Since 1981 Health School Chapter 418

  Chapter 418 Ventilator in space

   "Ventilator?" Chen Qi blinked.

  There is no ventilator in the Vietnam-Central region, and only the Provincial First Hospital in the entire Haidong Province has an imported ventilator. The problem is that ordinary people don't use it at all, and it is only prepared for special groups of people.

  In everyone's mind, this is definitely a high-tech medical equipment.

  So for the vast number of doctors in Huaguo in the 1980s, everyone may have heard of a ventilator, but most of them have never seen it.

   But those are ordinary doctors. For Chen Qi, a general doctor, there are not only ventilators in his space operating room, but even the more advanced extracorporeal membrane oxygenation machine ECMO.

  The principle of the ventilator is actually very simple. It is to generate positive pressure when inhaling, and press the gas into the lungs through the machine.

  When the pressure rises to a certain level, the ventilator will stop supplying air, and the exhalation valve will open one after another, and the patient's chest and lungs will passively collapse, resulting in exhalation.

   This thing is common in 2022, let alone doctors, even ordinary people.

  The hospital is an invasive ventilator, which requires endotracheal intubation or tracheotomy before use.

   There is also a sleep respirator for home use. It is like an oxygen mask when you sleep at night, covering your mouth and nose. It is especially good for those who snore heavily during sleep.

  Because these people often suffer from obstructive sleep apnea syndrome.

  What is Obstructive Sleep Apnea Syndrome?

   This is a very good distinction.

  For example, some people snore, especially obese men. At first, the hula hula sound is very loud, and then suddenly there is no sound. It takes tens of seconds, or even longer, before continuing to hula hula and continue snoring.

  People with this condition will have serious consequences. In simple terms, they are prone to chronic diseases such as high blood pressure, diabetes, and coronary heart disease, and in severe cases, they are prone to sudden death.

  In hospitals, clinically, medical ventilators are used more frequently.

  It is not only widely used in respiratory department, oncology department, infectious department, etc., but also in anesthesiology department, ICU, emergency department, etc. It is an indispensable machine.

  It is mainly used for severe respiratory failure, accompanied by carbon dioxide retention, and type II respiratory failure will appear to assist ventilation.

  It can improve ventilation and ventilation functions, reduce the work of respiratory muscles, and keep the airway unobstructed. It is an absolute life-saving artifact at critical moments.

   These one-by-one comparisons are aimed at the needs of Shen Lifen's son, the baby on the hospital bed.

  Chen Qi now understands that the prerequisite for a smooth operation is that conservative medical treatment must be successful.

  The key to the success of medical treatment is whether there is a ventilator, whether the respiratory function of the child can be guaranteed, and the continuous deterioration of respiratory failure can be avoided.

   To put it simply, people have to be alive to have the opportunity for surgery.

   But the question is, where to get the ventilator?

   Thinking of this, Chen Qi felt a little headache, because now the only possible source is his spatial operating room.

  It is easy for him to be taken out of the space, but if outsiders find out about it, the consequences will be serious. At that time, the machine will be sliced, and even he himself will be sliced.

  Even if he reasoned that this was a foreign test machine, he would inevitably be accused of "communicating with foreign countries".

  Between personal safety and the life and death of the little patient, Chen Qi was a little hesitant.

  But when he saw the baby on the hospital bed who was on the verge of death and out of breath, he had to sigh heavily in his heart.

  He picked up the patient, and he chose the path himself. Now, even if he is kneeling, he has to finish the walk, especially now that he is in a critical condition, and he can no longer think about it.

   "Then let's go get busy first, so Director Wang, Head Nurse Qiu, Yan Shifan, and Border League will stay for a while."

  Other doctors were happy to leave when they heard that they had nothing to do. Only Director Wang Xiaoxian was a little strange.

  Chen Qi called the four of them to the office mysteriously, and after checking that no one was outside, he locked the door heavily, and said softly:

   "Director Wang, if I can get a ventilator, can you guarantee that the little patient will get through this hurdle?"

  Director Wang Xiaoxian's eyes lit up when he heard it: "Really? This ventilator can be imported, and there are not many in the country. Where can you get it?"

   After finishing speaking, the old lady slapped her chest: "As long as you can get a ventilator, I guarantee that you will be able to stabilize your condition."

  Chen Qi gritted his teeth, looked back at Qiu Fang and said:

"Head nurse, you should immediately clean up the special-needs ward of the Second Department of Surgery and put on the curtains. Xiao Yan, you go to the Pediatrics Department and push the incubator here. Frontier League, you inform the Security Department and ask them to arrange people. 24 I guard the special-needs ward for hours, and no one is allowed to enter without my permission."

