The bright surgical blade reaches directly to the throat of the patient. Zhu Ting knows that in the next moment, the intense chest air flow will carry the new coronavirus and spray it out. But he didn't hesitate and went straight.
Cut along the inferior edge of thyroid cartilage, expose the trachea, cut the anterior wall of the trachea, quickly insert the tracheal tube, implant and fix the silica gel inner tube from the tube, and connect the ventilator A series of precise operations, completed in 15 minutes.
"65, 80, 97", the arterial oxygen saturation on the bedside monitor soared rapidly, and the vital signs of patients returned to stability. On the afternoon of February 28, in the war of "robbing people" with the God of death, Zhu Ting, director of Otolaryngology Department of East Hospital of Wuhan University People's Hospital, led the three party members "qiche team" to win again. The current score in this long-lasting game is 5-0.
For patients with novel coronavirus pneumonia who have been intubated, if tracheal extubation is not necessary for 7-10 days, tracheotomy is necessary. Tracheotomy is not complicated for otolaryngologists. But for novel coronavirus pneumonia, this kind of severe respiratory infectious disease, tracheotomy should be cautious. A large quantity of secretions will be ejected, and the virus particles deposited in the lungs will be exposed to the air directly. A little carelessness is a fatal threat to medical staff.
As of February 28, 5 cases of tracheotomy carried out by the "gas cutting team" in Dongyuan District led by Zhu Ting were all for critical patients with high viral load. Before each operation, they should do three levels of protection, including two layers of protective clothing, N95 masks, goggles, foot covers Unlike other colleagues, they wear positive pressure headgear and four layers of gloves at the same time.
Tracheotomy requires a high level of vision and touch of the surgeon, and the water vapor on the head cover will hinder the doctor's vision, while the 4-layer gloves on both hands will reduce the touch of the fingers holding the knife. In the case of double "failure" of vision and touch, Zhu ting and his teammates must rely on the rich experience accumulated in the past to complete each operation.
On February 20, the Department of Otolaryngology of Dongyuan district received an emergency call from the Department of critical medicine. A 70 year old novel coronavirus pneumonia critically ill patient had only 60% oxygen saturation after tracheal intubation. "Tracheotomy must be performed as soon as possible, or the patient will die of respiratory failure soon. Zhou Chenliang, director of the Department of critical medicine, discussed with Kang Yan, director of the Department of critical medicine of the well-known West China Hospital, and decided to ask the "gas cutting team" to operate the knife for tracheotomy.
Zhu Ting changed his protective clothing with Ding Yongjun and Deng Zhifeng, who were members of the "gas cutting team". He took the gas cutting bag and rushed to the ICU at the first time. He joined hands with Yang Jianzhong, the leader of the ICU group of Xinjiang medical team, who was supported by the ICU. Although wearing protective clothing looks bulky, Zhu Ting's movements are gentle and quick. After a series of precise percutaneous tracheotomy operations and re connecting the ventilator, Zou's risk of airway was reduced and his comfort improved immediately.
Zhu Ting said that for novel coronavirus pneumonia patients, the tracheotomy has a good effect of adjuvant treatment. "Reducing the novel coronavirus pneumonia mortality rate in critically ill patients requires multiple disciplines to work together. The party members and doctors should be more aggressive. If we need patients, we will have a mission to" cut the small teams'. " (correspondent Du Weiwei, Zou Yaqin, modern express + / zaker, Nanjing correspondent Xiong Pingping)
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Editor in charge: Lin Jingwei