This miracle doctor just wants to be fired!

Just then, the door to the emergency room was pushed open again.

The nurse at the triage station poked her head in, her voice urgent: "Dr. Zhou, Dr. Li, another patient with a closed abdominal injury has been brought in by ambulance. His blood pressure keeps dropping, and we suspect a ruptured liver or spleen. His condition is serious!"

Zhou Cheng immediately put down his water glass, grabbed the stethoscope hanging around his neck, his expression instantly tightening, and strode towards the door.

Li Degang smiled and shook his head, then quickly followed.

Just as Zhou Cheng and Li De rushed into the emergency room, the ambulance was pushed to the door of the resuscitation room with a bang. The accompanying doctor jumped out and spoke very quickly: "A 42-year-old man was riding an electric bike when he collided with a car. Forty minutes after the injury, he experienced severe abdominal pain and agitation. His blood pressure dropped to 70/45 and his heart rate was 130 on the way. We put him on two lenses, but he couldn't be stabilized."

Several people worked together to lift the patient onto the resuscitation bed.

Zou Qian and two nurses had already come in. They quickly inserted the IV and connected the monitor, without uttering a single unnecessary word.

As soon as the monitor was connected, a sharp alarm sounded. Blood pressure was 68/42, heart rate was 134, and blood oxygen was 92%.

Zhou Cheng put on gloves and reached out to press on the patient's abdomen.

Tenderness throughout the abdomen, most severe in the left upper quadrant, with significant rebound tenderness, the abdomen feels tense and hard, and shifting dullness is positive.

He looked up at Li Degang and said, "Teacher Li, there's a possibility of a ruptured liver and spleen, active bleeding in the abdominal cavity, and unstable blood pressure. We need to consult a surgeon immediately."

Li Degang nodded, picked up the phone and dialed the surgical consultation line. As soon as the call connected, he said directly, "Emergency room, closed abdominal injury from a car accident, suspected splenic rupture and hemorrhagic shock, blood pressure cannot be maintained, someone come immediately."

After hanging up the phone, Li Degang shouted to Zou Qian: "Eight units of crossmatched blood, half red blood cell suspension and half plasma, check four coagulation parameters and eight preoperative parameters, and prepare for autologous blood transfusion!"

Zou Qian agreed and asked the nurse to send the blood to the laboratory after the blood was drawn.

Zhao Xiao and Wang Zihao were also busy. One recorded vital signs, and the other helped connect oxygen and attach electrode pads. Their hands and feet were much steadyer than before, and they no longer panicked and their hands trembled.

Zhou Cheng took the abdominal paracentesis kit, disinfected, draped, and administered local anesthesia. His movements were quick and steady, without any unnecessary steps.

Upon insertion and aspiration, a full 10ml of dark red, non-clotting blood immediately gushed from the syringe.

"Abdominal paracentesis positive, confirming internal bleeding." Zhou Cheng removed the needle, pressed a cotton ball against the puncture site, and told the two students, "The patient is in shock, the abdomen is hard, and the blood drawn is non-clotting. There's no need to wait for a CT scan; send her directly to the operating room. If we wait any longer, the blood will drain out."

The two students quickly wrote the sentence down in their notebooks.

At this point, the patient's consciousness began to blur, he became extremely agitated, incoherently cried out in pain, waved his hands wildly, his blood pressure dropped to 60/35, his heart rate fell to 58, and the monitor's alarm sounded even more shrill.

"Stop the IV!" Li Degang immediately stepped forward and pressed down on the patient's shoulder. "1mg epinephrine IV push! Colloid solution drip at full speed! Put on the vasopressor pump!"

Without stopping, Zou Qian prepared the medicine and immediately pushed it in, turning both IV lines to maximum and connecting the vasopressor as well.

Half a minute later, the patient's heart rate slowly rose to 110, and his blood pressure barely rose to 75/50, but it was still unstable.

