Source: Shiyan Evening News
July 31
A man working at a construction site in Xunyang, Shaanxi
Accidentally fell from a 3-meter high platform
A threaded rebar pierces its neck
Life hangs in the balance
Due to the inability to dispose of it at the local hospital
The injured man was sent overnight
Shiyan Taihe Hospital rescue
After receiving information about the injured person
Experts from various relevant departments of Taihe Hospital quickly assembled
A life-and-death rescue begins...
The man fell from a 3-meter high platform
Threaded rebar pierces the neck
At 10:20 p.m. that night, with the sound of an urgent ambulance horn, a man was quickly carried by medical staff into the emergency department of Taihe Hospital.
The man's neck was pierced by a threaded steel bar, nearly half a meter long steel bar has not been removed, and blood constantly oozes from the wound. "The patient was admitted to the hospital with drowsiness, slow heart rate, shallow breathing, low blood pressure, 90% blood oxygen saturation, and a large hematoma in the neck." Fang Zhicheng, director of the emergency department of Taihe Hospital, introduced.
It is understood that the man, 60 years old, at about 6 p.m. on the same day, while working at a construction site in Xunyang County, Shaanxi Province, accidentally fell from a 3-meter high platform, and his neck was pierced by a threaded steel bar below.
"Through the pictures, we learned about the patient's injury, because the neck is punctured, the steel through the wound may hurt the neck airway, large blood vessels, nerves, etc., if the injury to the airway or the blood oozing from the wound block the airway, it can lead to suffocation death." Fang Zhicheng introduced that on the way of patients transferring Shiyan from Xunyang, they constantly contacted the doctors referring to the hospital to grasp the changes in the patient's condition and provide guidance at any time. Fortunately, the patient's breathing along the way was relatively stable.
Quickly establish artificial airways
The man's neck was punctured in multiple areas of tissue
After the patient is admitted to the hospital, an artificial airway should be established as soon as possible to avoid aggravation of airway injury or hematoma pressing the airway, resulting in narrowing, hypoxia, and suffocation of the airway, and also laying the foundation for subsequent surgery.
Due to the long rebar inserted into the patient's neck, which affected the establishment of the airway, CT examination and later surgical operations, Fang Zhicheng sought help from the Shiyan Fire Brigade. Soon, a fire rescue team arrived at the emergency department of Taihe Hospital, and under the premise of ensuring the safety of the patient's life, the doctor cooperated with the firefighters to cut off the steel bar that pierced the patient's neck.
The fire rescue team successfully cut off the neck-piercing rebar
Immediately after, the emergency department established an artificial airway for the patient. "This is a very critical step that needs to be done quickly and without any errors, otherwise the damage will be aggravated." Fang Zhicheng introduced that because the patient's neck was punctured by a steel bar, there may be a change in anatomical position, and the patient has difficulty opening his mouth, and it is impossible to perform endotracheal intubation at all, and can only undergo emergency percutaneous tracheostomy, and then give invasive respiratory support.
With exquisite technology, the emergency department doctor completed the percutaneous tracheotomy in less than 5 minutes, establishing a life channel for breathing.
The emergency department doctor at Taihe Hospital established breathing channels for the injured man
"After a perfect examination, the patient's cervical spine was not damaged, but the steel bar stabbed the large blood vessel in the neck, and the bleeding of the blood vessel was temporarily slowed due to the compression of the steel bar." Ni Xiaobing, chief doctor of the Department of Stomatology of Taihe Hospital, told reporters that in addition, some of the patient's chest lock papillary muscle, part of the mandibular hyoid muscle, part of the hyoid and tongue muscles, tongue arteries, and sublingual nerves were punctured, the pharyngeal cavity was punctured, and other small blood vessels in the neck were also damaged.
Peel off the cocoon under the microscope
Anastomoses damaged nerves and blood vessels
After the examination, the patient took the green channel directly to the operating room. The operation was personally performed by Professor Leng Weidong, vice president of Taihe Hospital, and assisted by two attending doctors, Ni Xiaobing and Liu Yongjian of the Department of Stomatology.
"First of all, the steel bar in the patient's body should be taken out." Ni Xiaobing told reporters that Professor Leng Weidong first enlarged the surgical incision, then protected the important large blood vessels, nerves and muscles, and finally slowly removed the steel bar. Since the rebar is threaded, in order to avoid secondary damage and infection during the extraction process, the doctor used a sterile sticker to wrap one end of the rebar.
After nearly an hour of surgery, the threaded rebar through the patient's neck was smoothly removed. "After the steel bar was removed during the operation, the bright red blood spurted out like a column at the large blood vessel where the patient's neck was broken, and we immediately repaired the damaged blood vessel." Ni Xiaobing said that if the rescue is not timely, the patient's life is in danger at any time.
Subsequently, the doctor debridement of the patient's wound. Because it is a penetrating injury, the wound is small, the diameter is large, and the requirements for debridement are relatively high, and the contaminated tissue needs to be cleaned and pruned to avoid postoperative infection.
Rather than pulling out the threaded rebar, the operation is more important to anastomose the broken nerves and blood vessels to restore the blood circulation and motor function of the tongue. The punctured pharyngeal cavity is reconstructed to lay the foundation for the recovery of the patient's postoperative respiratory function, swallowing function, and pronunciation function.
"Due to the delicate nerves and blood vessels, the whole operation, Professor Leng Weidong is carried out under a microscope. Microscopic sutures that anastomose blood vessels and nerves are thinner than hair. With superb surgical skills, Professor Leng Weidong successfully repaired the damaged blood vessels, nerves and pharyngeal cavity of patients after nearly 3 hours of surgery. After the operation, the patient was successfully taken offline, his vital signs were stable, and he is currently receiving further treatment in the ICU.
Threaded rebar removed from the injured person's body
Professor Leng Weidong said that the successful rescue of this patient with steel bars running through the neck is inseparable from the strong help of the fire department, the mutual cooperation of various departments, the smooth flow of green channels, etc., and everyone has worked together to win valuable time for the patient.
Text, photo/ Shiyan Evening News reporter Zeng Yu trainee reporter Zhang Wenliang Special correspondent Wang Hui