Chapter 2248: with translation of chapter title

"Lao Mu is in Shou Bing, what's wrong?" Su Yun asked lazily.

"The patient's heartbeat stopped!" the nurse shouted, then turned and ran back.

Er...

The neighboring Shujian?

Su Yun suddenly stood up, looking through the lead glass, saw Zheng Ren turn around, without even tearing off his sterile gown, he opened the sensing airtight lead door and strode out.

"Wu Lao, don't worry, I and the boss are going over." Su Yun strode away, not forgetting to explain a sentence to Wu Lao.

At Wu Lao's age, I really fear he'd join the 120 Emergency and end up giving himself a heart attack.

The interventional surgery room of Pengcheng Kaifaqu Renmin Yiyuan is not big, only five Shujian. Inside, the airtight lead doors of the Shujian with the surgery-in-progress red light are closed, and panicked sounds come from the control room.

"Push the drug! Atropine 1mg!"

Zheng Ren quickly walked over and immediately saw a pale System Panel, the diagnosis on it already blurred. Faintly visible were diagnoses such as atherosclerotic coronary artery disease, carotid artery stenosis, etc.

The Cardiology doctors were performing chest compressions, the nurses were drawing medication, preparing to inject.

The Shou Bing screen showed the carotid artery intervention site at the bifurcation of the right internal carotid artery, where baroreceptors are more sensitive, and the reflex regulation mainly responds to pressure sensing within a few short seconds.

This was to place a coronary stent; the heart stopped when the preceding procedure opened the carotid artery stenosis.

Zheng Ren glanced, saw the situation with Ming, and directly entered the System Operating Room.

Su Yun quickly followed behind Zheng Ren, seeing the nurse drawing medication a bit slow, she said: "Lao He!"

Lao He didn't respond, but walked over silently and firmly. He went to the rescue cart, broke open an atropine, drew it into a syringe, opened the three-way stopcock and injected it directly.

Emergency rescue tests psychological quality and Technique.

The little nurse was like a new soldier just arrived on the battlefield, hearing the booming cannon fire she was instantly frightened; how could she be as seasoned as Lao He, a veteran who has experienced countless big and small battles?

Originally her Technique was just average; once panicked, she really had nothing left.

"Lao He, intubate." Zheng Ren suddenly said, "Bring the ventilator over. Su Yun, go do chest compressions, increase the force and frequency."

After saying that, Zheng Ren tore off his sterile gown, removed his sterile gloves, turned and went to scrub his hands.

Su Yun didn't hesitate, walked to the operator's side, bumped with her shoulder, and pushed the operator away from the external chest compression position.

The operator was dumbfounded.

However, at such a time, if a doctor capable of confidently taking over the rescue appears, she certainly wouldn't stop them.

The Shou Bing had just begun, the balloon slightly expanded, and the patient suffered cardiac arrest. In this regard, the Cardiology department should be skilled, but after 30 seconds of compressions there was still no return of heartbeat, and they panicked.

"You, go charge the defibrillator." Zheng Ren went to scrub his hands, and Su Yun took over directing the rescue work.

He directed the operator without any scruples, full of the demeanor of a senior director.

One after another, atropine, dopamine, and epinephrine were pushed in; Lao He completed tracheal intubation at the fastest speed and handed the balloon to the assistant doctor.

Zheng Ren finished scrubbing and came in, putting on a sterile gown.

"Boss, what should we do?"

"The carotid artery stenosis still needs to be opened, how about Lao Mu?" Zheng Ren glanced, seeing Su Yun performing external chest compressions at a frequency of 110 per minute, the waveform on the ECG Monitor still not restored, just like in the System Operating Room, also somewhat urgent.

"Zheng Lao Ban, I'm here." Mu Tao finished the last step of that Shou Bing and hurried in.

The Cardiology doctors saw Mu Tao enter, finally seeing a savior, hoarsely saying: "Professor Mu, the patient's cardiac arrest..."

"Zheng Lao Ban, what should we do?" Mu Tao asked, frowning.

"You push the ventilator, I'll place the stent." Zheng Ren stood at the operator's position, glanced at Su Yun.

"What are you looking at me for? If I'm not wearing Lead clothing, I'm not wearing it; just get on with it." Su Yun kept her arms straight, continuing cardiopulmonary resuscitation.

The airtight lead door slowly closed, and Zheng Ren had already begun stepping on the line.

