The Enhanced Doctor

Chapter 1191: Chapter 1191: Another Success—It Really Is Director Liu

"I heard it’s pretty lively upstairs."

As Liu Banxia and his team arrived downstairs, Wang Chao came over.

"Indeed, there isn’t a single patient; everyone is here to congratulate us. Where is Shi Lei? Has he come down?" Liu Banxia asked.

"He came down; he is receiving patients now," Wang Chao replied.

"Enjoy this brief moment of leisure while you can. Once the number of patients really starts to increase, even the slightest chance of postoperative fever will keep you busy."

"Don’t say ’you guys,’ you’re an unofficial member of our second department as well," Liu Banxia said.

"Why can’t you let me off the hook? Actually, they don’t have any major issues. If things get really serious and they can’t handle it, I might struggle too," Wang Chao said with a bitter smile.

"The amount of work they’ve put in over such a long period is much more than other resident physicians. They’ve encountered more patients and gained rich experience."

"They’re still quite inexperienced," Liu Banxia said.

"Actually, our experience in receiving patients is accumulated during the process of caring for them, so we must pay extra attention in this regard."

"Anyway, you just can’t stand to see me relaxed," Wang Chao said helplessly.

"You are the chief resident; there’s no rule that says you’re only the chief resident of one department," Liu Banxia shrugged his shoulders.

"Director Liu, are you receiving patients? A car accident patient is about to be brought in, possibly with internal bleeding," Qi Wentai called out.

"Okay, I don’t have anything going on today anyway. Su Wenhao, get ready to receive the patient," Liu Banxia nodded.

Coming downstairs means helping out; if there’s work to be done, it must be done.

Su Wenhao didn’t hesitate and ran straight to the door of the waiting hall.

After less than five minutes, the ambulance arrived. What surprised Liu Banxia was that there were also two taxis following behind.

"The patient is 26 years old, a car accident victim. Blood pressure 110/80, heart rate 100, complains of abdominal pain, lost consciousness after getting in the car, fluid resuscitation and oxygen given on the scene," the paramedic who brought down the patient said.

"To the second emergency room, are the ones coming down behind also car accident patients?" Su Wenhao asked.

"They are with him, it seems to be a studio of some sort. Today is New Year’s Day, and they had an accident on the way to perform," the paramedic said.

"But the others aren’t as serious as him. On the way, they said he seems to be quite famous in the entertainment circle, but I don’t usually pay much attention."

"Doctor, doctor, you have to save Guang, he still has a performance today," a slightly burly man ran to Liu Banxia’s side.

"Of course we’ll save him, but you’re still expecting him to perform today? We don’t even know how severe the injuries are," Liu Banxia said.

"It’s okay, he might not have to go on stage, even a live stream is fine. That’s Guang’s idea; he’s in his rise period now," the man hurriedly said.

"Alright, let’s see his condition, but live streaming is not allowed in our ward," Liu Banxia left it at that and followed along to the second emergency room.

He still couldn’t quite understand how someone in such a state could still think about live streaming.

He had encountered more than once or twice where someone’s health was compromised for the sake of live streaming. There was a patient who did eating broadcasts, and it even caused his esophagus to tear from overeating.

"CBC, blood biochemistry, ECG, open a venous access; I will examine the patient," Su Wenhao said after moving the bed.

"Pupils not dilated; heart and lung sounds normal; bowel sounds normal. No abdominal muscle tension, slight abdominal distension, let’s do an ultrasound. What’s the blood pressure?"

"Blood pressure increased to 140/90, heart rate increased to 110, blood oxygen 97," the nurse quickly reported.

Su Wenhao furrowed his brows and began performing an ultrasound on the patient.

There was such a noticeable change in the patient’s blood pressure, something felt off.

"Teacher Liu, is there a hematoma in the spleen here?" After scanning with the ultrasound for a while, Su Wenhao asked.

Liu Banxia examined carefully and nodded, "It looks like it, but the ultrasound scanning is still not very clear."

"Dr. Su, systolic pressure is at 150," the nurse reminded again.

Liu Banxia remained silent, as Su Wenhao was handling the admission.

Su Wenhao frowned and picked up the blood pressure cuff to measure the patient’s lower limb blood pressure.

Liu Banxia nodded in satisfaction, as he had just thought of this himself.

With blood pressure first low then high, combined with the description of abdominal pain, one must consider aortic dissection.

"Teacher Liu, it might be aortic dissection, there’s a significant pressure difference between the upper and lower limbs; the patient needs an abdominal CT," Su Wenhao said after measuring the blood pressure.

Liu Banxia nodded, "Let’s do a rush scan..."

"Beep beep beep... beep beep beep... beep beep beep..."

Before Liu Banxia could finish, the heart monitor started beeping frantically.

"Blood pressure is dropping rapidly, blood oxygen is decreasing," the nurse quickly shouted.

"Increase fluid and blood transfusion, it might be a dissection rupture, notify the operating room to prepare." Su Wenhao bit his lip, then looked at Liu Banxia.

