novelslam Chapter 415
Chapter 415
Chapter 415
Stethoscope,
Lin Feng used a stethoscope to listen to the female patient’s lungs.
One listen,
Breath sounds, symmetrical!
“Pneumothorax can be ruled out…”
Because of pneumothorax, usually only one of the lungs (left and right lungs) will appear. If there is a pneumothorax, then this side of the lung is not inflated (compressed by air), and the breath sounds cannot be heard during auscultation, or the breath sounds are very low. On the other side are strong breath sounds.
Therefore, the breath sounds of pneumothorax are not known by the team.
If it is symmetrical, then breath sounds can be eliminated.
but!
Lin Feng frowned tightly!
Wet rales, very heavy! !
“Severe pneumonia?”
To be honest, Lin Feng has never heard such a wet rale in his eyes!
This shows that there is a lot of liquid in the lungs!
but,
Why is there so much liquid?
Is pneumonia so exaggerated?
Now the patient can’t move, and there is no way to do CT, because I am afraid of dying in the CT room at any time. If I have to move, I should be sent to the icu instead of the CT room.
Without CT, there is no way to confirm why there is so much liquid.
Moreover, there is so much fluid in the lungs,
Lin Feng thought of a disease – drowning! !
What does drowning mean?
That is, the lungs are full of water, and the alveoli are in the water. There is no way for air to get in. The patient is hypoxic!
so,
Why is the patient’s oxygen saturation so bad!
It must be because there is too much fluid in the lungs, making it impossible for air to get in!
At this moment,
Only high-efficiency ventilators ventilate the air and pump 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%…
“Where’s the ventilator? Why haven’t you come yet?”
Lin Feng shouted.
A nurse quickly explained: “Dr. Lin, the ventilators are all used up, and three of them are sending patients to the ICU. I have not yet come down. I have arranged a few people to go to other departments to borrow…¨々…”
Lin Feng: “……………………”
Pit!
The ventilators are not enough!
“Draw her blood and send it to be checked…”
Lin Feng ordered several inspection items, the most basic of course is blood routine.
The nurse took blood quickly and sent it for testing.
Lin Feng: “Has the family contacted?”
Another nurse: “I have been contacted, but they are not in the imperial capital, they are from other provinces, the patients are students, and they are studying in the imperial capital…”
Lin Feng: “Did you tell your family about the situation here…”
Nurse: “That’s it, the family members said everything is in accordance with the doctor’s orders…”
Lin Feng thought for a while: “If you don’t sign, you won’t be insured, and whoever may have a dispute, contact the medical office and ask them to come through a rescue procedure…”
Nurse: “Yes!”
The procedures done by the medical office can be used for emergency rescue without the consent of the family members.
And at this moment,
The ventilator is finally here.
“Dr. Lin, got the ventilator…” The nurse and the two trainees panted out of breath, sweating profusely.
Pushing a ventilator, he pushed in from outside.
Lin Feng urged: “Hurry up and intubate…”
The nurse hurriedly arranged intubation for the patient…
Before intubation, Lin Feng arranged a sedation:
“Pushed 5mg midazolam…”
It must be sedated, otherwise it is difficult to insert the tracheal intubation smoothly.
(Actually, sedatives also have side effects. If excessive sedation, it will inhibit breathing. The patient may die from hypoxia due to stopping breathing. In addition, sedatives can also cause low blood pressure. Therefore, the dosage of sedatives requires a doctor (usually an anesthesiologist) grasp.)
Push in the sedative, wait for the effect of the medicine, and then start to intubate the trachea.
result!
One intubation!
Found a big problem! !
“No, Doctor Lin, a lot of blood!”
The nurse screamed in surprise.
This is the first time she has encountered this situation.
Everyone around was shocked!
Lin Feng was also surprised when he heard it, and then walked over quickly.
one look!
That part of the throat is full of blood!
And it’s still bright red!
Lin Feng’s face changed!
impossible!
Most people, if there is blood in the airway and esophagus, they will definitely vomit blood and cough up blood.
But the patient does not? !
“what happened?”
However, what we have to do now is not to find the cause, but to quickly suck out the blood, plug it into the trachea, and relieve itching!
“Sputum suction device! Hurry up!!”
This is a common equipment in rescue rooms.
The nurse moved quickly and put the suction tube into the patient’s oropharynx.
Suck~~~~~
Blood is constantly sucked out from the suction tube! !
While inhaling, Lin Feng considered the cause.
Process: The patient has difficulty breathing-rescue-mask non-invasive breathing is not enough-there is blood in the throat…
“｀” Heart failure and pulmonary edema? ”
The function of the heart is to pump blood. If the heart fails and the blood cannot be pumped out, or it is difficult to pump out, then the excess blood will accumulate in the heart. The space in the heart is limited, and the excess blood flows through one of the channels— -Pulmonary vein reflux, leaking alveoli, or even filling the alveoli.
The blood and water will be ejected along the trachea, in the form of sputum.
but,
Lin Feng quickly shook his head.
“It’s not heart failure!”
Why do you judge this way?
Because of the appearance of patients with heart failure coughing up blood: pink foamy sputum (a mixture of red blood cells and water).
And now, the patient’s airway is full of blood, bright red! !
Exclude: “Heart failure and pulmonary edema”!
Lin Feng glanced at the ECG monitor, blood oxygen saturation has dropped to 82%!
(Qian Zhao) The patient’s performance is also very rush.
At this time, the nurse was still sucking blood.
He was sweating profusely, and his hands and feet were a little flustered.
“I come!”
Lin Feng took the suction tube from the nurse and started to suck continuously.
Just the moment it sucked dry suddenly.
Lin Feng’s hands and feet were clean and he quickly inserted the tracheal intubation into the trachea.
but,
Things suddenly changed.
“Cough cough cough~~~~”
The patient was originally lying on the bed, unconscious.
Suddenly he coughed violently, and the whole person bowed.
A cough,
A lot of blood was sprayed out directly.
Many doctors and nurses were sprayed a lot. The white coats and pink nurse uniforms were all dyed bright red at once.
“Ah~~~~”
The three doctors, nurses and interns screamed in shock.
hall.
..