Chapter 3467: 【3467】Specific circumstances

  Chapter 3467 [3467] specific circumstances

   Not all patients need surgery.

   Surgeons stay here, usually to assist.

  For example, when a patient is placed on a ventilator for endotracheal intubation, the anesthesiologist is required to come down to help when the physician cannot do it, and the surgeon may be required to do it when the tracheotomy is changed.

  Du Yeqing did not deny it: "Change the tracheotomy."

  Clinically, there are indications for changing tracheal intubation to tracheotomy. Generally speaking, it is impossible for doctors to cut open the patient's trachea casually, and prefer tracheal intubation as much as possible. Specifically, what are the indications that need to be changed to tracheotomy.

  Like the child rescue case in the previous stomatological hospital, the obstruction occurred and the endotracheal intubation was performed, so the airway could not be ventilated, so the tracheotomy had to be performed.

  Is Fan Yunyun's airway obstructed? Obviously not.

   Another common clinical situation where the tracheotomy is changed is that the invasive ventilator is on and the doctor can predict that the patient will not be able to leave the ventilator for a while.

  This involves various advantages of tracheostomy over tracheal intubation. One is that tracheotomy can better maintain the patient's airway patency. The second is that the tracheal intubation is easy to damage the patient's throat and oral cavity if it is intubated for a long time. The third is that most of the patients who cannot live without the ventilator for a long time have neurological symptoms. Those with brain problems will have symptoms such as coughing, phlegm, and difficulty swallowing. A tracheotomy is undoubtedly more conducive to suctioning the patient to prevent airway blockage. .

  Hearing this, people who know medicine can more or less understand what is going on with the patient.

  The head seems to be failing for the time being, and it may be necessary to prepare psychologically for the patient to be in a coma for a long time and unable to take care of himself. Doctors had to preventively give a tracheotomy and connect a ventilator.

  Is this the case? The human body damage caused by fire goes far beyond the nervous system.

   "It is said that she is on the seventh floor, and she has not been caught in the fire yet." Du Ye Qing, who said this, looked at Dr. Shi Lei who had been to the scene beside him, and then checked whether there were any mistakes or omissions in the news of the fire scene he had heard.

  Dr. Shi Lei is like a stone who doesn't like to talk, so he nodded in yes.

   "But." Du Yeqing continued, "Her lungs are already in a very serious state due to inhalation of a large amount of carbon monoxide and other chemical irritants."

   It’s the burning lungs that I just mentioned before.

   Fire burns the lungs, and cerebral edema is unavoidable.

  Du Yeqing admitted: "Dr. Cao Yong is here, and his diagnosis is acute cerebral edema."

  You may sound strange? No injuries or burns to the head, why is there cerebral edema?

  Just think about heart problems and lack of oxygen can directly kill the brain. It has long been confirmed that once the human body is hypoxic, it has too much to do with the brain. The lungs were severely damaged, it was difficult to inhale, and it was difficult to feed the human body. The brain, which is most sensitive to oxygen, was naturally and directly implicated again as a "serious injury".

  For this kind of patients, if the general situation permits, they should be sent to the hyperbaric oxygen chamber for treatment as soon as possible, which is good for brain and lung rehabilitation. But now, the patient cannot be sent on a ventilator at all. It should be said that at this stage, doctors do not consider the patient's future recovery stage at all, and whether the patient's life can be saved is a problem.

   "Is her heart unstable, Teacher Du?" Xie Wanying asked.

  Myocardial damage caused by carbon monoxide poisoning is too common, especially in such critically ill patients who have acute cerebral edema, nine out of ten will have severe myocardial damage.

  Who makes people's heart and brain are the two most vulnerable organs of the human body.

  (end of this chapter)