(Thanks to I’m Really Bad at Picking Nas, Book Friend 20180104091321611, Changhe Yuan, Naughty Dragon 1976, Idle Person Ah Idle Person, Flowing Year Ink Dawn, and Annani for their encouragent with monthly tickets.)
"A nine-year-old boy, in hypovolemic shock. He received blood and fluid replacent in the ambulance. Blood pressure is 40/70. He has a compound injury to his chest and abdon, and a laceration to the back of his head. He was receiving blood, fluids, and oxygen in the ambulance," said the paradic pushing the child.
"Resuscitation Room 1. Insert a central venous catheter and give a rapid blood transfusion after moving him to the bed," said Zhou Shuwen, pulling the stretcher.
"Patient’s family, please don’t interfere with the doctor’s ergency treatnt!" Zhou Li shouted at this ti.
"An eight-year-old boy, blood pressure 60/90, unconscious. He was flung against the car. There’s a foreign object in his right eyeball and a fracture in his left distal radius," the paradic from the second ambulance reported.
"Resuscitation Room 2. Doctor Wu, Doctor Qi, follow ," Shi Lei said, jogging alongside the stretcher.
"A six-year-old boy, unconscious at the scene, regained consciousness in the ambulance. He has an open fracture of his left tibia, blood pressure 50/80. Fluid replacent, oxygen, and Sufentanil for pain relief were administered in the ambulance," the paradic from the third ambulance stated.
"Brother Wei, I’ll take him to Resuscitation Room 3. Su Wenhao, you’re with ," Liu Banxia said.
Wei Yuan nodded.
"Move him to the bed, remove the backboard," Liu Banxia instructed upon arriving at Resuscitation Room 3.
"Little fellow, don’t be afraid," Liu Banxia said softly. "Uncle is going to check you over, and then you’ll feel much better after a little nap."
"Connect him to the monitor and draw blood. Su Wenhao, examine his chest and abdon. I’ll check the head injury. We don’t need to worry about the fracture for now; there’s no active bleeding, and there’s a pulse in his foot, so no major blood vessels seem to be injured."
Su Wenhao was taken aback. Could Teacher Liu tell just by briefly touching the child’s ankle while moving the bed? That level of sensitivity was incredible!
"Su Wenhao, focus," Liu Banxia said while examining the child’s head. "Because Sufentanil was administered for pain relief during the rescue, be ticulous with the ultrasound examination."
"Okay," Su Wenhao confird. "Heart and lung sounds are normal, abdominal bowel sounds are normal. I’ll perform an abdominal ultrasound." He imdiately began the procedure.
After examining the child’s head, Liu Banxia saw no external wounds or palpable fractures, which brought him so relief.
"The child’s pupils are also slightly asymtrical. Let’s get a head CT scan later. How’s the abdominal cavity?" Liu Banxia asked.
"There’s minor fluid accumulation in the abdominal cavity; it looks like a splenic laceration. Let’s also get a CT scan for a more accurate view," Su Wenhao said.
"Block the child’s line of sight; I’m going to examine the tibial fracture," Liu Banxia said.
A nurse quickly positioned herself between Liu Banxia and the child.
An adult would know to look away, but children are simply curious. If he saw his own injury, he might develop psychological trauma.
Liu Banxia first inspected the wound at the fracture site. Setting this bone is going to be tricky.
Although the child was fortunate that no major blood vessels were injured and the displacent at the fracture site wasn’t particularly large, the fractured bone surfaces were not regular. This ant that if he were to perform a manual reduction, every fragnt would need to be perfectly aligned. Even a slight misalignnt could significantly impact the child’s healing. Since the child was still in his growth and developnt phase, such an impact could last a lifeti.
The safest thod, of course, was surgery: properly expose the bone, and then perform a surgical reduction. But that would be quite invasive for a child who was just six years old.
"Teacher Liu, are you confident? Otherwise, we should just proceed to surgery," Su Wenhao suggested.
"Let try first. For him, avoiding even one surgery is crucial. Besides, the CT room is likely still occupied by the first two young patients, so we have so ti," Liu Banxia said, his hands gently probing the area as he spoke.
After the examination, he carefully cleaned the wound at the fracture site.
Once debrident was complete, Liu Banxia spread the thumb and forefinger of his right hand, pressing the web of his hand against the site. He positioned his two fingers on the fractured bone and then gently applied traction with his left hand.
Although the child had already received Sufentanil for pain relief, the traction still caused a sharp pain. The child cried out and then began to sob, his small body struggling instinctively.
At this mont, Su Wenhao and the others could appreciate the strength in Liu Banxia’s right hand; it held the child’s leg firmly in place while his steady left hand pushed the foot back into alignnt.
This process wasn’t easy. They could no longer see the fracture surfaces and had to rely entirely on tactile sensation.
After setting the bone, Liu Banxia frowned slightly and made a minor adjustnt with his left hand.
Ding! Consultation Completed.
Gained 200 experience points, 100 proficiency points for Diagnostic Skills, 100 proficiency points for Dressing Change Skills, and 100 proficiency points for Bone-Setting Skills.
"First, immobilize it with a splint and take an X-ray. When he goes for the CT scan, check his head and abdon. If those aren’t serious, get another CT of the fracture site," Liu Banxia said.
"Oh, and contact Orthopedics. Show them the films. It would be best if internal fixation can be avoided; otherwise, the child will have to go through more suffering."
