321 Tracheotomy (2/2)
The train's announcer continued to call out for doctors. ”Dear passengers with a medical background, there is a traveler who is in critical condition in coach number seven right now. He needs emergency medical intervention…”
The passengers with no medical background gazed at the seventeen or eighteen doctors who walked passed them with admiration, zeal, encouragement, and praise.
Some of the doctors who had their large white coats with them could not suppress the excitement within them anymore, and they had already put their coats on.
If anyone were to measure a doctor's sense of achievement when they saved a patient in the hospital from a scale of negative ten to ten, when a doctor got to save a person's life on a train while surrounded by a crowd, it would give them such a great sense of achievement that they would have the will and strength to endure at least two scoldings in the hospital. Incidents such as saving a person's life on a train usually happened during a span of around twelve years of their career.
When Huo Congjun, Ling Ran and Yu Yuan arrived at Coach 7, there were already five or six doctors around the patient.
Due to their arrival, the second half of the coach, which had been cleared up, was starting to seem a little crowded.
”Should I ask the passengers to leave the coach first?” the train conductor asked probingly.
”There's no need.”
”It's not a problem.”
”It's all right.”
The doctors refused in unison.
'Are you kidding me? If all the passengers leave, there'll only be a bunch of doctors left here. Then, the situation won't be no different from didactic ward rounds and guided surgeries.'
”Why don't we do this? Let's have the clinicians here examine the patient first. I'll introduce myself. I am Chief Physician Qu Shengzi from the Nephrology Department of Ruijin Hospital.”
”I am Chief Physician Lao Guateng from the Neurology Department of Huashan Hospital.”
”I've met you before.”
”Yeah, during the conference in San Francisco last time. We even consulted a patient together.”
”What a pleasure to meet you again.”
After the two chief physicians from top hospitals introduced themselves, another doctor introduced himself in a slightly regretful tone, ”I'm Associate Chief Physician Chang Aida from the Neonatology Department in the Children's Hospital of Zhejiang University School of Medicine.”
”I'm Associate Chief Physician Ge Ganzi from the Department of Hepatobiliary Surgery of Nanjing Drum Tower Hospital.”
”I'm Associate Chief Physician Duan Laochao from the Department of Gynecology of West China Hospital.”
Huo Congjun did not want to wait anymore. Even if those associate chief physicians were from top hospitals, they were merely associate chief physicians.
Huo Congjun coughed loudly. ”I am the department director of Yun Hua Hospital's Emergency Department, Huo Congjun.”
He had some regrets too. He wished that this had happened a few months later, as the emergency medical center could have been established by then. He would then sound a lot cooler.
The doctors present felt threatened too. Huo Congjun was from the Emergency Department, and that field of expertise was just what the patient needed right then.
As for the junior doctors present, they saw no point in introducing themselves and wasting everyone's time.
Huo Congjun extended his hands to separate the crowd. He then went towards the patient and stood in front of him.
The doctors who came earlier had already performed a preliminary examination on the patient. They spoke to Huo Congjun in a hushed tone, ”Tachycardia, with a heart rate of nine-six beats per minute. There are no signs of cerebral infarction, and his breaths are shallow…”
”It could be laryngeal obstruction caused by tumors or injury. Are any of the patient's family members around?” asked the chief physician from the neurology department, Lao Guateng.
”He was never injured. About tumors… I don't know…” The patient's family member was a middle-aged woman who was about forty years old. She gazed diffidently in the patient's direction and looked kind of lost.
”No matter what the reason is, we have to perform tracheotomy first to solve his breathing difficulties.” Huo Congjun was used to emergency situations, and his approach was completely different compared to that of doctors in other specializations. He only needed to hear a few sentences to come to a decision.
There were a few seconds of silence in the coach, until someone broke the silence and said, ”I agree.”
”That will do.”
”Does anyone have a scalpel?” Associate Chief Physician Chang Aida from the Neonatology Department, who was at the prime of his life, had arrived early on the scene and was standing in a strategic position. He squatted down as he spoke and started to touch the patient's neck.
