Chapter 89: with translation of chapter title

Chief Zheng, I called an Emergency Rescue Service ambulance, I didn't bring money, you have money right? Chang Yue's voice remained cold.

Zheng Ren let out a big yawn, morning grumpiness came out.

If it's an Emergency Department patient visit, don't even mention morning grumpiness; sometimes there's no time to put on shoes. But receiving Chang Yue's call early in the morning, that originally pretty face, always stern, appeared before me.

But Zheng Ren, who is always good-tempered, still dispelled the morning grumpiness.

These guys, they couldn't have been drinking all night, right? Just thinking about this, he immediately became energetic.

Damn, drinking all night, seeking death?! Actually called an Emergency Rescue Service ambulance? Won't he have drunk to gastrointestinal bleeding?

"Yes." Zheng Ren Tension, "How are you? How is Su Yun?"

"I'm fine, feeling energetic, feel I can go to work directly no problem. Su Yun had more, fell a bit, probably no big deal." Chang Yue said.

Zheng Ren slightly relaxed, secretly cursing, these two annoying guys, how could they drink all night?

"Chief Zheng, I also picked up a patient, middle-aged male, board-like abdomen, what do you think?" Chang Yue then said the most important content of calling Zheng Ren.

"Go to the Emergency Department, I'll go check." Zheng Ren said, immediately changed shoes, put on White Coat and rushed straight to the Emergency Department downstairs.

Just after leaving the door, he turned back, took 200 dollars from his wallet, and stuffed it into the pocket of the Isolation Gown.

Emergency Rescue Service ambulance is not free; each callout charges according to distance. Even if it's family, there's no cheap advantage to take. After all, for a hundred or so dollars, you still have to save face for Director Pan, you can't afford to lose face.

The crayfish restaurant is not far from the hospital; Zheng Ren arrived at the Emergency Department at the same time as the 120 Emergency ambulance arrived.

Two stretchers came over, one carried Su Yun. He drank a lot but his drinking manners were still okay, curled up into a ball, muttering unintelligibly.

Chu Yan zhi followed beside, looking helpless.

"I advised, but couldn't stop them." Chu Yan zhi explained, as if this matter were all her fault.

"It's fine." Zheng Ren comforted Chu Yan zhi.

Zheng Ren glanced, the System Panel indicated acute alcohol poisoning…… damn, how much did he drink, to reach alcohol poisoning.

"Send him to the Jizhenbingfang, give a slow push of naloxone, then give 500 dextrose plus two vials of vitamin C." Zheng Ren briefly instructed Chang Yue.

Chang Yue blankly, accompanied the orderly and stretcher up the elevator. Chu Yan zhi followed behind, waddling, compared to Chang Yue she was just a kid, even though their ages are similar.

After walking far, Zheng Ren noticed Chang Yue was barefoot, as if wet, each step leaving a footprint.

One alcohol poisoning, one lost his shoes…… Damn! Zheng Ren secretly cursed.

But this isn't important; the patient with board-like abdomen is Zheng Ren's main focus coming down.

On another stretcher lay a big-framed but thin man.

Zheng Ren looked at the System Panel, the marking in the upper right corner was bloody red, similar to the red of the patient with acute nitrite poisoning that day.

Acute gangrenous appendicitis, infectious shock.

Critical!

Speed up pushing the stretcher to the Emergency Resuscitation Room, Zheng Ren ran while shouting: "Get the ultrasound room to do bedside, prepare monitoring equipment, administer oxygen."

Arrived at the resuscitation room, two night-shift nurses started to remove the patient's outer clothing and set up the ECG Monitor.

Zheng Ren examined, as soon as his hand touched, a wave of heat was transmitted.

Fortunately…

Toxic shock, fever is normal. But if there is no fever, that's clinical cold shock, basically you can tell the family to prepare for the worst.

The patient still has fever, meaning the body's immune system can still maintain normal function; although dangerous, it's not the most dangerous kind.

Heart rate 130 beats per minute, blood oxygen saturation only 93%. The abdomen is like a hard wooden board, cannot be pressed.

