Chapter 410: 402 Stepping on the Red Line to Perform Surgery

Receiving the patient to the Jizhenbingfang, preoperative preparation, preoperative instructions—this series of tasks is very cumbersome.

Even though in the emergency they simplified the complex, but as long as the patient's condition allowed, they were busy for at least half an hour before Su Yun pushed the patient into the Operating Room.

When pushing the patient onto the table, the patient's systolic pressure had already dropped to 90 millimeters of mercury.

The continuously dropping blood pressure indicated that the patient's condition was not as simple as it appeared.

After anesthesia, Su Yun positioned the patient, laid the first sterile sheet, then went to scrub again. At this moment Zheng Ren had donned the sterile gown and began laying the second sheet.

The surgery officially began.

Zheng Ren reached out, and a Hemostatic Forceps with iodophor gauze was slapped into his hand.

After disinfection, he placed the Hemostatic Forceps at the patient's side, then reached out, and a scalpel was slapped into his hand.

Incising the skin, a 20 cm incision, then layer by layer dissection, blunt dissection, electrocautery hemostasis.

Cao Guozhen had already arrived in the Operating Room; he now stood behind Zheng Ren, observing the surgery from the surgeon's perspective.

The thoracotomy process was nearly perfect, with extremely little bleeding.

Although Cao Guozhen was still unconvinced, muttering that even if he performed a thoracotomy, there wouldn't be much blood.

Thoracotomy and laparotomy are two completely different ways of opening.

Many years ago, when electrocautery was not yet widely used in clinical practice, a thoracotomy would inevitably produce 500 ml of blood.

However, Zheng Ren and Su Yun's surgery had no visible bleeding; some larger blood vessels were directly picked out of the tissue with Hemostatic Forceps and ligated.

Only after cutting the muscle did they use electrocautery to cauterize the oozing blood within the muscle.

The surgery was neat and swift, and Cao Guozhen grew more fearful the more he watched.

These two monsters from the Jizhenbingfang—how could they possibly perform thoracic surgery so impressively? Just thinking about stealing thoracic emergency cases, it's really not just empty talk.

Zheng Ren and Su Yun, with good coordination, did not proceed with rib fracture internal fixation but first opened the chest cavity.

Because there was no strong evidence to justify a thoracotomy, they could only say they would perform rib fracture internal fixation.

This,

already is stepping on the line.

Even if postoperative recovery is poor and the patient's family makes a fuss, Zheng Ren and Su Yun could run into trouble.

Of course,

this trouble is of their own making.

Cao Guozhen's cold smile beneath his mask grew thicker; these two rascals from the Emergency Department are really arrogant.

Violating medical procedures—do they not know this themselves?

The patient surnames neither Zheng nor Su—is that really the case?

Or have they become swollen-headed, not even knowing their own surname?

Although after the thoracotomy they saw no problem, directly performing rib fracture internal fixation would also be fine; the patient's family wouldn't know, and they themselves wouldn't go stirring things up.

But, as the saying goes, one who often walks by the river cannot avoid getting their shoes wet.

Let them continue being arrogant like this; trouble is not far off.

Cao Guozhen stared unblinkingly as the two opened the chest cavity; Zheng Renyi raised his hand, and a heavy automatic retractor appeared in his grasp.

Opening the chest cavity, they used the automatic retractor to open an operating field about 8 cm wide.

Normally, the operating field would absolutely not be this large. However, the patient has rib fractures; at this moment the ribs lack that much elasticity and toughness, so the operating field is more spacious than before.

"I originally wanted to get into thoracic surgery precisely for this kind of operating field." Su Yun complained that the Operating Room was too quiet, began to mutter, "More spacious, and no need to fiddle with intestines or scoop feces. Boss, you'd say that's right, wouldn't you?"

As the buckles of the automatic retractor were turned round and round, the lungs came into view,

The right lung's middle and lower lobes each had a huge opening, the edges dark red, appearing in the operating field.

