You should know that in 2014, Lun Dun's air emergency team carried out the world's first pre-hospital (infield) resuscitation in the aortic intravascular balloon occlusion (reboa).

Currently in China, there is no!

So you can imagine how difficult it is to perform this surgery in the wild, as difficult as climbing to the sky!

Hu Dongwei doesn’t think that the young doctor in front of him can be compared with the doctors from the world’s top first aid team!

Even the director of the emergency department of their hospital definitely does not have the technology outside the hospital to perform resuscitation of the aorta and intraperitoneal artery resuscitation of the abdominal aorta and intraperitoneal artery.

However, if you perform resuscitation of aortic balloon blocking of the thigh artery outside the hospital, you can challenge it. After all, resuscitation of aortic balloon blocking of the thigh artery is relatively simple several times. You can find the artery directly at the upper end of the thigh artery fracture and insert the balloon into the blockage.

However, the difficulty of performing resuscitation of the abdominal aorta in the abdominal cavity is purgatory-level, and the country is currently blank. There is no first case yet!

The reason why this operation is difficult outside the hospital is that it is best to perform under ultrasound guidance when the operation begins with femoral artery puncture and catheterization.

The advantages are: precise positioning, identifying anatomical variation of the femoral artery, and reducing the risk of potential arterial damage. When shock or femoral pulse is not palpable, ultrasonic-guided puncture can also increase the success rate of the first needle puncture.

But if you do this puncture outside the hospital, there is no ultrasound guidance at all, and you will be completely blind puncture when you puncture!

It's entirely based on experience and luck.

Bad luck, gg.

In addition to this, when inserting the balloon catheter, this part of the operation is usually performed under x-ray fluoroscopy, but there are no instruments in this aspect outside the hospital (in the field). You can only use your experience and operation and luck to complete this operation.

When vascular blockade is finally performed, it is best to have a position of blocking the balloon under the x-ray chest x-ray. When filling the balloon catheter, it is best to fill the balloon under fluoroscopic monitoring. It is very important to maintain the position of the long sheath just below the balloon to provide support and prevent the filled balloon from being rushed down by blood flow.

The above key points are all required to complete auxiliary equipment.

If you are in the hospital, everything is easy to say!

But now outside the hospital, if you do this surgery, it means you have lost both eyes, and it is completely a blind monk!

Relying entirely on your experience, judgment and operation to make up for the above instruments that are not available!

This is also the reason why no one in China can perform such surgery before hospital (in the wild)!

"Are you sure you can? Do you know that you will be completely blind at that time!" Hu Dongwei felt that Ruan Bin was just a mess!

"Yes, if you make a mistake in operation, it's equivalent to giving the patient another knife. Now you're sent to the hospital, maybe there's still a chance!" Lei Jincheng next to him said in a deep voice.

"We are responsible for the patients, it has nothing to do with you. You should get out of the way!"

If something goes wrong in this matter, they will be responsible for it to the end!

"Two doctors, let him give it a try!" At this time, the woman saw Ruan Bin saying that it could stop bleeding and save her life, so she instantly chose to convince Ruan Bin, at least she would be a slaughter.

"I will be responsible for the accident alone!" Ruan Bin said.

He doesn't want to continue talking about this issue, saving people is important now!

"Did you block the balloon?" Ruan Bin asked anxiously.

"Yes!" Hu Dongwei heard the other party say he was fully responsible, and his family agreed. He simply planned to delegate power. Because he knew very well that the patient would definitely not be able to hold on to the hospital in this situation! For example, give it a try?

Soon Ruan Bin got the tools and began to make resuscitation of surgical tools for intravascular balloon occlusion. This is not a hospital, and the other party did not bring anything in this regard.

He can only make one temporarily!

Fortunately, they have something key to block the balloon!

At this time, the two doctors and nurses were shocked when they saw Ruan Bin quickly converting a catheter, a 14-digit needle, an arterial guidewire and an occlusion balloon into surgical tools!

"Is this possible?" Hu Dongwei was stunned.

"Although it's a little bit simple, it should be fine to use it. Give me 20 ml of normal saline!" Ruan Bin continued.

Get everything done and start the surgery!

Reboa surgery has 5 basic steps: arterial puncture and sheath implantation, balloon catheter implantation, filling the balloon, relaxing the balloon and pulling out the blood vessel sheath.

It seems simple, but it is not easy to operate, because you are tinkering with things in the abdominal aorta. Let’s not talk about whether you can blindly find the abdominal aorta. Can you successfully determine whether you have reached the bleeding point? Then perform balloon embolization to stop bleeding?

Picking up the knife, Ruan Bin began to incise the incision at the common femoral artery, and then pierced the common femoral artery!

With world-class experience, he made a very accurate judgment on this needle. At this time, his brain seemed to show the artery diagram of the patient's whole body. He could determine where the femoral artery was, how to use strength, how many points should he use, and in which direction to pierce it in. After piercing it, how to adjust the direction of the needle to ensure that it continues to pierce the femoral artery.

Next second!

He directly penetrated the common femoral artery with one injection.

"Have you entered the common femoral artery?" Lei Jincheng, who was squatting beside him, asked nervously, his palms were sweating. He felt even more nervous than Ruan Bin!

If the other party succeeds, it will become the first doctor in the country to perform reboa surgery before hospital (in the wild)! If the patient fails, he will say goodbye to the world completely!

"I'm judging the location of the external iliac artery." Ruan Bin said without raising his head.

"So accurate!" After hearing this, Hu Dongwei felt a little hope in his heart. The other party pierced the position of the femoral artery with one needle. This is a blind puncture! Now we are starting to look for the external iliac artery.

If this surgery is performed in the hospital, it requires ultrasound guidance and positioning puncture. This guy actually succeeded in blind puncture! It was so terrible.

"However, it is another huge difficulty to find the external iliac artery in the common femoral artery!" Hu Dongwei, who had just felt a glimmer of hope in his heart, began to nervous again.

Because it's still blind fucking!

Entering another artery from this artery is like threading needles and threading with your eyes closed!

At this time, Ruan Bin was manipulating the arterial guidewire and slowly exploring.

The calm and large hand senses the information transmitted by the arterial guide wire, so as to carry out the next transmission. How deep should the transmission be, and the direction control.

"It should be this position!" Ruan Bin roughly judged the distance and distribution of the femoral artery blood vessels and the external iliac artery blood vessels in his adults, then looked at how long the catheter in his hand had been in. Combined with the many experiences in his mind, he made an accurate judgment!
Chapter completed!