Chapter 2965: 2765 Third-Generation Explorer of the Heaven-Flying Immortal

The key to operating balloon mask ventilation technique is sealing and opening the airway.

If ventilation is unsatisfactory during single-person operation, consider double-person pressurized assisted ventilation, using manual techniques to open the airway and simultaneously using an oropharyngeal or nasopharyngeal airway. This technique is mainly used when the patient has aspiration and reflux risk, while also applying cricoid pressure.

Both laryngoscope and light-guide techniques have been employed; this basic single-person balloon-mask ventilation has already been ruled out by Zheng Ren and is not under consideration.

However, with double-person balloon-mask ventilation using small tidal volume, high frequency, high pressure oxygenation, the patient's chest rise and fall were not obvious.

"Laryngeal mask!" Zheng Ren shouted in a low voice.

At the same time, he had already put on sterile gloves, his gaze moving back and forth between the ECG monitor and the patient, yet he did not immediately perform a tracheotomy.

Performing a tracheotomy under the patient's current condition is a high-risk tracheotomy; Zheng Ren has tried it in the system operating room. Even with a lucky halo, even with a surgery completion degree +10 bonus, even though it's just a minor procedure, the final surgery completion rate was only 65%.

This means the patient, even with ventilator-assisted breathing, would likely not be able to get off the ventilator, and might not even be able to get off the operating table.

Zheng Ren tried many times; a 65% success rate is already the highest achievable.

Actually, patients requiring high-risk tracheotomy are not uncommon.

Mainly include short neck, obesity, sitting position, inability to extend head backward, agitation, wide thyroid isthmus or occupying lesion, high mediastinum, tracheal deviation, posterior tongue drop, severe dyspnea, inability to perform orotracheal intubation or orotracheal intubation without spontaneous breathing, poor coagulation function, sudden preoperative suffocation, and unclear bony and soft tissue landmarks of the neck and chest—all belong to the high-risk tracheotomy population.

Normally these can be compensated for with manual techniques, but the patient's condition before us is special; Zheng Ren feels helpless, this time he has encountered a particularly thorny matter.

Fortunately, the mask oxygenation effect is good; it has already been tested in the system operating room.

An anesthesiologist quickly opened the laryngeal mask and handed it to Zheng Ren.

After taking it, Zheng Ren pulled the patient's lower jaw with his left hand, just about to insert the laryngeal mask, when he was surprised to see it was actually a second-generation laryngeal mask!

Strange, in the system operating room we clearly used a third-generation laryngeal mask; what's going on?

The difference between second- and third-generation explorer laryngeal masks is significant; even if the third-generation laryngeal mask's final completion rate is only 98%, Zheng Ren dares not be careless.

"Third-generation explorer!" Zheng Ren immediately said.

Director Xu paused for a moment, "Third-generation explorer... laryngeal mask?"

The patient's blood oxygen saturation has dropped to 70%, yet Boss Zheng is still nitpicking between second- and third-generation laryngeal masks...

He was about to explain a sentence when Feng Xu Hui stood outside the operating room and loudly said, "Chief Zheng, please wait!"

He held his phone in his left hand, dialed a number, almost instantly connected, and Feng Xu Hui exclaimed urgently, "Emergency rescue box!"

While speaking, Feng Xu Hui hurried to the operating room door with steps sounding "dong bie".

Opening the operating room door, Liu Xiao Jie more than ten meters away forcefully pushed the box over. The heavy rolling case slid across the marble floor, arriving almost instantly as Feng Xu Hui opened the door.

Taking the box, the door closed; the whole process took 3.2 seconds.

Director Xu followed behind Feng Xu Hui, staying calm. After all, as head of the anesthesiology department, he has seen too many similar situations.

It's just that today's patient condition is a bit more special; if it were ordinary, a laryngoscope would have already settled it.

Boss Zheng delayed performing a tracheotomy; Director Xu also knew this was a high-risk patient, and once cut open, more troubles could arise. These troubles are not solely from the patient's family, but more from the patient themselves.

Worsening of the patient's condition after high-risk tracheotomy is not uncommon, so he also leans toward using a laryngeal mask.

Although the 912 laryngeal mask is still decent, that model has been used for many years, yet Boss Zheng actually wants a third-generation explorer. Such a laryngeal mask has only been heard of at academic conferences; the anesthesiology department of 912 has not yet evolved to this stage.

The small consumables vendor who has been following Boss Zheng around seems to be... the manager of the interventional consumables manufacturer; what did he just shout? Emergency box?!

After Director Xu saw a medium-sized rolling case "fly" in, the small consumables vendor immediately squatted on the ground and opened the case.

Inside the rolling case were neatly arranged various emergency rescue consumables in dazzling variety.

He didn't even look, just reached in; it seemed he knew exactly where dozens of consumables were.

A sterile-packaged bag was immediately grabbed by Feng Xu Hui; seeing Director Xu standing nearby watching him, Feng Xu Hui threw the bag over.

"Director Xu!"

During emergency rescue, there's no need for politeness, nor time for it. Every minute, every second is extremely precious.

Director Xu caught the sterile package; to his surprise, it was a third-generation explorer laryngeal mask.

"..."

Damn it, Director Xu felt an invisible burning sensation on his face.

But there was no time to think; he turned and ran, tearing open the outer packaging of the laryngeal mask as he ran.

Zheng Ren took the laryngeal mask and inserted it using the conventional blind technique.

With his left hand pulling the jaw to widen the oral cavity, his right hand held the laryngeal mask, opening facing the patient's lower jaw, inserting along the midline of the tongue against the posterior pharyngeal wall until it could not be pushed further.

After inserting the laryngeal mask and performing positive-pressure ventilation, Zheng Ren observed that the patient's chest rise and fall had returned to normal. He picked up a stethoscope, listened to bilateral breath sounds that were symmetrical and clear, and heard no air leakage noises in the anterior neck area.

Even though he had performed the operation more than ten times in the system operating room, and even though he now had a lucky halo after coming out, Zheng Ren still carefully checked whether there was any deviation in the procedure.

After placing the laryngeal mask, Zheng Ren then, under its guidance, inserted a gastric tube to vent gas, resolving the issue of excessive gastric gas causing diaphragmatic elevation and reduced lung capacity.

"Propofol 40mg!"

"Midazolam 2mg!"

"Dexamethasone 10mg!"

Zheng Ren kept looking at the patient's ECG monitor, continuously issuing medication orders.

"Intravenous drip aminophylline 0.25g plus 5% glucose 250mL!"

The patient's blood pressure fluctuated between 184~110 mmHg / 98~55 mmHg, and heart rate fluctuated between 60~98 beats per minute.

"Nitroglycerin 0.05mg, Urapidil 15mg." Zheng Ren said in a low voice.

Seeing blood pressure, heart rate, and blood oxygen saturation continuously rising, the atmosphere in the operating room eased a bit.

Boss Zheng's medical orders were being carried out perfectly, without any objection, even Director Xu was the same.

If he weren't there, Director Xu would also be preparing to insert a laryngeal mask next, but with Boss Zheng standing there, Director Xu inexplicably felt reassured, rather than feeling that his authority was being challenged as someone snatched the emergency-rescue position.

At this point, technology spoke for itself, and with that otherworldly third-generation explorer laryngeal mask, Director Xu had long lost any other thoughts.