This is a big car accident. With a loud bang, the car collided with a big truck, and the driver and five passengers were knocked out of the car. Only three of the six people were still breathing, and the other three died on the spot. Jimo city People's Hospital immediately sent an ambulance to the scene of the incident, and after emergency and simple first aid treatment, it was immediately sent to the local hospital. Liu Shu was covered in blood, his face was covered with blood, and his condition was the most serious. He opened the green channel and was transferred from the local hospital to the ICU of our hospital at the first time because of massive postoperative bleeding.
? The whistle of "120" and the telephone ringing of the department broke the quiet ICU ward.
Since he entered the ICU, our department has been ready to go all out to save patients.
A series of life-threatening factors, such as abdominal bleeding, multiple fractures, severe abdominal infection, multiple organ failure, and relying on a large number of vasoactive drugs to maintain blood pressure, need to be solved one by one to save the lives of patients. After the coordination of the chief duty, the multidisciplinary cooperation and joint treatment of the whole hospital were started, and the consultation of the whole hospital was held immediately. After weighing the advantages and disadvantages of all parties, the patient received bilateral femoral debridement+external fixation, vascular anastomosis, neuromuscular tissue repair+laparotomy+transverse colon repair+partial small intestine resection+splenic laceration repair under emergency general anesthesia. It is the doctor himself who makes patients and their families dare not trust.
If you don't operate on the patient, you will only die. If you operate, you may die on the operating table, but you will have a chance. During the family conversation before the operation, Liu Shu's relatives fell into panic and hesitation, worrying about whether the patient could leave the operating table alive. After patiently explaining the details of the operation, the icu director of our department repeatedly explained the condition, explaining the advantages and disadvantages one by one, and the family decided to agree to the operation. During the operation, considering that the patient may have asphyxia, airway obstruction, severe hypoxia and other critical situations at any time, the airway was immediately rebuilt and ventilation was resumed.
After several hours of fighting, the operation was successfully completed. As Bai said, the profession of doctor is between God, Buddhism and ordinary profession. When a serious illness comes, patients and their families should choose their trusted doctors, trust their parents and respect the uncertainty of medicine, so that doctors can wholeheartedly help patients overcome the disease. We have no other choice!
Because the abdominal pressure is too high, the abdominal cavity is still open after operation, which greatly increases the probability of abdominal infection and brings great challenges to the nursing staff in our department. In order to reduce infection, aseptic technique should be performed more carefully in the nursing process, paying special attention to the exudation of gauze in abdominal cavity, the color, characteristics and quantity of various drainage tubes, and the fluctuation of patient's body temperature, and reporting to the doctor in time, changing the dressing twice a day and replacing the gauze. When the abdominal pressure reaches the requirement of abdominal closure, actively close the abdomen for the patient.
Because of the car accident and a period of laparotomy, abdominal organs rupture, causing systemic inflammatory response (SIRS), and complications will cause shock and multiple organ failure syndrome. Will endanger the patient's life again. After a series of discussions by doctors, the patient was treated with continuous bedside hemofiltration (CRRT) and drug sensitivity treatment, and the corresponding antibiotics combined with CRRT were used. Finally, the inflammatory reaction of the patient was effectively controlled.
In addition, the car accident also led to multiple fractures (including comminuted femoral fractures), severe contusion of muscle tissue and skin accompanied by defects, which further increased the difficulty of nursing. Because the patient's condition is very unstable, our nursing team racked their brains to come up with the best method, and decided to adopt self-created therapies such as "five-person turning method", "alternately using liquid pillow method" and "hanging the patient" to carefully treat the patient with axial turning and general braking, so as to prevent the occurrence of related complications such as crush injury, falling pneumonia and deep vein thrombosis on the basis of ensuring the patient to suffer the least pain.
With the slow healing of the fracture, the patient gradually removed the gauze dressing and splint fixation. In order to improve his quality of life in the future, the hospital held a special meeting. After repeated evaluation and multidisciplinary consultation, the doctors decided to make a detailed rehabilitation plan for him, which was guided and supervised by rehabilitation experts every day.
Faithful wife, the patient's condition is getting better every day, the swelling of his legs is also decreasing, his spirit is obviously improving, and his muscle strength is also recovering. Under the premise of stable patient's vital signs and hemodynamics, we will gradually make offline plans for patients, from the initial transition from taking off one belt and three belts to taking off three belts and one belt, and then slowly to taking off five belts and one belt. At present, patients can completely leave the ventilator and realize spontaneous breathing.
There is no job in the world that is more fulfilling than saving people. Every successful rescue has devoted everyone's efforts, every continuation of life, everyone's sweat, and every team's best efforts have nothing to do with returns. Although Liu Shu is only the representative of many ICU patients, it is the epitome of our medical staff's daily struggle with death. Our busy work every day is to gain more time from death and get back more possibilities of saving lives from him. I hope the patients in ICU are as tenacious and hopeful as Liu Shu, and wish the world less death and more vitality.