manynovel Page 422
Page 422
But just as he finished speaking to Majima, a call came from the nurses' station.
Upon hearing that the patient who had been brought in earlier that night had fallen ill, the two quickly ran out of the department.
Upon arriving at the ward, they quickly assessed the patient's condition.
"SpO2 (blood oxygen saturation) has dropped to 70..."
"Rapid breathing, heart rate 150..."
"Blood pressure has dropped to 75/20 mmHg..."
"CVP (central venous pressure) 30cm...Prepare for intubation!"
After understanding the patient's condition, Aki Tomoya looked at Majima and made a decision immediately.
Even though initial treatment had been performed, but no further surgery had been done, it still didn't work.
"Mashima, we need to prepare for the surgery quickly!"
Chapter 477 The most feared thing is silence
"A cardiac stimulant, and a diuretic..."
After the intubation was completed, a large amount of pink frothy sputum gushed out of the trachea. Aki Tomoya calmly gave instructions to Majima and the on-duty nurse who were standing nearby.
To increase myocardial contractility and prevent eye damage leading to heart failure, a cardiotonic agent is administered.
At the same time, in order to reduce blood volume and relieve cardiac stress in heart failure, and to reduce cardiac concordance, diuretic treatment is given.
He was admitted to the hospital in the first half of the night, and a sudden emergency occurred at 6 a.m., before the other cardiac surgeons had arrived at the hospital.
Even though the patient's condition has stabilized somewhat, it is still important to schedule surgery as soon as possible.
"Prepare for emergency surgery, arrange the operating room, and call someone from the anesthesiology department!"
Without the slightest hesitation, Aki Tomoya gave the order to prepare for emergency surgery.
There is no time to lose; surgery must be arranged as soon as possible, otherwise the chance of survival will be missed.
"now?"
"You two, don't just stand there, get to the arrangements right away, and send someone from the anesthesiology department as soon as possible!"
Aki Tomo ignored the hesitant Majima and urged the two nurses to act, his tone somewhat stern.
The nurse dared not disobey and followed Aki Tomoya's instructions.
"Mashima, go wake up Dr. Yoshida and explain the situation in detail!"
As for Majima, he knew that the other party was still hesitant about whether they could decide on the important surgery.
But at times like this, Aki Tomoya is much calmer and more imposing than him.
Majima nodded involuntarily, developing a sense of trust in Aki Tomoya.
At 6:35, Aki Tomoya arranged for people to take action.
At 7:50, the patient, who had received consent from family members who remained at the hospital, was wheeled into the operating room. All available personnel were ready.
"I understand the situation. You two did a good job."
Yoshida Aoba, who was already outside scrubbing hands together, looked serious and praised the two of them.
The anesthesiologist from the anesthesiology department seemed somewhat hesitant at this point.
"I'm not sure, I might need Dr. Aoki to come over!"
This surgery not only demands high standards from the surgeon, but also requires the anesthesiologist to make no mistakes.
The patient, who experienced a sudden emergency at 6 o'clock, was scheduled for emergency surgery and taken to the operating room. His condition was critical and required immediate attention; any mistake in any step could have resulted in the patient's death.
With a rapid onset, severe illness, poor cardiac function, high surgical difficulty, and high mortality rate, this surgery, which required another artificial valve replacement, was not one that the anesthesiologist, who happened to be on night duty, was confident he could take on.
They should have more experienced and capable people assist their cardiac surgeons in performing the operation; that would be much safer.
"At a time like this, are we really going to wait for Dr. Aoki to arrive?"
Aki Tomoya frowned, surprised that the people from the anesthesiology department were actually scared when they got outside the operating room.
He could understand the other party's concerns upon learning that the patient was critically ill and that the surgery was extremely difficult, placing even higher demands on the anesthesiologist.
After all, once the patient enters the operating room, their life is in their hands.
Moreover, this was an emergency surgery, and there was no complete surgical plan beforehand; we had to improvise as needed.
Perhaps because of something Aki Tomoya said that made him feel ashamed, the anesthesiologist had no choice but to bite the bullet and prepare for the procedure.
"Follow our instructions when the time comes."
He also understood that it wouldn't work to approach a difficult surgery with that mindset, and at that moment, Aki Tomoya said something that gave Yoshida Aoba a bit of a headache.
"Dr. Aki, please trust your partner regarding the anesthesia."
