I run a clinic in the United States

Chapter 67 Murphy's First Live Tracheal Intubation

"Doctor Zhou! Doctor Zhou! Hurry up! Hurry up! Danielle is dying, she can't hold her breath!"

Pushing the pram, Cathy rushed in and almost fell, but luckily the baby was strapped in.

Elena ran out immediately and came to the baby stroller to see, the little Danielle was really pitiful, her face was pale, her breathing was rapid, her chest rose and fell with her breathing, and every time she inhaled, she would form a puff. The deep "pit" makes people worry even looking at it!
"Did she choke on something?" Elena asked quickly while unfastening Danielle's seat belt.

Cathy burst into tears, and cried quickly: "I don't know, I really don't know, I just went to the toilet, and she was like this when I came back!"

At that time, Cathy was extremely anxious and had no first aid experience, so she immediately pushed her to the Iris Clinic. Since she had no time to check the situation at home, she did not know what Danielle had swallowed.

Most likely, his little hands were scratching around, caught something, and stuffed it into his mouth.

"Could it be fudge? I ate a few fudge, maybe I dropped one on her crib?" Cathy said uncertainly.

At this moment, she was very regretful, what kind of fudge could she eat if she had nothing to do!

Elena tried the Heimlich maneuver, turning the baby's face down, supporting its chest and head and neck with one hand, and tapping the back and shoulder blades with the other hand.

However, little Danielle didn't spit out anything at all!

There was no problem with her operation. Babies under one year old have soft chests and the treatment method is different from adults. Elena just used the back tapping method.

Seeing that the back percussion method was ineffective, Elena immediately switched to the chest percussion method!

However, it still doesn't work!

Hay's first aid method is actually more suitable for suffocation caused by relatively solid foreign bodies with slightly higher hardness, and can be completely removed by pushing with air pressure.If it is a relatively soft thing, such as bananas, very soft fudge, the possibility of Hay's method is not likely to be discharged!

"What should I do? What should I do?" Elena was in a panic, and suddenly her eyes lit up, "By the way, the skin bag is pressurized, let her take a few breaths first!"

Elena hurriedly carried Danielle to the treatment room, and at the same time shouted to Cathy without looking back: "Help call Zhou Qiao and ask him to come back immediately! The phone number is posted on the wall!"

"Okay, okay, I'll call right away." Cathy also looked around, and finally saw Zhou Qiao's number, so she quickly took out her mobile phone and dialed.

Elena had already carried Danielle to the treatment room, and hurriedly found the breathing bag. After connecting the oxygen, she gave Danielle first aid, pressed it a few times, and found a finger-clip oximeter for Xiaodan. Neil clipped it, and continued to press.

Seeing the increase in oxygen saturation from 80% to 90%, just when I was happy, suddenly, Danielle’s condition took a sharp turn for the worse, and the big “pit” between breathing reappeared, and it lasted for a long time , for several seconds, at the same time, the oxygen saturation dropped rapidly, from 90% to 80% again, and continued to fall, 79%, 78%...

Every time the number jumped, Elena felt worried: "Joe, Joe, why haven't you come back?"

Elena is going to cry!He stomped his feet anxiously.

When I was in despair, a very calm voice suddenly came to my ears: "This is severe airway obstruction. There are two options. One is to directly remove the foreign body through surgery, and the other is to intubate the trachea first and then perform surgery after the foreign body is identified." "

"Ah?" Elena looked back and saw the cold girl from before, taller than her, with chestnut curly hair and many small freckles on her face, standing behind her.

She couldn't help but be inexplicably surprised, and asked, "Are you a doctor? Then you come to give first aid!"

Murphy pondered for a moment and then said: "It is better to perform tracheal intubation first, and then perform surgery after the cause is clear."

Elena immediately said: "There is a tracheal intubation, I will get it right away!"

Looking at the back of Elena running away, Murphy looked extremely calm on the surface, but he was slightly relieved in his heart, because she had theoretical knowledge of surgery, but had hardly practiced it!
Even for endotracheal intubation, she has only made a dummy, and it is an adult prop, and has never operated on such a small baby!

The difficulty of endotracheal intubation in infants is naturally higher than that of adults!Among other things, the baby's trachea is thin, and the mucous membrane is very fragile, which is prone to damage or even edema.

Elena hurriedly brought the complete equipment for tracheal intubation.

When they came in, Cathy was waiting at the door of the treatment room, waiting anxiously. Seeing Elena, Cathy hurriedly said, "Dr. Zhou has been contacted, and he said he will be right back."

Elena nodded, then immediately entered the disposal room, put the things on the table, and looked at Murphy.

Saving people is like putting out a fire, so she naturally couldn't wait for Zhou Qiao to return, even if it didn't take more than 5 minutes.

Murphy glanced at the equipment, including laryngoscope, catheter guide wire, suction tube, dental pad, syringe, anesthetic spray, etc., while the treatment room already had stethoscopes, oxygen masks, small portable ventilators, and hand-held end-expiratory instruments. Carbon dioxide monitor.

Although the clinic is small, it is quite complete.

Murphy's calm face was like the surface of a frozen lake in winter, and the theoretical knowledge and simulation skills learned in school before flowed slowly through his mind like an undercurrent at the bottom of the lake.

She glanced at little Danielle, and a virtual three-dimensional airway model appeared in front of her eyes.

It's like a holographic projection, but it doesn't exist.This is the condensed form of her imagination.

Immediately, her hands started to move.

Lift your chin and push your forehead.

Using Danielle's atlanto-occipital joint as a turning point, tilt her head as far back as possible so that her mouth, pharynx and larynx are in a straight line.

Then, he held little Danielle's mouth, put it close, blew in three big breaths, and gave her positive pressure artificial respiration!

Subsequently, little Danielle's throat was topically anesthetized with an anesthetic spray.

In fact, it is better and more convenient to perform endotracheal intubation after general anesthesia, but it is too late now.

"Laryngoscope, No. 1 lens, 3.5mm catheter."

Almost as soon as Murphy finished speaking, these things came into her hands.

Murphy couldn't help but glanced at the little nurse next to him in surprise!
Elena blinked her eyes, signaling her to hurry up!

Now with Murphy as her backbone, Elena, who was used to being a device nurse, calmed down and had already connected the carbon dioxide monitor. Almost as soon as Murphy opened his mouth, her things arrived.

Usually, there is a calculation formula for children's catheter selection: (legal number) F=age+18, and a total of 3 catheters with consecutive numbers thicker and thinner are prepared for backup.

However, this formula only applies to children over 2 years old.

对于足月的新生儿和小婴儿可以选择3mm或3.5mm的导管，1岁的小儿可选择4mm的导管，1-2岁则选择5mm的导管。

Little Danielle is just over a month old, so naturally it is more appropriate to choose one with an inner diameter of 3.5mm.

Poor little Danielle, there was no full moon wine or baby shower, but she was intubated at just over a month old!

And it was the first real-life operation of a resident doctor who couldn't find the internship hospital and was rejected N times!
　Thanks to "Stars and Seas MW" for the reward.

　　Thanks to "Book Friends 20220522001236052" for the reward again, this book has achieved the small achievement of the first hall master!
　　
　
(End of this chapter)