"Teacher Liu, do you think there might be a hematoma in the iliac artery?"
Li Hao asked.
Liu Banxia shook his head, "Although we don’t have a clear surgical field, I’ve just felt around there, and everything seems fine. I actually think it’s purely a coagulation issue."
"Especially the platelet count; even if it’s not extrely low, it’s an indicator. Just like coagulation ti, when these factors co together, there’s certainly a problem."
While talking, Liu Banxia continued working with his hands.
"That’s why I didn’t ask you to call the cardiac doctors earlier because I think there must be other symptoms we haven’t identified yet." Liu Banxia continued.
"That’s the main factor. For us, clarifying that is the most important. Hmm... Li Hao, examine the patient’s body."
"Huh? Teacher Liu, examine now?" Li Hao was startled.
"If not now, when? Be thorough with the examination." Liu Banxia said.
"Alright."
Li Hao responded and started examining.
He wasn’t doing this for the first ti, as Liu Banxia often checks for other physical symptoms on patients.
So patients describe their symptoms vaguely, while others selectively forget them. The body can provide answers, as many symptoms manifest physically.
However, it’s Li Hao’s first ti examining a body on the operating table. Even others in the operating room hadn’t experienced sothing like this.
The task fell to him, while Liu Banxia continued handling his work.
"Teacher Liu, I didn’t find anything else, but the bruises on the patient’s legs seem off." Li Hao said after examining for a while.
"Be more specific." Liu Banxia said.
"When we admitted the patient, I noticed the left leg was severely compressed by the car door. But the right leg only had minor impacts, so the bruising shouldn’t be this extensive." Li Hao continued.
Though Liu Banxia didn’t speak, he was pondering.
It’s because he frequently performs liver surgeries, developing a significant degree of muscle mory. Otherwise, he wouldn’t be able to execute such intricate procedures while being distracted.
Xu Jie glanced at Liu Banxia, understanding he was contemplating the problem.
Curious whether Liu Banxia could discern the patient’s condition.
He was quite anxious as the patient had been troubleso all day.
"Continue observing, and pay attention to signs of bleeding in the urine bag, soft tube incision, and nasal cavity." After over five minutes, Liu Banxia said.
"Director Liu, you figured out the diagnosis?" Qi Wentai asked, sounding pleased.
"Let’s see if there are subsequent symptoms. I recalled a previous patient I treated." Liu Banxia said.
"But that patient had a much lower platelet count; it was thrombocytopenic purpura, and so symptoms match this patient."
"TTP?" Qi Wentai involuntarily murmured.
"It seems so, and the related symptoms agree. I’m not sure if it’s trauma-induced today, otherwise it should have so physical manifestation under normal circumstances." Liu Banxia said.
"Last ti, the patient took a long ti to diagnose due to severe bleeding. Now I worry if he can endure the treatnt."
"Teacher Liu, there’s blood in the urine bag."
As soon as Liu Banxia finished speaking, Li Hao shouted.
"Ah... the fear cos true." Liu Banxia sighed.
"President Qi, we need to speed up the process. Otherwise, controlling this condition is troubleso; try restoring liver perfusion within thirty minutes for the liver to function normally."
It’s inevitable since the common therapy for thrombocytopenic purpura is plasma exchange combined with corticosteroids.
If the bleeding is severe, a pulse therapy with larger doses is required. If the liver can’t assist, treatnt is almost futile.
Having identified a potential cause, Liu Banxia seed hopeful. Though tired, his hand movents quickened.
"Li Hao, check other areas of the patient’s vascular system for embolism signs. Also, check if there’s a significant drop in blood oxygen levels." Liu Banxia continued.
"Director Liu, let him watch the leg; I’ll monitor the rest." Xu Jie volunteered.
"Haha, Doctor Xu, I’ll have to trouble you. We need to determine if it’s thrombotic thrombocytopenic purpura or idiopathic thrombocytopenic purpura," said Liu Banxia with a smile.
"Director Liu, the patient’s nostrils also have mucosal damage and bleeding," chid in the circulating nurse at that mont.
"OK, this is a full mobilization; we can basically diagnose it now, and next is the classification," said Liu Banxia.
"From the current situation, the patient’s symptoms aren’t too severe; otherwise, such a serious injury wouldn’t give us so much ti for surgery."
