Chapter 44: with translation of chapter title

0043 Extremely urgent, all-out rescue!

The two remained silent, jogging all the way to the Emergency Department.

Back in the Emergency Department, Director Pan ordered the discharge of patients with mild conditions, sending them to other hospitals for treatment.

Director Pan announced a mass poisoning incident; City First Hospital would concentrate resources on treating critical cases, and most patients still followed the arrangement, leaving on their own to seek care elsewhere.

Some with minor injuries, not in a hurry, stayed behind to watch the commotion.

But a few people started causing a scene. Having come all this way, they actually said they wouldn't see a doctor?! Is your hospital still a place to save lives and heal the wounded? If you refuse to treat me, then nobody gets treated!

Director Pan merely gave the noisy elders and troublemakers a cold stare, ignoring them completely, then turned to arranging the observation beds in the Emergency Department.

Those who could be discharged were sent home, paperwork to be done later, freeing up as many observation beds as possible in anticipation of the coming storm.

Five minutes later, the entire leadership team of City First Hospital arrived at the Emergency Department, setting up an on-site command, reallocating doctors and nurses from various departments to strengthen the ED.

After all, such a major event might occur only once in several years; thus the Emergency Department had no regular stockpile, only making temporary allocations.

A female patient in her fifties, wearing a hostile expression, saw the hospital leaders arrive, stepped forward and grabbed Dean Xiao, who was surrounded by stars, and began to cause a disturbance.

There was nothing anyone could do about an elderly person acting like a ruffian, and Dean Xiao was no exception.

Seven minutes later, nearby police forces arrived to provide support.

Upon seeing the shining national emblem, those causing trouble all backed down.

Nine minutes later, the wailing sirens of ambulances could be heard in the distance; all personnel were in position, ready to begin the battle.

Zheng Renhe, a nurse, and an orderly went together to the Emergency Department entrance to meet the 120 ambulance. Originally Zheng Ren didn't need to go, but he thought that if he could make a definitive diagnosis even a second earlier, perhaps he could save a living life.

The 120 ambulance braked sharply, tires screeching against the ground, emitting a piercing sound. A stream of white smoke rose, leaving black skid marks on the pavement.

The stretcher was pushed out, and Zheng Ren froze for a moment.

The patient's exposed skin was bluish-gray, a living Avatar.

Zheng Ren's mind instantly flashed a bad thought: This must be nitrite poisoning.

After undergoing training in the System, Zheng Ren's memory became countless times stronger than before.

Such a disease as nitrite poisoning, extremely rare, was mentioned only in a few brief sentences in school textbooks. After leaving school and starting work, Zheng Ren had never encountered a case of nitrite poisoning.

Yet this memory, just a few lines of text, appeared directly, with no vagueness at all.

Through the case diagnosis displayed in the upper‑right corner of his vision, Zheng Ren confirmed: this was nitrite poisoning, the patient was already in toxic shock and could die at any moment!

Pushing the stretcher, Zheng Ren sprinted.

At this moment, every second was extraordinarily precious, capable of deciding a person's life or death.

"Nitrite poisoning! Prepare methylene blue! Prepare potassium permanganate gastric lavage!" Zheng Ren shouted while pushing the stretcher and running.

His voice echoed throughout the hallway.

Xiao Zhao hid in an inconspicuous corner of the Emergency Department corridor, livestreaming. When he heard Zheng Ren's voice and saw him pushing the stretcher while sprinting, a sudden feeling of admiration welled up inside him.

Usually an ordinary, penniless, homeless, girlfriend‑less loser youth, at this moment he felt immeasurably tall.

"Prepare methylene blue, in large quantities!" Zheng Ren announced loudly as he passed Dean Xiao's side.

It sounded as if he were the director, his voice carrying authority.

Dean Xiao stared, stunned; the irrational, troublemaking woman in her fifties, despite the police's presence, continued to cause a ruckus.

Zheng Ren released the stretcher and said, "Establish an intravenous line, add 140 mg of methylene blue to 250 ml of 10% dextrose, infuse rapidly, and simultaneously perform gastric lavage with potassium permanganate."

