The Enhanced Doctor-Chapter 588 Severe Burns

The meal took a little longer than usual; Liu Banxia had really been his chatty self today.

After saying hello to Shi Lei, he let Xu Hui take the interns back first, while he went with Guan Wei to visit Jiang Tao in the coloproctology department.

"My goodness, what do I see? It’s the renowned President Liu!"

Seeing Liu Banxia approach, Jiang Tao teased him.

"Director Jiang, are you trying to make me die of embarrassment? I can’t take it! It’s not easy for me, you know," Liu Banxia said with a playfully plaintive tone.

The other doctors in the coloproctology department laughed along. They were no strangers to Liu Banxia; this guy had even come over to give a guidance session on dressing changes before.

"Has your department been busy just after the New Year?" Jiang Tao asked.

"It’s been manageable. The current interns can help handle many of the patients, so we’re not too overwhelmed," Liu Banxia replied.

"Does the coloproctology department still send personnel to the emergency center? I heard there’s some disagreement. Personally, I think it’s a good idea."

"Hahaha, you’re never satisfied, are you? Always wanting more," Jiang Tao laughed.

"The point of contention is whether there’s a need for coloproctology in emergency care. Many coloproctological diseases are chronic, so some feel assigning our staff there would be an unnecessary waste of resources."

"For now, the disagreement is only in our department. The urology and plastic surgery departments will send people, probably within half a month."

"Sigh, I really do hope Brother Guan can go. But it’s true, this is a problem; it would cause some diversion of patients," Liu Banxia nodded.

"And there’s another point: coloproctology patients are somewhat unique. They require daily centralized dressing changes, which needs quite a few staff members—at least four would have to go from my department," Jiang Tao added.

"Looks like there’s no chance then. I was just hoping for more people and completely forgot to consider that issue," Liu Banxia said.

"Managing a hospital, well, we can’t always do as we please. We have to consider costs and expenditures. However, your figures for the past few months have been very impressive," Jiang Tao commented.

"That’s purely from slogging away, especially during the period before the New Year—the number of patients was just immense. Many couldn’t get registered in the inpatient departments, so they drifted over to our emergency center," Liu Banxia said with a wry smile. 𝕗𝚛𝚎𝚎𝐰𝗲𝗯𝗻𝚘𝚟𝚎𝗹.𝕔𝐨𝕞

"Otherwise, why would I be so eager to get all the departments fully staffed now? Actually, the patient flow has picked up. But it’s mostly minor issues; the only tense situation in the last two days was a car accident emergency this morning."

"I heard from Director Zhou that the city’s dispatch center has started sending us more cases. Supposedly, we’ve withstood the test and demonstrated a strong capacity for receiving patients."

"Tsk tsk, getting a bit smug, are you? When Old Xu comes over, let’s all have a meal together," Jiang Tao said.

"He even mentioned to me that he absolutely has to treat you to a meal. You were on your break, yet he pulled you in for surgery, and you didn’t hesitate at all. That was giving him a lot of face."

"You’re teasing me again. Both Chief Director Xu and you have helped me immensely. If I came for a meal and let you pay, how could I show my face around here? Wouldn’t everyone call me an ungrateful brat?" Liu Banxia replied.

"Chief Director Xu has given me a lot of guidance. Otherwise, I would still be clueless. The work ahead is only going to get tougher. It gives me a headache just thinking about it."

"A headache is better than being idle. Whether it’s receiving patients or hospital management work, being busy is not a fear; being idle is," Jiang Tao said.

Watching Liu Banxia chat so easily with Jiang Tao, the doctors in the coloproctology department were struck by a familiar thought: This young man really isn’t what he used to be. However, there was no jealousy in their hearts, only admiration. Liu Banxia’s stunning performance in the coloproctology department was something they knew they couldn’t achieve, at least not currently—neither his speed in changing dressings nor the patients’ comfort levels. That was true skill; it had to be admired. Why else would the director personally receive him as soon as he arrived? Even in the emergency center, Liu Banxia was now a key figure.

Liu Banxia didn’t dare to stay too long. After less than half an hour of chatting, he scurried off.

He was the chief resident, required to be on call 24/7, so he was already bending the rules.

"You came back just in time. We’re expecting a burn patient soon—someone injured in a car fire. Get changed and ready to receive the patient," Shi Lei said when he saw Liu Banxia.

"Oh my, why wasn’t the patient sent to the Municipal Hospital?" Liu Banxia asked, frowning.

"The injuries are quite severe. Despite intubation at the scene, the patient’s condition isn’t too good, so he was sent here," Shi Lei answered.

Liu Banxia nodded and quickly changed clothes and put on gloves.

He had dealt with burn victims before and knew such patients were prone to infection.

Just as he finished changing, the patient was wheeled in. A paramedic quickly reported, "Extensive burns to the chest and head, difficulty breathing. Intubated and given oxygen at the scene."

