(Thanks for the encouragent from the Speed and Passion monthly ticket)
"You ca out just in ti. Four car accident patients will arrive soon, two of them in critical condition. Help hold the fort, the resuscitation room is empty."
Liu Banxia had just walked out when Qi Wentai grabbed him.
"OK, I'll follow your lead." Liu Banxia nodded and hurried to the side to put on surgical attire and disposable gloves.
Faintly, his heart was a bit excited.
He had always been fighting on the front line of ergency care, but recently he had been quite idle.
Xu Yino and the other six had successfully graduated, becoming formal residents at the Ergency Center. Their skills were quite good, handling general mild cases very well.
The General Surgery departnt at the Ergency Center is indeed strong and capable, so currently, the legendary Liu is sowhat "marginalized."
You can take it easy when it's busy, and that's quite pleasant. But when you want to be busy during idle tis? There aren't as many opportunities. This makes Liu Banxia, who is used to a fast pace, sowhat unaccustod.
Just like the on-the-spot surgery on the road and in the ambulance last ti, although there was the thought of saving patients, his habit also played a strong role.
Seeing him ready, the four trainees in the Ergency Center quickly lined up behind him.
"What, you're all following today? That's fine. No need for the nurses to follow, they can help out later." Liu Banxia said.
"Poor kids, take care of yourselves." Wei Yuan glanced at the four of them.
The four new trainees showed no fear, as they had heard from their peers in the Proctology internship that Teacher Liu's hands were incredibly skillful, and his wound dressing technique was absolutely at a godly level.
After waiting for a little more than three minutes, the ambulance stopped in front of the door.
"Patient's blood pressure 70/95, heart rate 110, abdominal crush injury. Blood, fluids, oxygen supplent, abdominal bulging, suspected internal bleeding, left arm radial fracture, tourniquet applied." The paradic pushing the patient down said.
"Resuscitation Room One, after the bed transfer, Xu Zhenkai do an EKG, Zhang Hongfei open another IV line, blood replenishing. Chen Hongi collect blood, quick blood test, cross-match, Li Tianyang notify Orthopedics to prepare the operating room." Liu Banxia issued a series of orders.
The four of them tensed up, thinking tasks would only be assigned after entering the resuscitation room, but they didn't expect Liu Banxia to distribute the tasks in such a short ti.
"One, two, three, transfer the bed."
"Bedside X-ray, chest and abdon, left arm fracture site."
"Scatter."
At his command, everyone quickly dispersed.
Looking at the X-ray film, Liu Banxia frowned.
First, he used a penlight to check the patient's pupils, which seed okay. Then, he auscultated the patient's heart and lung functions, his frown deepening.
"Call soone in to perform a chest drain." Liu Banxia said, and then cut open the patient's T-shirt.
A long, wide crush mark on the abdon, accompanied by bulging, looked particularly grueso.
"Apply couplant. Xu Zhenkai, what's the index?" Liu Banxia asked.
"Blood pressure 60/90, heart rate 130, body temperature 36.3 degrees Celsius." Xu Zhenkai quickly replied.
"Next ti after connection, report promptly. What can you deduce from these indexes?" Liu Banxia asked.
"I..."
"One, two, three, Chen Hongi, you say." Liu Banxia counted to three, then switched to another person.
"Indicates severe internal bleeding in the patient." Chen Hongi quickly said.
"The abdon's bulging like this, even if the ultrasound interface isn't very clear, you can tell. Charge the defibrillator to 150 joules, be prepared." Liu Banxia said.
Chen Hongi hesitated for a mont but quickly got to work.
"Beep beep… Beep beep..."
As she pushed the defibrillator over, the ECG monitor sounded an alarm.
"Heart… heart stopped." Xu Zhenkai said nervously.
Liu Banxia imdiately began chest compressions on the patient.
"Teacher Liu, need a chest drain?" At this mont, Li Hao walked in.
"Hold on."
"Teacher Liu, charged and ready."
Liu Banxia and Chen Hongi's voices rang out simultaneously.
"OK, you defibrillate, everyone clear." Liu Banxia said.
Chen Hongi was suddenly nervous, but fortunately retained a bit of composure—perhaps due to previous dical training—she operated instinctively.
"Zap"
The patient's body arched, but the heartbeat did not resu.
"Charge to 200 joules, 1 unit of adrenaline intracardiac injection." Liu Banxia said, directly administering the adrenaline to the patient.
"Charged and ready."
Chen Hongi shouted, her tone much calr than before.
"Hands off"
"Snap"
"Heartbeat restored, but blood pressure is still sowhat low," Xu Zhenkai quickly reported, staring at the electrocardiograph.
