(Thanks to the incredibly handso Uncle Shuai and wen for the monthly ticket encouragent)
"Director Liu, I’m really curious, did you just rely on the touch of your fingers to determine the patient’s injuries?" Xu Jie asked.
"Pretty much. Actually, after a long ti of receiving patients, you beco more sensitive to the flow of blood," Liu Banxia said with a smile.
"The liver’s laceration is large and easy to feel. The kidney’s is a bit smaller, but the bleeding isn’t small. The spleen is okay; we haven’t had ti to confirm the stomach and intestines."
"It’s really just to make a general judgnt. The patient is losing too much blood, and even if we all get involved, there’s no ti to stop it. We can only pack to control the bleeding first."
"It’s amazing, I’ve been in this line of work for quite a few years. I also worked in the ergency departnt back then, but I’ve never seen anyone so nimble during exploration," Xu Jie said emotionally.
"From the patient’s current condition, the main bleeding points are probably just these two. His blood pressure is steadily increasing, and his heart rate is very stable."
"Next, we’ll see how lucky he is. If we’re lucky, we’ll handle it a bit smoother and at least keep him alive," Liu Banxia said.
"What on earth happened? Get in touch with the dispatch desk to see if any of his family mbers have been contacted. The situation is quite complicated, so it’s good timing to communicate while waiting for hemostasis."
The circulating nurse quickly contacted the dispatch desk.
"Director Liu, the situation is a bit delicate. The wife of this male patient has already arrived at the hospital, and the other person in the car is not his wife," the dispatch nurse said after the call.
"Uh... it really is a bit delicate. I’ll go out and take a look. Anyway, we have to wait a while for the hemostasis," Liu Banxia said, initially thinking the people in the car were a couple.
Once outside, there were quite a few family mbers waiting.
"Director Liu, which patient’s family are you looking for?"
Just as Liu Banxia was about to shout, Ma Limin walked over from the side.
"The family of the first male driver brought in," Liu Banxia said.
"Doctor, doctor, Lin Qiang is my husband," a lady ran over from the side.
"Co with . I need to explain the situation to you. Officer Ma, I’ll leave the order here to you," Liu Banxia said.
"Okay," Ma Limin nodded.
"Your husband’s condition is quite serious. There’s a lot of internal bleeding in his abdominal cavity. We’re currently using gauze packing to achieve temporary hemostasis and buy us so ti for resuscitation," Liu Banxia said.
"Our exploratory results show the liver has a laceration, and the right kidney also has a laceration. We’ll try to repair the kidney as much as possible, but if we can’t completely fix it, we’ll have to remove it."
"The liver’s situation is more complicated. I initially judge that a partial resection is needed. Does your husband have any underlying conditions like high blood pressure, heart disease, or diabetes? Any other conditions, or has he taken any dication recently?"
After asking, Liu Banxia found the patient’s wife had no reaction at all, as if she hadn’t heard him.
Sighing inwardly, he realized this was too much bad news at once, and she couldn’t process it.
He gently patted her arm twice and repeated what he had just said.
"No, no illnesses at all. Today was their company’s team building. He said he’d be back a bit late. I never thought... never thought getting a call would lead to this," the patient’s wife started crying as she spoke.
"Soone will co by later with so quick-surgery consent forms, since you weren’t here earlier and we had to proceed with the ergency surgery. Now that you’re here, we need to get your authorization," Liu Banxia said.
"Save him, doctor, you have to save Da Qiang. Our family has money; I’ll get my family to send money over right away," the patient’s wife said.
"Don’t worry for now; otherwise, I fear sothing might happen to you. Your words are enough. We’ll try our best to save him," Liu Banxia comforted her.
"You should find so other family mbers to co over and stay with you. Such a big matter isn’t sothing one person can handle."
"Doctor, you must save our Da Qiang," the patient’s wife said.
Liu Banxia nodded, "I’ll head back to the operating room now. As soon as his bleeding is controlled, we’ll proceed with the surgery."
He couldn’t stay longer; he had already got the necessary information, which was enough.
"Teacher Liu, the patient’s platelet count is a bit low, and the coagulation ti is a bit long, but it’s within the standard range," Li Hao reminded as he just walked back to the operating room.
Liu Banxia nodded, "I just asked his wife, and there are no underlying conditions or hereditary diseases. As for his dication history, that’s unknown for now as his wife was too flustered."
"In the case of low platelet count, observe continually during the operation. What’s crucial now is to stop the bleeding for him. Doctor Xu, what are the vital signs like? What’s the blood pressure level?"
