top student at medical school

Chapter 371 On the Brink of Crisis! (Please Subscribe)

"Blood pressure is still low! Administer norepinephrine, IV push."

How much blood has arrived at the blood bank?

“Establish intravenous access.”

When Fang Ziye arrived at the emergency room, he heard chaotic footsteps, chaotic medical orders, chaotic instruments, and doctors in white coats scattered about...

Fang Ziye lifted the examination gloves he had prepared in advance and leaned forward: "What is the current condition of the patient who needs an urgent consultation with the trauma surgery department?"

Fang Ziye was ignored when he spoke.

The rescue operation was still ongoing, and the nurses and emergency room doctors were all busy. When one of the nurses rushed out, she almost bumped into Fang Ziye. They both turned to the side to avoid a collision.

After doing this, Fang Ziye moved to the side of the bed, stood still, and stopped disturbing the patient. He quickly scanned the patient's condition with his eyes and began to observe the patient's condition on his own.

He was injured in a car accident, and his abdomen is slightly swollen at this moment.

There was an open wound, the inside of which was temporarily stuffed with gauze, on the lower limbs...

Just as Fang Ziye's vision swept over the patient, his blood pressure dropped again!
"Drip drip drip drip!"

"Beep beep beep beep!" The machine's beeping notification was particularly jarring.

"Still not working. Have the general surgery and trauma surgery people arrived yet?" Finally, a doctor in a white coat started cursing.

"The trauma surgeons are here!" Fang Ziye quickly replied, ready to slip in at any moment.

During the rescue, everyone surrounded the patient, and the worst thing to do at that moment was to push people aside!

Medical procedures must be followed. No matter how skilled you are, you cannot push away others who are performing procedures on patients, to avoid irreversible consequences caused by your own cognitive errors.

Rescue is a team effort, not an individual act of heroism.

"An open, active hematoma in the pelvis! The bleeding was very heavy before, and our temporary pressure packing to stop the bleeding didn't work."

"Is there bleeding now?" Just as one of the people pulled away to explain to Fang Ziye, Fang Ziye had already drilled through the hole and arrived at the patient's side.

His hands, nimble as snakes, reached into her abdomen and began to take over, interrupting her: "Have you detected which specific arteries or veins are damaged?"

"Any test results?"

Some ambulances have onboard X-ray or CT scans; it would be best if you could have the examination data.

“No! The situation is urgent, we can only probe blindly now!” another person replied to Fang Ziye.

He saw Fang Ziye's agility, speed, and decisiveness; he knew Fang was a veteran, not a clueless newbie.

"Has the main duty phone been authorized?"

"In this situation, we have to drive all the way into the operating room!"

"Give me a wound cleaning kit, at least five!" Fang Ziye felt blood rushing into the blood vessels of his scalp, his heart filled with a mixture of panic and calm.

In this emergency, Fang Ziye didn't care about wasting knowledge points. After clearing all his knowledge points, he added them to vascular surgery theory, which was unrelated to trauma surgery.

While hemostasis is a skillful technique, it is the theory of vascular surgery that allows Fang Ziye to know how to achieve hemostasis throughout the entire body!

The more urgent the moment, the more calm you need to be.

Blind probing doesn't mean probing randomly; there's a proper order to it. It's necessary to clarify whether the bleeding is above or below the bifurcation of the abdominal aorta!
"Only one is open! I'll go open one right now."

"Wound cleaning kits, here are four wound cleaning kits!" a nurse shouted after responding.

Fang Ziye's ears perked up at this moment, temporarily avoiding all conversation, because his hands were feeling the fluctuations of blood in his abdomen. This was an ability that came with the Body Examination Technique at level 4, which allowed him to sense subtle fluctuations in blood.

When there is a bleeding point, the rushing blood will create turbulence. Generally, the greater the turbulence, the more intense the bleeding is, and the more important it is to find the bleeding point!

With auxiliary examination results, the clues can be found by reviewing the images. At present, Fang Ziye can only rely on his basic skills to break through!

First, divide it into upper and lower sections. Above the level of the bifurcation of the abdominal aorta, there is basically no active turbulence!

The patient's blood is still warm, indicating that there is still active bleeding, which should be coming from the lower edge of the bifurcation!
"Hemostats!" Someone handed Fang Ziye two hemostats.

"Put it on top!" Fang Ziye was feeling it, but no one was there to take it.

The turbulence on the left is stronger!
"This?" The person who gave Fang Ziye the hemostat hesitated.

After Fang Ziye felt the turbulence on the left side become more rapid, he did not hesitate to take a pair of hemostatic forceps and clamp the right common iliac artery from the root!

But all anyone could see was Fang Ziye inserting hemostats into the pool of blood in the patient's abdomen!
"Him?" The nurse holding the hemostat was a little flustered.

"Shut up! Don't disturb us!" the deputy chief physician of the emergency department shouted.

Fang Ziye continued to probe inside and found that after the left common iliac artery was clamped, the bleeding turbulence on the left side had indeed decreased significantly. However, some bleeding still remained, though not as severe as on the right. The patient had vascular damage on both sides.

There should be further venous damage on the left side, but the bleeding from the veins is not heavy, indicating that the opening is very small.

Look to the right; the turbulence on the right appears more impactful after the large turbulence on the left subsides!
The common iliac artery is divided into the medial and lateral iliac arteries. Fang Ziye placed his palm horizontally in the middle of the horizontal line of the medial and lateral iliac arteries on the right side. After careful feeling, he found that the turbulence was greater on the medial side.

