Doctor: Picking Up Attributes in the Hospital Chapter 164: A Double Blow—Discovery of a Brainstem Glioma!

"Dr. Zhao?"

The ergency room nurse, Wang Li, stood by, waiting for Zhao Heng’s instructions.

As an ergency room nurse, it’s fair to say that scenes like this play out several tis a day.

"Four units of Sodium Nitroprusside, 0.5 Esmolol bolus over 1 minute, maintain for 10 minutes."

Upon seeing the glaring red blood pressure numbers on the life monitor, Zhao Heng quickly made a decision.

This Sodium Nitroprusside is the drug of choice for hypertensive crises; it is a short-acting antihypertensive dication. Its nitroso groups decompose to produce NO, causing vasodilation, and it can dilate both arteries and veins.

As for Esmolol, it is a selective β-receptor blocker, mainly used for tachycardia and hypertension during anesthesia induction, tracheal intubation, intraoperatively, during anesthetic recovery, and postoperatively.

The reason Zhao Heng chose the combination of Sodium Nitroprusside and Esmolol was, on one hand, to quickly lower the blood pressure, and on the other, to stabilize the patient’s heart rate, preventing arrhythmias.

It’s fair to say that unless one is a seasoned ergency physician with decades of experience, such a comprehensive ergency blood pressure-lowering plan would be unimaginable.

"Alright, Dr. Zhao."

Upon hearing Zhao Heng’s instructions, Wang Li imdiately responded.

However, at this mont, Wang Li noticed a calm deanor in Zhao Heng usually only seen in senior doctors.

In no ti, Wang Li prepared the two dications and began injecting them into the patient.

Once the dication entered the patient’s veins, it took effect imdiately.

230/120

200/100

...

Three minutes later, the blood pressure dropped to 140/80mmHg; this blood pressure, at borderline hypertension, was now out of the hypertensive crisis.

"Senior, you can start the operation."

Seeing the blood pressure safely stabilize, Zhao Heng couldn’t help but breathe a sigh of relief and said to Liu Ziang.

"Alright."

Liu Ziang nodded.

He never doubted Zhao Heng’s ability to handle ergencies.

Every ti, Zhao Heng never let him down.

"Let’s begin."

Liu Ziang said to Li Yang and the two firefighter gentlen.

Next, Li Yang wrapped both ends of the rebar with cloth and then, with Liu Ziang, held each end of the rebar with their hands.

anwhile, the two firefighters, one used a hydraulic breaker to secure one end of the rebar, while the other held an angle grinder, gradually cutting the rebar, producing continuous sparks and a buzzing sound.

Soon, the part of the rebar sticking out of the laborer’s head was cut off.

The process looked extrely thrilling.

Once the portion protruding from the head was cut off, the laborer uncle was imdiately taken to the CT scan room for a brain examination.

Ten minutes later.

At the CT scan operation desk.

The laborer uncle’s head was already wrapped in thick bandages, and he lay on the examination table, ready for a brain CT scan.

Zhao Heng and Liu Ziang stood behind the operation desk, watching the real-ti brain images appearing on the electronic screen.

"Director Liu, this patient is very lucky. The rebar is only 0.5mm away from the middle cerebral artery."

The radiologist, Xu Jin, looked at the brain CT image displayed on the electronic screen and said sowhat amazed.

"Certainly lucky, otherwise, he wouldn’t have made it to the hospital."

Liu Ziang nodded.

Actually, each year, there are quite a few accidents on construction sites, and it’s not uncommon for workers to be penetrated by rebar.

There are always a few lucky ones who survive being pierced through the abdon, chest, or even the head by rebar.

At that mont, Zhao Heng noticed sothing amiss on the image on the electronic screen.

"Teacher Xu, can you enhance this area?"

Zhao Heng pointed to an area on the screen where the brain tissue density was significantly reduced.

"This area?"

Xu Jin was a bit puzzled, then looked in the direction Zhao Heng pointed.

"This... this is the brainstem area."

Just with a brief glance, the experienced Xu Jin was sowhat surprised.

The brainstem primarily functions to maintain vital life functions, including heartbeat, breathing, and digestion, all of which are related to the brainstem.

So, typically, lesions rarely occur in the brainstem area.

And if a lesion does occur, the situation is extrely severe.

"However, this low-density shadow could sotis be due to brainstem degeneration, which may not have clinical significance."

Xu Jin thought for a mont and then said.

"No, this is not brainstem degeneration; it’s a brainstem glioma!"

Looking at the area Zhao Heng pointed to, Liu Ziang said with a very grave expression.

"It couldn’t be, right?"

Xu Jin was sowhat taken aback by Liu Ziang’s judgnt; brainstem gliomas are extrely rare.

"It’s very possible. The co-workers who brought the patient ntioned that he fell from a two-ter-high scaffold. For an experienced worker, two ters aren’t a very high height. So, it’s highly possible that the patient had a sudden bout of dizziness, leading to his fall. Moreover, in the later stages of a brainstem glioma, cranial nerve palsy can also cause unsteady gait and ataxia, all of which could have contributed to the patient falling directly."

Zhao Heng pondered for a mont and said.

Back in the ergency room, Zhao Heng was already puzzled about this laborer uncle’s injury.

For soone who has long worked on construction sites, two ters isn’t considered a very dangerous height.

Many operations are carried out at heights of several ters or even dozens of ters.

Two ters is quite ordinary, and with such a height, if an accident causes instability, a person still has so reflex capacity; they wouldn’t just topple backward, falling headfirst into rebars penetrating their head.

"..."

At this mont, Xu Jin was at a loss.

Having a penetrating head injury and still being able to be taken to the hospital was already a miracle.

And now they even discovered a brainstem glioma!

The brainstem tumor has long been considered a "no-go zone" for surgery because the brainstem contains many nerve nuclei, conduction pathways, and reticular formations in a small area.

Brainstem tumors are mostly infiltrative gliomas, making surgery very difficult, prone to causing damage to essential structures within the brainstem, and surgery has a high rate of disability and mortality, with a poor prognosis.

Adding these together, Xu Jin didn’t even know how this surgery should be perford.

"Junior, do you have confidence in the anesthesia aspect?"

Liu Ziang asked Zhao Heng with a serious expression.

Given the patient’s condition, safely extracting the rebar from the head was already challenging enough.

Not to ntion, they would also need to simultaneously remove the tumor located on the brainstem.

The more daunting issue is that the brainstem controls the body’s vital functions like breathing and heartbeat. Performing surgery on the brainstem makes the patient susceptible to respiratory or cardiac arrest at any mont, highlighting the exceptional difficulty of providing anesthesia and maintaining the patient’s normal vital signs.