Chapter 446: How Do I Know that a Person Under General Anesthesia Is About to Faint?
Gretel's hand was steady.
His heart is also very quiet.
Fill the 20ml syringe with normal saline and insert it steadily into the vascular cavity of the stumped brachial artery. Hold the syringe with the index and middle fingers of your right hand, hold the piston head with your thumb, and push the injection forward slowly.
In the previous life, the injection needle used for blood vessel flushing should have a flat head to avoid damaging the lining of the blood vessel. However, Gretel did not expect this when he was making needles.
All needles are beveled! Let the gold coins be made and disinfected now, it's too late! When transplanting a severed limb, you need to race against time to minimize the damage...
He could only use his own steady operation to keep the needle parallel to the longitudinal axis of the blood vessel to avoid inserting the sharp needle into the inner wall of the blood vessel. Then, inject the liquid slowly and steadily, allowing the saline to enter the artery along the lumen of the blood vessel, and gurgling forward along the passage of the blood vessel.
Not fast, not slow. If it is too fast, the water column hits the lining of the blood vessel cavity, which will damage the extremely delicate intima; if it is too slow, the physiological saline cannot reach the end of the limb and then flow back along the vein.
The limbs have been severed, there is no heartbeat, no arterial contraction, and only the pressure given by the syringe can push the saline forward in the blood vessels. It is necessary to reach the end in order to flush out the accumulated metabolic products and clots in the tissues, and to expand the spasm and closed small blood vessels and capillary network.
In his previous life, he had never undergone replantation of severed limbs or organ transplants. What is the appropriate injection speed? He can only test it bit by bit based on his own estimation. Well, first of all, there is no pressure when injecting, which means there is no clot nearby, which is okay...
Inject one tube of normal saline, suck another tube, and continue injecting. Gretel muttered while rinsing:
"Oh, it would be nice if there was a pump... Flushing with a syringe can never ensure uniform and stable pressure... Heparin saline should be used here..."
"Heparin?" The silver dragon girl suddenly interrupted. Just like Grete, she pulled a floating saucer as a stool and leaned to the side to watch. Hearing Grete's muttering, he immediately asked:
"What is heparin? Is it squeezed out of liver?"
"Did you hear that?" A few steps behind the operating table, Elder Brock's voice was loud and his feather crest was vibrating:
"Master Healer needs a liver! Someone go and get a piece of liver! I need a fresh one!"
Under his heavy gaze, someone immediately turned around and ran out. Gretel Khan:
"Don't!"
Although heparin was, um, discovered from the liver, it doesn't mean that you can extract heparin by taking a piece of liver and squeezing the juice!
Whether it is unfractionated heparin or low molecular weight heparin, the production process is quite complicated and precise! If you give me a piece of liver, I won’t use it!
Besides, current heparin is mainly extracted from cow lungs or pig small intestinal mucosa, and it has nothing to do with liver...
The elder who ran out suddenly braked. Serila sat at the far end of the operating table, stared at the wounds of the severed limbs through her secret eyes, and asked in a low voice:
"What should we do?"
"What can I do? If I don't have it, I won't have it..."
Gretel answered dully through the mask. After all, saline flushing uses physical methods to remove blood clots; while the use of heparin prevents blood from coagulating again.
Well, as long as he connects the blood vessels quickly enough and throws in enough treatment techniques, he won't be afraid of blood clots!
"Grete, what are these red, blue, and yellow things?"
"Ah, these are the blood vessels and nerves I marked...the red ones are arteries, the blue ones are veins, and the yellow ones are nerves..."
"So later on, it's red after red, blue after blue, and yellow after yellow, right?"
"That's right. That's roughly it..."
Gretel stared at the wounds of the severed limbs and explained to her in a low voice. The mage's trick is so convenient. If it was in the previous life, silk thread would be tied on it to mark it when cleaning. Not to mention the difficulty of operation, blood vessels and nerves are so fragile. There will definitely be physical damage if they are pricked!
Behind the refuge hut, the elders gathered to listen to the lecture heaved a sigh of relief and almost knelt down in gratitude.
Miss Elf, you are so considerate! The healer answered your question casually, which saved us so much research time! Well, after I finish repairing the broken arm, I must give her a gift! Give lots of gifts!
Grete replied in a low voice, operating carefully and trying to maintain the stability of his movements. Seeing the red-stained flushing liquid flowing out, he breathed a sigh of relief:
Well, the flushing fluid is starting to flow out of the medullary cavity, which is good;
There is flushing fluid flowing out of the cephalic vein, basilic vein, and brachial vein, indicating that the physiological saline has reached the end of the limb and returned along the capillary network;
These three small points have been marked before and should be the radial accessory artery, middle accessory artery and superior ulnar accessory artery. The flushing fluid also flows out, great!
Of course, there were indeed bruises and swelling in some places, after all, it had been caught in a leopard's mouth. Gretel would clean up whatever he could. If he couldn't, he could only let him go for the time being.
After flushing the blood vessels, he assessed the situation and turned to Saivi, who was watching tremblingly with a broken arm hanging:
"Lie down, I'm going to start picking up!"
Sevi's face turned pale. Although I was mentally prepared, it still felt quite scary to actually lie down and be knifed. In particular, what he was given to lie on was not a table, but three disks connected together. They were slippery, translucent, and could move when pressed...
