Holding the surgical retractor, Zhang Shuping carefully helped Teacher Xie to close the surgical incision, and held his breath with the emergency nurse who was assisting him.
I only remember that the textbook said that if you probe at the wrong angle and want to touch the pericardium immediately, you may encounter obstacles or feel awkward. If the external pericardial compression is unsuccessful, you will need to cut the third and fourth ribs to perform intrapericardial compression. At that time, it is a last-ditch effort.
The best thing is to succeed in one go. Zhang Shuping felt that the hot air he exhaled was going to burn him to death.
The current situation is really a hot potato for him and Teacher Xie.
It's not possible not to think about saving the patient, but the success rate of this kind of desperate measure is too low.
This is also why external chest compression is routinely advocated in clinical practice, while internal chest compression is extremely rare.
According to medical statistics, the success rate of intrathoracic cardiac compression is no better than that of external cardiac compression. Therefore, doctors have to have special prerequisites to perform intrathoracic cardiac compression on patients. For example, in the current case, we have seen patients who had undergone thoracotomy surgery and had their chests left open after surgery but were given emergency treatment.
Surgeon Xie’s gloved right hand reached into the surgical incision.
She had never performed this type of surgery independently, but she had definitely performed chest compressions, otherwise she, the surgeon, would never dare to do it. She remembered the trick she was set up by the fairy brother when she was a child, and she frantically performed chest compressions on the baby with her bare hands.
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After having experienced worse experiences like this, her mentality was undoubtedly stable at the moment.
Thanks to Brother Shenxian, a group of "cruel and ruthless" teachers who taught her all kinds of painful experiences and lessons.
After touching the patient's heart wrapped in the pericardium, the first step is not to press, but to further clarify the diagnosis: Is the patient's heart completely stopped, or is it just asthenic, that is, the heart beats weakly and has no strength, or is it in ventricular fibrillation?
If the heart is weak, 0.1% epinephrine or 10% calcium chloride should be injected into the cardiac cavity to stimulate the myocardium and then perform cardiac compression. At the same time, a doctor's order should be given to the nurse to inject dopamine and other drugs into the intravenous channel to help maintain blood pressure.
If it is ventricular fibrillation, defibrillation is not performed immediately, but after a certain period of cardiac compression, the myocardial tension is improved. It can be seen that the most professional medical cardiac compression technique is not a simple compression like teaching laymen pre-hospital rescue, but requires precise emergency measures such as rescue medication.
After carefully feeling the patient's heart, Xie Wanying confirmed that it was cardiac arrest.
Is complete cardiac arrest scary? It seems to be the worst of the three situations above. But no matter which situation it is, doctors will not be good unless the heart is completely restored to normal beating. The patient's heart condition changes rapidly, and the three situations may change into each other.
What doctors need to do is to follow routine operating procedures step by step and abide by the valuable clinical experience left to future generations by countless medical predecessors.
Immediately take the gloved right hand further into the pressing position.
There are three methods of intrathoracic cardiac compression: single-handed method, double-handed method and sternum compression method.
The single-handed method is to use the thumb and thenar to touch the front of the patient's heart, and the other four fingers are placed behind the patient's heart. The purpose is to press the left and right ventricles evenly, forcefully and rhythmically.
The left and right ventricles are the main pumps of the heart, responsible for pumping blood. If the heart stops beating, the ventricles will lose their ability to pump blood, causing the heart and other organs of the human body to lose blood nutrients and die together. This is exactly the problem that cardiac compression is designed to solve.
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