Seemingly no dangerous painless gastroscopy examination, once the accident may be life -threatening

With the rapid development of comfortable medical care, many patients have chosen painless diagnosis and treatment techniques. For example: painless tracheoscope, painless gastrointestinal, painless abortion, etc. The majority of patients have enjoyed comfort, but there are disadvantages of everything, which brings huge work pressure to the anesthesiology department that the original person lacks, and the risk of painlessness is everywhere.

Today, let me talk to you about the painless gastroscopy!

On Tuesday, Dr. Wang and I were responsible for the anesthesia of the painless gastroscopy in the center of the endoscopy. We came to the endoscopic center early to prepare for the must -have equipment, medicines, disposable supplies, etc. Everything is ready, and immediately go to evaluate the patient.

Entering the waiting hall, the waiting hall that can accommodate 10080 people has been in vain, and the patients have also become two long dragons. Dr. Wang and I quickly checked the case, evaluated the patient, signed the anesthesia knowledge consent, charged ... everything is done in an orderly manner.

Entering the surgery, a female patient in her fifties was lying on the inspection bed, and the ECG monitor has been picked up by the nurse. At this time, I found that the patient was doing nails, but the blood oxygen on the monitor was normal. It just reminded a goodwill, trying to remove the nail art of a finger in the future, so as not to affect the judgment of the physician. At the same time, it was also found that the patient was painted with dark red lipsticks, and handed her a piece of paper, asking her to wipe off her lip.

At the beginning of anesthesia, the patient took a deep breath and slowly pushed into anesthesia. After twenty seconds, the patient slowly closed his eyes. Touching the patient's eyelashes and found that the eyelashes have disappeared, signal that laparoscopic doctors can enter the country.

For anesthesia doctors, the most critical moment of painless gastrointestinal is the stage of entering the border. On the one hand, it should not be too shallow and too shallow. Patients are moving and prone to various accidents, such as airway spasm. On the other hand, it cannot be tied too deep. During the examination, the patient must keep the patient breathing unobstructed. If it is too deep, it is very likely to have respiratory suppression. At this time, the gastroscopy occupies the throat again, and it is difficult for anesthesiologists to control the airway.

When entering the country, only when the throat was passed, the patient cough gently, considering that the anesthesia might be a bit shallow, so he added a little sedative medicine.

Suddenly, the alarm came from the guardians, and my heart just mentioned my throat. It was found that the blood oxygen flickered red lights, and the straight line dropped. My thoughts were running quickly, and a cold sweat was shocked. Experience tells me that severe respiratory suppression or apnea may occur.

After confirming that the patient did not breathe, the laparoster doctor quickly pulled out the gastroscopy. I dragged the anesthesia machine around me, immediately closed the mask, and pressed the oxygen. The laparistians are instructed to help press the thorax to help exhale.

Blood oxygen continues to decrease by 30%-40%about two or three minutes. It is difficult to distinguish whether there are lips and lips due to lipstick. But the heart rate has been normal. Continuously pressing under oxygen, the thoracic fluctuation is still not seen.

At this time, Dr. Wang also helped me prepare the intubation equipment. I thought that the blood oxygen would not be able to get the mechanical ventilation first! So as not to be hypoxic time, it will cause brain damage and leave sequelae.

When I gently raised my disgust, the patient had already reflected, and there was already a gas flow in and out. Tap his shoulders gently. The patient opened his eyes slowly, and the blood oxygen gradually picked up at this time. Taking a deep breath of his mouth, he still did not see the ups and downs of the thoracic. I set off her large pajamas, and everyone was stunned. It turned out that she was wearing a uniform in the chest and abdomen, and she couldn't even stuff up with two fingers. I turned around and asked the nurse, didn't you find it when he took care of it? The nurse's face was blank.

Moreover, the patient claimed that he had wearing his body for more than 20 years.

Unexpectedly, it was this bouquet of clothes that limited her breathing, and almost endangered life!

Twenty -four hours later, the patients were followed up, except for some chest discomfort, everything else was normal.

think:

First of all, as an anesthesiologist, keep in mind that there are only small surgery, no small anesthesia; surgery to treat diseases, anesthesia to save lives. Those who get the world are more important than heartbeat. Don't say how many years you have done, all the winds and waves have broken through, but you can still flip the boat in the small river ditch. Just like this "bodies" today, it is a painful lesson!

Secondly, what I want to talk to the endoscopic is that the throat must not stay too long during the enlightenment process. Because everyone's sensitivity is different, throat spasm may be induced at any time. Moreover, the throat cannot be qi, and the secretion of the throat after the qi may be blown into the trachea, causing the patient to cough violently. Not to mention water, that may directly enter the trachea, causing reflux and misusure, and severe suffocation may cause suffocation.

Finally, I have to say a few words to the majority of patients:

Be sure to prepare the gastrointestinal tract according to the requirements of the physician, and it must be sufficient for fasting and banning.

Do not conceal the history of the patient with anesthesiologists, and tell the physician to tell your doctor your past history, surgical history, and the history of drug allergies. To avoid misjudgment for the anesthesiologist for your life;

Do not make up before checking, make nails, and wear loose and fat clothes. Also remove jewelry, accessories, braces, dentures, etc.;

After the inspection, fasting for a certain period of time, so as not to fully recover the throat function, cough occurs, and may even cause inhalation pneumonia.

Do not sleep within 3 hours after gastrointestinal without pain, so as not to leave the residue of sedative drugs, leading to respiratory suppression. Do not drive within 24 hours, work at high altitude, sign important documents to avoid the impact of sedative drugs.

What else do you need to add? Welcome everyone to leave a message to communicate ~

Author: Sun Shuli, Nanhu Hospital, Tangshan Province, Hebei Province

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