Chapter 98: Chapter 98 - 0096: Who is the blood donor?

Front to back fixation, posterior pedicle screws, anterior steel plates.

Flush, insert drain, sternum steel wire fixation, layer by layer suturing for each incision.

The wood likely had a sharp slanting surface, and after removal, the skin had no obvious defects but was merely pushed apart.

Quick but not hurried, everything linked neatly together, the surgery naturally came to an end.

“Blood pressure, 90/55mmHg——”

The blood pressure is starting to rise!

“Hemoglobin 68g/L”

About every 200 milliliters of blood can theoretically raise hemoglobin by 6g. Considering losses, an increase of 4-5g of hemoglobin is achievable.

Despite the low hemoglobin level of 68g/L, as long as there is no more bleeding, the life of the patient can be saved. For acute blood loss, if the hemoglobin exceeds 70g/L, a blood transfusion may not be needed.

Spinal cord transacted. This is a challenge in world medicine. From now on, the patient will spend the rest of their lives in a wheelchair.

The surgery lasted about forty minutes.

“Ding Dong, task completed, reward twelve thousand points, plus a super cultivation series treasure box.”

A robotic female voice, accompanied by subtitles in the top right corner of my field of vision.

“Son of a bitch!”

The sterile sheet was lifted, and Zhang Lin swore.

“Director Zhang, the patient with the ruptured liver and spleen has arrived. President Dong has assigned you as the Chief Surgeon.” Someone rushed into the operating room to call for Director Zhang, their tone urgent.

Once this surgery was over, Director Zhang and Director Li had nothing else to do. After removing their clothes and gloves, they found their backs soaked with sweat, cold and damp.

Director Zhang rushed to operate on the patient with the ruptured liver and spleen while Director Li had to deal with a patient with multiple rib fractures and a lung contusion. A deputy chief physician from his department was currently operating, but he needed to get on stage.

The entire operating room was operating at high speed, with all elective surgeries being halted. The capacity was being squeezed to the extreme.

The subsequent seven patients arrived in the operating room, except for the patients with lung contusion in the Thoracic Surgery Department and the ruptured liver and spleen in the General Surgery Department.

The Orthopedics Department had one case of severe leg crush injury requiring amputation. Another case involved a pelvic fracture with combined bladder and urethra injury and unstable blood pressure; Director Miao was operating on this patient with assistance from Director Wang Hansheng of Sanbo Hospital. Yet another case involved an exploded vertebral fracture resulting in paralysis, operated on by another Associate Chief in Orthopedics. There was also a case of severe perineal tearing; both intestines and uterus were exposed. Director Chen Xiaoqiao from Sanbo was operating on this patient. In the neurosurgery department, a patient with intracranial hemorrhage, brain contusion, and brain herniation could not be saved and was declared dead.

The stretchers were rushing in and out. Blood, fluids, medications, gauze, instruments were all transported to the respective operating room. Nurses were running around.

The Vice-Dean in charge of clinical affairs and the Director of Medical Affairs wearing observer gowns were shuttling between the operating rooms, coordinating resources.

“The patient in the Thoracic Surgery is suffering from cardiac arrest. They have performed open-chest heart compressions. Hurry!”

“General Surgery needs another one thousand cc of blood!”

“Obstetrics and Gynecology need assistance from General Surgery!”

Fires extinguished here were re-igniting elsewhere.

“Should we assist Director Miao with the pelvic surgery?” Director Tian asked Yang Ping.

Dr. Tao guided them into another operating room where Director Miao was waging an uphill battle.

“How’s it going, Director Miao? Need a hand?” Director Tian asked.

Director Miao was studying images on the C-arm machine. He was installing an external pelvic fixation device. The patient had a precarious blood pressure, and there was a risk of him not surviving the surgery.

Yang Ping was reviewing radiographs on the viewing box. The primary fractures were around the front of the pelvic ring. External fixation should manage bleeding.

“I am putting the external fixation to stabilize the pelvic ring. Let’s consult with Interventional Radiology for embolization if the blood pressure still cannot be maintained, do you think it is appropriate?” Director Miao sought Director Tian’s opinion. It was comforting to discuss matters with someone during critical times.

Director Miao’s experience was invaluable; his treatment plan was extremely reasonable.

“Okay, how is the rectum and urethra?” Tian asked.

“The rectum is fine, but the bladder is ruptured and the urethra is severed. We will first create a urinary diversion stoma. The urethra can be repaired during a second procedure once the blood pressure is stable.” Wang Hansheng was on stage assisting Director Miao in managing the bladder and urethral injury.

This patient could be stabilized. Nothing much to see in the amputation case, as long as it is amputated in time to avoid triggering acute renal failure.

Director Tian wanted to examine Chen Xiaoqiao’s patient. He called Yang Ping to come along, as Yang Ping was proficient in managing thoracic and abdominal trauma, which made Tian feel relieved.

In the Obstetrics and Gynecology operating room, the O & G Department Director was assisting with the surgery.

Due to an unknown injury mechanism, the entire pelvic floor was severely ripped apart, resulting in heavy bleeding, and both the intestines and uterus were extruding from the body.

The patient was set in a lithotomy position. Dr. Chen Xiaoqiao was leading the surgery with assistance from the O & G Department Director from Shipo Hospital, who was wearing high-heeled shoes.

“How’s it? Need any support?” Tian Yuan asked.

Chen Xiaoqiao was intensely focused on the operation and requested while operating, “Ask General Surgery to send someone over; the rectum and colon are also ruptured.”

“Call General Surgery!” Director Tian instructed Dr. Tao.

Just as the Chief of Medical Affairs was patrolling nearby, “I’ve already called. They’ll be here soon.”

“We need more blood, at least a thousand more,” Chen Xiaoqiao looked up at the monitor screen.