The stretcher bearing the patient left Zheng Ren's hands and was caught by the nurse waiting at the Emergency Resuscitation Room door, done with practiced ease.

"We need a large amount of methylene blue; the Emergency Department has only its regular stock, which is insufficient." Zheng Ren walked to Dean Xiao and said solemnly and seriously.

"You're bullying this old lady; I won't let it go! I don't believe there's no justice left!" The old woman seemed to have gone mad, grabbing Dean Xiao's white coat collar and raising a commotion, ignoring even the nearby police.

Without a word, Zheng Ren stepped forward, seized her arm, and flung her aside.

With such force, he threw the troublemaking old woman into the crowd by the wall in one motion. She staggered for a moment, then immediately sat on the ground, began to wail dryly, slapping her hands on the floor, shouting, "Doctors are killing people, police are killing people!"

"You handle this; more people will be coming soon." Zheng Ren shifted into commander mode, directed the police to act, then told Dean Xiao, "Our hospital's stock probably isn't enough either—we should request aid from the city. If the city's stock is insufficient, we'll seek help from neighboring cities and counties."

Having said that, he turned and left immediately, without explaining why.

Emergency resuscitation is inherently a race against time; Dean Xiao's face grew grave, his disheveled collar ignored, he arranged for the Director of Medical Affairs to mobilize the hospital's methylene blue supply, then picked up the phone to begin contacting methylene blue sources across the city.

Methylene blue, also called azure blue, is clinically used mainly to mark surgical sites for localization; thus the hospital's overall stock is not large, because it is consumed sparingly.

In normal human and animal red blood cells there are substances that reduce methemoglobin, such as vitamin C and various glutathiones.

If the oxidizing capacity of nitrite entering the body exceeds the body's reducing capacity, then humans or animals will exhibit clear poisoning symptoms.

When methylene blue is administered, under the catalysis of reductase 1 it becomes reduced methylene blue. Reduced methylene blue can reduce methemoglobin to hemoglobin, while itself being oxidized to oxidized methylene blue. This cycle repeats continuously, allowing reuse.

This theory is known to few of the medical staff present; it is extremely obscure emergency knowledge. Nevertheless, it does not prevent everyone from recognizing the seriousness of the problem, given that the patient's whole body is blue, breathing is feeble, blood pressure is very low—anyone with a bit of clinical experience can see at a glance that the patient has entered shock.

If the shock state is not promptly improved, reduced blood perfusion will soon lead to hepatic and renal failure, cerebral edema, and other complications, followed by death.

After Zheng Ren finished arranging things with Dean Xiao, he entered the resuscitation room. At that moment he never imagined that his tone when speaking to the director might later cause him trouble.

The patient lay on the resuscitation bed, his upper garment cut off and tossed aside. His body was covered with electrode pads connected to the ECG monitor. A dense orderly array of wires transmitted his vital signs to the monitor via electrical current, turning them into numbers and images, making everything more direct.

Blood pressure 50/20, heart rate 40, oxygen saturation unmeasurable!

By ordinary standards, this would already be considered a corpse.

The head nurse was establishing an intravenous line, bent over; after three attempts she still saw no blood return. Sweat beaded on her forehead, and within ten or so seconds it had soaked her sterile cap.

Life or death hinged on whether the intravenous line could be successfully established.

At that moment the patient's blood pressure was 50/20, his pulse extremely faint; even the large neck and femoral veins had collapsed, their vessels flattened into connective tissue within the muscle, making them impossible to locate.

"Let me do it." Director Pan took out the incision kit, pulled down the patient's trousers, and began searching for the femoral vein, preparing to perform a femoral vein cutdown—a procedure once common but now rarely done.

Given the dire situation, even if Director Pan incised the skin and muscle of the groin, the femoral vein might already have turned into a mere thread of transparent connective tissue, challenging the practitioner's eyesight and experience.

Furthermore, doing this is slow; Zheng Ren seemed to hear again the distant wail of the 120 ambulance.

Without hesitation, Zheng Ren entered the System Space and shouted, "I want to buy training time!"