Chapter 72: Teacher Zhang, I Want to Be First Assistant

While touching Guo Qiancheng's father's forehead, Wang Chuan instructed the emergency nurse:

"Establish dual IV lines, Balanced Salt Solution rapid drip! Electrocardiogram Monitor, Blood Pressure Monitor, Blood Oxygen Saturation Monitor on immediately! Prepare to draw blood, Blood Routine....."

"Also, call Anesthesiology Department immediately! The patient is in early septic shock, needs urgent anesthesia assessment and support!"

Guo Qiancheng's father Guo Yong had a grey complexion, dry cracked lips, forehead covered in cold sweat, breathing rapid and shallow.

A label floated above his head:

【Right forearm Open Fracture with retained foreign body, postoperative infection, Pseudomonas aeruginosa infection, body temperature 39.8°C, heart rate 132 beats/min, blood pressure 90/60mmHg, respiration 28 breaths/min, moderate Dehydration, Hemoglobin HGB: 82g/L, Ulnar Nerve and Median Nerve postoperative function not recovered.】

This was the first time since Wang Chuan's Rebirth that he had seen a prompt with so much information.

"Chen Leyan, take Guo Qiancheng outside, trust me!" Wang Chuan's voice was steady and forceful, without a trace of an Intern's timidity.

After a while, having received the notice, Attending Zhang Yang and Doctor Wu Qinghua had already arrived.

Zhang Yang walked in quickly and said in a deep voice: "Wang Chuan, what's the situation? Hand the patient over to me."

Wang Chuan did not step aside, but instead shifted half a step to the side, letting Zhang Yang see the monitor and Guo Yong's condition more clearly.

He himself reported to Attending Zhang Yang at a fairly rapid pace, clearly and methodically.

At the end of the report, Wang Chuan stated his preliminary diagnosis:

First, severe postoperative infection of the right forearm Open Fracture, highly suspected incomplete Debridement with retained foreign body, possibly Pseudomonas aeruginosa infection;

Second, Sepsis, possibly early stage;

Third, moderate Dehydration;

Fourth, Hemorrhagic Anemia, Hemoglobin HGB estimated to be very low;

Fifth, postoperative functional damage to the Ulnar Nerve and Median Nerve after exploration.

After Wang Chuan finished speaking, he swallowed a few times, then continued to add: "I highly suspect Pseudomonas aeruginosa. Right now, I believe we must immediately perform a second thorough Debridement and exploration."

"Remove the retained contaminants, while aggressively fighting infection, fighting shock, and correcting fluid and electrolyte imbalances!"

Attending Zhang Yang felt that Wang Chuan's analysis and his own internal diagnosis of the situation he saw were roughly the same.

He himself had encountered quite a few cases where Reinforced Steel Bar had pierced the body without complete Debridement.

Pseudomonas aeruginosa is widely present in moist environments.

Construction-site Reinforced Steel Bar exposed to soil and sewage is a common habitat for Pseudomonas aeruginosa. The lower-level Hospital's failure to thoroughly remove contaminants provided a breeding ground for Pseudomonas aeruginosa.

Zhang Yang lifted a corner of the gauze; deep in Guo Yong's wound there was blue-green pus scab and a sweet, fishy smell—typical characteristics of Pseudomonas aeruginosa. Of course, a culture had to be done to confirm finally.

It seemed this Intern Wang Chuan was not just a Suture Monster; his Surgery Department knowledge was not weak.

He quickly instructed: "IV infusion of Tienan and Tobramycin, send intraoperative cultures, but treatment cannot wait! Notify the Surgery Room, prepare emergency second Debridement surgery! Wu Qinghua, you be First Assistant, Wang Chuan, you be Second Assistant!"

"Teacher Zhang, Teacher Wu!" Wang Chuan's voice was decisive and resolute.

"I request to serve as First Assistant! I have a special 'intuition' for the wound's structural layout, possible infection foci, and points of retained foreign body—I can pinpoint them precisely during Debridement and assist you in thoroughly clearing the source of infection! Please trust me!"

After completing its twelfth activation, Wang Chuan's 【Virtual Operation Training】 discovered that 【Clinical Medical Insight】 had upgraded: after he touched a patient, lesion labels would appear above various parts of the patient's body.

This was also the source of Wang Chuan's confidence in requesting First Assistant.

