The Enhanced Doctor-Chapter 553 Rapid Postoperative Infection

(Thanks to Cake Baker, the book lover, and Xingyu sdc for the support with monthly tickets)

Everyone was used to Liu Banxia occasionally conspiring with the interns.

Liu Banxia could sometimes be quite mischievous. Yet, everyone loved his playful side, as it always helped ease tensions and liven up the atmosphere.

After all, these six were the first batch of interns at the Emergency Center. Compared to internal medicine, there was a general shortage of surgeons as well.

This shortage wasn’t in the numbers, but in the lack of skilled individuals who could really hold their own.

In high spirits, Liu Banxia had fried noodles, two units of rice, a chicken leg, a serving of braised pork ribs, one stir-fried cauliflower, and a bowl of egg soup for dinner.

For him, the idea of eating less for dinner didn’t apply. That might work for people with nothing much to do at night, but they needed to eat their fill to keep going.

Regardless, Liu Banxia’s appetite was impressive. Most people would have to cut back on their vegetables if they added a chicken leg.

Not Liu Banxia, though; he never left a grain of rice behind.

"The braised pork ribs today were good, really flavorful. If I hadn’t ordered the chicken leg, I would’ve gotten a double serving," Liu Banxia announced upon returning to the Emergency Center.

"Don’t you get tired of eating like this every day? Consuming that much meat at every meal?" Shi Lei asked curiously.

"I have to eat; otherwise, I wouldn’t have energy. I use up a lot of energy each day, so I need to ensure I have enough intake," Liu Banxia replied sternly.

Shi Lei shook his head, conceding defeat on this matter. He really couldn’t compare, despite not knowing what Liu Banxia had for dinner.

"Take this seriously, guys. The main team has gone for dinner, so you’re the main force now. Make your own judgments; don’t be careless," Liu Banxia advised.

The "six little ones," along with Qing Kewa, nodded collectively. For Qing Kewa, however, he was currently somewhat playing a supporting role. With no crucial study tasks, he just needed to participate normally in seeing patients.

Liu Banxia was living a pretty good life. Even though the interns still couldn’t fully stand on their own, he didn’t have to manage the ordinary trauma patients who came in.

"Banxia, could you go check on the kid in the ward upstairs who was impaled by the iron rod today? He seems to be showing signs of somnolence and is running a fever," Zhou Li said, walking over.

"Somnolence and fever? Did you call Dr. Chen?" Liu Banxia asked, furrowing his brow.

"He’s been called. Dr. Chen asked for you too," Zhou Li replied.

"Fine, I’ll go take a look," Liu Banxia nodded.

This was simply a matter of procedure. Even though Liu Banxia was the attending physician and chief resident, the child’s care should now fall to Chen Xuehai, the attending in charge, since the kid wasn’t in need of emergency care at the moment.

After all, the boy was now a cardiothoracic surgery patient, not a general surgery patient.

Arriving at the ward, Chen Xuehai was conducting an auscultation.

"The situation isn’t looking good. His breath sounds are a bit weak. Body temperature is 38.8 degrees Celsius, blood pressure is dropping, and his blood oxygen saturation is now 97%," Chen Xuehai commented after the auscultation.

"Do you suspect a postoperative infection?" Liu Banxia asked.

Chen Xuehai nodded. "The wound is clean, and not much time has passed since the surgery. Now his temperature is rising, and his vital signs are declining. I suspect it could be due to a postoperative infection. Let’s do an ultrasound first."

A nurse quickly wheeled over a mobile ultrasound machine.

After just a couple of scans, Chen Xuehai furrowed his brows. "Why is there so much pleural effusion? A CT scan is out of the question at this point; it’s too time-consuming. Notify the operating room. We’ll collect blood for testing after we get him in there."

Liu Banxia was taken aback too. The area where the young patient had been impaled by the iron rod showed significant fluid accumulation. If this is due to substantial blood seepage, the situation could become very serious, given the volume of fluid.

"I’ll contact the anesthesiology department," Liu Banxia said, pulling out his phone.

He was very thankful for the nurse’s sharp observation. If she hadn’t noticed the boy’s abnormal condition and called for help, the situation could have become much more critical. At the very least, he would need immediate on-site chest tube drainage.

After making the call and returning downstairs, Liu Banxia was still preoccupied with the boy’s situation.

It wasn’t a major operation. How could he develop an infection so soon after? Given his high fever and somnolence, it has to be an infection.

If it’s a surgical site infection, that would be dangerous. After all, it’s the lungs. It would likely affect the patient’s respiration, blood oxygen levels, and cardiac function.

However, there wasn’t much he could do at the moment. He would have to wait for both the outcome of the operation and the results of the latest blood tests.

"President Liu, are you busy?"

Zhang Xiao approached him.

"Not really, what’s up?" Liu Banxia asked.

"It’s about the patient transferred to our neurosurgery department today—the one with the cerebral infarction from the car accident. She’s now running a fever, coughing up blood, and has weak breath sounds. She’s been sent for a thoracic CT scan," Zhang Xiao informed him.

"What? She’s also running a fever?" Liu Banxia’s voice rose.

"What’s wrong? Are there other cases like this in the hospital?" Zhang Xiao asked in surprise.