Currently, Liu Banxia had no relaxed expression at all.

An aortic dissection and a ruptured aortic dissection are two completely different concepts.

In the state of aortic dissection, you still have a lot of time to consider, but if it has already ruptured, what follows is rapid blood loss.

Blood and fluid supplementation might not be fast enough.

"It’s 90/70." The nurse staring at the monitor shouted again.

"We can’t wait for the operating room. Prepare for a left thoracotomy and descending aortic clamp. Notify Director Chen to prepare for artificial vascular replacement surgery in the operating room. He has experience and can save time." Liu Banxia said as he started putting on gloves.

"Su Wenhao, first intubate, then prepare for an abdominal incision. We’ll need to perform surgery right here. We must quickly find the site of the abdominal aortic rupture, clamp, and stop bleeding to reduce organ ischemia time."

There’s really no time left to consider. Although rapid blood transfusion and fluid supplementation have begun, the patient’s blood pressure is still dropping, which indicates that the length of this rupture may not be short.

We just examined the spleen with an ultrasound. Although there is also a hematoma, even if the hematoma ruptures, it wouldn’t cause such a drop in blood pressure.

Liu Banxia’s orders were issued quickly, but for performing two such significant surgeries in the rescue room, no one inside the room hesitated.

Everyone is aware that the patient’s bleeding is too severe, and if bleeding isn’t stopped in time, the patient won’t survive the trip to the operating room.

There isn’t much time for detailed preparation now. The iodine just washed directly over the patient’s sixth and seventh rib area on the left side, and Liu Banxia proceeded directly with the incision using the scalpel.

The patient is currently unconscious. Otherwise, the incision alone, if it didn’t cause the patient to pass out from pain, would still leave a psychological scar.

Su Wenhao wasn’t slow either. No sooner did Liu Banxia open the left thoracic cavity than he completed the intubation operation. Then, he picked up the scalpel, ready to perform an abdominal incision at any time.

After completing the thoracotomy, Liu Banxia directly inserted his hand inside and pressed down with a finger on the diaphragm.

"How’s the blood pressure?" After pressing, Liu Banxia asked.

"100/80, stabilized." The nurse shouted.

Liu Banxia nodded towards Su Wenhao.

Su Wenhao also proceeded to cut open the patient’s abdomen.

The amount of blood inside the abdominal cavity was substantial and began flowing out.

"Don’t panic, I’ve already compressed to stop the bleeding. Once you find the abdominal aorta, clamp the proximal end directly." Liu Banxia said softly.

"He has just this one bleeding site, it’s easy to find, just make sure to clamp accurately. Everyone should take notice, this composite emergency surgery significantly improves the patient’s prognosis."

"Otherwise, the time taken to reach the operating room and then perform the abdominal clamping to stop the bleeding, you can imagine how high the risk of ischemic organ damage would be over such a period."

"I can’t just press and release like a switch; that would cause even more damage to the patient. This type of surgery isn’t common, and it’s the fastest method to stop bleeding from a ruptured abdominal aortic aneurysm."

"Teacher Liu, found it, good heavens, there’s at least a four-centimeter-long dissection. This rupture was necessary, otherwise, as blood pressure rises, it would have continued tearing upwards." Su Wenhao said.

"Well done, Dr. Su remained very calm. This is exactly how it should be; emergency doctors, our hearts should be the steadiest, followed by our hands. Blood pressure?" Liu Banxia praised.

"130/80." The nurse quickly reported.

"Su Wenhao, stay focused. I’m about to release my hand, and if you haven’t clamped it properly, you’ll be reciting a thousand times in the lobby that you’re a pig." Liu Banxia said.

After speaking, he released his fingers and stared carefully at the clamping position Su Wenhao had just worked on.

"Director Liu, blood pressure stable, oxygen saturation at 97."

The nurse reported with a tone of delight.

Another success, as expected from Director Liu.

Now, even Su Wenhao wiped his forehead with his sleeve. He was sweating, and it stung his eyes a bit.

Don’t be misled by how orderly everything was when Liu Banxia issued commands. That’s the result of long-term experience and muscle memory.

But after Su Wenhao performed the abdominal incision and Liu Banxia completed the compression for hemostasis, everyone slightly relaxed, followed by a touch of post-fear.

Emergency care is all about the timing, and Liu Banxia seized this critical time.

This patient just underwent two major surgeries in the rescue room, both very successful, which will be greatly beneficial for the patient’s prognosis.

"Don’t panic, you’ll all have to try doing this kind of work in the future. Transport the patient to the operating room; I need to talk a bit." Liu Banxia said.

"Director Liu, I was just about to tell you, Director Chen has just started a surgery, so I notified Director Zhou." The nurse next to him said.

"You deserve praise for that, a very good reaction. Without waiting, you made a proper judgment." Liu Banxia said.

Being praised like this, the nurse felt a bit embarrassed.

Actually, it should have been reported immediately, but she got so engrossed watching the surgery that she didn’t do it sooner.

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