Situations are stronger than people. The elders of his tribe winked, and a group of spellcasters were watching him eagerly, so he had no choice but to climb up and lie down. A confinement spell fell, and he was immediately speechless, unable to move, and froze there.
"Well, it's not necessary..."
Gretel really wanted to say this, but when the words came to her mouth, she swallowed them back:
Replantation of amputated limbs in the arm, in theory, only requires anesthesia of the brachial plexus. However, considering the patient's acceptance of the operation, in order to avoid half-way through the operation, the patient jumped off the operating table and ran away. It is better to use general anesthesia!
No worries!
Anyway, magical anesthesia is not drug anesthesia. There is no problem of anesthetic metabolism, liver and kidney burden, etc. It is just numb...
He threw the silver skull and manipulated it to cut through Sevi's skin, stretch the muscles, and clamp the proximal blood vessels. Then, he raised his broken arm and compared the trimmed broken bones forward.
Alas, it was broken in the upper arm, which is relatively easy to reattach. There is only one humerus. If the forearm is broken, then the two bones are the radius and ulna. A colleague working in the orthopedics department once cried and complained that the two bones were reset together. The radius was healed, but the ulna was crooked. The ulna was healed, but the radius was misplaced again...
How can one cry when one hears it, and sad when one sees it.
Gretel had his own hands, the silver skeleton's hands, and five or six mage hands, flying up and down, busy non-stop. Clamp blood vessels, reshape broken bones, click with rongeurs...
During the previous debridement, Grete had already repaired the broken bone. Now, after incising the proximal skin and seeing the broken bones with his own eyes, he trimmed them extra carefully, smoothing them as smooth as possible so that they could fit together.
"Is it okay? Can I throw healing spells?"
Serila poked her head around, eager to give it a try. A ball of white light has condensed between your fingers, ready to be pressed anytime and anywhere. Well, Gretel is just a fifth-level priest with only a little bit of mental power. His mental power should be saved for more important things!
I'll do the treatment or whatever!
"Shh!"
Grete whispered to her to be quiet. Ah, I feel so unaccustomed to not making the cross section into a trapezoid, interlocking with each other, and not fixing it with Kirschner wires or screws...
But if it is shaped into a trapezoid, the bones and the entire arm will be significantly shorter. And here, the bone healing does not take too long, so there is no need to use trapezoidal bite, internal and external fixation to increase strength...
He calculated and operated. The heavy rongeur was as light as nothing in the hands of the silver skeleton. Click, click, click, after checking for a perfect fit, the previously stripped periosteum was re-covered on the bone stubble.
be careful!
Be more careful!
It is best not to injure the soft and delicate periosteum! Broken bones can easily grow back if they are covered by periosteum. Although the healing technique is powerful, if you can save a little, just save a little...
"Okay! Cerela!"
"coming!"
A group of white light condensed like substance descended. Gretel stared closely at the cross section of the humerus, watching the periosteum tightly wrapping the broken bone, and watching the gaps in the bones gradually close.
Lying down a little further, I took a photo with Cerela's headgear and looked at the bone seam at the far end that was bitten by the black clouded leopard. It was filled with the healing spell, and there were no more cracks...
sharp!
Excellent therapeutic skills!
Miss Silver Dragon competes high!
This healing technique is already stronger than the treatment of moderate injuries, it is enough to treat serious injuries! It completely fell on one bone. No wonder the bone immediately fit together, exactly the same as before it was injured!
Grete beamed with joy, raised his thumb to Cerela, and continued working. Well, now that the bones are fixed, next comes the blood vessels. If the blood vessels can be successfully anastomotic, the arm will be alive, and the only question left is how much function can be restored.
Gretel put away the silver skull, closed his eyes, and concentrated his mind. Then, the thumb and index finger of his right hand formed a circle and gestured to Miss Yinlong:
Magic magnifying glass, come~~~
"Too close! Move further! Further away!"
"Bigger magnification! No, I'm not asking you to make the magnifying glass bigger, I'm asking you to make the magnification bigger!"
"Crooked! Crooked! Raise the left side a little higher!"
"If you raise it a little higher, your hands will touch it! It will contaminate the lens!"
Facts have proved that the tacit understanding between Grete and Miss Silver Dragon still needs to be cultivated...
Up and down, stumbling. The magnifying glass was finally adjusted to a comfortable position for Grete. Grete concentrated on it and began to anastomose the blood vessels. Brachial artery, cephalic vein, basilic vein. With one movement and two stillnesses, the anastomosis of the three blood vessels was completed, and the blood vessel clamp was ready to be opened——
"Serila, prepare a healing spell! If he is dizzy, palpitating, or his eyesight goes black, cast a spell immediately!"
The blood volume has not been replenished and the blood pressure has not risen. Once the arteries are opened after the severed limb is reconnected, the patient's blood pressure will easily plummet!
At this time, we can only rely on healing skills to support the scene!
"...But he is imprisoned there, how do I know that he is dizzy and palpitating?"
"..."
"..."
This is a good question... If a person is under general anesthesia, you won’t know if he faints!
We should remove the blood pressure monitor as soon as possible!
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