“It’s here!” Just as she finished speaking, a nurse rushed in with bags of blood.

A deputy chief physician from Orthopedics was operating on a patient with a burst fracture of the spine, performing a posterior decompression and pedicle screw fixation.

They had no difficulty performing these surgeries, unlike the thoracoabdominal penetrating injury just now. Without sufficient experience, the smallest mistake could lead to severe bleeding.

The patient from Thoracic Surgery had multiple rib fractures, a lung contusion, and flail chest. The patient was struggling to breathe, so a lung resection and rib fracture fixation were being performed when suddenly the patient’s heart stopped.

The vice president of the hospital rushed over and asked Director Tian and Yang Ping to take a look. Director Li, who had seen them perform an operation on an aortic rupture, knew their skill was on par with top hospitals outside of their own and Anzhen.

Director Tian and Yang Ping quickly switched locations. Director Li was manually compressing the patient’s heart.

“Sudden cardiac arrest, fibrillation, get on the stage!” Director Li saw Director Tian coming over and quickly informed him.

There was no time to scrub in. The two of them quickly put on the sterilized gloves handed over by the nurse, changed into surgical gowns, and put on another pair of sterilized gloves.

Director Li stepped aside. Director Tian took over, compressing the heart. After a while, the heart started to pulsate, but the contractions were weak: “Inject 1 ml of 0.1% epinephrine directly into the heart.”

The syringe was handed over, filled with 1 ml of 0.1% epinephrine. It was injected directly into the heart.

They continued the massage, and finally, the heart began to pump forcefully. The blood pressure went from immeasurable to 90/60 mmHg.

“Use dopamine to maintain blood pressure, administer 5% sodium bicarbonate intravenously, that should do it–” Director Tian pulled his hand out of the chest cavity, turned around, and swapped positions with Director Li.

“The heart has contusions, use some drugs to protect the myocardium, check the injection site for bleeding, if it is, apply pressure, if not, continue with the surgery.”

Director Tian and Yang Ping removed their gowns and gloves and went around to check on the other patients. When they confirmed that no other patients required immediate attention, they decided to rest a bit. They could assist whenever necessary. The group retreated to the resting room.

“The jerk is rather lucky, to have us operate on him, even had a volunteer donate him the Rh negative A-type blood.”

Zhang Lin was not appeased.

“Can we smoke here?” Liang Fatty asked Zhang Lin.

“After we leave, it’s not our problem,” said Little Five.

“Let’s go ahead, give me one. I’m irritated. We almost got sacked by him, and we’re helping him through the surgery, sweating buckets,” Zhang Lin was still angry.

Liang Fatty handed out a cigarette to each of Zhang Lin and Little Five.

“It’s no problem to curse, but we’ve got to save the person anyways. Give me one too,” said Director Tian, who did not usually smoke.

“I’m just irritated. Haven’t we saved the patient? Even during surgery, I didn’t delay a second with the forceps,” Zhang Lin lit up his cigarette.

Leaning back in his chair, Yang Ping said, “Pass me one too.”

“You don’t smoke, do you? Waste!” Zhang Lin rebuked.

Liang Fatty flicked out a cigarette, Yang Ping took one, and Liang Fatty helped him light it up, “Isn’t Director Tian a non-smoker too?” The five men filled the resting room with smoke.

A colleague, Shipo, an anesthesiologist from the same hospital, who had just done anesthesia with Liang Fatty, walked in for a sip of water, just in time to overhear their conversation.

Sitting down, he said, “Talk about luck, not only did he run into you guys, but he also encountered a diligent person with a lot of rescue experience at the site. Furthermore, the person who donated blood was the same person. Some things in the world are just this coincidental.”

Zhang Lin asked, “Are you saying someone saved him at the scene? And also donated blood for him?”

“Yes, the Emergency Command Centre couldn’t find A-type Rh-negative blood, they even asked for help in the group, and damn, there was one person in the ER, the same person who brought him in. Were they twins in a past life or something?”

As the man knew emergency procedures, he could be a doctor. When Director Tian thought of this, his heart tightened. For some reason, he suddenly thought of Director Zhu, whom he had coincidentally met on the road. Director Zhu’s car was right in front of the bus he was on.

Was it him? That couldn’t be; how could things be so coincidental? It would be too cruel; such a passionate person about medicine was ruined. Although he’s doing well in insurance now, it’s not what he loves.

He felt a sharp pain in his chest. He said to Yang Ping, “You stay here; I’ll go down to have a look.”

He had performed several surgeries here before, and the security guard recognized him; he was familiar with the hospital environment.

“Do you know where the person who donated the blood is?” Director Tian asked the anesthesiologist.

Being an anesthesiologist meant being a Mr. Know-It-All. He replied, “Professor Tian, let me find out for you.”

The anesthesiologist picked up the phone and dialed his brother in ER. After confirming the details, he said, “He’s in the ER observation room receiving a fluid transfusion. He gave 800ml of blood and is now replenishing his fluids.”

“Professor Tian? Is he a friend of yours? How coincidental? Should I give a heads-up to the ER?”

Director Tian thanked him.

He hurriedly changed his clothes and headed to the ER. Upon introducing himself to the nurse, she immediately enthusiastically escorted him to the observation room.

For some reason, he felt heavy-hearted. He hoped that it wasn’t what he was thinking. It would be too cruel if that were the case.

He stopped, “Which room is he in? I can go myself; you can go back to work.”

The nurse pointed ahead, “Room number 3!”

Director Tian pondered for a bit, picked up his phone, and dialed Director Zhu’s number. They had exchanged numbers when they were both sent to Japan by the province. However, they didn’t contact each other regularly, and it was uncertain whether Director Zhu had changed his number.

The phone rang several times, and then it got picked up.