PD :: Volume #4

#337: ECMO

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„A'Jun independent heartbeat respiratory arrest two hours 5 minutes, defibrillation done, has hit the adrenalin, inserted the manages, outside making the chest holds back.” “阿俊自主心跳呼吸停止两小时5分钟,做过电除颤了,打过肾上腺素,插了管,一直在做胸外按压。” The propeller rumble, the rescue helicopter rescues in the cabin, the egg uncle was saying to the colleagues of rescue team fast general situation, the team is also the secret bureau personnel is a lord. 螺旋桨轰隆隆,救援直升机救护舱内,蛋叔给抢救团队的同僚们快速说着大致情况,团队也是天机局人员为主。 The headquarters medicine section first aid branch family background and present are also expert Liu Mingfeng of incantation technique section member are the team leader, this 40-year-old middle-aged man and Gu Jun, the egg uncles knew, what is just responsible is the logistics rescue work. Liu Mingfeng is listening, while fixing Gu Jun on stretcher is making the life symptom inspection. 总部医学部急救科出身、现在也是咒术部成员的专家刘明峰担任队长,这40多岁的中年男人与顾俊、蛋叔都认识,只不过负责的是后勤救援工作。刘明峰一边听着,一边给固定在担架上的顾俊做着生命体征检查。 After this task force enters the different space, has not lost the commodity equipment, portable defibrillation meter, portable life-support machine also, therefore the cpr quality of first aid is very high, the recovery medicine gave, the electric shock eliminated trembling, the trachea cannula by the life-support machine was ventilated, to continue outside the chest to hold back...... the egg uncle they to make to be able to do. 这次特遣队进入异空间后并没有失去物资装备,便携式除颤仪、便携式呼吸机等都还在,所以现场急救的cpr质量很高,复苏药物给了,电击除颤了,气管插管了由呼吸机通气,持续胸外按压……蛋叔他们已经做了一切能做的。 ...... 只是…… The two-sided mydriasis, vanishes to the light reflecting, whole body muscle all reflections vanish, the electrocardiogram that now is connected including the above also demonstrates not independent heartbeat. 双侧瞳孔散大,对光反射消失,全身肌肉所有反射均消失,现在连上的心电图也显示无自主心跳。 Has 125 minutes. 已经有125分钟。 The egg uncle said that at that time after fighting a decisive battle the situation is they slow a meeting can restore to act, therefore after the Gu Jun heartbeat stops suddenly in probably 6 minutes start to rescue, this even high-quality cpr, success ratio still only then approximately 10. 蛋叔说当时决战后的情形是他们缓了一会才能恢复行动,所以是在顾俊心搏骤停后大概六分钟内开始抢救,这样即使是高质量的cpr,成功率也只有约十。 The present international standard is the bare-handed implementation heart and lungs resuscitation rescue surpasses for 30 minutes, the patient had not had the restoration, then announced the death. 现行的国际标准是徒手实施心肺复苏术抢救超过30分钟,患者仍未有恢复,即可宣布死亡。 Moreover the heartbeat stops for over 5 minutes, because the brain blood supply interruption interval is long, the brain cell starts to have the irreversibility damage. Some cognitive death patients rescue the heartbeat to breathe, actually becomes the reason of vegetable. 而且心跳停止超过五分钟,由于脑供血中断时间长,脑细胞就开始有不可逆性的损伤。脑死亡正是一些患者抢救回来心跳呼吸,却成为植物人的原因。 The Gu Jun right side volume section also has the obvious skin lacerated wound is 5 cms, the partial skin swelling stasis is black, the right side hemophthalmia, may have the head injury. 顾俊的右侧额部还有明显皮肤裂伤长达5厘米,局部皮肤肿胀瘀黑,右侧眼球充血,有可能存在颅脑损伤。 Compares these two states, many bone fractures of his limbs appeared not anything obstruct greatly. 相比这两个伤情,他肢体的多处骨折倒显得不算什么大碍。 Situation, unusual is not optimistic. 情况,非常的不乐观。 Liu Mingfeng they are facing the body on stretcher, could basically be called the corpse. 刘明峰他们面对着的担架上的这具躯体,基本已经可以称为尸体了。 „He has not died.” The Wu Shiyu firm sound of standing on one side said the sentence, she is also grasping these dissection instruments, „I can feel, he has not died.” “他还没死。”站在一边的吴时雨坚声说了句,她还握着那些解剖器械,“我能感觉到,他还没死。” The egg uncle knows that this aspect is especially difficult to Wu Miss, was she leads to make old seal to hit to collapse that different banyan fig......, but her state of mind was steady. 