Zhang Yang and Wu Qinghua exchanged glances. Given Wang Chuan's earlier report and preliminary diagnosis performance, as well as his unbelievably skillful Suture Technique, letting him be First Assistant was not out of the question.

"Doctor Zhang, let Wang Chuan be First Assistant, I'll be Second Assistant. Good seedlings should be carefully cultivated."

Wu Qinghua glanced at Wang Chuan, inwardly believing in him.

"Good! I'll be Chief Surgeon, Wang Chuan First Assistant. Move fast, be thorough!" Zhang Yang decided with finality.

Inside the Surgery Room, the Anesthesiologist had completed all anesthesia matters; this time it was general anesthesia.

Under the shadowless lamp, Wang Chuan's past-life medical knowledge was clearly visible in his mind, his Muscle Memory awakened.

His posture steady as a mountain, fluid and forceful, he put on gloves.

When the gauze covering the wound was lifted, a foul stench spread. The wound was red, swollen, and ulcerated, pus and necrotic tissue mixed together, the Fascial Space swollen.

"Suction Device! Tissue Forceps!" Zhang Yang ordered.

Wang Chuan's operation was precise and swift, flawless as First Assistant.

He held the Suction Device, efficiently suctioning out pus and blood, while using Tissue Forceps to stabilize tissue, creating the best field of view for Zhang Yang.

Wang Chuan's 【Clinical Medical Insight】 had long been activated, labels constantly appearing in his field of vision, providing guidance.

"Teacher Zhang, watch here!" Wang Chuan's Forceps precisely pointed at a swollen Fascial Space. "There's a foreign body and Pus Cavity fluctuation deep inside!"

Zhang Yang cut along the guidance; Wang Chuan's Forceps immediately went in, steadily clamping out a small piece of Cement Debris and a few strands of tangled Clothing Fiber!

"And here, deep in the Tendon Space, Pus Cavity!" He rapidly assisted Zhang Yang with Incision and Drainage; yellow-green pus gushed out, the sweet fishy smell spreading.

Wang Chuan precisely coordinated the operation while clearly guiding in a low voice:

"The Ulnar Nerve is being compressed obviously here, the Median Nerve's course area has Adhesion, needs careful Decompression....."

With Wang Chuan's help, Zhang Yang's Debridement as Chief Surgeon was unusually efficient and thorough, carefully protecting important structures and decompressing the compressed nerves.

The two doctors' coordination demonstrated a high level; the surgery proceeded tensely and efficiently.

Zhang Yang said to Wu Qinghua: "The wound drainage fluid must be sent for Aerobic and Anaerobic Bacterial Culture and Drug Sensitivity Test, with key focus on screening for Pseudomonas aeruginosa. If the temperature hasn't dropped in 48 hours, add an Antifungal Drug."

Thorough Debridement, Blood Transfusion, copious irrigation, placement of Drainage.....

With the precise assistance of Wang Chuan, this First Assistant who possessed a "Golden Finger," the surgery's progress far exceeded the normal pace.

A surgery that originally required four hours, with Wang Chuan's help, took only two hours.

After the surgery ended, Guo Yong's body temperature began to slowly drop under the support of potent Antibiotics and Fluid Resuscitation, his vital signs trended toward stability, and he was sent to the Surgery Ward.

Yang Fang, who had just come out of the Surgery Department Office, saw Wang Chuan coming out of the Surgery Ward and immediately questioned him sternly: "Wang Chuan, what are you doing in the Surgery Ward?! You haven't even started your Surgery Department Rotation!"

Pei Nanli also sent a text message, asking him if he could get another Bar Invitation Card for Wang Chuan.

Yang Fang first pretended to agree, and as soon as half an hour arrived,

he told Pei Nanli that he had asked several Friends but couldn't get it. The Boss of Nanshan Blue Fire Bar is from Hong Kong; the whole style is copied from Hong Kong's, and it's the first of its kind in Mingzhou. The number of people wanting an Invitation Card is especially large.

At this moment, Attending Zhang Yang walked out from behind Wang Chuan. "Doctor Yang, there's a patient with a Reinforced Steel Bar in his right arm; the surgery was very successful, I did it together with Wang Chuan. That patient has been sent to your Surgery Ward postoperatively."

Creak—the ward door swung open, and Guo Qiancheng dropped to his knees with a thud in front of Zhang Yang and Wang Chuan.