Chapter 16: Seconds
Although Jiang Xu decided to push the antidote ahead of time before the blood test results came out, he thought it might be too late.
Two minutes later, the patient's blood oxygen saturation suddenly began to drop sharply. The emergency nurse looked at Jiang Xu nervously, but before Jiang Xu could react, Chen Qi suddenly said, "Mr. Jiang, the baseline fetal heart rate is too fast. With reduced variation!"
—It is very likely that the fetus has already experienced symptoms of intrauterine distress.
Liu Ran was shocked, "Why?"
Jiang Xu glanced at him, "Midafilon is used for sedation plus vecuronium bromide for muscle relaxation."
Shen Fangyu answered tacitly: "Prepare for endotracheal intubation."
The door was suddenly pushed open, and the nurse came in with the test sheet, handed it to the nearest Liu Ran, and reported to Jiang Xuhui at the same time: "The cholinesterase activity has dropped below the normal value, and the concentration of organophosphorus pesticides is 135ng/ml."
It is indeed organophosphorus pesticide poisoning!
After finishing the gavage, Liu Ran took the blood test sheet in disbelief, and read it over and over several times, "Why?" He handed the test sheet to Jiang Xu with a face full of shock, his eyes were not only incredible, but also subtle Adoration, "How do you know?"
"I don't have time to teach you now," Jiang Xu said, "The patient's symptoms are not obvious, so it should be because the dosage is not high." He took the second test sheet from the nurse and slowly lowered his gaze.
After intragastric administration and injection of the antidote, Zhang Yun's indicators were still unsatisfactory.
"The treatment is delayed." Although the amount of pesticide is small, it has already entered the blood circulation. Because of the previous delay, whether it is gavage or intravenous atropine, it seems to be long overdue.
"What does the family say?" Jiang Xu asked the nurse.
"Still insisting that the patient has not taken pesticides."
"Understood." Jiang Xu agreed lightly, without any expression on his face.
He kept his eyes fixed on Zhang Yun's blood oxygen saturation on the detector, but the last thing he expected to see happened.
Endotracheal intubation did not save the mother's precarious oxygen level, Shen Fangyu sighed, "Contact the ICU to prepare for hemoperfusion, I can only pray that the fetal heart rate will return."
It can meet the conditions for full-term delivery, and no one wants the child to be born prematurely now. If the fetal heart rate does not go wrong, it should be able to stay safely in the mother's womb for another two months.
However, I don't know if it's because Dr. Shen opened his mouth too much. Almost the moment he finished speaking, Xiao Chen exclaimed: "The baseline fetal heart rate is 150 beats per minute, and the variation is extremely poor!"
Jiang Xu cast a helpless glance at Shen Fangyu, who defended himself with a gloomy face, "I'm really not a crow's mouth."
However, as soon as he finished speaking, he suddenly remembered that when he was eating fried skewers tonight, he was still talking to Jiang Xu to see if he was not pleasing to the eye because he made him pregnant...
"After the operation, I will go to practice closed mantra." Dr. Shen was the first to promise.
When this happened to the fetal heart rate monitoring, Jiang Xu knew that there was no other choice.
To save the mother, hemoperfusion is the last hope.
If the baby is taken out, the mother will have to postpone the time for blood perfusion. According to Zhang Yun's situation, every second of delay may be a fatal blow, but if the baby is not taken out, the eight-month-old fetus will die in the hospital. It becomes a stillbirth in a very short period of time, causing a second blow to the mother who is not in good condition, and affecting the progress of blood perfusion.
Furthermore, hemoperfusion will affect hemodynamic changes, and it is very likely to cause uterine contractions or rupture of membranes in advance. At that time, hemoperfusion will be forced to stop, and the risk of fetal asphyxia will also increase.
In fact, on the real delivery bed, there aren’t so many dog-blooded caregivers in film and television dramas. Most of the time, the mother and the child are both prosperous and damaged, and are closely connected by an umbilical cord, and their lives are all tied together. .
And doctors never do multiple-choice questions, or let family members and patients do multiple-choice questions.
All doctors will do their best to keep a mother and child safe.
There was only one choice before Jiang Xu and Shen Fangyu.
— Race against time to take out the fetus as quickly as possible, and then send the mother to hemoperfusion.
And this choice is undoubtedly a huge challenge to the mentality and ability of the practitioner, and it is so harsh that it is frightening.