"65/95, it’s already at the limit," Xu Jie quickly replied.
Liu Banxia gritted his teeth. Although it’s an operable indicator, the patient is under circumstances where packing is used for hemostasis. Moreover, there’s been such a large infusion of blood and fluid, so this indicator is less than ideal.
"Let’s make a rough judgnt for now. The liver and kidneys can be confird for sure. I now see his spleen seems to have slight edema, but I can’t tell if it’s originally this way or caused by the impact," Liu Banxia continued.
"The procedure sequence goes as follows. President Qi and I will handle the kidney and try to repair it. Although removal might stop the bleeding faster, to give the patient a better prognosis, I think we can take a chance."
"Li Hao, be sure to control the pressure of the gauze on other areas. It’s either the liver tear is quite large, or there are other bleeding points we haven’t discovered."
Li Hao nodded solemnly. This was the second ti Liu Banxia ntioned it, and it must be taken seriously.
Due to the patient’s low platelet count, naturally leading to impaired hemostatic function, if the team isn’t alert, it might revert back to the very initial state of ergency rescue.
But by then, Liu Banxia and Qi Wentai have already started managing the kidney, either removing it or racing against ti to stop the bleeding, risking the patient going into hemorrhagic shock.
"Alright, everyone, let’s stay alert," Liu Banxia said, frowning after a brief hesitation.
The others didn’t overthink, since they understood that the success of today’s operation depended on how quick and effective his actions were.
In truth, Liu Banxia encountered a bit of a hiccup.
He knew ti was of the essence, so he considered getting a compound for so aid. However, when he attempted to call the system, it was still updating, and even the store was inaccessible.
He could only cheer himself up, relying on his current skills as being sufficient.
Cautiously removing the gauze near the kidney, more blood oozed out. Liu Banxia’s only focus was to separate the blood vessels and clamp them quickly, then clear the perirenal hemorrhage and suture the tears.
"Actually, kidney laceration repair isn’t that difficult, far simpler than nephrectomy. But this procedure has its own points to note, Li Hao, tell us about it," Liu Banxia said.
"After incising the renal fascia and the encapsulating fat capsule, with the loss of restrictive pressure, bleeding might worsen, needing increased transfusions," Li Hao hastily responded.
"Be precise with clamping, especially when the renal pedicle hasn’t been freed or in poor surgical field conditions after freeing, caution is needed to avoid damage to surrounding organs."
"Not bad, you rember the key points solidly. Next ti a patient requiring kidney laceration repair cos by, you’ll handle it," Liu Banxia said.
"Indeed, removing the kidney is easier, unlike now being so cautious. The saying goes, destroying is easy but building is hard, probably like our current situation."
"Doctor Xu is monitoring the blood pressure. Even in such an ergency, he handled it, so it should be fine. Let’s speed up a bit. As long as we can stop the bleeding and repair, even if the technique is a bit rough, it’s understandable."
"It’s looking pretty good now; no damage seen to tissues and organs around the right kidney. Let’s flush the area, OK..., now it’s much clearer."
He muttered under his breath, aiming to ease his mind.
Each person has their own ways to handle crises and issues, and this was his thod. After all, his ace was the system, but it was upgrading and temporarily unusable.
If it were a typical renal injury patient, it wouldn’t be as challenging. This one, however, has a more severe liver tear, not an easy feat to manage.
"Now it’s clearer, quite deep. Let’s handle this first. Suturing the parenchyma later won’t be easy either. Doctor Xu, how’s the blood pressure?"
"There was a slight fluctuation just now, but it’s manageable," Xu Jie replied.
"Great, this surgery has three major hurdles. The first was his bleeding, which we’ve managed. The second was his right kidney, and so far, our decision seems correct and has worked," Liu Banxia stated.
"Next is the liver, the big boss of the operation, a real concern. Everyone, let’s put in extra effort, there’s no relaxing. Li Hao, how’s the bleeding in the liver area?"
"No signs of exacerbation currently, it’s slowly oozing," Li Hao quickly reported.
Liu Banxia nodded before continuing the operation.
Though he muttered under his breath, internally, he was exerting full effort.
As he ntioned, the liver is indeed the fiercest hurdle. Therefore, the kidney procedure shouldn’t consu too much ti, as even if the kidney is repaired, it would be pointless if we fail the liver.
If another ER surgeon were handling this, they might have opted for nephrectomy for ti-saving.
However, if the patient doesn’t survive the rescue, though Liu Banxia’s decision seems beneficial for the patient, it would require extensive justification to assess accountability should the family raise issues.
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