Yoshida Aoba was afraid that Aki Tomoya would say the same thing and put all the blame on them, which would be troublesome if something really happened.
Although during surgery, the anesthesiologist will follow the surgeon's judgment because of the surgeon's leadership, it's not like Aki Tomoya did that. He said something that might take full responsibility in order to encourage his colleague who was a little discouraged to go into the operation.
However, Aki Tomoya didn't think that much about it. Right now, the cardiac surgery and anesthesiology departments only had the people there. If they didn't go, who else could save the critically ill patient who had already been pushed into the operating room and was waiting for help?
"Time is short, everyone should prepare early. Dr. Aki will be the first assistant, and Dr. Mashima will be the second assistant. As for the anesthesia, I'll leave it to Dr. Otani."
Yoshida Aoba completed all the arrangements in an instant.
Although Aki Tomoya and Mashima handled all the procedures before the operating room, he still had to be the chief surgeon.
In such a critical surgery, it is impossible to entrust the opportunity to two novices as the lead surgeon.
Firstly, it's for the sake of the success rate of the surgery; secondly, if any unexpected problems arise during the surgery, it's much easier for the chief surgeon to take responsibility than for two novices.
Of course, Yoshida Aoba was also confident that he could save the patient.
Around 8 o'clock, the patient was mechanically ventilated in the operating room using an anesthesia machine, and a large amount of pink frothy sputum also gushed out of the trachea.
Therefore, the defoamer was intermittently inhaled via high-frequency nebulization.
Subsequently, invasive arterial puncture and pressure measurement, venous pressure measurement, electrocardiogram monitoring, and urine output monitoring were performed under rapid local anesthesia.
Anesthesia was induced under direct arterial pressure monitoring.
"Maintain the depth of anesthesia..."
The anesthesiologist named Otani was probably the least experienced anesthesiologist at Kanto General Hospital. You could tell from his initial hesitation outside the operating room and the undisguised tension in his eyes inside.
Previously, I had been performing surgeries under the guidance of Yoshida Aoba, and the anesthesia was always administered by Yoshida Aoba's personal anesthesiologist, who is the same Dr. Aoki that Dr. Otani mentioned not long ago.
Even though it was his turn to administer anesthesia, Aki Tomoya couldn't bear to watch and reminded him.
Otani, who is also on duty tonight, doesn't know whether he should be glad that he had a rare experience.
The surgeon, Aoba Yoshida, performed an open-chest procedure and used cardiopulmonary bypass to perform the mitral valve replacement.
"Initiate re-injection!"
After the heart stopped beating, while following Yoshida Aoba's instructions, Aki Tomoya also reminded Dr. Otani to perform perfusion every thirty minutes when the other was busy.
Carefully incise the right femoral artery and femoral vein, and perform partial cannulation of the femoral artery and femoral vein after heparinization.
"The adhesions are very severe!"
Looking at the severely adhered heart and pericardium, Yoshida Aoba frowned slightly, but did not stop, slowly separating the superior and inferior vena cava.
Time ticked by, and no one dared to blink.
The entire operating room suddenly became quiet; nothing could be heard.
The surgeon, Yoshida Aoba, kept frowning.
In the operating room, I'm not afraid of hearing the doctors laughing and talking; I'm afraid of not hearing anything at all, of everyone being silent.
Chapter 478 Next Time You Come
During the surgery, it was found that the aortic valve was open normally, the mitral valve was open with limited opening, there was thrombus attached to the ventricular surface, and the tricuspid valve annulus was loose and enlarged.
"Preparing to remove the original mitral valve prosthesis..."
Yoshida Aoba finally spoke after a long silence, but his brows remained furrowed.
No one dares to let their guard down until the patient's life is completely assured.
After removing the patient's original artificial flap, he quickly instructed, "Artificial flap."
The original artificial flap was removed so that a new artificial flap could be replaced. Following Yoshida Aoba's instructions, the artificial flap was transferred there.
"Wiping sweat..."
After the artificial flap was replaced, Yoshida Aoba's brows relaxed a little.
Two hours and fifty-three minutes after the aorta was blocked, Yoshida Aoba ordered the aorta to be opened, and the heart automatically resumed functioning.
"No arrhythmia."
Aki Tomoya breathed a sigh of relief as he watched the monitoring system.
"Dr. Anki, please close your chest."