This miracle doctor just wants to be fired!

"What happened?! Everything was fine just now!"

Zhou Cheng grabbed the old man's wrist; his pulse was so weak it was almost undetectable.

Increased heart rate, decreased blood pressure, and decreased blood oxygen saturation are typical signs of shock.

Without a doubt, it was the increased pericardial effusion that triggered cardiac tamponade!

The nurse in the emergency room quickly said, "I don't know! Just now, the patient said he wanted to drink water. I had just poured him some when he suddenly complained of chest tightness, and then he became like this!"

At this moment, Fang Hang also ran over quickly, and his face instantly turned ugly when he saw the scene in front of him.

"How could this happen? He was fine at noon, and Director Wang said his condition was stable..."

As he spoke, his voice began to tremble, and he subconsciously looked at Zhou Cheng, asking for his opinion.

"Senior, go find Director Wang quickly!" Zhou Cheng stared at the continuously dropping blood pressure on the monitor, his brain racing as he considered countermeasures.

"The director went to a meeting in the administration building." Fang Hang paused.

"Then call him and tell him to come back right away!" Zhou Cheng shouted. "Then call Dr. Li in the operating room and tell him to come back as soon as he has time. Also, contact the cardiology department and have them send a senior physician for an on-site consultation immediately!"

"Received, I'll contact them right away!" Fang Hang nodded repeatedly, knowing that time was of the essence.

Every second that passes increases the risk to the patient.

Unlike at noon, the patient's condition deteriorated faster this time, and his blood pressure dropped even more drastically.

Zhou Cheng quickly made a judgment in his mind: if they waited for Director Wang or Teacher Li to arrive, there probably wouldn't even be time to save them!

He took a deep breath and gritted his teeth: "I'm afraid it's too late! There's no time to wait, I'll do it! Zhao Wenqi, quickly get the pericardiocentesis kit, lidocaine, and other emergency medications ready!"

Zhao Wenqi also came to the emergency room to help. When she heard Zhou Cheng's words, she was taken aback at first, but then she understood his plan: "Dr. Zhou, do you want to perform a puncture now?"

"Yes, we can't wait!" Zhou Cheng said in a deep voice.

Whether it was Director Wang Jianming, who was attending a meeting in the administration building, or Li Degang, who was in surgery, or the consulting doctors from the cardiology department, none of them could be present for the time being.

Upon hearing this, Fang Hang couldn't help but worry: "Junior brother, you're going to do a blind trek? Is that really going to work? What if Director Wang finds out..."

"We can't worry about Director Wang now, saving lives is the priority!" Zhou Cheng interrupted him, adjusting the patient to a semi-recumbent position to expose the precordial region, and said to Zhao Wenqi, "Quick! Disinfect! Lay down sterile drapes!"

Zhao Wenqi nodded quickly and swiftly prepared the sterile supplies.

The more pressing issue now is that the emergency department is not yet equipped with mobile ultrasound equipment, so they can only rely on touch and experience for blind punctures.

The patient was an elderly man who was overweight and had a thick chest wall, making it difficult to accurately locate the path on the left chest.

Zhou Cheng made a quick decision and prepared to perform pericardiocentesis via the subxiphoid process.

This approach avoids the obstruction of the ribs and is more suitable for obese patients.

However, the path below the xiphoid process is more challenging to execute than the path to the left chest.

The puncture point is 1 cm above the midpoint of the line connecting the xiphoid process and the navel. The needle needs to be inserted at a 45-degree angle to the left, avoiding the liver directly below while accurately piercing the pericardial cavity.

A deviation of 5 degrees in angle could cause the needle to penetrate the liver or stomach, posing a higher risk than the left chest route!

"Junior brother, are you really going to blindly follow the path?" Fang Hang couldn't help but swallow hard, a mixture of worry and admiration rising in his heart. "Or should we wait..."

This is a blind styling session!

Even under ultrasound guidance, most people probably wouldn't dare to undergo a puncture.

Not to mention, performing blind puncture without any ultrasound equipment is extremely difficult and risky!

