Doctor of Healing

Chapter 769 The fatal pleural reaction
Even in a half seat, Ji Xiang felt that it was becoming more and more difficult for him to breathe.

Countless gold stars were flying in front of his eyes, and Ji Xiang vaguely saw Meng Qingfei's figure.

Hallucinations, this must be hallucinations caused by lack of oxygen!Ji Xiang said to himself in his heart.

And every time Jixiang takes a breath, there should be enough oxygen, but there is an obstacle when the gas passes through the alveolar membrane.

Jixiang also knew that it was not any problem with his own body function, but that the air emerging from the opening in the lungs compressed the lung tissue, making it impossible for oxygen to pass through the alveolar membranes, respiratory membranes, and blood in capillaries for oxygenation. , increasing the oxygen content in the blood.

But in any case, he just felt that he was broken.

In a trance, Ji Xiang no longer saw Meng Qingfei, but felt that he was a mecha damaged in the battle, and the parts all over his body fell to the ground crackling, and he could clearly hear the sound of the parts hitting the ground.

Jixiang has experienced empathy many times, such as painful, crying, horrible and weird.

However, when he felt the pain of traumatic hemopneumothorax, those past seemed insignificant.

The strength in his body was withdrawn quickly, and Ji Xiang sat paralyzed, leaning on the back of the 120 emergency doctor.

"Boy, breathe evenly, don't be too deep or too shallow, don't be nervous." The 120 emergency doctor kept talking to Ji Xiang about precautions.

Especially nervous.

Jixiang also knows that even normal people will have difficulty breathing due to emotional tension.

If you are a 120 emergency doctor, you will also tell the patient not to be nervous.

but!

When I empathize with myself, I feel infinite terror coming. I am on the verge of dying, and I don't know if I can catch my next breath.

That's it, how can you not be nervous?

No matter how much Ji Xiang forced himself to be calm, he couldn't be calm at all.

"roar~"

"Hoohoo~~"

There was a small growl in Jixiang's throat.

He knew that this was caused by the spasm of the trachea. If he was an elderly person with underlying diseases, he might have already started asthma.

A combination of several diseases...

The consequences could be disastrous.

What a pain!Ji Xiang shouted in his heart.

Even Jixiang felt that if he kept in this state, he might as well be dead.

"Young man, don't be nervous. It's just a simple problem. Just go to the hospital and get a tube to draw out the gas." The 120 emergency doctor comforted Ji Xiang.

"Don't worry, the blood oxygen saturation is still 91%, and the trachea has not deviated. If it really doesn't work, I will use a syringe to help you pump out the gas."

"Don't be nervous, I'm here."

120 The emergency doctor comforted Ji Xiang constantly.

However, Ji Xiang only had one thought in his mind - try a pneumothorax if you have the ability!

Easier said than done.

He no longer had the energy to think about the question he had just made about Meng Qingfei in the emergency department. Venus flickered in front of his eyes, and even Ji Xiang vaguely saw a big light.

Ji Xiang didn't know what Da Guangming meant, he was already powerless to think.

The only thing is that the 120 driver was very experienced, and the private car along the way was also very cooperative, and there was no delay, and he rushed all the way to the hospital.

"Traumatic hemopneumothorax!" The 120 emergency doctor shouted, "Hurry up!"

He had already called the emergency department in the car, but at this time the 120 emergency doctor still yelled out.

Pingche pushed Ji Xiang away immediately, and the doctor who followed Pingche glanced at the blood oxygen value, then auscultated, and said peacefully, "It's nothing, why does it look so serious. This young man is quite hypocritical."

He spoke in a low voice, as if he was communicating with the emergency doctor, but Ji Xiang heard it.

If the blood oxygen saturation is 91%, there is nothing wrong with it. I will go to the thoracic surgery department for a closed thoracic drainage.

If he felt the same way, Ji Xiang would definitely think so.

But now!
Ji Xiang has already started to scold his mother in his heart.

Ji Xiang, who is usually gentle, elegant and calm, has already started to scold her!
"Hurry up and take a film, and then quickly get the tube off." The doctor in the emergency department replied.

