Chapter 372: Crisis on the Front Line! (Please Subscribe)

"Blood pressure's still low! Norepinephrine, IV push. ~"

"How much blood did the blood bank send?"

"Establish intravenous access."

When Fang Ziye rushed to the Emergency Department for the rescue, chaotic footsteps, chaotic medical orders, chaotic instruments, and the chaotic positions of the white coats came from inside...

Fang Ziye lifted the examination gloves he had prepared in advance and leaned forward: "Please, what is the current situation of the patient for the emergency trauma surgery consultation?"

The first time Fang Ziye spoke, he was ignored.

The rescue continued, the little nurse and the emergency doctors were busy as a swarm; a nurse rushing out nearly collided with Fang Ziye, and both sidestepped only then to avoid the collision.

After this, Fang Ziye maneuvered to the bedside, stood firm, no longer disturbing things, his eyes rapidly scanning as he began observing the patient's condition on his own.

Car accident injury; at this moment the abdomen was slightly distended.

There was an open wound, the inner gauze had been temporarily stuffed in haphazardly, the lower limbs...

Fang Ziye's gaze had only swept to this point when the patient's blood pressure dropped once again!

"Beep beep beep beep beep beep!"

"Beep beep beep beep!" The machine's beating alert was exceptionally piercing.

"Still no good, have the general surgery and trauma surgery people arrived yet?" Finally a white coat started cursing.

"Trauma surgery is here!" Fang Ziye hurriedly responded, ready to insert himself at any moment.

During the rescue, everyone surrounded the patient; the greatest taboo right now is to squeeze people away!

Medical treatment must have procedure; no matter how strong your capability, you cannot squeeze away others who are operating on the patient, to avoid irreversible consequences caused by your own cognitive error.

Rescue is a team task, not individual heroism.

"Open active hematoma in the pelvis! Previous blood loss was massive; we applied temporary pressure packing for hemostasis but it didn't hold."

"Bleeding now?" One person just pulled free, wanting to explain a few sentences to Fang Ziye, when Fang Ziye had already drilled through and arrived at the patient's side.

His two hands, like nimble snakes, probed into the abdomen and began taking over, interrupting: "Have you probed to find specifically which arteries or veins are damaged?"

"Are there any examination results?"

Some ambulances have onboard X-ray or CT; if there is examination data, nothing could be better.

"No! Situation is urgent, now we can only blind probe! ~" Another person replied to Fang Ziye.

Because he saw Fang Ziye's agile swiftness and decisive neatness; this is an old hand. Not a foolish greenhorn.

"Has the on-duty director authorized by phone?"

"With the current situation we have to go straight into the operating room!"

"Get me debridement kits, at least open five! ~" Fang Ziye felt the blood vessels in his scalp layer being backfilled by blood, his heart half panic, half calm.

This is a critical moment; Fang Ziye couldn't care about wasting knowledge points, cleared all his knowledge points, and added points into vascular surgery theory, which is unrelated to trauma surgery.

Hemostasis technique belongs to hemostasis technique — it is operational-level dexterity; but vascular surgery theory is what lets Fang Ziye know specifically how to achieve hemostasis throughout the whole body range!

The more urgent the moment, the more one must be calm.

Blind probing isn't blindly groping; it also requires sequence — one must clarify whether the bleeding is above or below the abdominal aortic bifurcation!

"Only opened one! ~ I'll go open more right now."

"Debridement kits, sending four debridement kits here! ~" A nurse loudly acknowledged and shouted outward.

Fang Ziye's ears pricked up at this moment, temporarily blocking out all dialogue, because his two hands were sensing the fluctuation of blood inside the abdomen — this is an ability after physical examination technique reached Level 4, able to perceive subtle blood flow fluctuations.

Where there is a bleeding orifice, it will jet blood creating a certain turbulent flow; generally the location with the largest turbulent flow is the most violent bleeding orifice location, and also the location most needing discovery of the bleeding point!

With auxiliary examination results, reading films can reveal clues; the current Fang Ziye can only rely entirely on his own basic skills to force a breakthrough!

First separate upper and lower; above the abdominal aortic bifurcation level, there is basically no active turbulent flow!

The patient's blood is still warm, proving there is still active bleeding; it should be coming from the lower edge of the bifurcation!

"Hemostats! ~" Someone handed Fang Ziye two hemostats.

"Place on top! ~" Fang Ziye was sensing; at this time he had no hand free to receive.

The left side's turbulent flow is more rapid!

"This?" The person who gave Fang Ziye the hemostats hesitated!

After sensing the left side's turbulent flow was more rapid, Fang Ziye unhesitatingly took one hemostat and directly clamped the right common iliac artery at its root!

But in everyone's eyes, they could only see Fang Ziye at this moment stuffing the hemostat into the patient's abdominal blood pool! ~

"He?" The nurse holding the hemostats was a bit panicked.

"Shut up! ~ Don't disturb!" The emergency department deputy director shouted a halt.

Fang Ziye's two hands continued probing in; he found that after clamping the left common iliac artery, the left side's bleeding turbulent flow indeed decreased a lot. But it remained; at this moment not as large as the right side.

The patient has vascular damage on both sides.

The left side should also have venous damage, but the venous bleeding volume is not surging, proving the orifice is very small.

Look at the right side; after the left side's large turbulent flow was stopped, the right side's turbulent flow appeared comparatively more impactful! ~

The common iliac artery divides into internal and external iliac arteries; Fang Ziye placed his palm horizontally at the middle of the horizontal line of the right internal and external iliac arteries, carefully sensed, and discovered the turbulent flow biased toward the internal side was somewhat larger.

