The anesthesia clinic is on duty, with the last painless gastroscope left. Turning his head to look at the table below, everyone seemed very satisfied. This is because, at eleven thirty the canteen delivers food. At this time, it was 15 minutes before eleven thirty. This is more than enough for a painless gastroscope. It doesn't matter if you cut a few polyps.
However, what to say, this patient complained: the doctor who had previously examined the gastros had said that she still had polyps in her stomach. However, because the polyps were too small, they were not cut. If the polyps are found to have grown during this examination, they will be cut off as well.
With the mood that they did not want the patient's polyps to grow up, anesthesia began.
60 kg, more than 30 years old, no special diseases in the body. So Dr. Liu, who was in charge of anesthesia, pushed the anesthetic into it according to the kilogram weight of 1.5 milligrams.
On the instructions, the use of this drug is 1 to 2 mg kg of body weight. Coupled with the great stimulation of the gastroscopic operation, which in itself requires a deeper depth of anesthesia, he chose 1.5 without problems. But everything that happened after that scared him so much.
Since the endoscopic chamber was also in a hurry, they had just pushed the medicine in, and they entered the mirror.
Logically, this is not a violation of the law. I have been working with the anesthesiology department for many years, and I have experienced it for a long time. They also know that an arm-brain cycle, that is, more than 10 seconds later, works.
Only a brief pause in the oropharynx, the mirror slammed straight into the stomach.
At the first sight of the stomach, everyone collapsed: several polyps.
Since you see the polyps, you have to cut them.
Preparations were being made to cut polyps over there, and Dr. Liu didn't just watch the hustle and bustle. His eyes, constantly looking from the monitor to the patient's chest, and from the patient's chest to the patient's oropharynx, on the collarbone, and on the sternum: he was trying to find signs that the patient was still breathing safely.
However, it had been two minutes since the administration of the drug, and the patient did not seem to have gasped for breath once.
He had always had a big heart, and decided to wait a little longer.
According to normal circumstances, the peak period of action of the drug in 2 to 3 minutes has passed. And this self-efficacy drug, which is very short-acting, will hardly have too long a time of action. In addition, once the body is deprived of oxygen, the gradually rising partial pressure of carbon dioxide will stimulate the respiratory center to resume breathing.
However, none of this came.
When the time came to three and a half minutes, he was nervous. Because, the blood oxygen is falling down little by little. The blood oxygen falls down, like a child playing with a slide: at first the slope is not so large and the speed is slower. Once it reaches the intermediate stage, it will accelerate abruptly. The decline in blood oxygen is also such a law: at first, the decline is little by little, and as the partial pressure of oxygen in the body is lower than about 80, the blood oxygen will accelerate the decline.
Don't think about it, he wants to solve this problem immediately!
However, the gastroscope is inserted in the patient's mouth, and the polyps have begun to be cut. Once the mirror is pulled out, it is not excluded that the polyp bleeding and other conditions are not ruled out.
At this time, he suddenly remembered the chest compressions of cardiac arrest: since CPR can provide effective changes in chest pressure, can her chest cage produce breathing movements through chest compression?
When all was said and done, Dr. Liu put his hand on the patient's sternum handle and gently pressed it. Obviously, the thorax had collapsed slightly.
Since standard chest compressions "evoke" the heart's function through high-frequency compressions, Dr. Liu deliberately slowed down the compression of the chest and the raising of his hand in order not to affect the normal function of the heart.
This movement was so inconspicuous that they had not noticed anything unusual on this side when they were concentrating on cutting the polyps.
On the monitor, once the blood oxygen slipped to 70, it was no longer lower than 90.
What puzzled Dr. Liu was that it wasn't until 10 minutes later that the patient's spontaneous breathing didn't come back, and normal people generally didn't have such severe respiratory depression. Even if there is, it is only a transient.
In the face of a strange case, Dr. Liu is ready to discuss this case with you in the case discussion next week.
At the same time, he did not forget to tell the patient after the examination that her constitution was abnormal. In case of anesthesia, be sure to remind the anesthesiologist before taking an anesthetic.
Finally, we throw out a question: Have you ever met such a special patient? Welcome to leave a message below to communicate~
【Warm tips】Point to pay attention, here is a lot of professional medical science, for you to reveal the secret of surgical anesthesia those things ~ ~