Chapter 2054 【2054】Double-Edged Sword
The laryngeal mask is widely used in the rescue of newborns, and general practitioners can think of it. The problem with the kid in front of him is not at all a problem of establishing an artificial airway.
The newborn baby has a slow heart rate and no breathing. Basically, there is only one reason, the airway is blocked. The blockage could be mucus, it could be meconium, it could be something else.
As the baby's heart rate dropped to a dangerous limit, the doctor had to do neonatal cardiopulmonary resuscitation first to keep the baby's heart beating. Then choose an opportunity to solve the airway problem.
Positive pressure ventilation to establish an artificial airway using a laryngeal mask, etc., is best done on the basis of a smooth airway, otherwise, each ventilation may push the obstruction into the airway. Therefore, they are very cautious when using breathing airbags. In the beginning, Song Xuelin didn't even need to inhale the airbag, but used his own mouth to blow air. In fact, he tried to inhale in vain, to see if he could suck out the things in the baby's airway.
Clear the blockages in the mouth and nose, the obstetrician did it when he first picked up the baby. When he, Song Xuelin, took over the baby, he did a quick inspection, and there was indeed no blockage in the baby's mouth and nose. It shows that the situation is very helpless. The blockage is expected to be blocked in a relatively deep place in the child's trachea and it will be difficult to get out, resulting in a dangerous situation for the child today.
To put it bluntly, if you want to use a laryngeal mask for intubation, it is better to use a tracheal intubation. If the endotracheal intubation is successful, at least make sure that the tube is in the trachea, you can put a suction tube in the endotracheal tube to connect to a negative pressure suction device, and carefully suck to see if the blockage in the trachea can be sucked out.
This is not a hospital scene where there is no negative pressure aspirator. The tracheal intubation dedicated to the neonatology department will not be available in the ambulance and emergency department. Neonatal intubation is technically difficult. The doctor on duty in the emergency department of a tertiary hospital is not a professional doctor in a pediatric hospital. He has no technical ability to perform tracheal intubation on such a small child, so he can only be sent back to the hospital to find a neonatologist.
What to do. It is right to try to revive the baby's heartbeat. The compression of cardiopulmonary resuscitation is carried out on the chest, which is equivalent to giving momentum to the trachea to a certain extent.
It's just that the efforts so far have shown that these rescue measures are insufficient, and doctors may need to take a gamble. The rigor of medicine makes doctors choose moderate measures first, and only take further risks if the patient's child fails. Any invasive medical operation is a double-edged sword. There are good and bad. When it is good, it can save lives. If it is bad, it will make life fall faster.
Faced with gambling, the doctor must first calculate whether the previous measures give the human body enough time to react. Song Xuelin raised his head and asked the time: "How many minutes have we been doing this?"
After receiving his question, Lin Hao and Li Qi'an looked at the clock and tried their best to remember and estimate: "Maybe seven or eight minutes—"
"It's been four minutes since I participated. Before, Dr. Song, you took the baby out for five minutes. The total is estimated to be about nine minutes and ten seconds." Xie Wanying said.
Lin Hao and Li Qi'an heard her spit out every precise time point, and sighed in their hearts: So time flies so fast. As who said, classmate Xie is no different from an old doctor, so they can only hold a candle to them.
There was a flash of light in Song Xuelin's slightly squinted brown eyes, and Dr. Xie was the most comfortable partner. Dr. Xie could always live up to everyone's expectations at critical moments.
"Doctor Song, let's switch hands. Let me try." Xie Wanying offered to propose.