Just because the system awarded proficiency points for bone-setting doesn’t an the reduction was actually successful. This isn’t a simple dislocation; an instrunt is needed to confirm.
"Got it," Su Wenhao nodded excitedly.
Although he had seen Liu Banxia perform bone reductions many tis, none had ever been as complex as today’s. Most were dislocations or simple fractures; today’s case had a very high difficulty factor. If the manual reduction just now was successful, it would genuinely spare the child a great deal of suffering.
This bone-setting technique was truly formidable.
However, he knew he could only watch in admiration; mastering such a technique was beyond him. That kind of tactile sensitivity in one’s fingers wasn’t sothing that could be gained through experience alone.
The X-ray, even just a frontal view taken right there, looked quite promising for now.
When Liu Banxia and the others left the resuscitation room, the area outside seed sowhat empty. Nurses were cleaning up the other two resuscitation rooms nearby.
"Brother Wei, how are the other young patients?" Liu Banxia asked.
"The first two are in sowhat critical condition," Wei Yuan replied. "The second young patient’s eyes can’t be saved; he’ll go into surgery as soon as his CT scan is done. The first young patient is the most severely injured, with massive bleeding in his chest and abdon; he was rushed straight to surgery."
"The one I treated had only minor injuries, just so abrasions. Those should heal well after cleaning and so rest. He was mainly suffering from shock, which will also take so days to recover from."
"My patient is being checked for any brain damage or edema," Liu Banxia added. "There’s so fluid in his abdon, diagnosed as a splenic laceration. But the problem shouldn’t be too severe; laparoscopy should be able to resolve it."
"Orthopedics will have to figure out the fracture. External fixation would be best, since the child is still growing. We really need to look after these kids, especially during the Spring Festival."
"Accidents like this happen every year. It’s just that if they don’t happen near us, they don’t grab our attention. With injuries like these, none of them are ever minor."
"It’s worse than that," Wei Yuan comnted. "They were actually quite lucky not to be hit directly by the manhole cover. The manhole cover hit a car, and the dislodged bricks and debris shattered the windows of a first-floor apartnt."
"There are still a few patients with minor injuries who ca in on their own in the treatnt room; they’re being debrided now. I suppose it’s a small rcy for those families that no one is demanding compensation from them."
"Oh, and the paradics ntioned a firecracker stall also caught fire. Two people were seriously injured and sent to the city hospital’s burn unit."
Liu Banxia shook his head helplessly. Setting off firecrackers during the Spring Festival was for celebration and excitent, but safety absolutely had to be a priority. With these things, it’s either no incident at all, or it’s a major one.
And this was likely just the beginning; the peak ti for fireworks hadn’t even arrived yet.
The CT results for the patient Wei Yuan was overseeing ca out first. Thankfully, there were no issues with the head. The results for Liu Banxia’s patient ca a bit later; thankfully, his head was also fine.
"Brother Wei, if the splenic laceration requires surgery, you can take Su Wenhao," Liu Banxia suggested.
Wei Yuan nodded. "Then I won’t stand on ceremony."
Patient numbers had been low recently, so surgeries were also infrequent. For surgeons, their hands could get itchy if they went too long without an operation. Not to ntion the extra inco from surgeries. No matter how small each fee, it all added up.
After waiting a bit longer, Su Wenhao called.
"How’s the situation?" Liu Banxia asked upon answering.
"The splenic laceration isn’t very severe, just minor bleeding. There’s also a senteric hematoma," Su Wenhao reported.
"Good. Then get an X-ray of the fractured leg. After that, explain to the child’s family that both areas need surgery. He’ll be taken to the operating room, and Dr. Wei will take you through the procedure," Liu Banxia instructed.
"Alright." Su Wenhao acknowledged and hung up.
"Treat the senteric hematoma as well?" Wei Yuan asked.
"Yes, let’s do it," Liu Banxia said. "With the child’s leg fracture, he probably won’t lie still in bed. If he ends up rupturing the hematoma, he’ll just suffer more. Since he’s already going for surgery, we might as well address it all at once."
Wei Yuan nodded. "Then I’ll go book an OR and head up there to wait. I’ll also ask Wu Mingyu about handling the fracture."
"Sigh... well, at least that’s so good news," Zhou Li comnted. "I wonder how those two children upstairs are doing."
"Let’s hope there are no complications," Liu Banxia said. "Things should be relatively stable now, so so staff can go eat first. We’ll have to wait until they’re out of surgery, and that probably won’t be quick."
Zhou Li nodded, not demurring on this matter.
On a day like today, they could only eat when they found a spare mont. Whether that would be early or late, no one could say for sure.
After treating such critical child patients, the atmosphere in the ER hall was not just quiet; it was also somber. After all, they were children, and such situations easily tugged at people’s heartstrings.
"Chief Director, what brings you here?" Liu Banxia looked up, saw Chen Zhenxing, and hurried over to greet him.
"How are things?" Chen Zhenxing asked.
"Director Zhou and Shi Lei have already taken the two severely injured patients to surgery," Liu Banxia reported. "Another patient, with a splenic laceration, senteric hematoma, and a left tibial fracture, will be going into surgery soon. Doctor Wei Yuan will be the attending surgeon."
"Then I’ll wait here with all of you for the results," Chen Zhenxing said. "It looks like today will continue to be busy. The city hospital is already swamped."
Liu Banxia nodded. This was just the beginning. Once night fell, there would be various festivities, aning more crowded places and a higher chance of accidents.
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