Chapter 43 (2/2)

“Methylene blue, large volumes!” Zheng Ren instructed loudly as he pa.s.sed Director Xiao.

He sounded like a director, his voice full of authority.

Director Xiao was momentarily surprised. In the background, that unreasonable middle-aged woman was still throwing a tantrum despite the police presence.

Zheng Ren let go of the stretcher and said, “IV line, 250 milliliters 10% glucose with 140 milligrams methylene blue. At the same time, flush the stomach with pota.s.sium permanganate.”

The stretcher trolley left Zheng Ren’s hands and the standby nurses at the emergency room took over expertly.

Zheng Ren walked up to Director Xiao and said seriously, “We need more methylene blue. Our usual stock in the emergency department won’t be sufficient.”

“You’re bullying an old lady! I’m not done with you! This is an injustice!” The middle-aged woman grabbed at Director Xiao’s collar and screamed like a maniac, ignoring the police officers by her side.

Without a word, Zheng Ren stepped up and flung the woman’s arm aside.

He did so without restraint, and the annoying woman lost her footing and stumbled back into the crowd. Startled, she dropped onto the ground and started bawling, her two hands slapping the floor. “These doctors are trying to kill me! The police too!”

“Please take care of this. There will be more patients coming in.” Like a king, Zheng Ren gave instructions to the police officers. Then, he turned to Director Xiao and said, “Our stock won’t be enough and we need to ask the city council for help. If the city’s stock is insufficient, we’ll have to seek aid from neighboring districts.”

With that, Zheng Ren turned and left, sparing no time to explain the situation.

Every second counted in the emergency room. Director Xiao’s countenance was grim as he directed the chief of the medical administration division to stockpile all the methylene blue in the hospital. He did not bother to set his collar before calling up the city council.

Methylene blue, also known as methylthioninium chloride, was typically used for surgical markings. Hence, there was not a large supply of it in the hospital as demand was usually low.

The red blood cells of a healthy human or animal contained substances that could reverse the formation of methemoglobin such as vitamin C and glutathione.

If the concentration of nitrite ingested was enough to overwhelm the body’s ability to equilibrate its oxidation, the person or animal would show symptoms of nitrite poisoning.

Methylene blue would be reduced to leucomethylene blue through catalysis by nicotinamide adenine dinucleotide. Leucomethylene blue could then reduce the heme group from methemoglobin to hemoglobin, regenerating the methylene blue. This reversible reaction allowed it to be reused.

This theory was not common knowledge to the emergency medical personnel on scene. Despite that, they were aware of the severity. Cyanosis, shallow breathing and low blood pressure; anyone with clinical experience would know the patient was already in a state of shock.

If they could not improve the patient’s condition, the reduced blood perfusion would soon lead to a decrease in kidney function, cerebral edema and ultimately death.

After briefing Director Xiao, Zheng Ren went into the emergency room. At this moment, he never considered if the tone he took with the director would land him in trouble.

The patient laid on the emergency bed with his s.h.i.+rt cut open and thrown aside. His chest was peppered with countless patches connected to an electrocardiogram. Intricate but orderly cables transmitted electronic signals from the patient’s body to the device which produced numbers and graphs.

Blood pressure 50/20, heart rate 40, oxygen saturation not detected!

Normally, such readings on a patient was a lost cause.

The matron was bent over setting up an intravenous line. Three jabs and none of them saw any blood flow. Cold sweat dripped from her forehead and drenched the sterile surgical cap in less than 20 seconds.

The patient’s survival was dependent on the intravenous line.

The patient’s blood pressure was at 50/20 with a weak pulse. Even the large veins like the jugular and the femoral vein were shrunken and difficult to locate among the muscle tissues.

“Allow me.” Old Chief Physician Pan held a surgical kit. He removed the patient’s pants and started to search for the femoral vein. A central venous line was a procedure done frequently back in the day but was rarely required now.

The situation was dire. Even after peeling open the skin and muscles of the inguinal area, the femoral vein might have become clear, transparent connective tissue that challenged a physician’s eyes and experience.

Furthermore, this method was very slow. Zheng Ren could hear the sirens of the 120 ambulances within his mind.

Without hesitation, Zheng Ren entered the System and shouted, “I want to buy some intensive training time!”

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