"The patient's condition is too much to wait!" Zhou Cheng took a deep breath, trying his best to calm himself down.

If he could wait, he wouldn't take such a risk to blindly traverse the area.

He yanked open the bag, put on sterile gloves, and quickly and steadily unfolded the sterile towel, placing it on the old man's upper abdomen.

The area below the xiphoid process has many skin folds, so disinfection must be more thorough. He picked up an iodine-soaked cotton ball and repeatedly disinfected the area from below the xiphoid process to above the navel three times, ensuring that the disinfection area covered a 10-centimeter radius around the puncture point.

Disinfection complete.

Zhou Chengyong pressed the tip of the xiphoid process with his left thumb and placed his index finger at the midpoint of the line connecting the xiphoid process and the navel, determining that the puncture point was 1 cm above his index finger.

This point must be far from the blood vessels at the edge of the xiphoid process, while ensuring that the needle insertion angle can reach the pericardial cavity directly.

"Senior, please stabilize the patient's shoulder and prevent him from moving!"

Seeing this, Fang Hang gritted his teeth and stepped forward to help.

Zhou Cheng picked up the syringe containing lidocaine with his right hand, first applied a wheal to the puncture site, and then slowly inserted the needle, tilting the needle tip 45 degrees to the left, to anesthetize the subcutaneous tissue and rectus abdominis muscle layer by layer.

He deliberately slowed down, drawing back the tube every 1 centimeter to ensure no blood or bile was drawn, thus avoiding accidental puncture of liver blood vessels.

After the anesthesia was completed, Zhou Cheng picked up the special pericardiocentesis needle, with a 20ml syringe containing saline solution attached to the end of the needle.

Blind puncture below the xiphoid process relies more on the pressure feedback of the syringe; when the needle tip passes through the abdominal wall tissue, a noticeable resistance will be felt.

Once the needle enters the pericardial cavity, the resistance will suddenly disappear, and the saline solution in the syringe may even be pushed back by the pericardial effusion!

Zhou Cheng used his left hand to stabilize the skin around the puncture point, and his right hand to hold the puncture needle, keeping it at a 45-degree angle to the left, and slowly inserted the needle toward the heart.

After advancing the syringe a certain distance, Zhou Cheng gently pulled it back while closely sensing the changes in resistance.

When he pushed it to 3 centimeters, he suddenly felt the resistance decrease, and Zhou Cheng's heart tightened.

Just then, the cardiac monitor next to the bed suddenly emitted a series of urgent alarm sounds.

"Junior brother, the patient's blood pressure has dropped to 65/40 mmHg again." Fang Hang couldn't help but exclaim, "Should we wait a little longer?"

"We can't wait!" Zhou Cheng didn't stop. He slightly adjusted the angle of the needle tip, avoiding the direction of the liver, and continued to slowly insert the needle while increasing the force of the aspiration.

Suddenly, the resistance under my hand disappeared instantly, and the pale red liquid flowed into the syringe through the needle.

This is hemorrhagic pericardial effusion!

"Success! We drained the fluid!" Zhao Wenqi exclaimed excitedly.

Zhou Cheng dared not relax, as the puncture needle along the subxiphoid route was more prone to displacement due to the patient's breathing!

He immediately pressed the base of the puncture needle firmly with his left hand, quickly pulled out the needle core, and then inserted the drainage tube along the puncture needle.

As the pale red fluid flowed continuously into the drainage bag, 300ml accumulated in just a few tens of seconds.

On the bedside monitor, the patient's heart rate dropped to 100 beats per minute again, and his blood pressure slowly rose to 85/50 mmHg.

On the hospital bed, the patient's breathing gradually calmed down. He slowly opened his eyes, still looking very weak.

Zhou Cheng immediately asked, "Grandpa, are you feeling any better?"

The old man nodded: "Thank you, doctor. I feel a bit better. I'm not as stuffy anymore."

Zhou Cheng breathed a sigh of relief upon hearing this.

Don't be fooled by his calm demeanor; his palms and the backs of his hands are actually covered in cold sweat!

Those last few minutes felt like a battle with death every second!