Dr. Zhang Peng from the general surgery department rushed in, covered in sweat. He quickly scanned the area with a portable ultrasound machine, revealing a clear rupture in the spleen and a fluid-filled dark area in the abdominal cavity.

His brow furrowed immediately: "The spleen is ruptured, and there's at least 2000ml of blood in the abdominal cavity. We must open the abdomen immediately; any later and there won't be a chance."

"Where are the family members?" Dr. Zhang asked, turning his head.

Just then, the nurse at the triage station rushed in, looking anxious: "We've made contact. The patient's wife is in a neighboring city; even if she takes the high-speed rail back, it will take at least two and a half hours. His parents are in the countryside; they're elderly, so it will take them even longer to get here."

The emergency room fell silent instantly.

Dr. Zhang frowned even more deeply, watching the blood pressure drop on the monitor. He gritted his teeth and said, "No family member signed the consent form, no one can sign the surgical consent form, and the operating room won't start the procedure. This is no small matter. Open surgery to remove the spleen under general anesthesia carries extremely high risks. If the bleeding can't be stopped, the patient will die. Who would dare to do it without a signature?"

Just as Li De was about to speak, Zhou Cheng spoke first, his tone steady without the slightest hesitation: "Dr. Zhang, the patient can't wait two and a half hours. I'm the first attending physician. I'll report to the medical affairs department and go through the emergency green channel to perform surgery first. I'll contact the patient's wife first, and she can agree over the phone."

Dr. Zhang was stunned for a moment, then looked at Zhou Cheng: "Zhou Cheng, have you thought this through? This isn't a pericardiocentesis, it's open abdominal surgery. If something goes wrong, it's no laughing matter."

"I've made up my mind." Zhou Cheng picked up the phone and dialed the medical affairs department's on-call number. After the call connected, he clearly explained the patient's condition, the severity of the emergency, and the fact that the family could not arrive in time. Finally, he said, "The patient's heart may stop beating at any moment, and surgery is necessary immediately. I request to activate the emergency rescue green channel."

The on-call medical affairs officer immediately replied: "We are aware of the situation and agree to activate the green channel. Save the person first, and complete the formalities later. I'm contacting the operating room and anesthesiology department now."

After hanging up the phone, Zhou Cheng looked at Dr. Zhang and said, "The medical affairs department has agreed, and the operating room has also been notified. Get her there as soon as possible."

Seeing this, Dr. Zhang nodded and immediately called the operating room to arrange for an emergency procedure.

Li Degang patted Zhou Cheng on the shoulder without saying a word, his eyes full of approval.

The patient's blood pressure dropped again, and the vasopressor was already at its maximum dosage; the patient fell into a complete coma.

Without delay, the team immediately intubated the patient, connected the patient to a ventilator, and pushed the stretcher towards the operating room.

When they arrived at the operating room door, the anesthesiologist was already waiting. He took the stretcher and pushed it inside.

Dr. Zhang patted Zhou Cheng on the shoulder: "Don't worry, we'll do our best."

Zhou Cheng nodded, watched the operating room door close, and then leaned against the wall to breathe a sigh of relief.

My back was already soaked with cold sweat. I hadn't even had a sip of water since I took over the shift this morning. I had saved two patients whose lives were hanging by a thread, and my nerves had been on edge the whole time. Only now did I feel tired.

Back in the emergency room, Li Degang handed me a bottle of water with the cap unscrewed: "Take a break, kid. You've been fighting with death today."

Zhou Cheng took the water, drank a couple of sips, and smiled, "There's no other way, this is the job I do, I can't just stand by and watch someone die."

At this moment, Zou Qian ran over with a smile on her face: "Dr. Zhou, Dr. Li, the CCU called. The patient who just had cardiac tamponade is in very stable condition, and the follow-up echocardiogram showed all his cardiac functions were normal. His wife specifically asked the nurse to tell him that once the patient is feeling better, they will definitely come to present him with a banner of appreciation."

Zhou Cheng nodded, feeling completely at ease.

For doctors, the best outcome is for the patient to be safe and sound.