The patient's right side corresponds to Fang Ziye's left side, so Fang Ziye had the opportunity to pull his right hand out of the pool of blood!

He picked up the hemostat and, like an eel entering a hole, burrowed into the pool of blood inside her abdomen!

The root of the right internal iliac artery was located very precisely, and after touching the root of the branch, clamping was chosen!

After a click.

Fang Ziye instantly felt the turbulent fluctuations within his left hand decrease significantly. He looked up and ordered, "Increase pressure for blood transfusion! Increase pressure for intravenous infusion!"

In non-cardiac shock, if the blood volume is greater than the blood loss, the circulating blood volume will gradually increase, and the blood pressure will rise further.

They were already administering a pressurized infusion; otherwise, given the amount of bleeding in the patient's abdomen, she would have already gone into shock and died!
"Beep beep beep beep!" Blood pressure feedback is very fast, especially under the influence of norepinephrine and adrenaline.

"High pressure 70 mmHg! It's gone up a little," the nurse in charge of monitoring the monitor reported.

"Should we adjust the oxygen flow rate?" She was also responsible for the ventilation rate of the patients' endotracheal tubes.

"Don't stop the flow rate! Check the blood pressure too. The patient's active bleeding shouldn't stop so quickly." The deputy chief physician of the emergency department was very calm. He looked at Fang Ziye, who had his hands inserted into the patient's open abdominal wound, and his eyelids twitched rapidly.

A person who dares to act so directly and decisively needs to have some skill, courage, and knowledge!
Fang Ziye did indeed feel that after the two major arteries in his lower limbs were clamped, the bleeding was much less, and at this moment, more bleeding seemed to be coming from his mid-abdomen!

The patient's wound is in the lower abdomen, making it somewhat difficult to insert the hand at this point. Fang Ziye should at least change the position!
He withdrew his hand, his expression serious, and looked up at the person near the foot of the bed, his meaning clear and decisive: "Teacher, I want your seat!"

The other person's name tag indicated that he was the deputy chief physician of the emergency department, but Fang Ziye still wanted this operating position.

The other person was very professional and stepped aside without hesitation!

Fang Ziye shoved his buttocks, and then immediately reached his right hand into the unknown territory inside the patient's abdomen!

Before performing hemostasis, it is necessary to determine where the bleeding is. Even when performing hemostasis blindly, the bleeding point must be located first.

Fang Ziye was not very proficient or familiar with non-orthopedic anatomical structures, so he did not dare to use hemostatic forceps to clamp the area directly after determining the general direction. Instead, he followed his sense of touch and kept getting closer.

On the left side, distal to the renal artery of the abdominal aorta, an arterial rupture!
"Hemostats!" Fang Ziye ordered.

"coming!"

Fang Ziye picked it up with his left hand, then reached into his abdomen and handed it to his right hand. Only then did he use his right hand to very carefully, slowly, and precisely pass through the intestines and locate the branch of the abdominal aorta.

Then it snapped shut!
At this moment, Fang Ziye's elbows and the cuffs of his short-sleeved white coat were already stained with blood!
When he pulled it back, there was a lot of blood inside his right glove, like a bloody hand being pulled out.

"Beep beep beep beep!"

Once the ruptured arterial bleeding site is clamped, the hemostasis effect is immediate, and the blood pressure immediately rises to around 80 mmHg!

"80! 80!" The nurse monitoring blood pressure quickly reported.

At the same time, he looked at Fang Ziye, whose right hand was covered in blood, and felt terrified, his body trembling slightly.

Fang Ziye gritted his teeth, closed his upper and lower eyelids tightly twice, and said in a low voice, "After the blood pressure is stabilized, it is best to send him to the emergency operating room as soon as possible after a CT scan!"

"I only temporarily addressed the bleeding. A proper surgery will require a specialist to carefully manage the hemostasis. There are still small bleeding points that haven't been treated!"

"I need to change my clothes and wash my hands."

"Send him to the operating room. Prepare a wound cleaning kit, a lower limb kit, and a pelvic fracture kit! Thank you!" Fang Ziye's instructions were decisive and swift.

Then they left without hesitation!
Fang Ziye has only pulled her back from the brink of death a dozen steps. She still needs to go back in at any time, but he has delayed her a little.

But everyone knew that if it weren't for Fang Ziye, the patient might have been beyond saving in just one more minute.

Finding a bleeding point in the blind and using hemostats to clamp and stop the bleeding within the complex anatomical structure of the human body is not something an ordinary person can do; it requires absolute skill.

Hard power is the fundamental skill for achieving a decisive victory!

Fang Ziye left, his right hand stained with blood, his left hand holding a sterile cotton pad to wipe it, looking like a butcher who had just killed someone, with a smile on his face.

In reality, Fang Ziye felt calm and at ease.

After so many years of striving, struggling, and climbing the medical path, I have finally accomplished something that no one else dared to do, relying on my own true strength and absolute ability.

This patient is someone I can declare dead, even if it means the King of Hell has to push her away at midnight!
Being on the brink of life and death, this sense of urgency has many wonderful aspects.

Fang Ziye's hands and clothes were stained with blood. He ran hurriedly, causing panic and even some medical staff to back away...

(End of this chapter)