   Head nurse Qiu was a little strange: "Dean, you are..."

  Chen Qi half-truth said:

"I have a way to get a ventilator, but this ventilator is developed in secret by our country, so we can't leak it in advance. If it is known by foreign countries, our patent will be gone, so everyone must keep it absolutely confidential. The whole treatment process , only the five of us are in charge, and everyone else is prohibited from entering or leaving.”

  Yan Shifan, Bian Meng, and Head Nurse Qiu immediately understood that when they were rescuing ectopic pregnancy, Chen Qi once took out an "autologous blood recycling machine", which was also an experimental machine, and everyone was required to keep it strictly confidential.

   Presumably the sources are all the same.

  Since it involves state secrets, everyone has nothing to say.

  Even Director Wang nodded again and again, expressing his understanding of the secrecy discipline. Anyway, the old lady is also a military doctor, so there is no need to emphasize this aspect.

  As for the other three, they are all Chen Qi's cronies now, so they can be completely trusted.

   "Okay, now that everyone understands, I'll go to the province to get the ventilator. The other family members can only be accompanied by their mother, and all other family members will be persuaded to leave. The child's mother is a teacher, so let her keep it secret."

  Director Wang was already excited because he could see the real ventilator, so he hurriedly urged:

   "Ah, then what are you doing in a daze, hurry up, this little patient may die at any time, and no one can bear the responsibility if it is too late."

  Chen Qi nodded, and quickly walked out the door. Before leaving, he took a large pile of newspapers in the office under his arm.

  Chen Qi drove the Santana, found an empty corner, and flashed into the spatial operating room.

   After entering the space, Chen Qi went around several operating rooms and found several models of ventilators inside.

  For example, emergency ventilators, respiratory therapy ventilators, anesthesia ventilators, pediatric ventilators, high-frequency ventilators, extracorporeal membrane oxygenation machines, etc.

   There is no need to choose. Generally, the pediatric ventilator is the first choice, but the problem lies in the large size of this kind of pediatric ventilator. It is too eye-catching when it is taken out in the open.

  Chen Qi shook his head, and turned out another emergency transport ventilator with an orange appearance, and his eyes lit up.

   First aid and transfer ventilator, this is more common in hospitals, most of which are in 120 ambulances, used for emergency ventilation rescue of patients with respiratory failure, and mechanical ventilation of patients during operation.

  This ventilator is designed so small that it can be carried with one hand, and it is very concealed to use.

  Chen Qi thought that he would need this machine, and it would be enough to put it in the ward with the oxygen tank connected, at worst, it would be fine to correct all kinds of data carefully.

   After deciding which ventilator to use, Chen Qi didn't care about the hygiene, so he directly smeared the paste on the machine, and then wrapped it tightly with newspaper, only the operation panel was exposed.

  Then flashed out of space and hurried back to the courtyard, holding the life-saving machine tightly in his arms.

  In the ward.

   "This is a ventilator? Why is it so small? I read in magazines that foreign ventilators are all that big~~"

  Director Wang looked at the ventilator, which was pasted with newspaper and was not much bigger than a shoe box, and he couldn't believe it.

  In the 1980s, the most advanced ventilator abroad was a constant-volume ventilator, which was about the size of a bedside table.

  In China, the general ventilator is still at the level of the 1950s and 1960s abroad, and the size is even larger, like an iron coffin. When using it, the patient needs to lie inside, with only one head exposed.

   is actually the famous "iron lung".

  The most feared thing about this kind of ventilator invented in 1929 is power failure. Power failure means that the patient will face the risk of death unless someone helps them manually operate the iron lung to assist breathing.

   Take another look at the ventilator that Chen Qi brought. It is so small that it can be easily placed on the coffee table, and a woman can easily carry it away.

  Director Wang Xiaoxian asked uncertainly again: "Can this thing work?"

  Facing this old lady, Chen Qi lost his temper, and said with a wry smile, "It works, I'll show you right now."

  He thought about it again, and decided to vaccinate Shen Lifen, a family member. After all, a baby was going to be intubated. That scene was definitely not something a mother could bear to see.

   "Mr. Shen, I will bring the ventilator now. Whether it can save your son's life depends on this machine. What I want to tell you is that this machine can only be used by inserting a tube into your son's trachea."

  Shen Lifen is a smart person, and has realized that endotracheal intubation may not be such a simple matter.

   Can it be simple?

  Many people's wills include their refusal to be intubated when they encounter an emergency department. You can imagine the pain of the patient when he was intubated.