"After the liver is repaired, tily dication will ensure he’s fine. When we’re done, it’ll definitely be past midnight. I’ll treat everyone to a late-night snack then."
"You just treated us tonight, and now you’re paying for a late-night snack too?" Xu Jie said with a laugh.
"It’s really tough; I’m exhausted. But our hard work isn’t in vain; there’s always a reward. Human life is precious, a late-night snack is nothing," Liu Banxia said.
"It’s also his luck; if we hadn’t taken so long to diagnose the condition before. I rember that patient was quite severe; they even considered performing a craniotomy."
"It’s also our luck, and that his condition wasn’t too severe. Otherwise, for such a major operation, we wouldn’t even have a chance to step down from the stage, and we wouldn’t have had any chance to save him."
"It’s fate; our luck is good, his luck is even better. Hang in there, hang in there a little longer, we’ll be done soon."
Everyone listened joyfully; it’s that familiar Liu Banxia, Director Liu again, so the patient must really be okay, or he wouldn’t be so relaxed.
What Liu Banxia said was not wrong; tonight, everyone was quite lucky.
If the patient’s TTP symptoms had been severe, the platelet count would have kept dropping. Bleeding couldn’t be stopped at all; there wouldn’t be any ti to isolate blood vessels.
The last patient led to intense discussion because he had head injuries and high intracranial pressure. This patient had injuries to the kidneys and liver, with significant liver laceration.
"Director Liu, blood oxygen levels have been stable, indicating hypoxia due to hypotension," Xu Jie continued after observing for a while.
"OK, you provide the oxygen, I’m about to finish here too. It should be idiopathic thrombocytopenic purpura; rember to administer dication shortly, with 0.5mg/kg intravenous drip of dexathasone."
"This counts as ITP, actually more common in children, with lower occurrence probability in adults. OK, liver’s done. Washing, restoring blood flow."
Hearing this, Li Hao rushed over to help as well. After restoring blood flow, they observed mild bleeding at the sutured site.
"Oh... our surgery was a bit slow. Keep packing for hemostasis, don’t close the abdon yet. Once the dexathasone takes effect and coagulation succeeds, we’ll close the abdon," sighed Liu Banxia.
"Teacher Liu, I think it’s quite good. Otherwise, after we close the abdon, if the patient bleeds profusely again, we’ll have to reopen and pack," Li Hao remarked.
"You’re channeling Xu Yino, hurry and pack, once done, we can rest, eat well and rest peacefully through the second half of the night," joked Liu Banxia.
Li Hao wasn’t bothered; the mood was joyful today.
After packing was finished, and the abdon wrapped, this ergency surgery was deed complete.
Ding! Ergency surgery task completed
Gained 600 experience points, 400 proficiency points for suturing skills, 300 proficiency points for dressing skills, 500 proficiency points for kidney surgery skills, 500 proficiency points for liver surgery skills, 8 Glory Points
Looking at the ager task rewards, Liu Banxia sighed inwardly.
It’s still because he was sowhat rough during the rescue; otherwise, for such a major surgery, how could he only get such a little reward.
Didn’t even get a rating; even a Flawless level would have been good.
Seems he still needs to work hard on training; ti constraints aren’t an excuse for clumsy techniques. It’s his technical skills that are lacking; the system doesn’t care about ti constraints.
When they wheeled the patient out, only his wife and friends remained waiting outside. Upon seeing the patient, she collapsed on the ground.
"Be strong, he’s still okay," said Liu Banxia.
"Because he has idiopathic thrombocytopenic purpura, so even after surgery, there’s still bleeding. We’ve administered treatnt, and now he’s being taken to the ICU."
"Once the dication takes effect tomorrow, we’ll close the abdon and then awaken him. Though tonight is still hazardous, the outco is leaning toward a positive side."
"Doctor, he’s really not dead? He can really survive?" The patient’s wife crawled up from the ground but hesitated to get closer.
"Let explain in detail shortly, we need to get him to the ICU," Liu Banxia replied.
This is a normal reaction; even for a married couple, seeing this scene isn’t easy to accept.
"Doctor, can he really survive?" At this point, one of the patient’s wife’s friends asked, loaded with doubt.
The previously cheerful mood plunged into an icy pit upon hearing this.
The implication is, considering current conditions and still being sent to the ICU, isn’t it just a scam for money?
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