allendalepharm Chapter 142
Chapter 142
Xiao Chenguang has taken many measures to treat patients who are difficult for them to treat.
Analgesia and sedation, deep vein puncture, and physical cooling with fans.
Each of these is a measure they have never thought of and dare not perform alone.
Propofol is a sedative for general anesthesia surgery. While deeply sedated, it is easy to cause respiratory depression.
That is, the respiratory rate is often slowed down, and irregular deep breathing occurs.
Then it affects the heart rate and blood pressure.
Therefore, when using it on patients without artificial airways, you need to be extra careful.
When the milky white propofol was brought by the nurse, Gong Liang seemed a little nervous.
"Director Xiao, is it possible?"
"Of course."
Xiao Chenguang was very calm. He visually estimated the height and weight of the injured and said, "Give him 10ml intravenous injection, and change the dressing later."
"So much?"
Nurse Wang Jia was a little surprised. She held the tube of "milk" in her hand and heard the nurse from the anesthesia department say that only 3-5ml was needed to instantly numb the patient who was still talking.
But Xiao Chenguang used 10ml right away, which was too much.
"The pain level of burn patients is the highest, so the dose of analgesics and sedatives must naturally be doubled."
Xiao Chenguang's mind emerged with a variety of pain level assessment scales that were later commonly used, and he had a general understanding of the current patients.
And sedatives like propofol were later used for auxiliary examinations of painless gastroenteroscopy in outpatient clinics.
The effect was good, and those who had used it said it was good.
As the drug was injected into the body, as Xiao Chenguang expected, the patient who was just screaming was immediately numb.
Gong Liang and Wang Jia were very nervous watching the patient, fearing that something might go wrong.
But the patient seemed to be fast asleep, and his breathing and appearance were normal.
Seeing this, they hurried to move the patient to the bed and change the dressings on him. They were very busy, but the patient was still sleeping soundly and didn't feel any pain at all.
"Director Xiao, you are amazing!"
After the ECG monitoring, the patient's vital signs were stable. Wang Jia, who was in charge of monitoring, was already full of admiration for Xiao Chenguang.
"Jia Jia, how do you know so well whether my director is amazing or not?"
Seeing that the patient's condition had improved, Gong Liang was also much more relaxed.
He put his hand on Wang Jia's shoulder and started to talk to her in a familiar way.
"Do I know you well?"
Originally, when Gong Liang was joking about her and Xiao Chenguang, Wang Jia was a little shy.
She even peeked at Xiao Chenguang's reaction.
Unexpectedly, the latter's attention was all on the burn patient. As for Gong Liang's car, let alone getting in, he didn't even open the door.
Just when Wang Jia was a little disappointed, Gong Liang's dirty hands slowly reached out. Wang Jia, who had nowhere to vent his anger, directly elbowed Gong Liang on the rib fork bone.
"Cough cough cough!"
This elbow hurt Gong Liang so much that he even felt a faint feeling of a stitch in the side.
He didn't expect that Wang Jia, who was usually able to make a joke, would take a bullet today?
Why is he so violent!
"Director Xiao, this is the puncture kit from the anesthesia department. How can I assist you?"
Just after confronting Gong Liang, Wang Jia respectfully came to Xiao Chenguang, with a bit of admiration in his tone.
"It's nothing, just like the regular puncture, prepare the disinfectant iodine, gloves, and suture needles and threads."
"Okay, I'll get ready right away."
Wang Jia listened carefully and moved quickly. According to Xiao Chenguang's requirements, he began to actively prepare.
"Wang Jia, your discrimination is too obvious."
Gong Liang had tears in his eyes, and he didn't know whether it was because he hadn't slept all night or because of Wang Jia's elbow.
"Director Xiao is capable and has a way to treat seriously ill patients. When you have this level, I will be gentle to you."
Wang Jia replied directly.
"Then I guess I will never see your gentleness in this life."
Gong Liang wanted to cry but had no tears. How could he be as good as Xiao Chenguang?
Since he went home with Xiao Chenguang, Gong Liang realized that geniuses also need to practice harder.
On the wooden table in the rental house, half of it is piled high with books, and the other half is neatly arranged with suture tools.
Whether Xiao Chenguang is at work or off work, he is always keeping his touch and honing his skills.
What about Gong Liang who can be ahead.
He can't wait to get off work, go out on a date, drink and brag with friends. Anyway, as long as it is not a hospital job, he is good at it.
At this time, Wang Jia had already prepared all the items. Xiao Chenguang opened the deep vein puncture kit and began to place a deep vein catheter in the patient.
The skilled operation appeared in front of everyone again.
This time, the patient had a large area of skin burns, so many positioning techniques could not be used.
Even the most basic skinXiao Chenguang had to be very careful when disinfecting, fearing that he would irritate the inflamed skin.
But even so, Xiao Chenguang still operated very quickly.
The puncture was so fast and accurate that Wang Jia, who was assisting, did not react.
Then the guidewire was extended, the needle was withdrawn, and the deep vein catheter was placed. The whole process was completed in an instant.
Gong Liang stood there in a daze, watching Xiao Chenguang's operation. In his heart, he could not find any other words to describe it except admiration.
"The patient's heart rate is fast and his blood pressure is low. Considering the insufficient volume, give him..."
Xiao Chenguang calculated according to the formula for fluid rehydration for burns, based on the kilograms of the patient's weight and the burn area in front of him.
About 12,000 milliliters of fluid should be replenished.
What a concept.
Equivalent to the 330ml bottled water of Nongfu Spring that we usually drink, a total of 36.36 bottles.
This is only the amount of fluid on the first day.
"So much fluid?!"
When Gong Liang heard the amount of fluid Xiao Chenguang gave the patient, he was stunned.
Not only him, but also Wang Jia beside him showed the same expression.
"Yes, that's right, and of the 12,000 ml of fluid, 6,000 ml must be directly infused into the patient's body in the first eight hours to support his circulation."
As Xiao Chenguang explained, everyone was stunned.
"Oh my God."
"No wonder Director Xiao wanted to put a deep venous catheter in his body. With this rate of fluid infusion, I can't fill it up even if I open five lines of fluid from the superficial vein."
Wang Jia was shocked.
Gong Liang was the same.
No wonder the patient kept shouting thirsty in the emergency room, it turned out that his fluid infusion speed was too slow.
As Wang Jia pushed a cart of crystalloid fluid, she opened all the fluids to the maximum and directly poured them into the patient's body through the deep venous tube.
In a short while, Wang Jia had changed several bottles of fluid.
The effect of such a fluid replacement speed was immediate.
The patient's heart rate began to gradually drop to an acceptable range, and his blood pressure was also rising steadily.
"Not bad, the effect is very good."
Xiao Chenguang nodded, seeming to be very satisfied with the patient's current condition.
He looked sideways at Gong Liang: "Have you told the family about the electric fan just now?"
"Yes, they have already bought it."
Soon, the family sent the purchased electric fan to the small ICU.
"How do we do this? Blow it on him?"
Gong Liang held the electric fan, and the image of Xiao Chenguang holding a water pipe and spraying water on the patient immediately appeared in his mind.
"That's right, and it also needs to cool down a large area."
After that.
Xiao Chenguang lifted the sheet on the patient, plugged in the power of the fan, and blew it directly on the patient's exposed skin.