Doctor Song, are you married?

Chapter 262 262. Cricothyroid membrane puncture

What is the cause of anaphylactic shock?What are the symptoms?How to diagnose?What auxiliary examinations need to be done, and how to respond quickly when encountering such patients in clinical practice, so as to gain rescue time for the patients, etc.

Although there are many questions, because they are common cases, everyone can answer them easily.

Today's emergency proficiency test clearly made everyone feel relaxed.

The emergency room seemed calm in the afternoon.

Even though most doctors have gone to do tests, the department still seems empty. There is a patient with mild trauma being sutured, a patient with a suspected fracture who has gone to take a radiograph, and will probably be transferred to the orthopedics department after the radiograph is taken, and A child with diarrhea is waiting for a routine stool test.

Dongfang Wenyan was hiding in the corner reading a book, while Luo Beilin was trying hard to carry the essentials of circumcision. As for Song Qi, he liked to walk around when he had nothing to do, such as to see how the patients under observation were recovering. How much infusion is left? When he was in college, his teacher once said that as a qualified doctor, you should not be stingy about the time you spend chatting with patients.

However, in today's medical environment, it is true that not many people have the time to have a good chat with patients.

On the contrary, it is common to spend hundreds of dollars to get a specialist account, queue up from early in the morning, and when it is your turn, the doctor will only see you for two to three minutes or even one or two minutes.

"Dr. Xiao Song, you're here to do ward rounds again! I think you're the most diligent in the entire emergency room. They do ward rounds every morning, but it's better for you to do ward rounds whenever you're free."

"Uncle Wang, I have nothing to do, so I came here to see you, mom. Has your blood pressure dropped? Are you still dizzy?"

"Well, my blood pressure is now normal, thanks to your care."

"Then you must remember to take antihypertensive medicine on time in the future."

“I will definitely remember this time”

"Aunt Li, is your stomach still bloated? Remember to check your blood routine tomorrow morning."

"Aunt Sun, you have to get out of bed and move around. You can't lie down all the time. What? Can't walk? You have to walk even if you can't."

Song Qi walked in the observation ward and greeted the patients from time to time.

The emergency department is different from the ward. Only patients who are under observation are hospitalized, but there are only a dozen people at most, so Song Qi has already memorized their conditions.

"Grandma Li, you look good today. You haven't finished the saline injection yet." When they arrived at the last observation bed, Song Qi greeted the old lady in the ward.

The old woman was admitted because of an upper respiratory tract infection. She had a high fever and was later prescribed antibiotics. Because she was old and her indicators were not very good, she was put in a observation ward.

"Well, it's good. I can go home after filling this bottle of salt water." Grandma Li pointed to the bottle of salt water she had just replaced.

"Ahem, Doctor Song, why is my throat a little itchy?" Grandma Li said, reaching out to touch her throat.

"Itchy throat? Have you drank water today? You have an upper respiratory tract infection. You need to drink more water." Song Qi said, and suddenly saw Grandma Li's mouth suddenly opened wide, breathing hard, as if she couldn't breathe.

"Grandma Li, how are you feeling now?" Song Qi quickly stepped forward and took her hand, asking eagerly.

"I, I, I" Grandma Li purred several times in her throat and stared hard.

Song Qi was shocked!
He quickly looked at the salt water he was sipping!
It turned out to be a bottle of Aloxin!

Alexin is a penicillin antibiotic.

Is it a penicillin allergy?
Song Qi's brain CPU was running rapidly, thinking whether it was right or not, turn off the liquid first!
At this time, Grandma Li's hands were stuck on her neck, her head was raised urgently, her face began to become cyanotic, and she was sweating profusely!
not good!This is airway obstruction!Could it be allergies causing laryngeal edema?
However, if the airway obstruction is not relieved as soon as possible, she will die soon.Do tracheal intubation?If the larynx is edematous and the airway is blocked, tracheal intubation is obviously not possible, so tracheotomy is the only option?

While Song Qi was thinking about how to make a decision, the old lady wheezed a few times in her throat, then her eyes suddenly rolled up and she fell onto the bed.

"No! Anaphylactic shock!" Song Qi shouted and quickly pressed the bedside pager.

He needed a helper, and at this moment, Grandma Li's family members happened to be out, and there was no one in the bed next to her.

Song Qi's eyes were looking for the ambulance in the observation ward.What's worse is that he didn't see the ambulance at all!
This observation room is the one furthest from the nurse station.It is generally used for observation in relatively mild cases.

At this time, the bedside pager beeped ten times before someone finally answered it.

"I'm Song Qi. The patient is in anaphylactic shock. Please prepare all first aid supplies immediately!" Song Qi said loudly, then laid Grandma Li's body flat, and then raised her chin as high as possible.

This will open the airway as much as possible.

After hearing Song Qi's words at the nurse station, the nurses present basically stood up at the same time and went straight to the observation ward.

Pan Chengcheng was at the front, pushing the ambulance.As soon as she entered the door, before Song Qi could give medical advice, she took out the epinephrine.

"Epinephrine 1mg subcutaneous injection. Also, give me a 20ml syringe!"

The head nurse also rushed to the observation room at this time. It was not surprising to hear that epinephrine was injected subcutaneously. Even without a doctor's order, the nurse knew that this was the first step. But why did he need a 20ml syringe?

"Why do you need a syringe?" the head nurse asked quickly.

"Cricothyroid membrane puncture!" Song Qi said, his hand already starting to position the patient's neck.

Thanks to Dongfang Wenyan, Song Qi has been supplementing human anatomy recently.

Cricothyroid membrane puncture is completed by understanding the anatomy of the larynx.

And the anatomy books he read these days were not for nothing.

If in the past he was only about [-]% sure about cricothyroid membrane puncture, then recently, through his supplementation of the human anatomy atlas, he could basically reach more than [-]%.

If the degree of certainty of an operation can reach more than [-]%, then you will be much more calm when you start.

Therefore, despite the emergency, Song Qi was not very nervous, but concentrated on the patient's throat.

The positioning of cricothyroid membrane puncture is: the puncture point is between the lower edge of the thyroid cartilage and the upper edge of the cricoid cartilage arch in the midline of the neck.

Pan Chengcheng was about to hand a 20ml syringe to Song Qi when the head nurse held her down.

"Song Qi, this is an invasive operation and the risk factor is too high. Let's call Li Da first!" The head nurse remembered Li Da's instructions.

"It's too late!" Song Qi smoothly took the syringe from Pan Chengcheng's hand.

(End of this chapter)