The balloon's position shifted slightly; Zheng Ren pushed it further in, found the carotid artery stenosis, opened the narrowed segment, and delivered a CRISTALLOideale-SE6-9mm×40mm self-expanding stent.

As the carotid artery opened, Su Yun's movements gradually slowed.

On the patient's ECG Monitor, the squeezing fluctuation gradually recovered into ventricular tachycardia, and after a few seconds, sinus rhythm was restored.

Zheng Ren stopped stepping on the line, saying: "Put on the Lead clothing."

Su Yun glanced at the monitor's numbers, nodded, and turned to go put on the Lead clothing together with Lao He.

"..." The Cardiology operator stood blankly at the side.

"Little Sun, what's going on?" Mu Tao asked.

"The patient's diagnosis is atherosclerotic coronary artery disease, exertional angina; bilateral lower extremity arterial sclerosis; carotid artery stenosis. Originally we wanted to first address the carotid artery stenosis, then place the stent, but we didn't expect that as soon as the balloon went in, the heart stopped."

Mu Tao nodded.

Significant carotid artery stenosis is an important risk factor for perioperative stroke in coronary stent patients, with stroke incidence as high as 3%–11%, and positively correlated with the degree of carotid artery stenosis.

The patient's condition is clear; preoperative diagnosis and surgical indications are fine.

The handling was correct, the surgery should normally first address the carotid artery stenosis. Only the patient's cardiac arrest lasted a bit long, leaving them dazed.

"Zheng Lao Ban." Mu Tao asked softly.

"Tell me about the Shou Bing process." Zheng Ren said, "There shouldn't be any big problem, don't be nervous."

"The patient's condition is much better now; do we still need the ventilator?" Mu Tao asked.

"We must." Su Yun came back wearing Lead clothing, and said disparagingly: "Patients with coronary artery stenosis who suffer stroke during the perioperative period due to carotid artery stenosis have a poor prognosis, with a mortality rate of about 50%."

Mu Tao is an interventional doctor, not a Cardiology doctor. If he followed along to help with the rescue and perform coronary stent surgery, he'd be fine. But when it comes to more detailed matters, especially pathology and physiology, he's unable to cope.

"Tell me about the process." Zheng Ren reminded again.

"Preoperative angiography showed 90% stenosis at the proximal right internal carotid artery; I used a super-slip guidewire to send an 8FMPAI guiding catheter to the right common carotid artery, SpiderRX5.0mm to the distal right internal carotid artery, delivered a Sapphire4.0mm×20mm balloon, inflated to 15 atm. Five to six seconds later, the patient's heartbeat stopped."

The operator should be the Director of Cardiology at Pengcheng Kaifaqu Renmin Yiyuan; under Zheng Ren's intimidation, he directly became a little doctor and began reporting the surgery process.

When 120 Emergency basically had no effect, someone stepping forward was undoubtedly a relief for the operator.

Faced with cardiac arrest, to still be able to command the rescue so firmly and full of confidence, how much higher the technical skill is compared to oneself goes without saying.

"Mm, the compression hit the carotid artery baroreceptor." Zheng Ren said, "After balloon expansion, the occurrence of cardiac arrest, followed by ventricular fibrillation malignant arrhythmia, are common complications."

"Zheng Lao Ban, I still thought we'd have to give up the surgery." Mu Tao let out a breath and said.

"No need. The cardiovascular activity center in the brain, via the sympathetic and vagus nerves, controls heart and blood vessel activity, keeping arterial blood pressure at a certain level."

"When the balloon expands, the arterial pressure receptors immediately transmit this information via afferent nerves to the cardiovascular center; the center's activity then changes accordingly, causing heart rate to slow, peripheral vessels to dilate, and blood pressure to fall."

"The pressure inside the balloon rising too quickly, the diameter being too large, the pressure being too high, the expansion lasting too long, and the pressure-sensitivity reflex being overly sensitive may cause the heart to stop."

"After the surgery is done, they'll be able to recover after a while." Zheng Ren smiled.

"Lao Mu, where's Wu Lao?" Su Yun suddenly asked.

"The Teacher is looking at the patient in the Shujian..." Mu Tao said.

"That's fine; prepare the next surgery over there, this side should be resolved soon." Zheng Ren smiled.

"We don't need to insert the heart stent, right?" Su Yun asked the operator.

"No… no need, thanks." The operator murmured politely.

"At times like this, pulling the patient back also means pulling oneself back; the operator feels that any way of expressing thanks is not excessive."

"But she's still a bit dazed, still immersed in the nightmare of the patient's sudden death, unable to recover."