Chapter 393

The little nurse's voice wasn't small in volume; it rang out from the distance of the corridor, echoing through the entire ward.

Fang Ziye merely hesitated for one second, then first half-squatted to place the box in his hand at a corner of the corridor passage, then stood and hurried toward the source of the sound.

Fang Ziye is currently the Chief Resident; if something happens in the ward, no matter what Fang Ziye is doing, he is the first person responsible. Under the current circumstances, Fang Ziye happens to be in the department, which is instead the most reassuring thing for Fang Ziye.

The Inpatient General Office is still a short distance from the Doctor's Office; before Fang Ziye had run past the Doctor's Office, Duty Doctor Guo Ruodun and Lan Tianluo, two white coats, rushed out of the Doctor's Office in haste.

Lan Tianluo ordered rather experiencedly: "Guo Ruodun, you hurry to find the cricothyroidotomy kit, push the medication cart to the bedside, best to find povidone-iodine at the first time; if not, forget it."

Lan Tianluo's voice was hurried; while running, he took out his mobile phone intending to call Fang Ziye.

"Daddy, Doctor Brother threw away the box..." Xiao Lizǐ saw Fang Ziye's action and looked at her father a bit uneasily.

However, his wheelchair was slightly blocking the passage; his father hurriedly moved his wheelchair sideways to a position against the wall.

After making way for Fang Ziye, Lan Tianluo, and the others, watching Fang Ziye running hurriedly and walking side by side with Lan Tianluo, he then turned Xiao Lizǐ's wheelchair again: "Xiao Lizǐ, Doctor Brother went to work."

"He might have gone to save someone else's mother, someone else's child, or maybe another child's father; the things have been delivered, let's go..."

"Is that so?" Xiao Lizǐ is not very old.

He fundamentally doesn't understand what suffocation means; his cognition can only think that Fang Ziye threw away the gift he gave Fang Ziye.

"That's right! Let's not disturb your Brother Fang anymore; after you're discharged, after your mother is also discharged, we'll come together to thank him, okay?" The man explained sensibly, then pushed the child away.

After people grow to a certain age, they must learn to have empathy...

"Senior Brother, I was just preparing to call you; just now a nurse said Bed 34 patient has difficulty breathing..." Lan Tianluo saw Fang Ziye catch up and walk side by side, briefly explaining two sentences.

Fang Ziye nodded, giving Lan Tianluo a mental thumbs-up: "Let's go look at the situation first!"

Lan Tianluo did not believe the nurse's descriptive diagnosis of suffocation.

Suffocation is a pathological state where the human body's respiratory process is obstructed or abnormal due to some cause, producing hypoxia in all organ tissues, carbon dioxide retention, causing tissue cell metabolic disorders, functional disturbances, and morphological structural damage.

"Okay, Senior Brother." Lan Tianluo saw Fang Ziye at his side, his tightly furrowed brows visibly relaxed seven or eight parts.

While Fang Ziye ran quickly, a thought moved in his heart: "You handle it; I'll watch from the side."

Lan Tianluo's running legs went slightly soft, expression incredulous: "Senior Brother, me?"

"You're already near the end of Master's First Year; counting your standardized training as one year, you've already stayed in the department for nearly two years."

"Suffocation caused by airway obstruction, the relatively worst handling situation is tracheotomy."

"Arrived; you go in, handle it first!" Fang Ziye said.

Suffocation caused by airway obstruction has a certain degree of rescue time; overall calculated, it's the golden five minutes.

But Fang Ziye is confident he can directly complete the tracheotomy incision technique in thirty seconds!

Under such circumstances, Fang Ziye simply handed the first consultation right to Lan Tianluo first.

Young doctors always have to grow; wherever Lan Tianluo's handling isn't adequate enough, Fang Ziye can also take over at the first time.

The two had just entered when they saw the patient's family members and the neighboring bed's family members gathered together in a panic, some patting chests, some helping support backs.

The patient is a middle-aged man in his forties; at this moment both eye sockets are wide, eyeballs protruding, mouth wide open, chest heaving violently.

"Doctor! Quickly come look, my husband suddenly became like this~" Seeing the white coats, the middle-aged woman's eyes held tears, voice breaking as she pleaded.

Lan Tianluo quickly approached, scanning something.

After Fang Ziye walked up, he continued doing inspection.

The patient's forehead is covered in cold sweat, sternocleidomastoid muscles prominent and taut, lip color relatively dull, should be signs of impending hypoxia.

Looking again at the patient's chest breathing amplitude, due to respiratory muscles violently contracting and rapidly heaving, but during the heaving process, still unable to make breathing smooth.

The patient's throat emits an unpleasant "uh, uh" sound.

"What did he just eat? Betel nut or fruit, or both together?" When Lan Tianluo approached to do physical examination, the first thing he smelled was that the odor wasn't right.

"Yes~" The patient's wife nodded, crying: "He said he wanted to eat, so I bought it for him; I also didn't expect it would become like this..."

Fang Ziye timely reminded from the side: "Stethoscope, listen to whether turbulent airflow sound can be heard inside the throat."