The train conductor quickly said, ”I've already asked someone to get a first aid kit and a scalpel.”
”We need alcohol too, and it'd be great if there's a soft and thin tube,” Chang Aida said before he explained to the patient's family member, ”The patient's having difficulty inhaling air right now. We'll be making a cut on his throat and exposing his trachea. This is a very minor surgery with very low risk. The main problem right now is that we don't really have all the equipment we need…”
As he spoke, one of the staff brought a small scalpel and a first aid kit over.
Even though it was a first aid kit, it appeared more like a debridement pack, a box of equipment used for physical examination, or a medicine chest. There were instruments such as a blood pressure gauge and a stethoscope. There were also some medication used to cure symptoms such as headache and fever, along with a syringe. Additionally, there were bandages, cotton balls and a bottle of antiseptic solution. But none of the equipment needed for tracheotomy was present.
”Can I have a pen? I'll make a temporary tube with the tube of the pen…”
Before Chang Aida finished his sentence, a few people handed him a pen.
The patient's family member was extremely anxious as she watched the scene.
”Can we wait until he gets to the hospital?” the patient's wife asked in a soft voice.
”It'd be too late. The patient could stop breathing at any time.” Chang Aida shook his head as he spoke. He chose the pen with the thickest tube and prepared to disinfect it.
”Why don't you let me do it?” When Ling Ran saw that, he felt like it was his responsibility to take over. He squeezed through the crowd with his bag in one hand, and Yu Yuan in the other.
Before the others could respond, Ling Ran kneeled down on one knee, took out his box, and opened it.
Inside his silvery-white aluminum box, various instruments were arranged neatly from left to right. There were a pair of straight mosquito forceps, a pair of curved mosquito forceps, a pair of 5.5-inch unhooked hemostatic forceps, a pair of 5.5-inch hooked hemostatic forceps, a pair of 6.3-inch unhooked hemostatic forceps, a fine needle holder, a pair of small dressing forceps, a pair of large dressing forceps, a pair of tissue forceps, a pair of towel forceps, a pair of tissue scissors, a pair of tracheal expansion forceps, a goiter retractor and a tracheal retractor. What the patient needed most right then were also present; a size seven tracheal cannula, size eight tracheal cannula, size nine tracheal cannula, and size ten tracheal cannula...
It could be said that apart from the fact that there were no scalpels in the blade holders, Ling Ran had all the equipment needed.
Huo Congjun could not help but flash a proud smile.
Ling Ran then opened the second drawer of his box and took out two mouth face masks. He passed one to Yu Yuan before he put on the other one. He then took out two pairs of gloves…
”Please make some space for us.” Ling Ran turned and ordered, ”Clean the area where the cannula will be inserted.”
The moment Yu Yuan heard Ling Ran's words, as though out of reflex, she started to clean the patient's neck.
She was extremely used to carrying out surgeries with Ling Ran.
Take the idea of people who have never eaten pork before, but may have possibly seen pigs run in their lives. The idea is that those who have never experienced something may have heard of the matter before. Now, take, for example, a butcher who has moved from village to village to slaughter pigs. He can kill more than one hundred pigs in one year. Apply both reasonings to Yu Yuan. Even though Yu Yuan only followed Ling Ran around as his assistant, based on the number of surgeries she assisted him with, she had gathered around seven or eight years of experience as a chief surgeon.
”Drape.” Ling Ran adhered completely to the usual surgical process.
When all the other doctors saw that Ling Ran even had a fenestrated drape sheet, they could not help but inch backward to make more room for Ling Ran and Yu Yuan.
”Keep it in the center.
”Scalpel.
”Hemostatic forceps.
”Perform traction with a small retractor.”
As all the doctors and most importantly, countless other passengers who held up their cell phones, watched him, Ling Ran quietly performed Perfect Level Tracheotomy. The other doctors could barely hold back their excitement.