Zheng Ren and Su Yun exhaled a breath.

Indeed, there really is a problem—my intuition was not wrong!

Zheng Ren felt a lingering fear, silently cursing the system—this Big Pig Trotter—only saying it was a lung rupture, without marking how big.

Could a 0.5 cm abrasion-like lung rupture be the same as this 10 cm long, 10 cm deep lung rupture?

Zheng Ren probed with the Hemostatic Forceps; the forceps went all the way in before he could reach the bottom.

The right lung's middle lobe was almost pierced through.

Cao Guozhen stood behind Zheng Ren, stunned.

How could this be?

With such a huge lung rupture, why is there no hemothorax? Impossible!

Unbelievable!

He was bewildered.

Cao Guozhen has been practicing medicine for ten years, having seen countless traumas, yet this situation is still the first time he's encountered it.

What is going on?

While Zheng Ren probed, Su Yun chattered, "Boss, I estimate the force of the rebar strike was too great; the broken ends of the rib fractures resembled a dagger, injuring the right lung's middle and lower lobes, and then, due to the ribs' own elasticity, they snapped back.

Because the force was too great and the injury too severe, it was still similar to a sharp weapon injury. At the instant of injury, multiple bronchial arteries were damaged, gushing out large amounts of fresh blood, directly filling the lungs."

Zheng Ren's mental recollection of the process was similar to what Su Yun said, without much difference.

"So on the imaging films, it looks similar to traumatic wet lung. Because the fresh blood is all poured into the right lung's bronchi and bronchioles, there is no pneumothorax. The lung itself is not compressed; the pressure is huge, and the blood cannot escape, so there is also no hemothorax."

"This case is simply too misleading." After Su Yun finished examining the patient's lungs, he was especially happy, and his words never ceased.

Compared with his previous caution, it's as if he had become a different person.

Cao Guozhen stood behind Zheng Ren, already in a petrified state.

What Su Yun said makes sense. But if it were me, having such a hypothesis, would I dare to perform a thoracotomy?

He pondered for a long time; he was certainly not daring enough.

Without Shou Bing indications, if one randomly opens the chest, it's possible to be reported to the medical mediation committee by those patients' families with ill intent.

These two…… their guts are simply too big.

However, as he continued thinking, Cao Guozhen broke out in a cold sweat in an instant.

If it weren't for Zheng Ren and Su Yun's persistence in wanting to open the chest for examination, after observing the patient for a few more hours, the blood likely wouldn't have appeared in the thoracic cavity but would have seeped bit by bit from the upper respiratory tract.

Similar to the process of drowning, only this time what impacted the patient's breathing was his own blood.

This is even more of a headache than drowning; once the blood clots into a scab, the airway gets blocked……

The patient would then damn well die in the thoracic surgery department.

Just thinking that the patient was fine when hospitalized, didn't even make it through one evening, and died in the thoracic surgery department…… Cao Guozhen was an idiot.

Even just thinking about it feels as terrifying as watching the scariest horror movie, sending chills down one's spine and making one shiver without cold.

His whole body's blood seemed to have coagulated; in his mind he recalled a patient who had once appeared in the ward with a rib Bone fold and aortic dissection—when a CT was done, the dissection was mild and not detected; a few hours later the dissection ruptured and the patient died suddenly.

After the patient's death, dozens of people came to the house, wearing mourning clothes, placed the corpse at the entrance of the thoracic surgery department, and burned paper money while wailing.

Just imagining that scene, Cao Guozhen's legs went weak.

It's not that the doctors aren't conscientious, nor that the patients' families want to cause trouble. A perfectly fine person says they're gone and they're gone—who can bear that?

But doing ten or eight CT scans in one evening to prevent and avoid?

In a year, the thoracic department has to admit hundreds of bone fractures; otherwise they'd likely end up being sued to death by the patients' families.

It's damn scary; thinking about it, Cao Guozhen's palms were drenched in sweat.