This is a typical sign of peritonitis, inflammation irritates the peritoneum, causing abdominal muscle tension, also called board-like abdomen.

Commonly seen in hollow organ rupture, digestive juices flow into the peritoneal cavity. Or solid organ rupture bleeding, blood irritates the peritoneum causing it.

The ultrasound room doctor quickly came pushing the cart, while efficiently applying gel to the patient's abdomen, asking: "Patient's name."

Because a report will be issued later, the name must always be asked. This is routine; otherwise a careless mistake in the report would delay patient treatment, which is a big deal.

"John Doe, male, about 35." Zheng Ren sized up the patient's appearance, roughly estimated age, and blurted out.

"Lower abdominal mass, consider periappendiceal abscess, or appendiceal perforation causing. Other areas have lots of gas, ultrasound unclear. Pelvis has a small amount of fluid, remainder negative." The ultrasound doctor quickly reported the main diagnosis to Zheng Ren.

The condition is serious, requires surgery.

Zheng Ren, while ordering medical staff to transfer the patient to the Jizhenbingfang, picked up the phone, hesitated a bit, then dialed.

This early, bothering Director Pan is somewhat inappropriate. But this matter must be reported to the senior physician, it's no joke.

If the patient truly had no family, that would be fine; but if the surgery goes wrong or due to severe condition cannot be saved, often relatives and friends pop out from nowhere, crying and wailing, shouting injustice.

This is secondary; Zheng Ren has no time to consider. The main problem is right in front: need surgery, no one to sign.

Director Pan answered immediately, tone very serious.

"Little Zheng, what's up?"

Zheng Ren rarely disturbs Director Pan's sleep; this is his first time in the Emergency Department. So Director Pan is a bit nervous, this is doctors' instinctive reaction.

"John Doe, male, around 35. Considering acute gangrenous appendicitis, acute toxic shock, no family contact." Zheng Ren reported the main points in one breath.

"Prepare for pre-op, I'll contact the Medical Department." Director Pan answered without hesitation, immediately.

Zheng Ren hung up, trotted upstairs, didn't wait for the elevator, took the fire escape.

"Pre-op preparation." While directing nurses, Zheng Ren picked up the phone, called Chu Yanran and Xie Yiren to get them ready for surgery.

Emergency Department blood draw, ECG, etc. test results returned, Zheng Ren glanced and brought the patient with already placed gastric tube and urinary catheter to the third-floor Operating Room.

Handed the patient to Chu Yanran and Chu Yan zhi, then returned to the Jizhenbingfang.

At this time, Director Pan was already on the way; the on-duty staffer of the Medical Department yawned, brought recording equipment to the doctors' office in the Jizhenbingfang.

When Director Pan arrived, the Medical Department staffer began recording a legally effective video file.

Zheng Ren reported the medical history, described the patient's condition, proposed Solution, and pointed out that due to lack of family, pre-op communication and signing were impossible.

Next, the Medical Department, representing the hospital, authorized Director Pan, granting the Jizhenbingfang the authority to perform surgery.

Such procedure is indispensable, a self-protection behavior of medical staff.

After finishing the video, the staff of the Medical Department, carrying equipment, returned to the office with sleepy eyes.

Zheng Ren felt a bit embarrassed, "Director Pan, sorry for waking you up so early."

"Old people sleep little, I'm already awake." Director Pan waved his hand, "Go perform the Shou Bing, are you confident?"

Facing toxic shock, no one has absolute confidence.

Unlike shock caused by nitrite poisoning, toxic shock caused by diffuse peritonitis has no specific drug; only Shou Bing can block the source of contamination, and after the Shou Bing large amounts of antibiotics are used to resolve the problem.

As for whether recovery is possible, it still depends on the patient's own condition.

That person… Zheng Ren recalled that skin-and-bones frame, his expression grew somewhat dim, and he shook his head.

"Do your best." Director Pan patted Zheng Ren's shoulder, "Regarding the expenses, I'll consult with the hospital after work."

Zheng Ren nodded and hurriedly went to the Operating Room.