蛋叔知道这个局面对吴姑娘尤其艰难,是她带领着打出旧印打崩了那棵异榕树……但她的精神状态还算平稳。 No matter who how the feeling, rescues the team not to think giving up, their working copies compete for the life with the god of death. 不管谁的感觉怎么样,抢救团队都没有想过放弃,他们的工作本就是与死神争夺生命。 Although is rarely seen, but stops 2-3 hours of patient, even also having the matter that the cerebral hemorrhage patient rescues in the ordinary hospital first-aid room the heartbeat, is not how rare. Gu Jun is also not an average person, but they have the best medical resource use. 况且虽然不多见,但在普通医院急救室里把心跳停止2-3个小时的患者、甚至是还有脑出血的患者救回来的事情,也不是多么罕见。顾俊还不是一般人,而他们则有着最好的医疗资源使用。 Another two injured, Deng Ximei situation is lighter, Xue Ba is heavier also early, but the scene cpr quality is very high, cannot give up. 另外两位伤者,邓惜玫情况轻一些,薛霸更重一些也更早一些,但是现场cpr质量都很高,都不能放弃。 Meanwhile, Zhang Huohuo continues to make outside the chest to hold back to Gu Jun, has the nurse to bind the head of Gu Jun to decrease temperature with the ice cap immediately, has the nurse to insert the ureter to him. Liu Mingfeng, the egg uncle they look at that transparent urine bag anxiously, the first aid have the urine to have the opportunity, without the urine can lead basically rescued inadequately. 与此同时,张火伙给顾俊继续做着胸外按压,有护士立即用冰帽裹住顾俊的头部以降温,另有护士给他进行插尿管。刘明峰、蛋叔他们都紧张望着那个透明的尿袋,急救有尿就有机会,没尿导得出来的基本就救不成了。 When ureter, saw that the deep yellowish urine derives the ureter, spills into the urine bag. 当尿管一通,就见到有深黄褐色的尿液导出尿管,涌进尿袋里。 „Has the opportunity, has the opportunity!” The egg uncle the excited happy say/way, the spirit of people are encouraged immediately, the Wu Shiyu complexion also changes for the better. “有机会,有机会！”蛋叔顿时不由激动喜道,众人的精神纷纷振奋,吴时雨的面色也有好转。 „Right, is saved, amount of urine.” Liu Mingfeng said to the nurse decidedly, before these urines also possibly are the Gu Jun stupors, exists in the urinary bladder, but there is a urine to be always meddlesome, said: „On ship that side has prepared to make ecmo, gets down to do.” “对,还有得救,记尿量。”刘明峰对护士决然道,这些尿也可能是顾俊昏迷前就存在于膀胱的,但有尿总是好事,又道:“船上那边已经准备好做ecmo了,一下去就做。” ecmo is outside the body membrane lung oxygenate, the principle with the pipe patient the artificial heart machinery equipment of vein join dependency, directs the oxygenator to conduct the artificial oxygenate the venous blood, then the power pump backflows patient within the body these oxygenate blood again, maintains the organ function, the help heart and lungs recovers. ecmo就是体外膜肺氧合,原理是用管子把患者的静脉连接相关的人工心肺机器设备,把静脉血引到氧合器进行人工氧合,然后动力泵再将这些氧合血回流患者体内,维持器官机能,帮助心肺复苏。 This external circulation can substitute the heart and lungs in a short time completely, it can be said that last of critically ill first aid. 这种体外循环在短期内能完全替代心肺,可以说是重症急救的最后一手。 However because the equipment is expensive . Moreover the operative technique difficulty is big, has the equipment also needs special has taken advanced courses the ecmo team to be good. Therefore domestic Sanjia Hospital is not every can make ecmo, the mature team is few. But these are not on the destroyer the issue of standby rescue team. 不过由于设备昂贵,而且操作技术难度大,有设备也需要有专门进修过的ecmo团队才行。所以国内三甲医院也不是每家都能做ecmo,成熟的团队很少。但这些不是驱逐舰上待命抢救团队的问题。 Cardiovascular internal medicine department, department of cardiac and involvement branch, ER, anesthesiology department, neurosurgery department, nerve internal medicine department, orthopedics, breath and Guatemalan critically ill medicine branch...... 心血管内科、心脏外科、介入科、急诊科、麻醉科、神经外科、神经内科、骨科、呼吸与危重症医学科…… Team that over a hundred experts and professors of many divisions/disciplines compose, some at the scene, some in long-distance connect, this ecmo must rapidly complete. 诸多学科的上百位专家教授组成的团队,有些就在现场,有些则在远程连线,这个ecmo一定要快速完成。 