"Su Wenhao, have the lab results for your patient co out yet?" Seeing Su Wenhao pass by, Liu Banxia asked.
"We’ll have to wait a little longer. There are quite a few samples to check today, and so of them also need urgent processing," Su Wenhao replied.
"Alright, keep an eye on it and administer dication as soon as the diagnosis is confird. Have his family arrived?" Liu Banxia then asked.
"They’ve arrived, and I’ve provided them with an explanation. Teacher Liu, do we need to admit him?" Su Wenhao asked.
"Not for now, but we need to be cautious during intravenous therapy after the diagnosis," Liu Banxia replied. "Also, perform liver and kidney function tests on the patient before administering the dicine. He is elderly and has diabetes, so remind the nurse to be extra careful during the infusion."
Su Wenhao nodded and continued his work.
While Liu Banxia could leisurely peruse patients’ cases, the interns had a different reality. Still, they weren’t too worried; once the new interns arrived, they could delegate tasks to them.
Liu Banxia stretched her neck. After a day’s rest, working on familiar tasks felt a little exhausting. This was without even performing any surgeries. If she had to operate once or twice, the day would feel significantly tougher.
People are inherently prone to inertia. When she first took over as chief resident, she was full of energy. But now? She’d actually grown lazy.
"Dr. Liu, there’s been a severe car accident at the expressway intersection! Multiple injured individuals are on their way, including two in critical condition!" a dispatch nurse shouted at that mont.
"Okay, Shi Lei, Wei Yuan, if you’re free, prepare to receive patients. Interns, stand by. Notify Cardiothoracic Surgery, Orthopedics, and Anesthesiology. We might need to go into ergency surgery," Liu Banxia ordered.
Everyone sprang into action. Unless their current patients required imdiate critical care, they had to prioritize the incoming ergency patients.
"What’s with the last couple of days? Either no ergency patients co in, or when they do, they’re all major cases," Wu Mingyu, who had rushed over, comnted.
"A major accident on the expressway, two critical patients... this won’t be easy," Liu Banxia said with a frown.
"President Liu, you must have tid this for when I just got out of surgery," Chen Xuehai, who had also rushed over, remarked.
"It can’t be helped. Let’s see the patients’ conditions. We’ll wait at the entrance; there are quite a few of them. I’ll handle triage," Liu Banxia replied.
Hearing the commotion, Director Fang and his filming crew also hurried over. However, he was sensible enough not to interfere and simply fild from the sidelines.
Liu Banxia glanced back at him and gave a thumbs-up.
By now, they could hear the ambulance sirens, and everyone tensed up.
"Male, 37 years old, blood pressure 120/90, heart rate 65. Unconscious, head trauma, multiple lacerations on his upper body," the paradic reported as the patient was wheeled in.
"Shi Lei, Resuscitation Room One. Xu Yino, go with him," Liu Banxia ordered.
"Driver of the oncoming car: female, 26 years old, blood pressure 80/60, unconscious. Neck laceration, possible vascular injury, significant bleeding at the scene. We started IV fluids in the ambulance," the paradic from the second ambulance reported.
Without hesitation, Liu Banxia commanded, "Old Chen, take this one for now. We might need to perform an on-site vascular suture. Resuscitation Room Two. Su Wenhao, you assist."
"Passenger, unconscious at the scene, blood pressure 90/40, obvious collapse of the right chest," the paradic with the third ambulance relayed as they brought the patient in.
"Liang Xiaolin, you take this patient. Resuscitation Room Three. Wei Yuan, Liu Yiqing, assist her," Liu Banxia directed.
"Passenger: vital signs stable, two fractures in the left leg, no sensation in the left leg. Multiple severe injuries; the patient was run over by the fourth car after being ejected from their vehicle," the paradic from the fourth ambulance reported.
"Okay, Doctor Wu, Resuscitation Room Four. Miao Rui, you assist," Liu Banxia ordered.
"Passenger, right ulnar fracture, temporarily splinted at the scene, vital signs stable," the paradic from the fifth ambulance reported.
"To an examination bed, stand by," Liu Banxia ordered.
"Vital signs stable, multiple lacerations over the body, most wounds contain glass fragnts," the next paradic reported, pushing another gurney.
"How many more injured are there?" Liu Banxia asked the police officer who had accompanied them.
"Three more, but they all have minor injuries," the police officer hurriedly replied.
"Send this one to an examination bed as well; I’ll check on them later," Liu Banxia said.
She hadn’t expected so many patients at once, with four of them requiring treatnt in the resuscitation rooms.
The next three patients, as the police officer had stated, had minor injuries. However, "minor" was relative to the previous patients; many had extensive abrasions and deep lacerations.
Nevertheless, these weren’t very serious issues. They had received initial treatnt at the scene and only required wound cleaning and suturing. Her main concern was still the four patients who had been sent to the resuscitation rooms.
"Sister Li, please manage the two on the examination beds and these three for now. I’m going to check the resuscitation rooms, then I’ll co back to handle them," Liu Banxia said.
"Alright, you go ahead. Leave them to ," Zhou Li nodded.
Liu Banxia hurriedly jogged towards Resuscitation Room One, but before she could enter, she saw Shi Lei and Xu Yino walking out.
