Chapter 1128: Chapter 1128: Frenzy on the Rescue Table (Part 2)
(Thanks to Shang Chengjiu, book friend 20180307130147604, and Mangmangliu for the encouragement of monthly tickets)
"Why not defibrillate immediately? Isn’t it more dangerous the longer you delay?"
Zhang Hongfei blurted out in the observation room.
"It is indeed very dangerous. Whether successful or not, Teacher Liu is likely to bear responsibility," Su Wenhao, who was also watching, said.
"Senior Brother Su, do you know why Teacher Liu is doing this?" Zhang Hongfei asked.
"I can only guess. Considering the patient’s current condition, although there is a chance with direct defibrillation, the bleeding volume is too large. Even if sinus rhythm is restored, the patient could still be in danger due to excessive bleeding, possibly even dying."
"Teacher Liu is probably racing against time, aiming to control the main bleeding points within two to three minutes, which would give significance to defibrillation."
Upon hearing Su Wenhao’s words, everyone in the observation room widened their eyes.
Truly Teacher Liu, quite insane.
The usual procedure would be to defibrillate immediately, ensuring the doctor is not at fault even if the patient cannot be saved.
But Teacher Liu took a different path, opting for risky maneuvers, intending to perform many crucial operations within those two to three minutes, akin to an impossible mission.
Although CPR is being performed now, there are certainly issues with cerebral oxygen supply. The window of opportunity for resuscitation is becoming shorter, possibly leading to failure.
Even if resuscitation succeeds, delays might result in leaving the patient with aftereffects.
Therefore, Su Wenhao said regardless of resuscitation success, Teacher Liu could bear responsibility. It depends on how the patient’s family thinks and considers these aspects.
"30 seconds."
Li Liwei began to report the time in the operating room.
Liu Banxia made no response, decisively wielding the scalpel, freeing the patient’s left kidney.
Judged by standard criteria, Liu Banxia’s operation now would rate a "zero." It’s truly rough and causes substantial damage to surrounding tissues.
But everyone knows it’s all to save the patient time.
The damages caused now can be repaired later; if bleeding is not stopped, a life would be lost.
"One minute."
Li Liwei reported again.
Wei Yuan’s forehead slowly perspired, but he had no time to wipe it.
Realizing his role as the first assistant struggled to keep up with Liu Banxia’s speed.
If not for Li Hao assisting with stretching, his slower pace might have delayed Liu Banxia’s operation.
"One minute thirty seconds."
Li Liwei reported again.
"Left kidney bleeding temporarily stopped. Next, I’ll temporarily suture the liver to reduce bleeding. Wei Yuan and Li Hao find remaining intestinal tears, CPR at two minutes."
Liu Banxia spoke while his hands continued to move.
The liver laceration is long; now, there’s no time for surgical vessel clamping. The aim is as Liu Banxia stated, to temporarily suture the tear to reduce bleeding.
The abdominal fluid isn’t cleaned up yet, posing challenging tasks for Wei Yuan and Li Hao.
Within thirty seconds, they need to examine the patient’s intestines thoroughly without disrupting Liu Banxia’s operation.
"Wow, the suturing is too fast!"
"Teacher Liu is too incredible, I can barely see the movements."
"Less than ten seconds remaining, keep going."
"It’s doable, certainly doable. Dr. Wei also found an intestinal laceration, with considerable bleeding."
...
The observers began discussing and were apprehensive about the operating room’s actions.
It’s so tense; only Liu Banxia could make such insane decisions and persevere unwaveringly.
"Two minutes have passed."
Li Liwei called out.
"Hands off, shock."
As two minutes were up, even though Liu Banxia hadn’t completely finished suturing the liver, he stopped the operation.
"Pop"
"Continue compressions, two hundred joules, rub the blood bag vigorously."
Liu Banxia said, as he finished suturing the remaining part of the liver.
"Charging complete"
"Hands off"
"Pa."
"Charge again, administer another unit of adrenaline."
"Charging complete."
"Hands off."
"Pa."
"Alright, sinus rhythm restored, blood pressure is starting to rise."
Looking at the numbers on the monitor, Li Liwei’s voice had a slight tremor.
"Hoo... hoo... hoo..."
Wearing a mask, Liu Banxia slightly raised his head and took a few deep breaths.
To him, the recent operation had already pushed him to his limits.
Someone who had never experienced trembling hands, now found himself shaking from fatigue and excitement due to the extreme procedure he had just performed.
He gently shook his hand, "The first stage of the task is temporarily complete, flush the abdominal cavity, continue the exploration."
