Chapter 2919: 2719 The Precious Blade Never Ages

"Find someone to perform a transesophageal echocardiogram!" Director Miao continued.

Su Yun had already picked up her phone and called Lao He's mobile. Lao He was already preparing to get off work, humming a tune, sitting in the Zhibanshi smoking.

After receiving Su Yun's call, Lao He didn't ask what exactly had happened; he only knew it was a Urology Department surgery that needed an immediate transesophageal echocardiogram.

Lao He's ultrasound skill is quite high; he is one of the few doctors who can use ultrasound to diagnose pneumothorax. This kind of skill is one of the few that can be shown off in front of Zheng Lao Ban; he didn't expect that during the rescue he would also think of himself.

Pushing the bedside ultrasound machine, Lao He trotted quickly into the Operating Room.

The Operating Room was in chaos, but strangely Lao He didn't see Zheng Lao Ban and Yun Ge'er. Meanwhile, Director Liu of the Urology Department held his phone, constantly changing the angle, through which came Director Miao's voice directing the rescue.

Wow... Lao He first froze, then suddenly understood, immediately realizing what had happened.

Director Liu was dumbfounded!

It's a habit formed over many years: when encountering a problem they can't solve themselves, First Time they seek out the senior director.

In a life-and-death crisis, Director Liu forgot that Director Miao had retired, having gone from a frontline clinical chief to an old man who daily dances in the square and enjoys a leisurely retirement.

The voice coming from the phone was Director Miao's, still calm, full of authority and an indisputable aura.

Where are Zheng Lao Ban and Yun Ge'er? Lao He pushed the bedside ultrasound machine to the patient's head, taking the opportunity to look around.

Nobody!

Never mind that; Yun Ge'er said to perform a transesophageal echocardiogram.

Lao He quickly inserted the transesophageal ultrasound probe into the patient's mouth, avoiding the endotracheal tube, overcoming the interference from Yu Zong performing external chest compressions, and guided the probe into the esophagus.

"Yu Zong, stop for 20 seconds!" Lao He shouted loudly.

"Little Yu, stop for 20 seconds, the anesthesiologist will do the echocardiogram." Director Miao's voice came through; the memory contained in Yu Zong's body made him First Time stop the external chest compressions.

"Gas detected in the right heart! Gas also detected in the left heart!" Lao He quickly scanned, saw the gas in the heart, reported to Director Miao via the phone video, saved the image, then withdrew the probe.

"Place a small sponge pad on the right side!" Director Miao's voice came through, "Continue compressions, intermittent CPR. Central venous catheter..."

"Director Miao, I'll handle this part." Zheng Lao Ban's voice came through the video.

Lao He understood instantly, but he didn't dwell on why Zheng Lao Ban was at Director Miao's home; instead, he quickly pushed the bedside ultrasound machine aside, found the central venous catheterization kit in the cabinet, and hurried to the patient's side.

The patient's head was already crowded with people; Lao He didn't explain, but forcefully made a space. At that moment the phone rang; before the puncture he took out his phone, turned on speakerphone, and placed it aside.

"Lao He, perform a central venous catheterization." Zheng Lao Ban's deep, steady voice came through.

Lao He steadied his mind, preparing the puncture while saying, "Right away, 22 seconds!"

He used an improved subclavian central venous catheterization method, finding the optimal puncture point at the intersection of the vertical line through the midpoint of the right clavicle and the horizontal line of the sternoclavicular joint, with the needle tip pointing toward the inferior edge of the thyroid cartilage for the puncture.

After entry, the central venous catheter extended downward into the right heart. Lao He had great confidence in his technique—exactly 22 seconds, not a millisecond off.

"There's a gas lock effect; after entering, aspirating lets you feel the pressure." Zheng Lao Ban's voice came through the phone.

Although everything said was what Lao He already knew, he inexplicably felt a bit more steady in his heart.

"Already in the right atrium." Lao He said, "Currently aspirating gas."

Constantly probing, because of the gas lock effect, the syringe movement was not smooth.

The gas lock effect, also called gas lock phenomenon, is a blockage phenomenon in a flowing liquid where gas, due to differing pressures within the liquid, obstructs flow. This phenomenon usually occurs at high points in the piping, causing a typical centrifugal pump to fail to draw liquid.

Lao He made a slight probing attempt; suddenly the syringe in his hand twitched slightly, moving a short distance, about 5 ml.

"Zheng Lao Ban, aspirate 5 ml of gas." Lao He quickly withdrew the blood and gas, while reporting to Zheng Ren.

Continue; just now looking at the echocardiogram, there's still gas in the ventricular cavity.

Zheng Ren said while holding his phone.

"Boss, it's normal to have gas in the atrium; I've never understood why there would be gas in the ventricle." Su Yun asked from the side.

Although not in the Operating Room, one could still feel the atmosphere filled with adrenaline and dopamine.

Zheng Ren shook his head and said, "There are too few cases; I'm not entirely clear either. Existing cases show that the vast majority are bilateral chamber gas accumulation, and none have congenital right-to-left shunt disease."

Paradoxical air embolism is when gas absorbed into the venous system finally enters the arterial system?

It usually occurs in patients with a cardiac right-to-left shunt, where gas accumulated in the right atrium or right ventricle passes through the right-to-left pathway into the left heart system, causing coronary or cerebral arterial embolism?

This is a question; during the emergency rescue, the two also had a tacit understanding not to continue discussing it.

Lao He's operation was up to standard, even aspirating excess. Soon the gas in the left heart was also withdrawn, resolving the cardiac arrest issue.

After approximately 20 minutes of continuous external chest compressions and intermittent defibrillation, the patient's hemodynamics and respiratory function tended toward stability.

Director Miao let out a sigh of relief, put the phone aside, and leaned back against the sofa. Zheng Ren saw his expression—no fatigue, only the tension and excitement of the emergency rescue giving way to relief and pleasure.

"Director Miao, are you tired?"

"Not tired." Director Miao laughed, "Directing the rescue via phone, this old man is experiencing it for the first time."

"The precious blade never ages!" Su Yun gave a thumbs-up in praise.

"A laparoscope once caused a gas embolism that I encountered before; at the time I was dumbfounded, rescuing while pondering. However, that time it was my operational error, making it easy to think carbon dioxide had entered the blood vessel. After symptomatic treatment, the patient had no postoperative complications and was discharged in a few days."

"How many years ago was that?" Su Yun asked.

"At the end of the last century." Director Miao said.

"Back then, when laparoscopic surgery was just being introduced, you encountered a gas embolism? Why didn't you write a case report?" Su Yun asked curiously.

"Case report… I wrote it." Director Miao said, "I thought this case should be rare; I didn't submit it to any Chinese‑language journals, but sent it directly to Willow Leaf Blade. Unfortunately, my English is mediocre and I wasn't clear on the format, so it came to nothing."

So that's how it was; Zheng Ren smiled.

"Director, how is your health?" Director Liu's voice came from the phone.