  But when she thought that her son was in danger, she couldn't care less, so she gave it a go:

   "Yes, Dean Chen, my son's safety is up to you. No matter what you do, I will support you. My child's father and I will always be grateful to you."

  Chen Qi nodded: "Don't worry, I won't let the hero bleed and cry, but when you are intubated, you should avoid it for a while, and I will call you when I am done."

  Shen Lifen did not hesitate, and quickly left the ward wiping away tears.

  At the same time, Chen Qi also took out all the intubation tools and started preparing for intubation. Director Wang, Yan Shifan, and Bian Meng quickly surrounded him.

   In fact, Chen Qi was quite nervous. Endotracheal intubation is a basic skill for a surgeon, and he can do it with his eyes closed.

  But the newborn in front of him was intubated, and he really couldn't do it. After all, in his previous life, this kind of intubation was performed by anesthesiologists, and he had never done it before.

   But now he is the only doctor who can do endotracheal intubation in the entire Yuezhong. If he does not go to hell, no one will go to hell.

  Chen Qi carefully lifted the lower jaw of the little patient with his right hand, and opened his mouth.

  Then left-handed laryngoscope goes deep into the oral cavity of the little patient, revealing the uvula, and then goes deep into the pharynx of the newborn along the back of the tongue, lifts up the epiglottis, and exposes the glottis.

   While doing it, Chen Qi explained his operation steps to several doctors next to him.

"At this point, we need to look for anatomical landmarks first. The vocal cords look like vertical stripes on both sides of the vocal cords, or like an inverted "V". If the vocal cords are closed, the right and middle fingers can be placed under the new chest. Rapid opening at /3, suctioning out secretions can also help improve vision. Note that inability to adequately expose the sound is a failure of intubation.”

  Yan Shifan and the border alliance listened very carefully, this is definitely a small matter.

  Many skills are not overwhelming. Whoever is the first to learn tracheal intubation in the Yuezhong area will undoubtedly improve his clinical level to a higher level.

  I saw Chen Qi's right hand inserting the organ catheter that had already been inserted into the catheter core from the right side of the mouth. After the catheter penetrated into the glottis, he withdrew the catheter core. At this time, he opened his mouth to remind:

"This step is very critical, and it is also the biggest difference between infants and adults. The total trachea of ​​children is short, and the distance from the glottis to the carina is only 4cm for newborns. Therefore, the insertion depth is generally appropriate when the front end of the catheter exceeds the upper edge of the sternum. In addition, the entire operation The fast course must be fast, try to control it within 20 to 30 seconds."

  After speaking, Chen Qi pushed out the laryngoscope and started to fix the intubation.

  Yan Shifan still didn't understand: "Chen Tou, is this the end? Insert it? I don't even understand. How do you judge success and failure?"

  So Chen Qi was fiddling with the ventilator while explaining the clinical experience of whether the endotracheal tube was inserted in the correct position.

  Following Chen Qi turning on the switch and adjusting the automatic breathing mode, the small patient whose breathing rate was extremely irregular immediately became regular with the inhalation and exhalation of the ventilator.

   Immediately afterwards, visible to the naked eye, his complexion slowly began to improve. It was originally a bit bluish purple, but now it is slowly fading.

  Director Wang Xiaoxian was excited when he saw it: "Hey, it's amazing, this ventilator works so well."

  Following the pleural effusion drainage performed by the border alliance again, this little patient who was on the verge of death due to respiratory failure unexpectedly fell asleep slowly and balancedly, and no longer moaned in pain like before.

   Not only Director Wang was greatly surprised, but even Shen Lifen who had just opened the door and walked in was tearfully surprised.

  Patients were relatively short-lived and paid more attention to the situation in front of them. Seeing that his son was able to fall asleep peacefully, Shen Lifen grabbed Chen Qi's hand:

   "Genius doctor, what a genius doctor, thank you very much, Dean Chen."

  Chen Qi's face turned red, and he quickly pulled out his hand. If his wife finds out about this, will he still be able to survive?

   "This, this, ahaha, this is the first step. The next step is to see Director Wang's internal medicine treatment. Don't be discouraged, Mr. Shen, everything will be fine."

   "Yes, it will be fine."

   I'm really busy, the hospital has been occupied by patients, and all the chapters have been archived for the past half month, and I hardly have time to type. Now that it's open, it's even worse, too busy to keep your feet on the ground. 4000 words is really the bottom line. If you are still so busy, it is possible to break the update. Sometimes looking at Chinese patients is really emotional. They are too tired to live and are constantly being tossed.

  (end of this chapter)

Chapter end