"Go to the operating room."
"be quick!"
With the final decision of the two doctors, all the doctors and nurses involved in the rescue immediately pushed the instruments and the delivery bed, and began to transfer to the operating room. Termination of pregnancy, real-time monitoring of blood oxygen indicators—"
The fast pace made him gasp, and Shen Fangyu continued without hesitation: "Please consult the neonatology department, notify the ICU to prepare for hemoperfusion, and tell them that our place will end soon!"
Every second in the critical care and emergency department is a race against the **** of death, but the **** of death in the obstetrics department is too greedy and wants to take away two people at a time.
When a group of people rushed to the door of the operating room with the hospital bed, a strong man suddenly stopped in front of Jiang Xu and grabbed his arm. Jiang Xu looked down at him inexplicably, and the big man hurriedly said: "Doctor, You are pushing my wife, remember that if something happens, you must keep it young, keep it young!"
Without saying a word, Jiang Xu just shook off his arm.
"Protect you, sir!" Shen Fangyu followed behind Jiang Xu, furious, and cast a sideways glance at the man, "Next time you come to the hospital, remember to wear your face. If you really don't have one, turn left to the plastic surgery department on the eighth floor."
He usually smiled, but his sudden cold face was especially scary. The man shivered and avoided Shen Fangyu's gaze.
The hospital is the place that can best witness humanity, and in the obstetrics and gynecology department, there are not only the love that all doctors and nurses envy, but also the dross that makes people scold him and can't understand their hatred.
Seeing the door of the operating room closed in front of him, the bearded man spat viciously and muttered, "Are there any doctors like you? Do you have medical ethics? I want my mother to complain. You!" After he finished speaking, he went to grab the passing nurse, and said fiercely: "What are the names of the two little boys who just walked in?"
The nurse gave him a blank look, and raised her voice in disgust: "Security—"
Jiang Xu and Shen Fangyu quickly washed their hands and disinfected them. The sterile water splashed down. The two stood side by side. Jiang Xu said directly, "I'll be the surgeon." He tilted his head and said to Shen Fangyu, "You help me."
"You asked me, a deputy chief physician, to help you?"
"Didn't you just say follow me in the office?" Jiang Xu asked without stopping his hands.
The discussion in the office was about children's anger, and Shen Fangyu's face was full of shock: "You must be switching emotions too quickly."
However, Jiang Xu ignored him at all, he lowered his head and asked the little doctor beside him, "What's your last name?"
Chen Qi is young, and he was trained by an outer court, not in his group, and Jiang Xu didn't know him.
"Teacher Jiang, my surname is Chen."
Jiang Xu nodded, "You go together."
In the operating room, the doctors in the anesthesiology department had already set up the equipment and ECG monitoring. Two shadowless lights were turned on at the same time, and the patients on the operating table were illuminated extraordinarily brightly.
When Jiang Xu raised his hand and the nurse put on the sterile gown and walked to the operating table, Shen Fangyu had already naturally stood in the first assistant's position.
Jiang Xu glanced at him, and the latter looked up at the ceiling, "It's important to save people, I'll let you once."
He lowered his eyes, and his glasses blocked a little fluctuation in Jiang Xu's eyes.
The author has something to say:
Thank you very very much for the mines thrown by the reader "ccaa" × 1, thank you for your support, heartfelt love ~ bow!
References in this chapter and later for this case:
[1] Zhu Wenting. Nursing care of a case of dichlorvos poisoning after more than 8 months of pregnancy [J]. Everyone's Health (Academic Edition), 2015, 9(24): 266.
[2] Wang Chunfang, Yin Sufang, Pan Yannan. Nursing of 19 cases of organophosphorus pesticide poisoning during pregnancy treated with hemoperfusion [J]. Chinese Health Standard Management, 2013, 4(21): 40-41.
[3] Zhang Juan. Clinical nursing of a case of premature birth caused by organophosphorus pesticide poisoning combined with 8 months of pregnancy [J]. Qilu Journal of Nursing, 2013, 19(02): 99-100.
The case is adapted from my teacher's personal experience.
I will look through the books and check the literature for things I don’t know very well, and try not to make big mistakes, but I don’t make any professional guarantees for any relevant knowledge in this article. For romance novels with an essential medical background, the relevant settings are all for the plot. See Just have fun, thank you for understanding, bow!
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