? July 21, 2018 Yulin First People's Hospital Cardiothoracic Vascular Surgery Director Gan Naiyan as usual is in the ward to check the patient to understand the patient's condition. Suddenly received a notice from the medical department of the hospital: about seventy kilometers away from our hospital in Luchuan County Liangtian Health Center, there is a patient clavicle fracture, subclavian artery hemorrhage, the condition is very critical. Director Gan Naiyan knew the risk of subclavian artery hemorrhage and the difficulty of dealing with it by virtue of his professional sensitivity and decades of experience in cardiothoracic and vascular surgery. He was calm and composed, and immediately arranged for Chen Jun, the experienced deputy director, and Dr. Lv Kai to attend the clinic to deal with the patient and explain the precautions. At the same time, considering the limited conditions of primary hospitals, he contacted anesthesiologist Huang Hailin, who has rich experience in anesthesia, and nurse Chen Ou in the operating room, and at the same time, contacted the blood bank and brought 4U of red blood cells and plasma with him. Everything is ready, the emergency team non-stop after more than two hours of bumps to reach the destination, do not have time to drink a mouthful of water to put into the work.
The reality is more serious than imagined. Clavicle fracture combined with rupture of the subclavian artery, subclavian artery diameter, anatomical location of special, blood vessels located in the subclavian, high pressure, difficult to expose, the condition of the vicious, rupture is often uncontrollable hemorrhage, shock and even death. At that time, the patient's hematocrit was only 59g/L, severe anemia. If directly transported back to the First Municipal People's Hospital, there is a possibility of bleeding to death on the way. If the patient was transported after the surgery to stop bleeding, the conditions of the local health center were extremely poor, there was no blood source and blood substitutes, there was no anesthesia for intravenous anesthesia, and the anesthesia brought in could only last for 3 hours, and there was no ventilator, so what should be done? Clinical resuscitation must compete for time, after reporting to the director of Gan Naiyan, Wu Minister of the Ministry of Medical Affairs and Luo Yunping, vice president of the decision at all costs, to overcome the difficulties, first surgical hemostasis and then transport the patient.
And as a city hospital cardiothoracic vascular surgery director Chen Jun and Lv Kai doctors are the backbone of the department, quickly developed a treatment plan with the anesthesiologist Huang Hailin and operating room nurses Chen Ou emergency team immediately put into the rescue work. Dr. Huang Hailin quickly performed arterial puncture, established arterial monitoring, and intubated general anesthesia. Dr. Huang quickly performed arterial puncture to establish general anesthesia. The surgeon sawed open the sternum to reveal the left clavicular artery, and then sawed open the clavicle to reveal and repair the ruptured blood vessel after blocking it. Everything was done skillfully and methodically.
Because there is no ventilator equipment in Liangtian Hospital in Luchuan County, the patient must be intubated with general anesthesia before performing open heart surgery, so the whole process of using a simple respiratory airbag to assist breathing.
At the end of the operation, the patient's vital signs were stable, and the endotracheal tube was removed immediately without any adverse reaction, and the cooperation was perfect. In order to the patient's safety, such as lifting the life-threatening factors back to the city hospital cardiothoracic vascular surgery intensive care unit treatment. At present, the patient's condition is stable, has been moved to the general ward.
In the absence of excellent equipment, poor environmental conditions, the emergency team used their extensive clinical experience and solid technical skills to complete the subclavian artery rupture repair surgery, and the speed of death, to save the time does not wait for the patient's life, for them to praise (?ò?). ó?).
? Our cardiothoracic and vascular surgery team is a team that can fight hard. They have made many trips to Yulin Orthopedic Hospital, Beiliu, Luchuan, Bobai, Rongxian, Xingye and other hospitals to rescue the clavicular artery, abdominal aorta, heart and other vascular diseases were successful. The success of this rescue is the effective organization of the medical department, hospital leadership, anesthesiology, operating room, blood bank, the results of the active cooperation of the 120, is the hospital unity and cooperation, the virtues of all beings, the embodiment of the proximity to the good.
Edited by: Zhang Xiaoyi, Ning Yu, Chen Jun
Photo contributed by: Ning Yu
Edited by: Chen Jun, Ning Yu