The Enhanced Doctor-Chapter 834: Another Bleeding Point?

(Thanks for the encouragement from the Speed and Passion monthly ticket)

"You came out just in time. 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. 𝑓𝑟𝑒𝘦𝓌𝑒𝑏𝑛𝑜𝘷𝑒𝘭.𝒸𝘰𝑚

Faintly, his heart was a bit excited.

He had always been fighting on the front line of emergency care, but recently he had been quite idle.

Xu Yino and the other six had successfully graduated, becoming formal residents at the Emergency Center. Their skills were quite good, handling general mild cases very well.

The General Surgery department at the Emergency Center is indeed strong and capable, so currently, the legendary Liu is somewhat "marginalized."

You can take it easy when it's busy, and that's quite pleasant. But when you want to be busy during idle times? There aren't as many opportunities. This makes Liu Banxia, who is used to a fast pace, somewhat unaccustomed.

Just like the on-the-spot surgery on the road and in the ambulance last time, although there was the thought of saving patients, his habit also played a strong role.

Seeing him ready, the four trainees in the Emergency Center quickly lined up behind him.

"What, you're all following me 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 supplement, abdominal bulging, suspected internal bleeding, left arm radial fracture, tourniquet applied." The paramedic 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 Hongmei 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 time.

"One, two, three, transfer the bed."

"Bedside X-ray, chest and abdomen, 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 seemed okay. Then, he auscultated the patient's heart and lung functions, his frown deepening.

"Call someone 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 abdomen, accompanied by bulging, looked particularly gruesome.

"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 time after connection, report promptly. What can you deduce from these indexes?" Liu Banxia asked.

"I..."

"One, two, three, Chen Hongmei, you say." Liu Banxia counted to three, then switched to another person.

"Indicates severe internal bleeding in the patient." Chen Hongmei quickly said.

"The abdomen'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 Hongmei hesitated for a moment 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 immediately began chest compressions on the patient.

"Teacher Liu, need a chest drain?" At this moment, Li Hao walked in.

"Hold on."

"Teacher Liu, charged and ready."

Liu Banxia and Chen Hongmei's voices rang out simultaneously.

"OK, you defibrillate, everyone clear." Liu Banxia said.

Chen Hongmei was suddenly nervous, but fortunately retained a bit of composure—perhaps due to previous medical training—she operated instinctively.

"Zap"

The patient's body arched, but the heartbeat did not resume.

"Charge to 200 joules, 1 unit of adrenaline intracardiac injection." Liu Banxia said, directly administering the adrenaline to the patient.

"Charged and ready."

Chen Hongmei shouted, her tone much calmer than before.

"Hands off"

"Snap"

"Heartbeat restored, but blood pressure is still somewhat 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 moment of hesitation and Xu Zhenkai hurried over to help squeeze the blood bag.

"Li Hao, and the four of you come on stage with me, Li Tianyang and I will prep in the operating room first," Liu Banxia said as he walked outside.

Li Tianyang returned without a moment's hesitation and chased after Liu Banxia.

"President Qi, the patient has severe internal bleeding, no time for other checks, tell the orthopedic doctors and surgeons to come 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 time; Liu Banxia resisted the urge to open up the patient in the emergency room. He judged that although the patient's blood pressure had dropped again due to the delay, rapid transfusion could stabilize it.

But the time to get on the operating table became urgent; there's hand scrubbing, gowning up, and gloving needed, which takes quite a while.

He trusted Li Hao's emergency skills, even if there were further complications with the patient, Li Hao could handle it, freeing this time 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 time," 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 emergency 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 medical 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 time 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 abdomen, blood, clots, and stool spilled out. Even mentally prepared Li Tianyang was startled by the sight.

Liu Banxia and Liang Xiaolin, however, proceeded immediately, 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 some blood and clots from the abdominal cavity, it was clear that the spleen was mostly shattered, and the colon had a two-centimeter longitudinal wound.

"Teacher Liu, I'm gowning up."

While Liu Banxia searched for the splenic artery, Li Hao's voice came over.

"Good, then take Linlin's place. Bleeding this severe, the mesenteric 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 extremely severe, solving the bleeding problem was the priority.

"OK, spleen removed, now looking for mesenteric 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 fragment," Liu Banxia cursed.

"Mesenteric 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.