She was in surgery, her blood pressure dropped, the doctor found the culprit

A few days ago, an orthopedic surgery once again concerned all the staff in the operating room. During the operation, the patient's blood pressure dropped sharply and was very unstable. After routine operations such as reducing anesthesia and replenishing blood volume, there was still no obvious improvement. Continuous low blood pressure is definitely not good. If low blood pressure lasts for a long time, various organs will be damaged due to ischemia. Therefore, the cause of low blood pressure must be found as soon as possible.

However, it is difficult to find the cause through routine examinations, and it is obviously impossible to carry the patient to the CT room or ultrasound room for examination.

At this time, someone suggested that the transesophageal ultrasound system from the cardiac surgery room could be moved here for examination.

This proposal was immediately agreed by the director of the anesthesiology department. This is because, in the process of analyzing the reasons, the idea is actually quite clear: the factors for maintaining blood pressure are nothing more than vascular tension, blood volume and cardiac power. There was no obvious bleeding during the operation, and the fluid replacement was sufficient, so insufficient blood volume can be almost 100% ruled out. In terms of vascular tension, no vasodilator drugs were used, and it is impossible for acid-base imbalance to cause changes in vascular elasticity or peripheral resistance in a short period of time. Therefore, there is no clear reason for this. Finally, only cardiac power is left.

It can be said that cardiac power is an important factor affecting blood pressure. It can not only cause blood pressure to change in a short period of time, but also cause blood pressure to remain at a low level.

Someone at the scene raised an objection that the patient was less than 40 years old, was in good health, had no history of heart disease, and it was impossible for him to suddenly have heart problems.

However, the analysis made by the director of the anesthesiology department left him unable to refute.

The director of the anesthesiology department analyzed: This is not an ordinary patient. You know, this patient has been bedridden for many days due to fractures of both lower limbs, and the trauma of orthopedic patients themselves is enough to disrupt her coagulation-blood coagulation system. In addition, lying in bed for a few days has greatly increased the incidence of deep vein thrombosis in the lower limbs. During the operation, due to the large-scale operation itself and the impact on circulation, the blood clot is likely to fall off. The detached blood clot is likely to block the pulmonary artery with the blood flow. In other words, she had a pulmonary embolism!

When hearing the word "pulmonary embolism", almost everyone became nervous. This is because pulmonary embolism has a high mortality rate. Therefore, the top priority is to make a clear diagnosis and treatment as soon as possible.

Some people also want to say that this is an invasive procedure, that the patient has spent too much money, etc. However, they may feel that they are not making sense, and they mutter in a low voice, and almost no one can hear them.

While they were arguing, the machine was already pushed in.

In order to allow the probe to enter the esophagus accurately, everyone slowly put the patient into a near side-lying position.

After pushing the dental pad and catheter to one corner of the mouth, the director of the anesthesiology department held the front 1/3 of the probe and slowly pushed it forward. Soon, the image of the heart was clearly displayed in front of everyone.

While the operation was taking place, other anesthesia colleagues worked hard to raise blood pressure.

Soon, a blood clot in the left pulmonary artery flashed on the screen. At this point, everyone understood what was going on.

Afterwards, the probe observed that the right side of the heart was overloaded, which further confirmed the diagnosis of pulmonary embolism as the culprit.

Once a problem is discovered, an interventional specialist is immediately invited into the operating room.

After the blood clot was treated in a short time, the blood pressure gradually returned to normal, thus eliminating a fatal risk.