Plague Doctor

Chapter 337: ECMO

“Ah Jun has gone into cardiopulmonary arrest for 2 hours and 5 minutes already. We’ve done electric defibrillation, given him adrenaline shots, and applied constant external cardiac compression.” The rotors buzzed noisily as Uncle Dan brought the rest up to speed inside the cabin. The rescue team was led by Phecda members as well. Liu Mingfeng, who graduated from the emergency rescue unit into the Spell Department was the leader. This middle-aged man knew both Gu Jun and Uncle Dan. As Liu Mingfeng listened to the updates, he checked vitals on Gu Jun. The man laid supine on the stretch.

As mentioned before, the Special Mobile Force did not lose any supply after entering the abnormal space so they had access to both mobile defibrillators and respirators. So all possible emergency rescue efforts had been administered, in other words, Uncle Dan had done everything he could but…

The man’s pupils dilated and there was a noted lack of response to light. Zero muscular response to stimulus, and there was not even a heartbeat on the electrocardiogram. According to Uncle Dan, they gained their mobility only moments after the final battle. Therefore, the emergency rescue on Gu Jun began 6 minutes after his cardiopulmonary arrest. Even with the best effort, the success rate was only 10 percent. According to the current international standard, if CPR was conducted after 30 minutes of cardiac arrest and the victim showed no signs of recovery, the patient would be announced dead.

In Gu Jun’s case, it was worse because his heartbeat had stopped for more than 5 minutes before CPR. That meant a prolonged lack of blood flow to the brain, causing irreparable damage to his brain cells. Cerebral death would lead to permanent coma even if the patient was rescued. There was an obvious skin laceration more than 5 cm long on Gu Jun’s right cheek. Part of his skin was bruised and swollen. His right eye was bloodshot. All these pointed towards cerebral damage.

Compared to these two situations, the fractures over his body did not appear that serious. In one word, the situation was not optimistic. Technically speaking, the body on the stretcher would scientifically be labelled as a cadaver.

“He’s not dead.” Wu Siyu suddenly piped up. She was still holding the medical instruments. “I can feel it in my heart. He is not dead.” Uncle Dan knew how hard this situation was for Miss Wu, after all, it was her who led everyone to deliver the fatal blow on the banyan tree… But overall, her mental state was rather stable. Regardless of the official scientific diagnosis, the rescue team did not give up. Their job was to wrestle with death. As rare as it was, there were still precedences of patients who were rescued after hours of cardiac arrest as well as patients who awakened from certified coma. Gu Jun was not a typical person, he’d pull through.

Regarding the other two injured members, Deng Ximei’s situation was not so bad but Xue Ba was in a much worse condition. However, the rescue effort did not cease on either of them either. Zhang Huohuo continued the external chest compression on Gu Jun while nurses hurried over with an ice-pack to lower the temperature around his head. Another nurse attached Gu Jun to a catheter. Liu Mingfeng and Uncle Dan stared closely at the urine bag. If there was urine, then it meant there was still a chance. Once the catheter was connected, they saw dark brown urine streamed into the urine bag.

“There’s still a chance!” Uncle Dan screamed out from joy. Wu Siyu’s face brightened immediately.

“Yes, there is still a chance. Quick, record the urine volume.” Liu Mingfeng informed the nurses. The urine might exist inside Gu Jun’s bladder before his coma but it was still a good sign. “Tell the ship to prepare ECMO. We’ll need it once we land.”

ECMO or extracorporeal membrane oxygenation is an extracorporeal technique of providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequate amount of gas exchange or perfusion to sustain life. ECMO works by temporarily drawing blood from the body to allow artificial oxygenation of the red blood cells and removal of carbon dioxide. Generally, it is used either post-cardiopulmonary bypass or in late-stage treatment of a person with profound heart and/or lung failure.

Due to the technical difficulty of operating such a device and its high price tag, not every hospital had ECMO or a team to perform surgeries with it. However, these were not problems for the team waiting on the destroyer. Vasculocardiology experts, cardiosurgery experts, invasive technology experts, emergency rescue experts, anaesthesiology experts, neurosurgical experts, neurology experts, orthopaedics experts, critical care experts… formed a team on the ship. Some of them were present in person while others joined through Skype. This ECMO would be carried out immediately.

Everything weighed heavily on this operation. With ECMO, even if Gu Jun was already a cadaver, it would help to preserve his body. Xue Ba would be put under ECMO as well.

“Is there a supernatural influence behind the patient’s comatose condition?” Liu Mingfeng asked.

Uncle Dan shivered as he thought back to what happened back on the island. “It was Ah Jun who gathered the dark energy to one spot. Basically he was consumed by it before we had the chance to mount a counter attack. It was the explanation behind his fall from a tall spot. The fractures and cranial trauma came from that.”

Both cleansing stone and Ancient Seal were used. Gu Jun showed no sign of mental corruption. Wu Siyu shared her views. “I don’t think there is supernatural influence here. Yes, the dark energy once swallowed him… but at the last moment, the energy was blasted away. He still tastes salty, granted not as salty as before, but it still tastes like him.”

Liu Mingfeng nodded. Hopefully that was true or else it’d seriously complicate the situation. Less than 5 minutes later, the helicopter landed on the deck of the destroyer. They carried Gu Jun on the stretcher directly towards the ECMO surgical room set on the ship. The cardiac compression was applied throughout. One minute difference could determine the patient’s life and death. The battle at the frontline was over but now it was the start of the war for the logistic members. They had to fight to achieve victory here as well.

Back at the command central, Elder Tong and Yao Sinian’s faces were stern as they watched the emergency rescue on ship. Gu Jun was soon pushed into the ECMO surgical room. The nurses changed him into a surgical scrub. The waiting team moved into action. The first step was to perform venous cannulation, it was the most difficult and important step. While the cardiac compression was ongoing, they would open a small hole on Gu Jun’s calf to search for his arteria cruralis and femoral vein to perform cannulation. Then they would be connected to the ECMO machine through a long pipe. A mishap during this step would cause immense blood loss. It’d delay the emergency rescue and make the situation worse.

With the shadeless lights working in the background and directions provided by the ultrasound, several doctors and nurses performed operations on Gu Jun who laid serenely on the surgical table.

…

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