"Resuscitation Room Two!" Liu Banxia ordered, feeling a surge of tension.

He only took one look, but the severity of the patient’s burns was horrifyingly clear. The winter coat on the patient’s upper body was completely charred and fused to him.

His face was extensively burned. The extent of the chest burns couldn’t be determined yet, though his back seemed somewhat better. Both arms were also in bad shape, severely burned.

If the burns on his chest are also severe, we won’t even be able to connect the monitor.

"Transfer the patient to the bed! Establish IV access in the groin, start fluids! Draw blood, and notify the OR to prepare!" Liu Banxia ordered upon entering Resuscitation Room Two.

Seeing that the patient’s wrist area was relatively intact, Liu Banxia reached out and felt for his radial pulse.

"Radial pulse is around 96. Scissors!" Liu Banxia said after checking the pulse.

A nurse quickly handed over the scissors.

Taking the scissors, Liu Banxia began to carefully cut away the patient’s winter coat.

He dared not make any large movements, worried about aggravating the patient’s burns. Many modern winter coats are made of synthetic fibers, which burn more intensely once they catch fire.

Cutting down to the patient’s navel, Liu Banxia felt a slight sense of relief; the skin on the abdomen in the exposed area seemed undamaged so far.

But as he tried to cut further down, he frowned. The scissors wouldn’t go through.

He adjusted his position and tried cutting downwards from the collar.

This time was even worse; there was no purchase for the scissors at all.

"Damn it! Scalpel!" Liu Banxia called out urgently.

Miao Rui quickly handed him a surgical scalpel.

Liu Banxia took a few deep breaths and then sliced downwards with the scalpel.

The interns gasped. What is he doing? they thought. Slashing like that, isn’t he going to cut right into the patient’s abdomen and chest?

To their astonishment, as Liu Banxia’s scalpel sliced across, the patient’s chest actually moved, and the gasping motions at his neck became more pronounced.

"That was too close. We almost lost him," Liu Banxia said, his voice tight.

"Remember this for the future: with patients like this, where the chest area is completely charred, you must perform an escharotomy for decompression. This helps expand the skin on the chest and restore breathing."

"Because the chest is charred, the skin loses its elasticity, preventing the chest cavity from expanding. This can stop the patient from breathing. It’s not just about how long it takes; the intense pain can also contribute to asphyxiation."

"Take him to the OR for debridement. I’ll contact Director Xie at the Municipal Hospital to consult on post-debridement care for such extensive burns. The area is too large."

The interns quickly moved the patient towards the operating room.

They had seen it clearly: the patient’s chest was completely charred, clothes and flesh fused together. And what Liu Banxia had just done? A blind incision, made entirely by feel—so decisive, so masterful!

"Liu Banxia, why did you think of calling me?" As the call connected, the warm voice of Xie Chunli could be heard.

"Director Xie, I need to ask for your guidance," Liu Banxia said quickly.

"Our hospital just received an emergency patient with extensive burns to the face and chest. The burn area on the chest is probably over 50%. I’ve just performed an escharotomy to help him breathe."

"I’m planning to debride him next. After debridement, how should we care for such a patient? We don’t have experience with burns this extensive. Standard protocols probably won’t be sufficient, right?"

Xie Chunli was silent on the other end for a moment. "Banxia, patients like this are very difficult to manage. The prognosis is extremely poor. They might even develop multiple infections and sepsis."

"There are no special tricks, really. Your debridement technique is perfectly fine. Thorough debridement is crucial for recovery. However, the pain during the recovery period... it’s not something an ordinary person can endure."

"This is the initial trauma phase. After you finish debridement and the anesthesia wears off, the pain will be excruciating. You must provide good psychological support for the patient; otherwise, it’ll be very tough for him to pull through."

"Understood, thank you. I’ll do my best. If I encounter anything I’m unsure about, I’ll consult you again," Liu Banxia said.

"That’s the way it has to be. This case is much more complex than the firefighter you debrided last time. I have another surgery shortly; I’ll come over to your hospital to take a look after I’m done," Xie Chunli said.

"That would be wonderful! Thank you so much!" Liu Banxia was so happy he almost shouted.

Actually, he had wanted to invite him, but he didn’t think he had enough clout. This wasn’t like an internal consultation within the Second Hospital; they were from different hospitals, after all.

For Director Xie to offer to come over himself, that was giving him immense face.

"Alright, you get busy then. I’ll chat with Old Zhou when I get there," Xie Chunli said.

"Great! I’ll treat you to a meal in our hospital cafeteria then. It absolutely has to be my treat," Liu Banxia said.

"Alright, alright. In that case, I’ll have dinner at your hospital," Xie Chunli said with a chuckle before hanging up.

Liu Banxia’s confidence grew a little. At least the immediate medical challenges were addressed. Now, it all depended on whether the patient could endure.

Just as Xie Chunli had said, for severe burn patients like this one, the key factor was often the patient himself.