exclude: "Heart failure, pulmonary edema"!
Lin Feng glanced at the ECG monitor, and the blood oxygen saturation had dropped to 82%!
The patient's performance is also very urgent.
At this time, the nurse is still constantly sucking blood.
Sweating profusely, my hands and feet were a little flustered.
"I'll come!"
Lin Feng took the suction tube in the nurse's hand, and then began to suck continuously.
Just at the moment of sudden suction.
Lin Feng's hands and feet were clean and he quickly inserted the tracheal tube into the trachea.
But
Things suddenly changed.
"Ahem~~~~"
The patient was lying in bed, unconscious.
Suddenly coughed violently, and the whole person arched.
A cough,
A lot of blood directly spurted out.
Many doctors and nurses were sprayed a lot, white coats, pink nurse uniforms, all of a sudden dyed bright red.
"Ah~~~~"
3 doctors and nurse interns screamed in fright.
.
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