Chongqing, January 19 news (reporter Liu Chun correspondent Li Chunmei) "Looking back on the situation at that time was too terrible, now it feels like a dream. On January 18, in the emergency medicine department of the Army Military Medical University Xinqiao Hospital, Master Ou, who had died nine times, recalled the scene of the accident on the construction site more than ten days ago.
Reinforcement through the neck (Courtesy of Xinqiao Hospital)
Accidentally dropped by the steel bar through the neck
At about 5 p.m. on January 4, 21-year-old construction worker Master Ou was working on a steel bar at a construction site in Jiulongpo District, when he suddenly slipped his foot and fell down, and a steel bar about 5 centimeters in diameter and about 2 meters in length passed through his neck. When the workers saw the situation, they immediately found a chainsaw to saw off the foundation of the steel connection, and then the company took the steel bar and rushed it to the emergency medicine department of the Army Military Medical University Xinqiao Hospital.
"Slow down, slow down, put it here!" "Be careful! Patients may have a little vibration, resulting in more severe internal bleeding. "ECG monitoring, blood gas check...", in the emergency medicine department of Xinqiao Hospital, after Master Ou was sent to the rescue room by the workers, the medical staff immediately activated the emergency plan for trauma patients. Because the steel bar runs through the neck, the neck has a wealth of blood vessels and nerves, a small action will lead to further injury to the blood vessels and then cause heavy bleeding and blood vessel damage, once the heavy bleeding is difficult to have the "power to return to heaven".
Medical staff carry out rescue (Photo provided by Xinqiao Hospital)
The steel bar is close to the blood vessel and hangs in the balance
After the emergency plan for trauma treatment was launched, Associate Professor Zhou Yong, the leader of the trauma treatment team, commanded and coordinated the treatment, maintained the patient's vital signs, urgently stopped bleeding, anti-infection, etc., and at the same time notified Associate Professor Tan Dan of the emergency operating room to the scene to assist in rescue and emergency preoperative assessment.
How is the endotrachea intubated before anesthesia? Because Master Ou's right neck was penetrated by the steel bar and injured, the steel bar was just pressed on the neck, the breathing was short and laborious, the heart rate continued to be above 130, and the endotracheal intubation was difficult before the operation. After discussion, Associate Professor Tan Dan made a suggestion, informing the operating room to prepare a difficult airway car to prevent accidents at any time.
Has the reinforcement damaged the carotid artery? From the ct and ultrasound and other imaging examinations, the carotid artery and the steel bar are very closely attached, and it is impossible to judge whether the steel bar damages the blood vessel. Associate Professor Zhou Yong said that even if the steel bar does not penetrate the blood vessel, it may cause heavy bleeding when removed, and the specific situation can only be determined according to the exploration situation.
For anesthesia, surgery, bleeding and other situations, the experts conducted detailed discussions and formulated a number of emergency surgical plans.
2 hours of life and death speed successfully removed the "murder weapon"
In order to ensure the stability of circulatory function (blood pressure, heart rate, oxygen saturation, etc.) during major bleeding, experts need to establish intraoperative infusion and blood transfusion pathways.
The abundance of blood vessels in the neck is the key location for puncture when establishing the pathway, but the position of the rebar affects the neck puncture operation, which increases the difficulty of the preoperative anesthesiologist to establish the infusion channel for the patient. The anesthesiologist retreated to the second place, and could only choose multiple peripheral venous pathways such as the femoral vein of the leg and the middle vein of the upper elbow to ensure rapid infusion during surgery.
After Associate Professor Tan Dan, who is in charge of anesthesia, fully established to maintain the patient's circulatory stability, two surgical assistants carried the steel bar at both ends to prevent the steel bar from further compressing the blood vessels or changing the position during the operation and further damaging the blood vessels, and then Associate Professor Zhou Yong and Zhan Xiaobo's attending physician carefully performed the operation.
During surgery (Courtesy of Xinqiao Hospital)
"It's dangerous, it's a real difference." Dr. Zhan Xiaobo said that the steel bar and other foreign bodies pierced into the body will form a closed wound, hastily pulled out will cause heavy bleeding, fortunately the steel bar avoids the carotid artery large blood vessels, a little bit may be difficult to save, it is really unfortunate in luck.
Incision, removal of steel bars, vascular anastomosis, removal of residual iron filings and sutures of traumatic tissue... Under the doctor's meticulous surgery for more than two hours, the steel bar was smoothly removed and the blood vessels and wounds were smoothly sutured.
After the operation, under the meticulous treatment and care of the medical staff, Mr. Ou successfully passed the bleeding pass and the infection pass. At present, Mr. Ou is actively receiving follow-up treatment and his condition is stable.