Laryngeal masks are often used in neonatal rescue, and most practicing physicians would think of them. The problem of the child in front of me was not about establishing an artificial airway at all.
If a newborn baby has a slow heart rate and no breathing, there is basically only one reason: the airway is blocked. The blockage may be mucus, meconium, or something else.
As the baby's heart rate was about to drop to a dangerous limit, the doctor had no choice but to perform neonatal cardiopulmonary resuscitation to maintain the baby's heartbeat during the rescue, and then solve the airway problem at an appropriate time.
Positive pressure ventilation and the use of laryngeal masks to establish an artificial airway are best done when the airway is clear. Otherwise, each ventilation may push the obstruction into the airway. Therefore, they are very careful when using the breathing bag. At the beginning, Song Xuelin did not use the breathing bag, but blew air with his own mouth, in fact, he was trying to suck it out to see if he could suck out the things in the baby's airway.
The obstetrician had cleared the blockage in the baby's mouth and nose when he first received the baby. When Song Xuelin took over the baby, he quickly checked and found that there was no blockage in the baby's mouth and nose. This showed that the situation was very helpless. The blockage was probably stuck deep in the child's trachea and was difficult to come out, causing the child's current dangerous situation.
To put it bluntly, it is better to use tracheal intubation than laryngeal mask airway for intubation. If the tracheal intubation is successful, at least the tube is confirmed to be in the trachea. A suction tube can be placed in the tracheal tube and connected to a negative pressure suction device, and the obstruction in the trachea can be sucked out carefully to see if it can be sucked out.
This is not a hospital, where there is no negative pressure suction device. The National Association of Ambulances and the emergency department do not have spare tracheal intubation tubes for neonatal departments. Neonatal intubation technology is difficult. The emergency doctor on duty at the tertiary hospital is not a professional pediatric doctor and does not have the technical ability to perform tracheal intubation on such a young child. He can only be sent back to the hospital to find a neonatologist.
If you want to ask what to do, it is right to try to revive the baby's heartbeat. CPR compression is performed on the chest, which is equivalent to giving a force to the trachea to some extent.
However, the rescue measures seem to be insufficient so far, and doctors may need to take a gamble. The rigor of medicine makes doctors choose mild measures first, and only take further risks if the patient or child is not doing well. Any invasive medical operation is a double-edged sword, with both good and bad sides. If it is good, it can save lives, but if it is bad, it will make lives fall faster.
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When faced with a gamble, the doctor first had to calculate whether the previous measures would give the human body enough time to react. Song Xuelin looked up and asked the time: "How many minutes have we been doing this?"
After receiving his question, Lin Hao and Li Qi'an looked at the clock and tried their best to recall and estimate: "Maybe seven or eight minutes--"
"I have been involved for four minutes so far, and the time when you, Dr. Song, took to carry the child out was five minutes. The total time is estimated to be around nine minutes and ten seconds." Xie Wanying said.
Lin Hao and Li Qi'an heard every precise time she uttered, and sighed in their hearts: Time flies so fast. As someone said, Xie is no different from the old doctor, which makes them look up to him.
There was a gleam of light in Song Xuelin's slightly narrowed brown eyes. He felt most comfortable working with Dr. Xie, who always lived up to everyone's expectations at critical moments.
"Doctor Song, let's switch hands and let me try it." Xie Wanying took the initiative to suggest.
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