"If the betel nut's position isn't very deep, see if forceps can be used to remove it." Fang Ziye's speech was very fast.

But Lan Tianluo's reaction was also fast; grabbing the ever-ready stethoscope and applying it: "Senior Brother, turbulent flow sound is very low down."

After partial airway obstruction, airflow striking the trachea and obstruction emits local wheezing-like sounds.

"Cut~" Fang Ziye ordered without the slightest hesitation.

At this time he is here; the command must be given by himself to have persuasiveness.

"Senior Brother, cricothyroidotomy kit arrived."

"Povidone-iodine also opened." Guo Ruodun quickly pushed the medication cart over, on it lay flat a sealed cricothyroidotomy kit.

Fang Ziye saw Guo Ruodun didn't have much experience, so he actively went to help, tore open the cricothyroidotomy kit, rotated and turned the instruments inside right-side up again.

At the same time, revealing the sterile tray, Fang Ziye opened the povidone-iodine and poured it into the tray: "After putting on gloves, quickly rotate to disinfect, choose midline incision line."

Lan Tianluo started putting on gloves when Fang Ziye opened the cricothyroidotomy kit.

Right now he had just roughly finished dressing; after dressing, Lan Tianluo directly picked up the povidone-iodine cotton ball from the tray, quickly instructed the patient's family to help fix the head and chest, then said: "Guo Ruodun, go call ICU and Anesthesiology Department emergency consultation, go call Otolaryngology consultation."

"Emergency consultation~"

"Senior Brother~" Lan Tianluo was just about to have Fang Ziye help open the local anesthetic lidocaine.

Fang Ziye had already opened the properly proportioned lidocaine and normal saline respectively, and mixed them together!

"Draw, local anesthesia, begin~" Fang Ziye practically sent all operations right to Lan Tianluo's mouth.

Because this is Lan Tianluo, Fang Ziye knows Lan Tianluo's current incision technique can absolutely complete the tracheotomy incision technique.

Lan Tianluo no longer hesitated, quickly injected a skin wheal, then standardly completed the three-part local anesthesia of one-side needle entry, aspiration, and drug injection.

In merely twenty seconds, Lan Tianluo completed the local anesthesia.

Then, shifting body, connecting needle holder with surgical knife handle and blade, left hand holding toothed forceps in reverse grip in palm, choosing anterior neck midline as incision, directly quickly cut a straight line until the suprasternal notch.

Immediately after, Lan Tianluo used vascular clamps along the midline to separate the sternohyoid and sternothyroid muscles, exposing the thyroid isthmus!

At this moment Fang Ziye had also finished putting on assistant gloves, took over the vascular clamps, acting as assistant for Lan Tianluo.

"Give me the small hook, I'll expose the cricoid for you." Fang Ziye's voice was decisive and calm.

"Okay, Senior Brother." In Lan Tianluo's panic, a sense of composure finally emerged.

Fang Ziye had already become the assistant, so he could become the lead surgeon at any time.

Lan Tianluo could rest assured.

"2-4, 1-2 principle! Incise." Fang Ziye continued to instruct.

Upon hearing this, Lan Tianluo no longer hesitated, and along the 2nd to 4th tracheal rings, using a pointed blade from bottom to top in an arc, incised the anterior wall of 1 to 2 tracheal rings to form an anterior tracheal wall flap.

The moment the anterior tracheal wall was breached, the patient's breathing immediately eased.

From the laryngeal tube, a 'whoosh-whoosh' sound of turbulent airflow emerged.

At the same time, his tense expression slowly settled into composure, his whole body limp and flat on the bed as if after death, as if the entire world had become incomparably quiet.

The moment a suffocating patient suddenly gets ventilated, the degree of comfort is not less than that shudder, even a hundred times more comfortable than that shudder...

"I see it, half the betel nut head is here, spread it open and see if we can remove it. If it can be removed, then remove it."

"It's really stuck tight." Fang Ziye was still guiding.

Lan Tianluo merely clamped gently with the forceps and plucked out the betel nut residue intact, and after observing left and right for a moment said: "Good thing it's betel nut dregs, if it were chewing gum adhesion it would be quite troublesome."

"Insert a tracheal tube temporarily first, wait for the ICU and Anesthesiology emergency consultation superiors to come up and handle the follow-up!"

Fang Ziye finished speaking, looked at the patient's family, coldly: "You come with me, we'll sign a supplementary consent. Then, I'll give you a proper inpatient education."

"Our department, I remember from the first admission we said, during hospitalization, chewing betel nut is prohibited, especially when inconvenient to move post-op, has no one told you?"

In Fang Ziye's heart, there was truly a bit of anger!

If this patient's symptoms were a heart attack or other symptoms, spending time and effort to rescue them would feel quite rewarding.

Damn it, making trouble out of nothing, chewing betel nut and choking, then doing a tracheostomy, cut it open, took out the betel nut, rescue over, purely superfluous and self-inflicted suffering.

And, such a situation, if rescue is not timely, Fang Ziye's chief resident career has a certain possibility of being extended.

