Chapter 29: Barehanded Bleeding Control
The resuscitation room did not run a general practice. When faced with critically-ill patients who had complicated conditions and serious trauma, their duty was to stabilize the patient’s vital signs, and then transfer them to specialized departments for treatment.
If the bleeding could not be stopped no matter what, the patient could not be considered stabilized. Moreover, bleeding meant more than just that, it also signified serious trauma.
“What have you used?” Huo Congjun stood still, neither anxious nor irritated. All sorts of strange diseases could always be seen in the Emergency Department. Being anxious and irritated would not solve the problem.
Under his influence, Zhao Leyi the attending physician also calmed down. He said, “Intramuscular injection of reptilase, iced saline, and norepinephrine. We expedited the application for erythrocytes and plasma of the same blood group, and also gave multiple ethamsylate injections. The patient has been administered a total of 47 ounces of fluids.”
As Huo Congjun listened to him, he shined a torch on the patient’s pupils and said firmly, “Prepare for emergency surgery. Perform exploratory laparotomy and increase fluid replacement.”
“Are we performing exploratory laparotomy now?” Zhao Leyi was a little hesitant. Right now, they still could not confirm that the bleeding source was inside the stomach. If they got it wrong, the patient would be dealt an extra blow.
“Save the patient first before treating him!” Huo Conjun said through gritted teeth.
“The patient is going into shock!” a nurse yelled loudly.
Many patients suffered from circulatory collapse in the resuscitation room, but it was usually not good news for a patient to go into shock during an emergency treatment.
Ling Ran still kept his eyes on the patient. But at this moment, he turned to leave and began to wash his hands in the isolated area.
“Excuse me.” A plain and ugly resident doctor who was once in the same group as Ling Ran elbowed Ling Ran aside and started washing his hands under the faucet beside Ling Ran.
Ling Ran shifted a little to the side and continued washing his hands meticulously.
When he saw that Ling Ran was washing his hands so seriously, the resident doctor kindly reminded Ling Ran, “During busy times in the resuscitation room, you’ll have to come into contact with countless patients in a day. You can usually just wash your hands with an alcohol-based hand sanitizer and let it air-dry. Or else, if you wash your hands too often, your skin will peel off.”
“I’m preparing for surgery,” Ling Ran answered and started rubbing his hands together. He did that non-stop, causing heat to be produced.
He had not only sutured almost a hundred patients during his few days in the treatment room, he had also familiarized himself with the way the hospital worked.
The resident doctor looked around in astonishment. “What surgery?”
All the doctors in a hospital’s departments were divided into groups. Each treatment group was led by a chief physician or an associate chief physician, and was responsible for one or more patients.
It was also like that during an emergency treatment. All doctors who came into contact with a patient were usually from the same treatment group.
The medical interns were not divided too strictly, but since Ling Ran was following Department Director Huo today, if he wanted to perform surgery, he would naturally be part of Huo Congjun’s treatment group.
The plain, ugly resident doctor saw that Huo Congjun was busy with that critically-ill patient. He could not refrain from pursing his lips and thought. ‘It’s already considered impressive for an intern to be able to run errands during this kind of emergency operation. How would he get to perform surgery?’
If a patient went into shock, it meant that his risk levels had gone from Level 2 to Level 1.
Near-death patients were the most troublesome beings in the resuscitation room. Even regular attending physicians might not be able to participate in their rescue. To put it in a more westernized way, the patient’s level of criticality had increased by one.
Ling Ran left the wash basin and returned to the resuscitation room with his hands held together. He put on a pair of latex gloves.
In the Emergency Department, it was actually relatively rare to see a doctor be so serious and ready for surgery. The sight of Ling Ran raising his hands to put on his gloves in such a serious manner attracted many doctors’ attentions.
Upon returning to his operating post, the plain, ugly resident doctor could not refrain from laughing out loud. “As expected of a young’un. No matter how highly Department Director Huo thinks of him, it’s impossible that Department Director Huo will let him try his hand on a patient who is near death. What is he thinking?”
Doctor Zhou turned to glance at Ling Ran and said casually, “Young Ling just started his internship. He’ll understand in the future.”
“It’s already good that Department Director Huo didn’t chase him away. The patient is losing blood and going into shock, and an exploratory laparotomy is about to be performed. What’s he doing, going there—Oh my god!” As he spoke, the plain, ugly doctor began shouting.
“Why are you shouting?” Shocked, Doctor Zhou followed the other party’s gaze and was startled as well.
Ling Ran stood between the attending physician and Department Director Huo, and was actually directly extending a hand into the open wound on the patient’s stomach.
All the doctors in the Emergency Department who saw this were stupefied.
‘He actually had the audacity to operate directly without setting up a surgical field. Is this a murder scene?! Even if you disregard the fact that he did not give any warnings before he did this, such a thing is still not seen even during normal surgeries.’
Huo Congjun’s enraged stature immediately appeared in the plain, ugly resident doctor’s mind. He trembled violently as if he had experienced the department director’s scolding himself, and said, “This is the most daring intern I have ever seen.”
Even though Doctor Zhou wanted to defend Ling Ran, he had nothing to say.
Compared to the onlookers, Huo Congjun scored the highest on the shock index. From his interactions with Ling Ran in the past two days, Ling Ran was a meticulous young man. Even if Huo Conjun were to become even more imaginative, he would not be able to imagine that Ling Ran would dare to suddenly extend his hand in the middle of an emergency operation, which was a matter of life and death for the patient.
“Ling Ran, let go!” Huo Congjun could not pull Ling Ran’s hand away because it would hurt the patient even more.
“The bottom of the patient’s Glisson’s capsule is bleeding. It’s in a bad position and will be hard to suture. If the bleeding isn’t stopped quickly, there will be too much blood loss.” It only took a few brief sentences for Ling Ran to explain what he was doing and what he was currently doing.
He sounded as if he knew what he was doing, forcing Huo Congjun and Zhao Leyi, the attending physician, with no choice but to look at the monitor.
“Department director, the bleeding has stopped.” Zhao Leyi’s expression was one of extreme disbelief. Huo Conjun became even more shocked.
He knew that Ling Ran was using the barehanded bleeding control technique. This method was widely used in the resuscitation room, especially during first aid.
The most commonly used acupressure technique could be used on patients whose heads and faces were bleeding by pressing on the maxillary artery on the same side, and on patients whose necks were bleeding by pressing on the carotid artery of the same side. It was also very effective to press on one’s axillary artery to stop upper arm bleeding.
But for the bleeding of the liver capsule… If Ling Ran was right, how did he identify the position?
From what Huo Congjun could remember, people who could perform barehanded bleeding control to this extent were rare even in military hospitals. How did a medical intern manage it without corresponding practical experience? Why was he so daring?
“Department director?” Zhao Leyi urged.
Time waited for no one, and changes to the patient’s condition could happen at any time.
Huo Congjun glanced profoundly at Ling Ran and spent another few seconds checking the numbers. He finally nodded and said, “Ling Ran, get onto the gurney, don’t move the patient. Young Zhao and I will go into the operating theater.”
The barehanded bleeding control technique could only temporarily stop the hemorrhaging. Surgery would still need to be carried out.
Huo Congjun called two resident doctors over and instructed them to carry Ling Ran onto the gurney.
The group of people then pushed the patient and Ling Ran into the operating theatre.
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