The flat car roared, and Jixiang heard similar words from many doctors—the sound of the emergency flat car was the most annoying.

Now Jixiang feels that if he hears this voice in the future, he is afraid that he will suffer from coronary artery spasm and have a sudden myocardial infarction.

"Young man, stand up, it only takes a few tens of seconds."

The thoracic surgeon comforted Ji Xiang.

Ji Xiang was speechless at this moment, he felt like a dead fish thrown ashore, rolling his eyes, unable to even struggle.

The thoracic surgery doctor is quite reliable. Although he thinks Ji Xiang is hypocritical, but because he has no family members, he wears a lead suit and stays with Ji Xiang in the room to prevent Ji Xiang from falling when his body position changes.

An "upright" film was taken at a 45° angle, and the thoracic surgery doctor leaned over to take a look.

"There's not much blood, and the lung tissue is compressed by 60%, which is okay." The radiologist said easily, "I saw the patient's condition, and I thought it was going to die."

"Hey, who would have thought that a young guy would be so hypocritical. A few days ago, I met a patient whose lung tissue was compressed by 85%. I admitted him to the hospital and he refused to do anything. He said he didn't feel anything at all, and he wanted to go cycling. "

The thoracic surgeon said, and glanced at Ji Xiang.

Ji Xiang burst into tears in his heart.

Are you hypocritical?
It seems so, but these negative feelings are all clearly felt by myself!
Now the sense of near-death is getting heavier, and even the thinking has become chaotic.

There is only one sentence circling in Jixiang's mind-individual differences.

In the past, Ji Xiang never thought that individual differences could be so serious. A pneumothorax with less than 80% compression of lung tissue would make him want to die.

Do not!
It's already made me not want to live...

That's what he said, but the doctor in the thoracic surgery department didn't waste time, he took the time to take Ji Xiang back to the ward.

"are you ready?"

After returning to the ward, the doctor in the thoracic surgery department immediately asked.

"Ready!"

The nurse said simply.

Ji Xiang didn't have the strength to sit up, and it was even more difficult to breathe after lying down. No matter what position or posture, he felt uncomfortable.

The light in his eyes was gone, and he watched as the thoracic surgery doctor was quickly arranging the incision kit, while the nurse was helping to prepare the closed chest drainage bottle.

Blades, sterile towels, incision kits, chest tubes, and saline poured into chest bottles. All steps are in order. It seems that this hospital is still professional.

However, Jixiang felt the power of the theory of relativity.

The doctors in the thoracic surgery department are professional enough, and the nurses cooperated without any problems.

Ji Xiang felt that all their actions were like slow motion, played frame by frame, which was extremely irresponsible to patients.

Oh shit!

Ji Xiang also knew that this was a wrong perception in his dying state, but this perception was so clear and true.

"Get an injection, don't move around." The doctor in the thoracic surgery department said indifferently with a syringe after disinfection.

Yes, Ji Xiang feels that the attitude of the doctors in the thoracic surgery department is indifferent.

He even felt that the doctors in the thoracic surgery department looked a little grim, hurry up and do it!
The needle was pierced like a mosquito biting himself, and there was no pain at all, but the little monster in Jixiang's heart grew up gradually, roaring crazily.

Cut it open, no pain.

Bluntly separate the muscle tissue, until the hemostatic forceps hit the pleura, the muscles of Ji Xiang's whole body suddenly stiffened.

The parietal pleura is like a switch, and Ji Xiang can't move at the slightest touch.

"Be patient!" said the doctor in the thoracic surgery department, "just poke it in."

Ji Xiang was sweating profusely, and exhausted all his strength to let out a "huh".

He had closed thoracic drainage during his internship, and Ji Xiang also said what the thoracic surgery doctor said.

Indeed, the moment the pleura is punctured, some patients will struggle violently.

But as long as the closed chest drainage bottle is connected, the gas and blood are discharged, and the feeling of dying will disappear.

The last step!Ji Xiang encouraged himself in his heart.

The hemostat was a little cold, and the lights in the treatment room were a little dim.

In the next second, the sound of "噗嗤" came, and the sound was accompanied by the "Sisi" sound of air leakage.

"Ow~~~"

Ji Xiang screamed.

