Although Jiang Xu had decided to administer the antidote before the blood test results came out, he feared that it might still be too late.
Two minutes later, the patient's blood oxygen saturation suddenly began to drop drastically. The emergency nurse looked at Jiang Xu with a nervous expression, but before Jiang Xu could answer, Chen Qi suddenly spoke, "Mr. Jiang, the basic fetal heart rate is too fast with reduced variability!"
The fetus is most likely experiencing high intrauterine pressure.
Liu Ran was very surprised. "How could it be?"
Jiang Xu glanced at him and instructed, "Administer midazolam for sedation along with vecuronium for muscle relaxation."
Shen Fangyu continued, "Prepare for tracheal intubation."
The door suddenly opened, and a nurse came in carrying a test sheet. He gave it to Liu Ran, who was the closest nurse, and reported to Jiang Xu, "The cholinesterase activity fell below normal; the organophosphorus pesticide concentration was 135 ng/ml."
It was indeed organophosphate pesticide poisoning!
Liu Ran, who had finished flushing out the patient's stomach with the gastric tube, took the blood test sheet in disbelief and read it over and over, asking, "How could this happen?" He handed the test sheet to Jiang Xu with a surprised expression; in his eyes was a faint expression of admiration alongside disbelief. "How did you know?"
"I don't have time to teach you a lesson now," Jiang Xu said. "The patient's symptoms were unclear, so she probably took a small dose." He took the second test sheet from the nurse and read it with a grim expression.
Even after clearing her stomach and administering an antidote, Zhang Yun's condition was still not satisfactory.
"Treatment is too late." Although the amount of pesticide was small, it had already entered the bloodstream, and because of the previous delay, both the gastric lavage and the atropine injection appeared to be delayed.
"What does the family say?" Jiang Xu asked the nurse.
"They still insist that the patient did not consume pesticide."
"Understood." Jiang Xu agreed indifferently, his face unreadable.
He kept watching Zhang Yun's oxygen saturation level on the monitor, but the situation he wanted to see never happened.
Tracheal intubation did not save the mother's precarious oxygen levels, and Shen Fangyu sighed, "Call the ICU to prepare for hemoperfusion; we can only pray for the fetus' heartbeat to return."
No one wants their baby to be born prematurely if the requirements for term delivery are met, and if the fetal heart rate returns to normal, the baby should be able to remain safely in the mother's belly for the next two months.
However, perhaps because Doctor Shen spoke too much, just as he finished speaking, Xiao Chen exclaimed, "The basic fetal heart rate is 150 beats per minute, and the variability is very poor!"
Jiang Xu glanced at Shen Fangyu helplessly. The other party defended himself with a depressed expression on his face, "I'm not exaggerating."
However, when he had just finished his sentence, he suddenly remembered that when he was eating fried satay earlier, he had said whether Jiang Xu was glaring at him because he had made him pregnant...
"I will practice meditation with my mouth closed after surgery." Doctor Shen immediately assured.
With the fetal heart monitor in this condition, Jiang Xu knew that there was no other choice.
To save the mother, hemoperfusion is the last hope.
If the baby is expelled, the mother's blood flow must be delayed. According to Zhang Yun's condition, every second that passes could be fatal, but if the baby is not removed, this eight-month-old fetus will be stillborn in a very short time, dealing a second blow to the mother, whose condition is not good, and affecting the blood flow.
Furthermore, hemoperfusion influences hemodynamic changes, which may increase the chance of premature contractions or rupture of membranes, which will then force cessation of hemoperfusion and also increase the risk of fetal asphyxia.
Even in a real maternity ward, there was no such thing as bloodshed as seen in TV dramas. However, as long as they are still connected by the umbilical cord, the mother's and baby's lives remain tied.
And doctors never ask multiple-choice questions, or ask the patient's family to make a choice; all doctors will do their best to ensure that mother and child are safe.
Jiang Xu and Shen Fangyu had only one choice.
- A race against time to expel the fetus as quickly as possible, then send the mother for hemoperfusion.
And this choice is certainly a huge challenge to the operator's mindset and abilities, and is so tough that it is scary.
"Move to the operating room."
"Do it quickly!"
As soon as the two doctors gave the order, all the medical and nursing staff involved in the resuscitation began to move into the operating room in an instant, pushing instruments and delivery beds. Jiang Xu spoke very quickly all the way to the operating room, almost without pause: "Continue to check the condition of the fetus, prepare for a caesarean section, monitor the blood oxygen indicators directly -"
The fast speed made him breathless, and Shen Fangyu took over without hesitation: "Please request a neonatal consultation, tell the ICU to prepare for hemoperfusion, and tell them that we will finish up soon!"
Every second in the ICU was a race against death, but death in the Obstetrics department was so greedy that it always wanted to take two people at once.
When the group of people supported the hospital bed and rushed to the door of the operating room, a burly man suddenly stopped in front of Jiang Xu and grabbed him by the arm. Jiang Xu looked at him in surprise, and the burly man said, "Doctor, that's my wife you're operating on; remember, if anything happens, you have to protect the little one! Protect the little one!"
Jiang Xu didn't say a word and brushed his arm away.
"Protect the mother!" Shen Fangyu, following behind Jiang Xu, confronted the man angrily, "Next time you come to the hospital, remember to bring your face. If you really don't have one, turn left to the plastic surgery department on the eighth floor."
He usually smiled, but his suddenly cold face looked extremely scary. The man shivered and avoided Shen Fangyu's gaze.
Hospitals were the best place to witness the true face of humanity, and in the obstetrics and gynecology department, there were not only loved ones that made all the doctors and nurses jealous, but also scum that made people want to curse them.
The bearded man saw the operating room door close in front of him, and he spat viciously and muttered, "Are all doctors like this? Do you guys have any medical ethics? I'll complain about you!" After finishing, he grabbed a passing nurse and said fiercely, "What are the names of those two pale faces who just came in?"
The nurse stared at him blankly and raised her voice in disgust: "Security!"
Jiang Xu and Shen Fangyu immediately washed their hands to sterilize themselves. Sterile water flowed down as the two stood side by side, and Jiang Xu said bluntly, "I will lead the way." He lowered his head towards Shen Fangyu, "You will be my first assistant."
"You asked me, a deputy chief physician, to be your first assistant?"
"Didn't you just say in the office that you would take responsibility?" Jiang Xu didn't stop moving his hands and asked indifferently.
The talk in the office was about babies, and Shen Fangyu was very surprised: "You change your mood too quickly."
However, Jiang Xu no longer paid attention to him. He turned around and asked the young doctor beside him, "What is your surname?"
The young Chen Qi trained in another hospital and was not in his group, so Jiang Xu did not know him.
"Teacher Jiang, my surname is Chen."
Jiang Xu nodded, "You come too."
In the operating room, the doctors from the anesthesia department had prepared ECG instruments and monitoring. Two shadowless lamps were turned on at the same time, and the patient on the operating table was brightly illuminated.
The nurse helped Jiang Xu put on a sterile gown, and when he walked to the operating table with his arms raised, Shen Fangyu was naturally already standing in the position of the first assistant.
Jiang Xu glanced at him, and the latter stared at the ceiling, saying, "It's important to save lives; I'll allow it once."
He lowered his gaze, his glasses blocking the slight flicker in his eyes.