"No chance?" Liu Banxia asked.
"His blood pressure dropped drastically after he was moved to the bed. It rose after we administered norepinephrine and vasopressors, and then we intubated him on-site. On examination, his pupils were dilated and unresponsive; he was unconscious. He’s been declared brain dead. Neurology has been called to perform the final confirmation," Shi Lei explained.
Liu Banxia nodded. "Please go check on the patients at the examination beds first. Xu Yino, you co with ."
"Okay," Xu Yino quickly responded.
"Old Chen, what’s the situation?" Liu Banxia asked after arriving in Resuscitation Room Two.
"He’s stable for now. The wound on the maxillary artery isn’t large, only about a milliter, and we’ve temporarily controlled the bleeding. However, it still needs to be sutured in the OR. We’ve already administered blood products and IV fluids, and run blood tests and cross-matching. Will you take this case, Old Chen?" Chen Xuehai asked.
"Shi Lei just finished with his patient. Su Wenhao, take your patient to the OR. Old Chen, co with to check on Linlin’s patient," Liu Banxia said.
Upon reaching Resuscitation Room Three, Liu Banxia held her tongue. Liang Xiaolin and Liu Yiqing were currently inserting chest tubes for the patient, and it was bilateral drainage.
"You’re here just in ti," said Wei Yuan, who was performing a thoracic ultrasound on the patient. "The patient’s blood pressure is dropping quickly. There must still be bleeding in the thoracic cavity; blood transfusions and IV fluids haven’t managed to raise her blood pressure."
"Then let’s hand her over to Old Chen. I’ll book an OR for you. Sound good?" Liu Banxia said, looking at Chen Xuehai.
"Prepare a thoracotomy tray," Chen Xuehai said. "The pleural effusion has increased further and is likely compromising cerebral blood flow by now."
"Brother Wei, there are five patients at the examination beds. Please help take an initial look at them," Liu Banxia said.
"Alright. Is Shi Lei’s patient also going to surgery?" Wei Yuan asked.
"His patient is likely brain dead and is undergoing final assessnt. The second patient, who needed the maxillary artery sutured, was taken directly to surgery."
"Old Chen, Linlin, I’m leaving this to you. Liu Yiqing, stay here and assist. If anything else cos up, call again."
"Got it. Clear the room; I’m going to open the chest now," Chen Xuehai nodded.
Liu Banxia and Wei Yuan quickly exited. This was a thoracotomy, so they needed to ensure the best possible conditions.
The reason for performing an on-site thoracotomy was the critical concern for the patient’s cerebral oxygen supply. If the thoracic bleeding wasn’t controlled, even if they managed to get the patient to the OR, they’d likely end up with another brain-dead patient on their hands.
"President Liu, could you try to restore blood flow to the leg?" Wu Mingyu asked when he saw Liu Banxia enter Resuscitation Room Four.
"What about his other conditions?" Liu Banxia asked.
"We perford a primary trauma survey; aside from his leg, he seems okay. He was thrown from the car, which is actually quite lucky. We just need to clean and bandage his wounds. The main problem is his leg. It was severely crushed, and the bone is twisted, compromising blood flow."
Liu Banxia glanced up at the X-ray of the leg. The femoral fracture was severe, with overriding bone fragnts.
"Give fentanyl for pain. I’ll try to reduce it. Then you can take him directly to the OR," Liu Banxia said.
"Hmm... Wang Lei and the others should be able to manage. There’s another patient outside with a radial fracture. I’ll take a look. If I can handle it, I will. If not, I’ll call your orthopedic team."
"Alright, please help deal with this leg first. It’s been without adequate blood supply for too long," Wu Mingyu nodded.
Liu Banxia carefully palpated the patient’s fracture site. "Even with the painkillers we’ve given you, this is still going to hurt quite a bit when I work on it."
"Help immobilize him securely. If he struggles, the bone fragnts could sever blood vessels. That would make things very difficult to manage; amputation might be the least of his worries then."
"Doctor, don’t worry," the patient said, gripping the raised bed rail. "Just save my leg."
Liu Banxia felt the area carefully again. Then, gently cradling the fracture site with one hand, she began to pull steadily with the other.
"Aaargh..."
Even though the patient was sowhat prepared and the painkillers were working, the pain was more than he could bear.
"That’s about it. The fibular neck fracture can also be addressed in the OR. Blood flow to the leg has been restored," Liu Banxia said, wiping sweat from her forehead.
This wasn’t easy; it was far from a simple bone setting. The patient had overriding bone fragnts at the fracture site. It was hard to know what exactly happened at the scene. Perhaps he was run over multiple tis, leading to such an injury. But as Wu Mingyu said, being thrown from the car yet landing on the side of the expressway—he truly had cheated death.
"Doctor, thank you," the patient managed to say, clearly exhausted.
"You’ve had a close call; that often ans good fortune will follow. Focus on recovering well after the surgery," Liu Banxia said with a smile and a nod.
When she went back out, the main hall was even more crowded. These were likely the families of the patients who had just arrived, along with the less critical patients who had been brought in subsequently.
To her surprise, Ma Limin was also in the hall, helping to maintain order.
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