He was thrown up like a fish, and fell heavily on the bed in the treatment room.

"Too young and in good health, the pleura and intercostal muscles are very tense." The doctor in the thoracic surgery department sighed, "Just put the chest tube in."

There was a bright light in Ji Xiang's eyes.

As for what the thoracic surgeon said, he didn't hear clearly at all.

The moment just now was extremely sour, and Ji Xiang never expected that the moment he punctured his pleura, he felt as if he had died once.

The thoracic surgeon clamped the chest tube with hemostatic forceps and inserted it into the incision after blunt dissection.

"Humph!"

The thoracic surgeon tried hard to insert the chest tube.

But just like what he said, Ji Xiang was young, his muscles were tight, and his pleura was also tight. The thoracic surgeon did not send the chest tube in at one time.

"Damn it!" The thoracic surgeon was a little annoyed.

Especially after he heard Ji Xiang's screams, he almost dropped his equipment.

"Brother Wang, the cored chest tube used to be so useful, why is it gone?" The nurse couldn't bear it, and asked in a low voice.

"It is said that there is a problem with the purchase of high-value consumables. The medical insurance does not reimburse it or something else. If you use one to pay for the other, it is our bonus..." The doctor in the thoracic surgery department said depressedly, his voice became weaker and weaker. It's already as thin as a mosquito.

But Ji Xiang could guess what he was talking about.

Ji Xiang almost didn't cry.

If I have money, I can use that kind of chest tube with a steel core!
There used to be a high-value consumable with a steel core in the chest tube lumen, which means that the tube is hard and it is not too convenient to poke into the chest cavity.

Now, doctors in thoracic surgery clamp the chest tube with a hemostat, and send the chest tube in by the metal part at the front end of the hemostat.

The latter has to fight hard, otherwise it will not be sent in.

Ji Xiang was in pain + had difficulty breathing, and burst into tears.

Damn surgery, hurry up and end it!
"Hold on, right now." The thoracic surgeon said the word "immediately" again.

Ji Xiang wanted to say, you should shut up now, it is real to hurry up and put the chest tube in.

But in the next second, the doctor in the thoracic surgery department stabbed violently with all his strength.

Ji Xiang's body moved a few centimeters, and Ji Xiang even felt that the bed under him moved with the strength of the thoracic surgeon.

Although the strength was enough, the chest tube was still not sent in.

Both Jixiang and the thoracic surgeon fell silent.

Ji Xiang's whole body was drenched in cold sweat, as if he had just taken a bath, and he was shaking uncontrollably.

Ji Xiang even wanted to stop empathizing with what happened to the real mother and return to Meng Qingfei.

But Ji Xiang still didn't hesitate, he just had a flash of thought, and he curbed the idea of ​​going back.

The empathy continues.

After three purgatory attempts, Ji Xiang even felt that the thoracic surgeon was going to break his ribs, so the chest tube was inserted into his chest.

"Even the chest bottle!" The voice of the thoracic surgery doctor was a little louder.

Finally, Jixiang heard the sound of bubbling in the chest bottle of gurgling.

He knew very well that the gas in his chest was drawn out, the pneumothorax was healed, the lung tissue opened up, and the rest of the healing was trivial, the most important thing was that he didn't have to suffer any more.

however!
Because of his near-death feeling, Jixiang forgot one thing—what happened to the patients he met in the emergency department.

As the air in the chest was drawn out, Ji Xiang's body just relaxed, and more serious symptoms swept his body immediately.

There was no strength at all, even the strength to breathe was taken away at once.

The eyelids could not be opened, the whole body was itchy, the heart seemed to be beating in a large cavity, and the sound of thumping was right next to my ears.

And the heart beat faster and faster, Jixiang felt that his heart rate had reached about 180 beats per minute.

The situation in front of him was more serious than before, but Ji Xiang entered an ethereal state instead.

It was as if his soul had come out of his body, and his whole body became quiet.

This is the state of traumatic shock?
The shock state caused by gas and fluid discharge after closed thoracic drainage, vagus nerve dysfunction, and misjudgment of the body?
should be.

Jixiang never expected that a small treatment, not even an operation, could make him go into shock!

