When Lu Cheng came to the operating room seven, Li Zhiliang arrived in a hurry and had not even had time to change into his surgical gown. There was still blood on a pair of gloves. He and Lu Cheng walked into the operating room and were undressing at the same time.

Then he asked: "How is the patient?"

When Lu Cheng and Li Zhiliang walked in, there were already two groups of people present.

However, people from both teams are not in a hurry. After all, the trauma in the orthopedics department is there now. The patient is in hemorrhagic shock. What the orthopedics department needs to solve is life-saving problems. They only need symptomatic surgery.

It is equivalent to the orthopedics department taking the pressure and they are responsible for cooperating.

Where is the look of anxiety?

When the anesthesiologist saw Li Zhiliang, he quickly said, "The patient's blood pressure is very unstable now. It is already below the shock blood pressure. Even if a blood transfusion is performed, it is still not stable. It is considered that there may be active bleeding."

"Your orthopedics department must stop the bleeding quickly, otherwise it won't matter how many bags of blood you transfuse, and the patient will die if he says no."

The anesthesiologist who performs emergency surgery is not an anesthetist specializing in orthopedics. So I don’t know Lu Cheng and Li Zhiliang.

Shock is the biggest problem faced by patients now.

For all emergency patients, even if it is written in the textbook, the first step is always to replenish blood volume and then perform emergency surgery.

Therefore, it is very important to find the bleeding point.

Li Zhiliang threw the bloody surgical gown into a green cloth bag, then looked at the patient's basic condition and said: "Teacher anesthesia, this patient's blood pressure is unstable, but it has little to do with our orthopedics department. If the patient has a fracture,

The position is in the pelvis, where we can still be found.”

"However, for a trauma near the knee joint, even if the tibial artery or popliteal artery is injured, a tourniquet will be enough."

Li Zhiliang took a quick look and said, "Whether this patient's leg can be saved, and whether it will still function after being saved, is another question. My detection here is very fast. If there is a problem with the blood vessel, I will immediately call the vascular surgery department."

Just deal with it. If there is no vascular problem, just put a VAC on it and it will be done."

"I'm going to go out and have a brief chat with the patient's family first. You should ask the brothers from the Department of Surgery and the Department of Chest Surgery to do it first. Where are the patient's medical records?"

"Lu Cheng, you first apply pressure to the popliteal artery to stop the bleeding. If you press for five minutes and the blood pressure stabilizes, it basically proves that there is a problem with the blood vessel. The unstable blood pressure is caused by bleeding. If there is still a problem with the blood pressure, you have to find another person.

problem.”

Now he is an emergency patient, and the paperwork related to orthopedics has not yet been written, so Li Zhiliang needs to take the medical records to handwrite the conversation. This is an emergency plan in an emergency.

If I go to get a consent form for surgery now, the patient will be gone.

However, even at this time, they still need to follow formal procedures.

Hearing what Li Zhiliang said, Lu Cheng nodded in his mind. Li Zhiliang still had a good foundation and knowledge. After all, he graduated from Xiangya, so he should not be underestimated. Maybe his surgical skills were not as good as his own.

, but some basic theoretical knowledge will definitely not be much worse than mine.

Lu Cheng took a brief look at the patient. He had top-level knowledge of limb anatomy and immediately determined the location of the patient's popliteal artery based on the patient's body shape. After Lu Cheng put on his gloves,

First, the vascular signs were checked. The blood flow was active, which proved that there was no arterial thrombosis for the time being.

The left hand twisted the patient's calf, and the thumb of the right hand quickly pressed towards a certain position.

Immediately afterwards, I released my left hand. After pressing for a few seconds, I checked the distal vascular sign with my left hand. I found that there was a problem with the blood vessel filling.

This exactly represents the position where Lu Cheng pressed to stop the bleeding, which is extremely accurate.

Seeing Lu Cheng's operation, several people were shocked.

Li Zhiliang: "..."

Shenwai Team: "..."

Chest team: "..."

MMP.

In a few seconds, the orthopedic problem is solved.

At this moment, Lu Cheng compressed the popliteal artery, which was close to the trauma. If the patient's shock was caused by bleeding from orthopedic trauma, then after he compressed the artery, the blood loss would be temporarily stopped.

If the bleeding is stopped but shock is still present and the blood pressure is still falling, it is not an orthopedic issue.

The anesthesiologist was speechless after reading this. Seeing this, he could only press the button to measure the patient's blood pressure again, and at the same time start checking the blood gas and electrolytes again.

A patient who has lost a lot of blood cannot be saved by a large amount of blood transfusion.

It is also necessary to check whether the blood oxygen saturation and electrolytes are disordered, especially hyperkalemia, which can lead to cardiac arrhythmia, cardiac arrest, and death.

This condition can come and go without a trace, so blood gases and electrolytes must be checked at regular intervals.

Even so, the anesthesiologist originally thought that the patient had active bleeding. Although he heard Li Zhiliang said it was easy, just anastomose the blood vessels and it would be over.

But the essence of treatment for all diseases in this world is actually very simple to say.

It's just hard to do.

As for the popliteal fossa, there are extremely important structures such as the popliteal artery, anterior tibial artery, posterior tibial artery, the great saphenous vein on the inside, and the popliteal nerve.

How can it be so easy to detect the specific bleeding location, find the bleeding point, and perform electrocoagulation or suturing to stop the bleeding?

It is not easy to stop bleeding under direct vision, let alone by finger pressure.

Pressing to stop bleeding is easy to say, as long as you have hands, but you also need to press accurately.

The general direction of the arteries of the lower limbs is that the femoral artery continues into the popliteal artery and the remaining arteries are branches of the popliteal artery. Because the femoral artery is larger in size, it is not easy to press to stop bleeding. Therefore, pressing to the popliteal artery is generally preferred to stop bleeding, which is more reliable.

But reliability is reliable, and it doesn’t mean that you can find the correct position as soon as you get started, and then press it to basically eliminate the following problems?

Can I still be a human being?

Give neurosurgery and thoracic surgery some time to react.

With this hand pressure to stop bleeding, the patient's blood pressure will be unstable, and there will definitely be no orthopedic trouble. Then if the patient dies in the end,

Just call someone to ask the neurosurgery, thoracic surgery, and anesthesiologist about the problem.

There is no active bleeding in orthopedics, but the patient has active bleeding. You can go find it yourself. It has nothing to do with me.

Although there is another possibility that after trauma, the blood is in a hypercoagulable state, leading to arterial or venous thrombus, and then the thrombus falls off, leading to pulmonary embolism, cerebral infarction and other fatal risks, but such risk is extremely small, and even if it occurs

, it can also be processed immediately in the operating room.

Moreover, what Lu Cheng was pressing at this moment was the popliteal artery. The detachment of the arterial thrombus would only lead to distal arterial embolism at most, but would not lead to pulmonary infarction or cardiac embolism.

So even if related risks occur, it is not Lu Cheng's problem...

The anesthesiologist could only smile;

"The patient's current blood pressure is still extremely unstable. It is now only 75/65mmHg. Although he has been taking norepinephrine, it cannot rise back. You may need to perform craniotomy and thoracotomy immediately."

Whether it is extracranial high pressure or hemopneumothorax, it can cause the patient to go into shock.

Upon hearing this, the neurosurgery and thoracic surgery teams even accelerated their disinfection speed by a full three points.

When they entered the operating room, they saw trauma in the orthopedics department, but they were quite calm.

Emergency consultation is actually a game and competition between various departments. As long as someone can prove that there is no problem with the other party, you have to quickly deal with the problems of your own department.
Chapter completed!