Chapter 187 - 170: Return to the First City Hospital, a Grand Display of Skill

Chapter 187: Chapter 170: Return to the First City Hospital, a Grand Display of Skill

Besides, in a situation like this, an abdominal paracentesis was indeed the best method. As long as they could determine the condition inside the abdominal cavity, they could administer the fastest symptomatic treatment.

"Yasui, simultaneously draw a blood sample for cross-matching, administer oxygen, keep the airway clear, and closely monitor the patient’s vital signs..."

"Sister Xiao, you prepare the syringe and needle..."

Wu Ting calmly began giving orders while starting the most basic abdominal paracentesis.

Soon, by examining the peritoneal fluid, Wu Ting made a basic assessment.

"This is bad. The patient’s condition is critical—obvious massive internal bleeding with bile leakage. We can basically confirm it’s a massive hemorrhage caused by a liver rupture!"

"A liver rupture!"

The expressions on Xiao Xixi and Yasui’s faces turned grim. They lacked the means to handle an emergency in the field of hepatobiliary surgery.

At this point, the patient’s face was pale, his pulse was rapid, his blood pressure was dropping, his abdominal breathing had all but disappeared, and his muscles were tense...

Xiao Xixi felt a surge of panic. Looking at the patient’s condition, she thought, ’This is bad. The patient is probably going to die on the way.’

"There’s definite shifting dullness in the patient’s hepatic region, and his bowel sounds are diminished..."

Yasui, monitoring the vitals on the side, spoke with a raised voice, clearly anxious.

Old Zhou sped up as well, but at their current distance, they wouldn’t make it to City First Hospital in time for emergency treatment.

What could they do?

Xiao Xixi had already taken out her phone and started calling Director Huo. He wasn’t at the hospital at the moment, but once the call connected, she began to report the general situation.

Director Huo was about to give instructions while rushing to City First Hospital when he heard Wu Ting’s calm voice over the phone.

"Sister Xiao, tell Director Huo to immediately contact doctors from general surgery, hepatobiliary surgery, orthopedics, and radiology. As soon as we arrive at City First Hospital, we need to give the patient immediate emergency care. I will do my best to ensure the patient makes it back to the resuscitation room in stable condition!"

After saying this, Wu Ting looked directly at Yasui and issued his command:

"Dr. An, it’s confirmed that the patient has a massive hemorrhage caused by a liver rupture complicated by rib fractures. The liver is rich in blood vessels and has fragile tissue, making this extremely dangerous. Moreover, the patient’s condition is changing rapidly, and the mortality rate is very high. Therefore, we can’t wait until we get to the ER to start resuscitation."

"Right now, I need to perform emergency treatment for traumatic liver rupture here in the vehicle."

"In clinical practice, the most crucial part of emergency treatment for liver rupture is to replenish blood volume. We need to quickly establish three IV lines to ensure rapid intravenous medication... Infuse 1000-1500ml of balanced salt solution. Once we get to the emergency center and the blood is cross-matched, we’ll transfuse whole blood..."

With Wu Ting’s commands, Yasui and Xiao Xixi now had a backbone to rely on, and they both began to act according to his instructions.

Old Zhou glanced at the young doctor in the back, his confidence surging. He focused on driving, pushing the speed even higher to buy as much time as possible for Wu Ting.

Soon, thanks to the emergency measures taken by Wu Ting, Yasui, and Xiao Xixi, the patient was effectively resuscitated. They quickly established a clear airway and surgical field while correcting his hemodynamics...

The patient’s vital signs gradually stabilized.

"We’re running out of time. Once we get to the resuscitation room, perform a bedside B-scan ultrasound immediately. We need to perform an emergency laparotomy on the patient!"

"Sister Xiao, you’ll be in charge of arranging the expedited pathway. Yasui, you’ll assist me in surgery."

"We need to stabilize the patient’s condition before Director Huo and the others arrive!"

In such a time-sensitive situation, Wu Ting couldn’t afford to hold back; he had to use every skill at his disposal.

It was all thanks to Director Fu’s Traumatic Liver Rupture Emergency Measures (Purple)!

"Okay."

"Okay."

Xiao Xixi immediately called the director of the ultrasound department. The relevant on-call doctor rushed to the resuscitation room to await the arrival of Wu Ting’s team.