"Huh? What's the matter?" The thoracic surgery doctor looked at Ji Xiang suspiciously.

"It doesn't seem right."

"Enable ECG monitoring." The doctor in the thoracic surgery department said, "Hurry up and push Sabo over."

Saab...

Ji Xiang has not heard this name for a long time.

There is no Sabo in the emergency department of the Second Affiliated Hospital, and he met him in the Affiliated Hospital during his internship.

The full name is Saab cardiopulmonary resuscitator, which uses machines instead of manual heart compressions.

I didn't expect that one day I would use Saab too.

This thing is really good, but there is only one downside - it is expensive.

When Ji Xiang was thinking wildly, the ECG monitoring had been connected, and the doctor in the thoracic surgery department frowned and looked at the above value.

"Push 5mg dexamethasone."

"Any allergies?" the nurse asked.

"Go ahead and have a look, and get ready for adrenaline." The thoracic surgery doctor said, "It should be fine. It's caused by a pleural reaction. It doesn't look heavy, but be careful."

"It's rare for patients to have this kind of situation." The little nurse asked without understanding.

"During the process of thoracentesis, the patient has a series of reactions such as dizziness, chest tightness, pale complexion, sweating, and even fainting. Pleural reaction is a serious complication during pleural puncture. Through nursing intervention on patients, pleural reaction can be obvious. reduce."

"..."

"I heard this question when you took the exam in the Nursing Department, did you memorize it?"

"Do not have time……"

The little nurse stopped talking, she lowered her head and was busy.

With the injection of the medicine, I don't know how long it took, Ji Xiang felt much better.

This kind of goodness is not the kind of goodness when the illness disappears like a silk thread, but a sudden cliff-like improvement, the whole person escapes from the dying state and is full of energy.

"Doctor, I seem to be fine." Ji Xiang said tentatively.

"Scared me." The thoracic surgeon saw that Ji Xiang was speaking sharply. Although the vital signs on the monitor had not fully recovered, he knew he was fine and let out a sigh of relief.

"I'm fine..."

"All right?" The thoracic surgeon leaned against the window sill with his arms folded, chatting with Ji Xiang while resting.

Although Ji Xiang looked fine, the thoracic surgeon didn't dare to leave at all, who knows what will happen in the next second.

"During my internship, I rotated in the chest department. A classmate pulled out the chest tube for the patient. He just pulled out the tube and tied it with the reserved thread. Such a fart operation ended up in an accident."

"Huh? What happened?" Of course Ji Xiang knew that it was easy to remove the chest tube, because Ji Xiang always did similar things during the internship.

Although he had just been pulled back from the brink of death, Ji Xiang had already been infected with gossip syndrome by Shen Lang, and his ears had been pricked up unknowingly.

"The chest tube was pulled out, a small amount of bright red blood gushed out of the incision, and the patient suddenly passed out.

At that time, we were shocked, and a family member of the patient went to the doctor immediately.

I pressed the wound immediately, and the bleeding stopped. The bleeding was about 50ml. I measured the blood pressure immediately, and the blood pressure dropped sharply to 90/50mmHg.

The teacher rushed over, immediately gave a rapid infusion and subcutaneous injection of epinephrine, and then the blood pressure dropped to 50/30mmHg, which was not responded to, and he immediately performed cardiopulmonary resuscitation. Half an hour later, the cardiopulmonary resuscitation failed and he was declared clinically dead. "

"Wipe!!!" Ji Xiang was surprised.

"Finally, it was determined that it was caused by a pleural reaction." The thoracic surgeon's eyes were fixed on Ji Xiang. "The possibility of extubation causing a pleural reaction is very small, and the probability may be about the same as winning the lottery."

"My teacher also said that he has been doing chest surgery all his life, and he has never encountered a similar situation. But when he did, it was [-]%."

The thoracic surgeon said it simply, but Ji Xiang understood what he meant.

"You say you are a man, why are you so nervous." The thoracic surgeon complained.

"Nine out of ten who do the same operation are men. If you replace the matter of having children with men, the population will be reduced by at least half." Ji Xiang retorted.

