"The annular non liquid dark area in the pericardium can be seen on the four chamber view under the xiphoid process, excluding pericardial tamponade."

    The anesthesiologist used the fastest speed to do B-ultrasound according to Wu Mian''s requirements, and reported the results loudly at the first time.

    Wu Mian is quite satisfied. The anesthesiologist''s level is really OK.

    "Keep looking for blue points."

    "Well... This teacher, I can''t do well. You can teach me." the anesthesiologist is very magnanimous and can''t tolerate falsehood in emergency rescue, he said directly.

    Although he doesn''t know who Wu Mian is, he can''t pretend to have that powerful momentum and full details. Especially in the face of difficult severe rescue, people without ability will not move forward at all.

    The teacher''s cry was sincere.

    "Both hands, excluding the thumb, are placed on the front chest wall on one side of the patient. The little finger of the upper hand is close to the lower edge of the clavicle, the fingertip is in the middle of the sternum, the little finger of the lower hand is about the lower front edge of the lung, and the area covered by both hands is equivalent to the unilateral lung area; the third and fourth metacarpophalangeal joints of the upper hand are the upper blue point, and the lower hand is the lower blue point."

    Wu Mian said while the anesthesiologist did it. At the same time, several rescue methods have been simulated in Wu Mian''s mind.

    The anesthesiologist followed suit, said Wu Mian, and his movements were kept until. The overall movement is rapid and orderly. It seems that the anesthesiologist has learned or is learning, and has a certain foundation.

    Wu Mian felt the difference after "upgrading" for the first time and adjusted himself in a short time.

    Even Wu Mian himself couldn''t tell what was different. He just felt that the values displayed by various instruments were no longer static pictures, but continuous dynamic images.

    Nevertheless, the brain is not as headache and dizziness as before, but particularly cool.

    Director Xu stood and looked at it in a daze. He didn''t understand what Ren Haitao and Wu Mian were communicating.

    Using bedside B-ultrasound to judge the condition and adjust rehydration is a new diagnostic technology in recent years, which is quite sophisticated. Not many people have heard of it. Don''t say you can do it.

    "Hands, steady!"

    "The probe angle tilts 15 ° downward to the right."

    "Bat sign, pleural sliding sign, visible B-line, excluding pneumothorax and tension pneumothorax."

    "There is no dark liquid area between pleural cavities at bilateral diaphragmatic points, excluding hemothorax; there is no liquid dark area in spleen stomach space and liver stomach space, excluding liver and spleen bleeding."

    "On the four chamber view of the tip of the long and short axis near the sternum, it is found that the shape and movement of the heart are normal, the pulse is strong, but it is empty."

    Anesthesiologists continue to report.

    "The possibility of anaphylactic shock is high." Wu Mian calmly looked at various instruments and didn''t care much about the value of high-pressure 35 mm Hg.

    Hearing Wu Mian''s words, director Xu of anesthesiology department almost didn''t cry.

    Miss Wu, you are my brother. It took more than a minute for you to come to such a conclusion?

    Although differential diagnosis is very important, but... What are the patients like? Why do you still regard this emergency rescue as teaching!

    "Stop hydroxyethyl starch immediately, stop dexmedetomidine and remifentanil, and replace all infusion pipelines."

    "Director Xu, help, replace the infusion pipe on your right hand quickly."

    Director Xu still complained in his heart, and Wu Mian''s medical advice hit his head.

    "Intravenous pump injection of dopamine 10 ~ 15" μ g·kg－1·min。”

    "Adrenaline 0.2 ~ 0.4 μ g·kg－1·min－1。”

    "Dobutamine 10 ~ 15" μ g·kg－1·min－1。”

    "Norepinephrine 0.3 ~ 0.5" μ g·kg－1·min－1。”

    "Maintain the whole process and assign special personnel to watch."

    "Prepare B-ultrasound to guide fluid resuscitation."

    A series of medical orders, like the start of the nuclear power module, all the people in the operating room moved in an instant.

    The basic quality of the medical staff of the second hospital of Medical University is excellent. In the case of unknown reason, they quickly complete Wu Mian''s medical orders by relying on the body''s instinctive memory.

    Director Xu turned a blind eye and thought only one thing in his mind. B-ultrasound guided fluid replacement? What the hell is this!

    Rehydration is rehydration. Why do you need B-ultrasound guidance?

    General doctors, when facing shock and blood pressure, will certainly replenish a lot of fluids, and do not care about hypovolemic shock or other shock. Anyway, the low blood pressure is probably due to insufficient fluid.

    However, experienced doctors will judge that patients with anaphylactic shock have given adrenaline several times and done other symptomatic treatment, but the effect is not good.

    Anesthesiologist Ren Haitao just used B-ultrasound to judge that the patient is not pneumothorax and make differential diagnosis. Director Xu has heard of this.

    In director Xu''s memory, B-ultrasound can not be used to diagnose pneumothorax, because there is a vast expanse of white under the probe and nothing can be seen. How to diagnose? But I seem to have heard of similar technology recently.

    This is the latest technology for director Xu. He doesn''t understand what Wu Mian says next.

    It doesn''t matter whether director Xu understands or not, because there is only one king in the operating room.

    The rescue directed by Wu Mian continues.

    "Give methylprednisolone 40mg intravenously and put an ice cap on the head."

    "The patient is lying on the left side. Anesthesiologist, you pay great attention. Find the apical four chamber view to understand the left cardiac function."

    Wu Mian saw on the B-ultrasound screen that the ventricle was almost empty at the end of systole, and the * * muscle was almost in contact. The patient''s condition was particularly critical.

    "The rehydration speed is accelerated. We need plasma, fresh."

    "Anesthesiologist, IVC section under xiphoid process."

    Director Xu was crying when he heard the English abbreviations popping out of Wu Mian''s mouth from time to time.

    He is the director of the Department of anesthesiology. He is very dedicated and often stares at various journals and papers. Director Xu will attend domestic academic conferences whenever he has time.

    Director Xu doesn''t want to be eliminated by the times so early. Holding the technology of more than ten years ago, he has become a stumbling block to the progress of the anesthesiology department.

    Seeing teacher Wu Mian''s rescue and listening to all kinds of words that he didn''t understand, director Xu had a feeling that he was an intern.

    He also had extravagant hopes that he could stand up to the tide, take the anesthesia department of the second hospital of Medical University across the provincial level, and at least become a domestic first-class in technology.

    But the harsh facts silently told him that he was just the front wave flattened on the beach, and the back wave was in front of him... Wave, wave.

    "Miss Wu, I''m not familiar with IVC," said the anesthesiologist.

    "Probe, under the xiphoid process, with the marker point facing the patient''s head side."

    The anesthesiologist immediately adjusted the position and angle of the B-ultrasound probe according to the cold sound.

    "Shake... Anesthesiologist, listen to me. First shake the right atrium to the middle of the screen; show the point where the inferior vena cava flows into the right atrium and the hepatic vein flows into the inferior vena cava."

    "Wrist, pay attention to strength. Almost, no, come again."

    "What we need to do is to show the full length of the inferior vena cava. The echo of the anterior and posterior walls of the vein should be clear and sharp. Sharp, remember it is sharp." Wu Mian said patiently while controlling the overall situation everywhere.

    Rescue needs a lot of people. It needs a collective effort like a machine. If Wu Mian throws himself here, even if he knows all the rescue steps and his hands and eyes are like electricity, the rescue will still not succeed.