Finally, thanks to the emergency measures taken by Old Zhou and Wu Ting’s team, they got the patient to the resuscitation room.

The bedside ultrasound began immediately. Wu Ting took a quick look and was basically certain: it was a liver rupture. Besides suturing the laceration, they would have to resect the necrotic part of the liver lobe. There was no time to lose!

"Yasui, we’re starting the laparotomy now. You’ll assist me with hemostasis and controlling the bile leakage..."

"I’ll be responsible for debriding the injured tissue and placing drains... After that, I’ll perform the liver suture and a partial segmental hepatectomy!"

"Of course, the most important thing is to start replenishing blood volume and ensuring intravenous medication!"

...

After giving his instructions, Wu Ting moved quickly.

Under Wu Ting’s methodical arrangements, the patient’s central venous pressure, blood pressure, urine output, heart rate, and other indicators began to stabilize.

The airway also remained clear.

"Sterile drainage bag... decompression tube... check biochem, liver and kidney function, ECG..."

After stabilizing the patient’s condition, Wu Ting began to arrange the next steps.

Meanwhile, Huo Yun and the other department heads had also rushed to the emergency room.

Director Lu Xiong from Orthopedics, Director Lin Hu from General Surgery, and Director Cai Qi from Hepatobiliary Surgery had all arrived.

They discussed the case as they hurried toward the operating room.

"According to Xiao Xixi’s report just now, the patient has a massive hemorrhage from the liver, complicated by rib fractures! Wu Ting performed an abdominal paracentesis in the ambulance—bile leakage, massive bleeding, it’s definitely a liver rupture..."

Because of Wu Ting’s rapid arrangements, the information these directors had received was from before the surgery began.

Xiao Xixi was busy cross-matching samples and arranging blood transfusions, so she hadn’t had time to update the directors.

After hearing this, Huo Yun and Cai Qi’s expressions turned grim.

"Based on the timeline, the patient’s prognosis isn’t optimistic. If it’s really a massive liver hemorrhage, he needs immediate blood replenishment and two to three established IV lines..."

"Although Wu Ting made a preliminary diagnosis of massive liver hemorrhage right away with the paracentesis... we still need to do ultrasound and CT imaging. Only with careful examination can we be confident about what we’re dealing with."

Cai Qi’s skill level wasn’t high enough to perform a laparotomy and make judgments intraoperatively. Besides, with a case involving fractures and massive bleeding, the abdominal cavity would be a complete mess. For all they knew, a part of the patient’s entire liver could be necrotic, making it difficult to judge by sight alone.

"We could get an expert from Haijin Port on the line, or a hepatobiliary specialist from Jin Province Tumor Hospital, for a remote consultation."

Lin Hu suggested.

"Right, didn’t the ER bring in Deputy Director Zhang Heng from the Provincial Tumor Hospital? His skills in liver surgery are very impressive. Get him over here immediately. If it’s really a liver injury, he can assist with the subsequent partial hepatectomy."

Huo Yun thought that made a lot of sense. Zhang Heng’s fundamentals in liver surgery were very solid.

A short while later, he arrived. Zhang Heng happened to be working overtime today, preparing for several upcoming patient surgeries.

But after learning about the patient’s condition, Zhang Heng’s expression also became very solemn.

"It’s been over twenty minutes since the patient was picked up. The situation is dire. If I had been on that ambulance call, I might have been able to keep the patient stable."

"This kind of massive hemorrhage requires immediate imaging diagnostics to determine the surgical plan."

Zhang Heng was both daring enough and skilled enough to handle the emergency, but he needed to proceed at his own pace from the very beginning, performing the most comprehensive examinations. He preferred to over-prepare; he was afraid that a rough, direct judgment would lead to unexpected complications during surgery.

"Actually, this Dr. Wu Ting has already done quite well, being able to decisively perform the abdominal paracentesis."

"Well, we have no choice but to follow this course of action now. Let’s hope Wu Ting and Yasui were able to perform some effective procedures over there."

Zhang Heng was extremely tense, but he was also itching for a chance. If he could successfully save the patient under these circumstances, it would be a huge boost to his reputation at City First Hospital.

However, when the few of them quickly entered the operating room, they saw a scene they would never forget for the rest of their lives.

"This..."