"..." The thoracic surgeon laughed, "What you said is true. Women are really tolerant. Some people say that the pain threshold is high."

"Perhaps the race with a high pain threshold in men and a low pain threshold in women may have died out long ago."

Ji Xiang is really healed, he has the energy to talk and laugh with the thoracic surgeon.

Even though he was still weak in speaking, he was full of energy to talk nonsense.

Next, Ji Xiang asked a lot about the case of sudden death of a patient who had a chest tube pulled out during his internship as a thoracic surgeon.

The thoracic surgeon just got out of the tension, chatted with Ji Xiang, and said a lot of things.

This is all clinical experience, and Ji Xiang wrote down everything that should be written down.

Although it is estimated that there will be no chance to do thoracic surgery in this life, but in case of encounter in the future, there is also a reference.

Pleural reaction, shock, although the probability of occurrence is not high, but if you buy a lottery ticket, as long as there is no mischief, there will always be a lucky one.

It's this "luck" that doesn't seem so good.

After a while, Ji Xiang gradually fell silent.

Because the excitement after the near-death feeling disappeared, the hormone level in the body decreased, every time Ji Xiang took a breath, he could feel the chest tube poking his lungs.

A little uncomfortable, a little uncomfortable, and the pain caused by the chest tube compressing the intercostal nerve.

Of course, Jixiang knew that his experience was caused by many coincidences, and patients with so many clinical symptoms were rare.

As the vital signs stabilized, the thoracic surgeon was relieved and let Ji Xiang carry the chest bottle by himself.

"Attention, the chest bottle should be lower than the chest wall, otherwise the water inside will pour back into the chest cavity."

"Well, I know." Ji Xiang skillfully carried the hook on the breast bottle and followed behind the doctor.

"It's okay, you scared me just now." The thoracic surgeon said with lingering fear, "Once something bad happens to you, bad luck to you, and bad luck to me."

"Doctor, can't it be prevented in advance?" Ji Xiang asked.

"How to prevent it? Most thoracic surgeons will never encounter it in their lifetime. We have to go to the ICU to prepare in advance?" The thoracic surgeon seemed to have a lot of complaints. He hesitated, "I chose the wrong profession in this life. If there is a next life, I will not be a doctor at all."

Ji Xiang smiled.

When he came to the ward, Jixiang's eyes flickered, and he opened his eyes in the next second, and saw the system npc.

"Teacher, I'm back." Before Ji Xiang finished speaking with the chest doctor, he suddenly saw the system NPC and was taken aback.

"Put your hands down, don't be in the posture of holding the breast bottle, it looks uncomfortable." The system npc reminded Jixiang.

Ji Xiang was stunned, laughed, and rubbed his hands vigorously.

"Feel the severity of the pleural reaction?" The system npc asked jokingly.

"Not only the pleural reaction, but also pneumothorax. When the chest tube was put in, I felt like being tortured." Ji Xiang sighed, "Teacher, it would be great if I could not get sick."

"Yes." The system npc said.

Ji Xiang stared intently at the system npc, as if he had heard some secret.

"The patient's feelings are like this. If you encounter a similar situation in the future, don't take it for granted." The system NPC began to instill the worldview again.

Ji Xiang instantly activated his passive skills, shielding the NPC from the system's force-feeding.

I don't know how long it took, the system npc said with a smile, "There are not many cases of extubation and pleural reaction leading to the death of patients. According to my statistics, although there are more cases than heart tumors, when I was the director, I could meet patients every year." 2-3 times will be the best."

"so."

"What should be paid attention to should be paid attention to. Grasping the details in the middle is part of clinical experience." After the system NPC finished speaking, he waved his hand.

Ji Xiang returns to reality.

The voice of Pingche seems to be still echoing in his ears, but Ji Xiang's heart is no longer the same person he was just now.

"Xiaoji, do you know what the patient's problem is?" Meng Qingfei asked.

"A rare pleural reaction."

"..." Meng Qingfei was stunned for a moment.

Ji Xiang had an anxious expression just now, why did he suddenly say a definite diagnosis?
And looking at his appearance, it seems that he is determined in his heart, and there is something unspeakable hidden.

(End of this chapter)