"Teacher Liu, you’re incredible."
At this moment, Su Wenhao’s excited shout came through the loudspeaker.
Liu Banxia turned around and glanced, "It seems like the operation just now was decent if it even got our honest child so excited."
Although the surgery was not yet over and the patient had not left the danger period, the observation room was immersed in a sea of joy.
Such operations are simply not found in books; if it were someone else, it might have been a different result. Who else could complete so many complex procedures in such a short time? Only Teacher Liu.
"Exploration reveals, the spleen has been excised after fragmentation. Fragmentation of the left kidney, excision surgery is feasible. There is a scratch about ten centimeters long on the liver surface, depth about five millimeters, temporarily sutured, feasible for partial hepatectomy." Xu Yino began to report.
"Two tear wounds at the colon area, measuring three centimeters and a circular wound, approximately thirty centimeters apart, feasible for bowel resection and end-to-end anastomosis."
"OK, then let’s proceed step by step." Liu Banxia said.
"Dr. Wei, my isolation of the kidney was somewhat rough, and I am still a bit tired, you and Li Hao take over for the remainder. I will assist Xu Yino first, and deal with the bowel."
"OK, leave it to me." Wei Yuan nodded.
Knowing that this was Liu Banxia creating an opportunity for him to perform surgery, and now with urology, kidney-related surgeries are relatively less frequent.
"Teacher Liu, two minutes isn’t a long time, it shouldn’t affect the patient, right?" Xu Yino asked while performing bowel resection and end-to-end anastomosis.
"It’s hard to say right now, it depends on how the situation unfolds." Liu Banxia replied.
"His situation is really rare, just such a small tube caused so much damage in the abdominal cavity. So try to avoid conflicts, fighting serves no good purpose."
"My Director Liu, in our emergency center, you’re likely the only fighting doctor, right?" Li Liwei joked.
Everyone in the operating room and observation room laughed, for in this area, if Liu Banxia were to claim second place, no one would dare claim first.
"Actually, each time I’m forced into it, what am I like? Something similar to a monk sweeping the ground, hardly making a move." Liu Banxia said earnestly.
"You guys, who are just watching the fun, also observe Xu Yino’s operations more closely, they’re currently handled quite well, meeting standards, and the speed is also good."
"As for technical points and all, I won’t waste my saliva here. You all have been in the emergency center for quite some time; bowel tear, bowel obstruction, and bowel perforation are also familiar cases to us."
"Everyone certainly has certain characteristics when operating. I don’t want each of you to be like a mold. As long as you ensure the quality of the surgery, you can have your own creative expression."
"Also to save me from taking you back for a review, my operation on the table today is not recommended for imitation. Even if you encounter such a situation in the future, restoring the sinus rhythm should be the primary principle."
Hearing him say this, whether it was Li Hao and Xu Yino operating in the surgery room or Su Wenhao and the others watching outside, they became serious.
"When we admit patients, especially these emergency cases, we are bound to encounter some very complex situations, which require our judgment to choose." Liu Banxia said.
"But as doctors, while rescuing the patient, we also need to protect ourselves. You all watched the interview I did last time, right? I talked about this there too."
"This type of consideration seems cold-blooded, because regardless of what is done, there is always a certain success rate before it is attempted."
"But our choices in such situations must lean towards rational judgment. You can be a bit timid and opt for safe and standard procedures."
"However, I also understand that emergency doctors on the operating table often feel very ’high’. Thinking ’I can do it, I truly can,’ and thereby dare to attempt anything."
"This is basically to tell you, always be clearly aware of what your strength encompasses. Within this scope, if you attempt it, who knows, it might just work."
"But what if it’s far from this scope? It’s similar to the condition of cars getting inspected; theoretically, all these cars should meet design requirements, they should all be fine."
"Yet after coming off the line, they at least need to spend a few days at 4S with a heap of fault codes. Some cars even directly get scrapped; this is common news."
"Though the situation is not exactly the same, the rationale is roughly similar. Being able to recognize your own level, that’s what makes a qualified doctor."
"After all, we also have lives of our own. It doesn’t mean that just because you finished this surgery, your life ends. If an accident occurs because you insist on taking risks where you have options, it might affect your entire life."
"The path of medicine is long, I don’t want you to abandon it halfway due to reluctant reasons. Even if you decide to give up because it’s too exhausting, I will respect your choice."
These words sounded weighty in everyone’s ears; they are very real, not so grandiose.
Yet these are issues every emergency doctor faces and truly require careful consideration.
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