Because the hospital has a rule, regardless of reason, as long as a ward has an elective surgery death case, regardless of whether it's the chief resident's responsibility, there is liability for negligence.

Emergency death cases excepted.

Emergency examination not thorough enough, sudden blood vessel rupture, won't put pressure on the chief resident.

"Doctor, we said, mainly my husband he can't control his mouth, he insists on eating ah." The middle-aged woman was still arguing.

"He insists on eating so you give it to him?"

"Is he a child or are you a child?"

"Whether betel nut is healthy is not within my scope of explanation. The main cause of this sudden choking is you mistakenly letting betel nut enter the trachea, such an accident is very dangerous."

"What if, I'm saying what if, your husband can't be rescued, what will you do?" Fang Ziye was also venting his anger all over, after venting a few sentences, only then said this.

Then his voice softened considerably, looked at the 14 floating knowledge points, said: "Hmm, alright then, things are already like this, tracheostomy is inevitably necessary, you come sign a supplementary consent..."

"This kind of thing in the future, no need for me to explain again, right?"

The middle-aged woman nodded vigorously: "Rest assured, Doctor Fang, this time if my husband wants to eat again, I'll give him a few big slaps..."

The middle-aged woman then tilted her head, looking at the tube inserted in her husband's larynx, heartache and heartache, helpless and helpless...

Fang Ziye actually knew, this couple's relationship was definitely extremely good.

Otherwise, a general man couldn't beg his wife to help buy things like betel nut.

Watching Guo Ruodun finish signing the supplementary consent in front of the patient, the Anesthesiology and ICU chief residents both rushed over.

The ICU chief resident stood by the bed for a while, seeing nothing wrong with the situation, said: "Symptoms currently resolved, continue to do postoperative education well, airway already patent, patient's muscle tissue still okay, just seal the tube and extubate directly..."

About half an hour later, Fang Ziye said to Ning Shan who stayed to handle the tracheostomy wound: "Thanks ah Director Ning, this tracheostomy incision, we really have no experience handling it."

"I've been in the department for many years, also first time encountering a tracheostomy procedure."

Ning Shan is the ICU chief resident, hearing this, while taking off gloves, pressed hand disinfectant: "So it's still you surgeons who have guts, never encountered it before, yet dare let a resident physician operate."

"If it were in our ICU, it's completely unimaginable."

Ning Shan's height not tall, about 1.6 meters, figure very thin, wearing a neat ponytail, rubbing her slender ten fingers.

"Hmm, this fellow trainee of mine is not bad, I thought the operation isn't difficult either. So I let him operate." Fang Ziye walked toward the hospital area door seeing Ning Shan off, while smiling and explaining.

"Hmm, is okay, you surgeons do many surgeries, doing this kind of tracheostomy, should be a piece of cake."

"Director Fang, add a WeChat, convenient for private exchange later, if our group has orthopedics emergency consultation, I can also call you at the first time ah." Ning Shan's voice very crisp, naturally carrying a loli-voice softness.

Fang Ziye generously added: "Fang Ziye, Trauma Surgery. Director Ning remember to save with detailed notes."

Ning Shan narrowed her eyes, figure looked thin and small, but guts not small: "Rest assured, like us big girls, encountering a handsome guy, will note very detailed."

Fang Ziye did not pick up this topic: "Then trouble Director Ning, I still have surgery, go back still need to handle this patient's follow-up first."

Finished speaking, after parting with Ning Shan, Lan Tianluo very sensibly jogged up.

"Senior Brother, just now, do I count as having independently performed a tracheostomy as primary operator?" Lan Tianluo exceptionally excited.

Tracheostomy is also a separate small surgery, although its operation is simple, its meaning is extraordinary ah, this is truly a life-saving surgical operation.

Lan Tianluo came to Zhongnan Hospital two years, only finally waited for this one opportunity.

"It... is... Doctor Lan." Fang Ziye deliberately dragged his voice very long.

"Hehehe, can't be called that, compared to Senior Brother you still far behind."

"But in the training room can also cut octahedron golden pyramid, this basic skill really can be put to use!" Lan.

Incision technique cutting out octahedron golden pyramid, is the Master's to PhD stage training room passing standard, representing a high level of an age group.

Fang Ziye said: "Operation level roughly whatever, impact on you Tianluo not big either, you later also not relying on surgery to eat."

Lan Tianluo said very seriously: "No, Senior Brother, the more skills to make a living, the more retreat paths, the relatively more free a person is."

"Just like now, if I don't want to be a doctor I can not be a doctor, if I don't want to do math I don't do math, if I don't do computer research projects I don't do algorithm research, if I don't do clinical..."

Lan Tianluo thinking while turning head, when opened eyes again discovered Fang Ziye already walked far, hurriedly chased up: "Senior Brother, I'm not pretending anymore."

"Today Senior Brother Jie thought of a particularly good idea, he had me pay attention to Senior Brother your off-stage time, once Senior Brother Fang you step down, he'll come to the department to report to you..."

(Chapter End)