Chapter 27 First Aid
"Get out of the way! Get out of the way!"

While running ahead, Mu Tu reminded the crowd in front of him, and the medical staff and family members pushing the transfer bed followed closely behind.

It has only been a week since he was transferred to the emergency department, and Mutu already felt exhausted, even more tired than in the intensive care medicine department. He was in a state of high concentration 24 hours a day, dealing with sudden patients who did not know when they would arrive.

This also understands why the emergency department will transfer doctors who are engaged in emergency work to the general practice department after they are over 45 years old, and nurses who are over 35 years old can transfer to other positions.

This also shows the hard work of the medical staff in the emergency department, and the transfer is a kind of care and love for them by the hospital.

Not long after, Mutu and his party came to an emergency room.

At this time, there were already four patients lying on eight beds in the emergency room.

The emergency doctor with the wooden figure asked: "What's the patient's condition."

Mu Tu replied: "Mr. Jiang, the patient is abnormally enlarged."

Dr. Jiang closed the curtain and untied the bath towel from the patient, only to see that the patient's affected area was straight, and all parts of the affected area were swollen and dark red in color.

"This patient, have you overdosed on the drugs that can help you, such as the little blue pill?" Dr. Jiang asked.

The man looked panicked and said embarrassingly: "Doctor, I have never eaten that thing. I went out to drink with friends yesterday and came back. After returning home, I went to the bathroom to get a tuba. After I finished, it became like this , I can’t go down no matter what. I have used cold compresses and hot compresses all day today, but there is no softening. Now it is painful and swollen.

The man's wife also looked anxiously at Dr. Jiang.

"No, it's because the congestion is blocking the blood vessels, causing the affected area to swell. You'll be fine after the congestion is discharged and the blockage is cleared." Dr. Jiang explained the condition while comforting the patient's emotions.

Seeing that the patient had calmed down, he turned to Mutu beside him and said, "Inject noradrenaline first to see the effect. If the effect is not good, prepare for cavernous body shunt."

Norepinephrine is an α-adrenergic receptor agonist. By stimulating the α1 receptors of blood vessels, it causes a strong contraction effect on the blood vessels in the cavernous body, softening the affected area and returning to normal.

One hour after the emergency nurse injected noradrenaline, the patient's affected area was still in a numb state, with no sign of softening.

Dr. Jiang said: "Prepare the operating room for cavernous body puncture and shunt."

operating room.

Seeing that the anesthesia had produced an effect, Dr. Jiang picked up the NO.18 puncture needle and punctured the cavernous body on the dorsal side of the head of the affected area. The puncture needle penetrated five centimeters. five centimeters.

The affected area is composed of three spongy bodies, one urethral spongy body and two side-by-side spongy bodies, and the three spongy bodies are distributed in an inverted triangle.

The cavernous body shunt is to establish a new venous channel to introduce the corpus cavernosum congestion into the systemic circulation, and the head-cavernous body puncture shunt is the operation with the least trauma.

Dr. Jiang put the puncture needle into the tray and slowly squeezed the affected area with his hands.

I saw some black and red congestion with many blood clots of different sizes flowing out from the two puncture holes.

When no more blood flowed out, Dr. Jiang said, "Heparin solution."

Mu Tu handed the syringe containing the heparin solution to Dr. Jiang.

Dr. Jiang inserted the syringe into the punctured hole and repeatedly rinsed it with heparin solution until bright red blood flowed out from the hole, then began to rinse another sponge.

When blood flowed from both cavernous bodies, the patient's affected area softened to a normal state.

Heparin solution is a bio-extracted anticoagulant. Repeated washing is to dissolve the blood clots in the cavernous body that block the cavernous body and restore the normal blood circulation of the cavernous body.

Just after Dr. Jiang finished the suturing operation, the patient's affected area swelled up again.

Facing the abnormal situation, Mu Tu said, "Dr. Jiang, could it be that the urethral cavernous body is also clogged with blood?"

Dr. Jiang took a scalpel and made a straight longitudinal incision on the junction of the affected area and the capsule, and on the side of the affected area, and performed urethral-cavernosal shunt. The principle is the same as that of cavernous body puncture shunt, and it is a new vein channel. , the cavernous blood stagnation into the systemic circulation, but the surgical method is different.

After Dr. Jiang washed away the clogged blood in the urethral cavernous body, just when the suture was about to be done, the affected area swelled abnormally again.

Looking at the swollen affected area again, after two surgical sutures, the patient was no longer suitable for further surgery, otherwise it would easily cause functional impairment, Dr. Jiang couldn't help frowning.

Looking at Dr. Jiang who was frowning and thinking, Mu Tu suddenly thought of Huang Su, and wondered if Chinese medicine could be given a try, but he didn't know Dr. Jiang's attitude towards Chinese medicine.

Mu Tu cautiously took a step forward and approached Dr. Jiang, and tentatively said softly: "Mr. Jiang, why don't we ask Dr. Huang from the Department of Traditional Chinese Medicine to have a look? Maybe Chinese medicine has other treatment ideas. If we miss the treatment time , patients may lose their fertility."

There is a golden time for treating abnormal swelling of the affected area, usually within twelve hours.

Within [-] hours, non-surgical conservative treatment such as pain relief, sedation, cold compress, infusion, etc. can be taken.Alpha-adrenoceptor agonists can also be injected into the affected part of the cavernous body to play a role by regulating the vasoconstriction of the cavernous body.If the above method is not effective, puncture of the cavernous body can be performed, the accumulated blood can be drawn out, and heparinized saline can be injected for flushing.

Within 48 hours is the silver time. After conservative treatment fails, shunt surgery should be started as soon as possible within 36 hours of onset.In ischemic patients, the longer the abnormal swelling persists, the less effective phenylephrine is.

Now Dr. Jiang has undergone puncture shunt and urethral cavernous body shunt, but the affected area is still swollen.

The patient has already spent a day at home. If the abnormal swelling is not resolved within 48 hours, as the swelling continues, the acidosis caused by ischemia will damage the smooth muscle of the cavernosum to respond to drugs such as phenylephrine. If it is weakened until it is invalid, the cavernous body will undergo irreversible fibrosis, and even if the affected area softens in the end, it will lose its reproductive function in the future.

Dr. Jiang looked at Mu Tu and asked suspiciously, "I've heard of Dr. Huang's medical skills, but can Chinese medicine cure this kind of emergency?"

Seeing that Dr. Jiang didn't have any aversion to Chinese medicine, Mu Tu became bolder in speaking: "It should be possible. A few months ago, there was a pregnant woman with high fever who was rescued by Dr. Huang overnight."

Dr. Jiang nodded and said, "Whether it can be treated or not, let's find him first."

Then Dr. Jiang scanned all the people in the operating room and asked, "Does anyone have the contact information of Dr. Huang from the Department of Traditional Chinese Medicine?"

Mu Tu said: "Teacher Jiang, I live in the same dormitory with Dr. Huang, I will go back to the dormitory and call him."

Dr. Jiang said unhappily, "Then go back and call someone, why are you still standing here!"

"Hey!"

Mu Tu pushed open the door of the operating room, only changed the slippers on his feet, and didn't have time to change the surgical gown on his body, so he quickly ran out of the emergency building of the hospital and ran to the dormitory.

(End of this chapter)

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