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

Picked up a hemostat, and again like an eel entering a hole, drilled into the abdominal blood pool plane!

Extremely precisely found the root of the right internal iliac artery; upon touching the branch root, chose to clamp!

With a crack sound.

Fang Ziye's left hand instantly felt the internal turbulent flow fluctuations decrease significantly; he raised his head and instructed: "Pressure transfusion! Pressure IV infusion! ~"

To raise the patient's blood pressure, under non-cardiogenic shock conditions, if intake volume is greater than blood loss volume, it will cause the body's circulating blood volume to gradually increase, and blood pressure will further improve.

Actually it was already being pressure-infused; otherwise, with the patient's abdominal bleeding volume, they would have gone into shock and died long ago! ~

"Beep beep beep beep!" The blood pressure feedback is very fast, especially under the action of norepinephrine and epinephrine.

"Systolic 70 mmHg! It's gone up a bit." The nurse responsible for monitoring the monitor reported.

"Should we adjust the oxygen flow rate?" She was simultaneously responsible for the patient's endotracheal intubation ventilation flow rate.

"Don't change the flow rate yet! ~ Let's watch the blood pressure again, the patient's active bleeding, it shouldn't stop this fast." The Emergency Department Deputy Director was very calm, looking at Fang Ziye with both hands inserted into the patient's open abdominal wound, his eyelids twitching rapidly.

Someone who dares to act this directly and decisively, without some capability it won't do, without some resolve it won't do, without some knowledge it won't do!

Fang Ziye indeed also felt that after the two major arteries in the lower limbs were clamped shut, the bleeding volume decreased considerably, and moreover, at this moment even more bleeding seemed to be coming from the mid-abdomen!

The patient's traumatic wound was in the lower abdomen, inserting a hand in at this time appeared a bit difficult, Fang Ziye at least had to change position!

Withdrawing his hand, his expression serious, he raised his head to look at the person near the foot of the bed before him, meaning clear and decisive: "Teacher, I need your position! ~"

The other's name badge clearly read Emergency Department Deputy Director, but Fang Ziye still needed this advantageous operating position.

The other was very professional, stepping aside without the slightest hesitation!

Fang Ziye's buttocks shifted, then he immediately extended his right hand alone into the patient's unknown abdominal interior!

The premise of performing the hemostasis technique is to determine where the bleeding is; even blind manual hemostasis requires first finding the bleeding point.

Fang Ziye was not that proficient and familiar with non-orthopedic anatomical structures, so he dared not simply judge the approximate direction and then directly clamp with the hemostat, but instead followed the hand feel, constantly approaching afterward.

Left side, distal renal artery of the abdominal aorta, arterial breach!

"Hemostat! ~" Fang Ziye instructed.

"Coming!"

Fang Ziye directly took it with his left hand, passed it into the abdomen to his right hand, then used his right hand very cautiously, slowly, precisely to pass through the intestines, probing to the abdominal aorta branch position.

Then with a crack it clamped shut!

At this moment, Fang Ziye's elbow, the cuff of his short-sleeved white coat, were already mottled with bloodstains!

When withdrawing again, inside his right hand's glove, a lot of blood had coiled, like a bloody hand, pulling out outward.

"Beep beep beep beep! ~"

After the arterial bleeding breach was clamped shut, the hemostasis effect was immediate; at once, the blood pressure rose again to around 80 mmHg!

"Systolic 80! Systolic 80! ~" The nurse watching the blood pressure hurriedly reported.

Simultaneously looking at Fang Ziye whose right hand was all bloody, she felt horror, her body trembling slightly.

Fang Ziye gritted his teeth, tightly closed his upper and lower eyelids twice, lowered his voice and said: "After blood pressure is maintained well, best to do a CT scan once, then first time send to Emergency Operating Room!"

"I only temporarily handled the bleeding position; the specific surgery still needs the specialty to slowly operate hemostasis, and there are also small bleeding points not dealt with! ~"

"I'm going to change clothes, and wash my hands."

"Send to Operating Room, prepare Debridement Kit, Lower Limb Kit, Pelvic Fracture Kit! Thank you!" Fang Ziye's instructions, decisive and crisp.

Immediately leaving, without the slightest hesitation!

Fang Ziye right now had only dragged her back a dozen steps from the Ghost Gate; the aftermath could still enter anytime, but he had delayed a bit of time.

But everyone knew, if not for Fang Ziye, perhaps in another minute this patient would have been beyond saving.

Wanting to find the bleeding breach under blind vision, in the complex human anatomical structure, using a hemostat to clamp and stop bleeding — this isn't something ordinary people can do; this is absolute strength.

Hard strength, the basic skill of a dimensionality reduction strike!

Fang Ziye left, right hand bloodied, left hand holding sterile cotton pad wiping, looking as if a butcher who just finished killing, and with a smile on his face.

In reality, Fang Ziye's heart was calm and at ease.

On the road of medicine, running around for so many years, struggling so many times, striving to climb for so long, he had finally, for the first time, relied on his own true strength, used his own absolute capability, to accomplish what everyone dared not accomplish.

This one patient, can be declared as: I won't let her die, even Yama would have to push it back three watches!

Life and death on the frontline, this kind of pressing feeling, has many kinds of subtle sensations.

Fang Ziye's two hands stained with blood, clothes stained with blood, footsteps hurried, running all the way, causing many patients and even medical staff to panic and retreat...

(Chapter End)