Chapter 489: Lao Gu's Self-Blame

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Lu Chen was shocked. When he first came to bed No. 1, he clearly saw that the patient's health trend was a plus sign.

How come it turned into two minus signs in the blink of an eye?

A plus sign turned into two minus signs, which is a world of difference!

This means that the patient's condition at this time has suddenly taken a sharp turn for the worse!

Just as Lu Chen was thinking, he suddenly noticed that the patient on the bed stared upwards, his expression was dull, and his upper limbs trembled involuntarily.

At the same time, the ECG monitor next to the bed sounded a harsh "beep beep" alarm.

Lu Chen felt something was wrong, and he reacted immediately and went forward to check.

He patted the patient's shoulder, "Uncle, uncle! Can you hear it?"

The patient didn't respond at all!

Lu Chen quickly touched the carotid artery on the other side and placed the stethoscope at the position of the apex of the heart.

There was no heartbeat at all!

"Oh no, the heart has stopped!"

Seeing this, Lu Chen rolled up his sleeves and immediately began chest compressions.

On the side, Gu Xinyue was also quite nervous.

He placed the patch on the patient's puncture point and assisted Lu Chen in cardiopulmonary resuscitation.

Fortunately, it was in the CCU ward, and the nurse in charge of the bed immediately reacted and called other nurses to push the rescue vehicle from the nurse station.

Zhou Bin happened to come to the ward at this time, and when he saw this scene, he immediately ran to the bed.

"Quick, adrenaline!"

"Prepare the defibrillator!"

Zhou Bin immediately determined the patient's condition and began to issue rescue orders.

"What's wrong with the patient? Isn't it a tube removal?"

Gu Xinyue paused and said, "Teacher Zhou, I just pulled out the tube and helped the patient press the puncture point for two minutes, but his heart suddenly stopped!"

"The heart stopped?" Zhou Bin frowned.

When the patient's condition was the most critical, he did not suffer from cardiac arrest.

How come the patient's condition improved, but suddenly the heart stopped?

But now is not the time to think about these things. Zhou Bin calmly issued various rescue orders.

"Inject Cordarone, and another bottle of sodium bicarbonate!"

"Ventricular fibrillation! Prepare for defibrillation!"

...

Hard work pays off.

After Zhou Bin and Lu Chen took turns to perform chest compressions, the patient's heartbeat finally recovered.

When the faint beating of the heart came from the stethoscope, Lu Chen finally breathed a sigh of relief.

However, the patient's consciousness did not recover, and he was still in a state of not responding to calls.

"Hu... It's good to be able to rescue him." Zhou Bin sighed slightly.

For patients with cardiac arrest, the chance of being able to press back is not high.

Lu Chen shook his sore hands, "Cardiopulmonary resuscitation is really a physical job!"

He has been in the CCU ward for only a few days, but the number of chest compressions he has performed has exceeded the total of the past few months.

In the CCU ward, rescuing patients is a common occurrence!

On the side, Gu Xinyue looked a little dazed.

"Old Gu, what's wrong with you?"

Gu Xinyue was stunned, lowered his head, looked a little unnatural, and said hesitantly: "Lu Chen, you said the patient's heart stopped, could it be because of me..."

Lu Chen was stunned, "Why do you think so?"

Even if the patient's condition is slowly recovering, he may still suffer from malignant arrhythmia, acute heart failure, or even cardiac arrest, sudden death and other unpredictable malignant events at any time.

"I..." Gu Xinyue lowered his eyebrows, "He was obviously fine just now, but after I removed the tube, his heart suddenly stopped."

"Maybe it was a coincidence that you removed the tube." Lu Chen said, "If you didn't remove the tube, his heart would stop at this time. We were by his side and rescued him in time. Didn't we help him?"

Gu Xinyue was silent for a while. He glanced at Lu Chen and said slowly: "I have my own reasons."

"What reasons? Make you doubt yourself?" Lu Chen asked doubtfully.

"Lu Chen, I was wondering, did I just...press his carotid sinus?"

The puncture point for this patient was not the subclavian vein, but the internal jugular vein.

Lu Chen recalled Gu Xinyue's actions just now. After removing the catheter, he did press the carotid sinus on one side.

The outer membrane of the carotid sinus vascular wall contains abundant sensory nerve endings, called carotid sinus pressure receptors

This location is superficial. When stimulated, it will lead to the occurrence of carotid sinus syndrome symptoms, which can be manifested as decreased heart rate, weakened myocardial contractility, decreased cardiac output, and decreased blood pressure.

Pressing both sides of the carotid sinus at the same time can indeed make the vagal reflex excited and even cause syncope.

"Old Gu, let's not talk about whether you pressed the position of the carotid sinus." Lu Chen said, "Even if you pressed it, gently pressing the carotid sinus on one side, do you think it will cause cardiac arrest?"

Gu Xinyue bowed his head and remained silent after hearing this.

Lu Chen knew that at this time, Old Gu's mentality was extremely self-blaming.

I was just discussing with the patient about transferring him back to the general ward tomorrow morning, and in the blink of an eye, he was lying in bed and couldn't be woken up.

Lu Chen patted Gu Xinyue on the shoulder, "Old Gu, let's do our own things. As for the rest, don't think too much and don't waste time."

Gu Xinyue nodded, looked up at Lu Chen, "Thank you."

Lu Chen smiled and responded, "It's okay if you can think more positively."

...

Back to the doctor's office.

Zhou Bin also knew Gu Xinyue's thoughts and said with relief: "Xiao Gu, you said that the possibility of cardiac arrest caused by pressing the carotid sinus cannot be completely ruled out, but the possibility is very small."

"Teacher Zhou, then, why did the patient suffer cardiac arrest?"

Gu Xinyue stared at Zhou Bin closely, trying to find some answers from her.

Zhou Bin smiled and asked: "Xiaogu, let me ask you, a nurse can complete such a simple operation as extubation, why do you need a doctor?"

Gu Xinyue frowned and didn't answer for a while.

In fact, his entire extubation operation just now took less than a minute.

If it is just a simple extubation operation, UU Reading www. uukanshu.net There must be nurses!

Seeing this, Lu Chen paused and said: "I remember a literature report that central venous catheter removal can cause accidental central venous catheter removal syndrome, which manifests as tachycardia, syncope, hypoxemia, inertia and even heartbeat and breathing. Stop, shock and coma, etc., the mortality rate is 57%.”

Zhou Bin nodded with satisfaction: "Lu Chen is right. Even if it is just a simple extubation, it actually still has certain risks, so the doctor must be present when the tube is extubated!"

In addition to massaging the carotid sinus, there is also the possibility of intravascular thrombosis and gas embolism!

However, after Lu Chen and Zhou Bin took turns to enlighten her, Gu Xinyue's mood improved significantly.

"Lu Chen, thank you." Gu Xinyue said softly.

"No thanks, just bring me a bowl of beef noodles tomorrow morning." Lu Chen smiled.

"Okay." Gu Xinyue nodded.

…

After half an hour, I finally got off work.

Lu Chen's night shift also started.