Liu Banxia pinched the bridge of his nose. "The young patient who was admitted with her is also experiencing the same symptoms. There’s significant fluid accumulation in his chest injury area, which suggests possible seepage. Dr. Chen has already sent him straight to the operating room."

"Something’s not right. Could this be an outbreak of a hospital-acquired infection? Their preoperative examination results were all normal: one with a lung puncture wound, the other with a cerebral infarction."

"Sister Li, please have the nurses work a bit extra to check the temperature of each patient and their family members in the rooms. Also, inform the patients’ families not to move around freely for now, and have the public areas disinfected."

"Be careful with your tone and attitude when notifying them to avoid causing panic among the patients and their families. This is just our speculation at the moment. Also, the parents of the child—the ones who were with both patients—need to be temporarily isolated and have their blood drawn."

"Could it really be a hospital-acquired infection?" Zhang Xiao asked. "We also have a patient who underwent a craniotomy for a brain tumor today, and there were no issues with them. Could it be bacteria brought in from outside the hospital?"

"It’s better to be safe than sorry," Liu Banxia said. "Even if it was brought in from outside, it’s affecting patients now. Moreover, these are patients from two different operating rooms and two different wards, yet they’re exhibiting similar symptoms."

"Currently, one has pleural effusion, and the other is coughing up blood. Their common symptoms are weakened breath sounds and high fever. It might be a lung infection, which is not a good sign."

Hearing this, Zhang Xiao also grew anxious.

Indeed, if a patient developed a lung infection after surgery, it would be very dangerous. If they couldn’t quickly identify the source of the infection, it could affect the patient’s breathing.

At that point, they would have to be sent to the ICU and put on a ventilator. If the cause still couldn’t be determined, they would have to resort to ECMO—extracorporeal membrane oxygenation.

Judging from these two patients’ conditions, they both seemed to have acute pneumonia, and the illness was progressing rapidly.

"Wait for me. I need to tell the nurses to immediately deal with the bed and the sputum and blood coughed up by that patient, and to start a sputum culture," Zhang Xiao said before hurrying back.

After a slight hesitation, Liu Banxia knocked on the door to Zhou Shuwen’s office.

"What is it?" Zhou Shuwen asked.

"Director, a mother and child were admitted today. The mother had a head laceration complicated by a cerebral infarction. After thrombectomy, she developed a high fever, started coughing up blood, and has weak breath sounds. She’s now been sent for a CT scan," Liu Banxia hurriedly reported.

"The young patient has significant fluid accumulation at his lung surgery site. Dr. Chen has already taken him directly to the operating room. I suspect this could be some kind of infectious pathogen, and I’m worried about a hospital-acquired infection."

Zhou Shuwen frowned.

"The two were in different wards after their respective surgeries, but they are now showing remarkably similar symptoms," Liu Banxia continued.

"The only discernible link for their admission so far is the parents of the patient with the cerebral infarction. They have been in both wards. This is currently the only connection."

"What steps have you taken?" Zhou Shuwen asked.

"We’re checking the other patients, disinfecting public areas, and locating the parents I mentioned for temporary isolation and testing," Liu Banxia said.

"Good. But you forgot one thing: you didn’t notify the operating room," Zhou Shuwen pointed out.

Liu Banxia smacked his forehead and quickly picked up the phone.

"Operating Room 2."

The voice of the circulating nurse came through the line.

"This is Liu Banxia. Put it on speakerphone," Liu Banxia said.

"Banxia, what’s going on?" Chen Xuehai’s voice came through.

"The child’s mother is also showing symptoms of fever and coughing up blood. I suspect it might be some type of acute pneumonia, and it could be contagious to some extent," Liu Banxia explained. 𝙛𝒓𝓮𝒆𝔀𝒆𝙗𝓷𝒐𝙫𝒆𝙡.𝒄𝓸𝓶

"I can’t tell yet whether it’s a hospital-acquired infection or bacteria brought in from outside. The child’s mother is having a CT scan; I’ll contact you as soon as we have the results."

"Okay, we’ll put on protective gear," Chen Xuehai’s voice came over.

"How is the child’s chest? Is there a lot of bleeding?" Liu Banxia pressed.

"It’s not good. It’s pyohemothorax. We just took a sample and sent it to the lab for testing," Chen Xuehai responded.

"The child will need to be transferred to the ICU after surgery. I suspect sepsis has already set in to some degree. The child started having chills on the way to the operating room; I don’t know if we caught it in time."

"Just do your best. We’ll do our best out here too," Liu Banxia said, then hung up the phone.

"Banxia," Zhou Shuwen called out.

"Director, have you thought of any possibilities?" Liu Banxia asked anxiously.

Zhou Shuwen shook his head. "You handled this situation very well. Even I might not have thought of everything you did. You take the lead on this; I’ll observe."

"Ah... Director, sepsis... I almost panicked the last time I dealt with a case like this," Liu Banxia said, sounding flustered.

Zhou Shuwen frowned at him. "What’s there to panic about? You have to save the patient’s life. Anyone can panic, anyone can get flustered, but you can’t."

"I’m not saying I’ll wash my hands of it. It’s just that, based on the current situation, what I can do is also limited. Besides, you’ve been managing things for a long time now; you have your own rhythm. Go ahead and do what you need to do. I’ll provide support."

Liu Banxia gritted his teeth and nodded firmly.