Does Gu Jun this life have, now counts on this. 顾俊这条命还有没有,现在就指望这个了。 So long as joins ecmo, even if Gu Jun is really a corpse, does not make him that quick rotten. 只要接上ecmo,即使顾俊真的已经是一具尸体,也不让他那么快腐烂。 But Xue Ba will also make ecmo to save. 而薛霸同样也会做ecmo进行挽救。 „Does the stupor of patient have the influence of unusual strength?” Liu Mingfeng also asked at this time. “患者的昏迷存在异常力量的影响吗？”刘明峰这时又问道。 An egg uncle recollection then situation, somewhat was absolutely terrified, „was A'Jun the dark strength gathers together, he was basically swallowed, we had the opportunity that the counter-attack won. Also caused him to crash from the upper air like this, these bone fracture and volume section damage came.” 蛋叔一回想当时的情形,就有些毛骨悚然,“是阿俊把黑暗力量聚在一起,他基本被吞噬了,我们才有反击获胜的机会。也是这样造成了他从高空坠落,这些骨折和额部损伤就这么来的。” Spiritual old seal has also hit, the purification stone has also used, showed that Gu Jun not by the situation that the spirit corrodes. 精神旧印也打过了,净化石也用过了,都显示顾俊并没有被精神侵蚀的情况。 This must say the feeling by Wu Shiyu, „I feel not to have, the dark strength once almost swallowed him......, but final time, these strengths had been struck to disperse, his flavor is salty, without is so salty, but the salt taste, is he.” 这就要由吴时雨来说说感觉,“我感觉没有,黑暗力量一度几乎吞了他……但最后的时候,那些力量已经被击散了,他的味道还是咸的,没那么咸,但还是咸味,就是他。” Liu Mingfeng and the others nod, hoping does not have, otherwise the situation had too the unknown. 刘明峰等人点点头,但愿是没有,不然情况就有太多未知数了。 Takes off not to use from the island for five minutes, the helicopter lands in the deck of destroyer, they immediately carrying the Gu Jun stretcher are lifting to put on the first aid bed, are waiting for in the deck the sending and picking up personnel pushes the first aid bed the ecmo operating room that toward shipboard sets up to dash to go, outside the chest holds back to continue unable to stop. 从小岛起飞还不用五分钟,直升机就降落在驱逐舰的甲板上,他们立即把载着顾俊的担架抬出去放到急救床上,早在甲板等着的接送人员就推着急救床往舰上设的ecmo手术室飞奔而去,胸外按压持续不能停。 Early one minute, or late one minute, possibly decided that the patient is dies lives. 早一分钟,或晚一分钟,都可能决定患者是死是活。 The fight of mobile task force frontline was completed, the fight of their logistics just started, must take the victory full power. 机动特遣队前线的战斗完成了,他们后勤的战斗才刚刚开始,一定要全力拿下胜利。 But that side the control center, Master Tong and Yao Shinian and the others is congealing the complexion, looks at the rescue through the large screen. 而在指挥中心那边,通爷、姚世年等人都凝着面色,通过大屏幕看着抢救的现场。 Quick, Gu Jun was advanced the ecmo operating room, the nurse changes into the sickness clothing/taking his uniform/subdue, has prepared the good surgery team to start immediately. 很快,顾俊就被推进ecmo手术室,护士把他的制服换成病服,早已准备好的手术团队立即开动。 First is to make moves the venous cannula, is the surgery main and most difficult one step. 第一步是做股动静脉插管,也是手术最主要、最困难的一步。 While continuing the chest holds back, they must open the eyelet toward the thigh of Gu Jun, found his femoral artery and stock vein completes the intubation, approaches the ecmo machine with the thick long connecting pipe even/including again. This is not good to cause the patient massive hemorrhage, not only loses the first aid time, but also makes the situation worse. 在持续胸外按压的同时,他们要往顾俊的大腿开小孔,找到他的股动脉和股静脉都完成插管,再用粗长的连接管连向ecmo机器。这一步一个不好就会导致患者大出血,不但耽误急救时间,还让情况更糟糕些。 At this time, the shadowless lamp illuminates, under the ultrasound guide, wears more than ten doctor nurses of blue germ-free surgery clothing/taking to gather round lies low Gu Jun on surgery table is busy at work. 此时,无影灯照亮,在超声引导下,身着蓝色无菌手术服的十几个医生护士围着平躺在手术台上的顾俊忙活。 The robot tile strength said 机器人瓦力说 First, last day asked the double monthly tickets, sought the subscription! Everyone National Day is joyful! 第一更,最后一天求双倍月票啦,求订阅！大家国庆快乐！
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