"Fool, the low blood pressure is because of too much bleeding in the abdominal cavity, why aren't you starting rapid blood transfusion yet? Li Hao, right chest drainage, then push to the operating room," Liu Banxia said.
Prepared long ago, Li Hao started operating directly.
A mont of hesitation and Xu Zhenkai hurried over to help squeeze the blood bag.
"Li Hao, and the four of you co on stage with , Li Tianyang and I will prep in the operating room first," Liu Banxia said as he walked outside.
Li Tianyang returned without a mont's hesitation and chased after Liu Banxia.
"President Qi, the patient has severe internal bleeding, no ti for other checks, tell the orthopedic doctors and surgeons to co directly to the operating room when available," Liu Banxia said.
"OK, OR 4 is ready," Qi Wentai responded promptly.
"Great, notify Li Hao and the others," Liu Banxia said before running off.
This also saves ti; Liu Banxia resisted the urge to open up the patient in the ergency room. He judged that although the patient's blood pressure had dropped again due to the delay, rapid transfusion could stabilize it.
But the ti to get on the operating table beca urgent; there's hand scrubbing, gowning up, and gloving needed, which takes quite a while.
He trusted Li Hao's ergency skills, even if there were further complications with the patient, Li Hao could handle it, freeing this ti for him.
The three people remaining in the rescue room, watched Li Hao calmly and skillfully perform a right chest drainage on the patient, filled with admiration.
"Teacher Li, the patient's blood oxygen is dropping," Xu Zhenkai shouted.
"Don't panic, I'll intubate first, likely injured the alveoli during the impact, can handle it in ti," Li Hao replied.
"You'll get used to it, when treating with Dr. Liu or other doctors, you must not panic. Whether or not you've done ergency procedures before, unless it's directly life-threatening, just get to it."
"Otherwise, even with plenty of practice, your actions can falter. Now, how's the blood oxygen? OK, it's up. Push to the operating room, quick."
The three of them nodded and pushed the stretcher out with Li Hao.
"OR 4, Liang Xiaolin already there, Chen Xuehai handling reception, no contact with family, uncertain dical history," Qi Wentai remarked as they exited.
"Got it."
Li Hao responded verbally, but continued moving quickly.
He too knew, Liu Banxia was racing to save ti for the patient.
When they arrived at the operating room, Liu Banxia and others were already gowning and gloving.
"Teacher Liu, blood pressure still didn't increase, right alveoli possibly ruptured," Li Hao said.
"Leave alveoli to Linlin, move after shifting the bed, scrub hands," Liu Banxia instructed.
"Li Tianyang, assist with handling the abdominal bleeding, possibly ruptured spleen, lots of blood clots in the abdominal cavity. Suction may be too late, need manual scoop."
"While scooping, be cautious not to cause secondary damage to patient's abdominal organs. Linlin assist with opening up and handling alveoli, Li Tianyang may not keep up with my pace."
"Got it," Liang Xiaolin replied, moving to the first-assistant position.
Gloved up, Liu Banxia moved to the operating table, "Old Li, you're up next. Knife."
The surgical nurse handed Liu Banxia the scalpel.
With an incision made in the abdon, blood, clots, and stool spilled out. Even ntally prepared Li Tianyang was startled by the sight.
Liu Banxia and Liang Xiaolin, however, proceeded imdiately, pulling open the incision.
"Increase blood transfusion, bleeding too severe, suction," Liu Banxia instructed.
The situation was far worse than Liu Banxia had predicted.
After removing so blood and clots from the abdominal cavity, it was clear that the spleen was mostly shattered, and the colon had a two-centiter longitudinal wound.
"Teacher Liu, I'm gowning up."
While Liu Banxia searched for the splenic artery, Li Hao's voice ca over.
"Good, then take Linlin's place. Bleeding this severe, the senteric artery is likely also torn," Liu Banxia said.
"Banxia, speed needs to increase, blood pressure is dropping. Hold on, Doctor Liang," Li Liwei said.
The patient's injuries were extrely severe, solving the bleeding problem was the priority.
"OK, spleen removed, now looking for senteric vessels. Blood pressure status?" Liu Banxia asked.
"Hasn't increased yet, might be a third bleeding point," Li Liwei stated gravely.
"Damn, a liver laceration, hidden by a spleen fragnt," Liu Banxia cursed.
"senteric artery bleeding point found, clamping now," Li Hao announced, holding the intestines.
"Patient's blood pressure still low, Banxia, work faster," Li Liwei urged.
"Liver repair done, blood in abdominal cavity unchanged, continue searching," Liu Banxia said without any emotional tone.
The operating room atmosphere grew tenser, everyone knowing that this indicated a possible undiscovered fourth bleeding point, likely substantial too.
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