Nineteenth Century Medical Guide

Chapter 354 350. The end of the little man (7)

21:20
Opera House entrance

The fire had been burning in the magnificent building for half an hour, expanding from a small flame in a pinch of kerosene lamp to a flame large enough to cover the entire opera house.The light of the fire reflected the night like day, and also brightened everyone's face.

It's just that this kind of light didn't bring any joy. In addition to the sound of flames torturing wood, there were only people's cries of despair and collapse.They were kneeling, lying, sitting, and staring at the soaring fire, their eyes were dull, and their minds were blank.

Many people forget that they have been hurt, and don't know whether the tears are from smoke or sadness, and it doesn't matter.

They just stay there so overwhelmed.

What's more, not long after escaping from the sea of ​​fire, she got up crying and walked towards the fire.If no one stopped them, maybe they would fall back into the embrace of death.Maybe I think that this way I can completely forget the tragic memory, and stay with my relatives, friends, and strangers who watched the opera together forever.

"It's all over"

Mason, who was only wearing a tattered shirt and vest, looked up at the flames and thick smoke, and saw a dozen firefighters with buckets on their backs still doing futile work. Their bodies fell to the ground like puppets with their strings broken. : "It's all over"

He joined Barnes in the rescue as soon as the fire started, and even if it didn't make a real difference, he did his best.This half an hour felt extremely long to him. Even if he pried open the theater door at the last moment and finally rescued many people, he didn't feel much sense of accomplishment.

"We have done our best." Barnes stood aside, comforting as an elder.

"But it's not enough, it's not enough!" Two lines of tears flowed down Mason's blackened cheeks, "They were burned alive. I saw them burnt to death with my own eyes. Maybe we haven't done our best yet."

The high temperature scorched his throat, and his voice was stuck in his throat, making it extremely hoarse and deep.

"It's over, it's all over," Barnes corrected his phrase, "it's not over, it's just over, the part that requires our intervention is over."

". Then what?"

"And then?" Barnes sighed. "Wait until it burns out counts as 'then'?"

"."

"Cheer up, young man, you've got to look like a young man."

After all this tossing, Barnes was also very embarrassed, and only half of the uniform he picked up again was left.He didn't care, he took out his pocket, took out the wine he just bought, and drank it in a big gulp: "It's a pity that your pack of cigarettes is gone, I should have put it in my pocket if I knew it earlier."

"."

"Come on, get up." Barnes put the bottle in his hand, "Leave it alone, let's go."

"Go? Where?"

"Of course I'm going back to the police station. I have to change this suit first." Barnes found Mason's hat under a half-burned plank, "Fortunately, it's just a hole, and the police badge is still there. Remember, young man, that you are a patrolman of the Paris police!"

At this moment, an unknown audience member who survived the accident suddenly said, "It turned out to be the policeman, thank you, thank you for saving me."

Mason looked back at the source of the sound in confusion, not knowing how to respond.

As more and more people thanked him, he felt more and more uncomfortable: "I'm sorry everyone, I couldn't open those doors at the first time, and I couldn't save more people. I admit that I was a little confused at first, I The whole person is ignorant, I may not try my best enough.”

"Son, you really tried your best." Barnes put his hand lightly on his shoulder, "It won't help if you blame yourself too much. There are still many things waiting for us to do."

It wasn't long before Ma Sen entered the police station. It was the first time he had seen such a big scene in his early 20s, and it was also the first time he had rescued people in a fire alone.

It's not about courage and work, it's just an instinct to save other lives.After a moment of hesitation he realized how dangerous it was to stand in front of a huge building that was already on fire.Many people were injured by the falling objects, including the hat on Mason's head.

On the other side, the younger Carvey is used to such big scenes.

For him, such a major event as saving lives does not matter whether it is easy or heavy, nor does it matter whether it is a responsibility or a job. It is actually a part of his daily life.

As the chief director of emergency trauma, the best thing is trauma management.Burns in trauma are extremely special. There is no bleeding, and there is almost no substantial damage to organs. The flame only burns off the skin of the wounded.

But such a thin layer is an important barrier for the human body to resist external damage.

What the burn brings is not skin damage, but loss, which is equivalent to erasing the walls of a city, which is several times more terrifying than simply breaking them.

Simple skin loss is not terrible. Burns cause more fatal cell damage, including tissue and blood vessels, which will cause a large amount of body fluid loss.Therefore, every burn patient needs to go through strict mathematical calculations before actually doing trauma treatment.

Calculate the proportion of the burned area, and then calculate the subsequent water shortage from the area proportion to give the corresponding amount of fluid replacement.This is the most important thing in surgery, and it is often packaged with the calculation of burn fluid rehydration and appears in various clinical medical examinations, especially for practicing physicians, almost every year.

"The first carriage has arrived!" The guard yelled and stepped forward, holding the reins to help stabilize the horses. "Someone help!"

It was a stagecoach that had just passed the Opera House half an hour ago.The people in the car got out of the car to help when they saw the fire, and also gave up the empty seats in the car.

In order to save space, the wounded try their best to sit on the seats, and only those who are extremely serious can lie down. The situation is not much better than that of the front line.Even because the stagecoach needs to walk on the rails, there are many detours in the middle.

And this was already a classic example of urban first aid at that time. Although the railway track route was fixed and difficult to change, compared with other countries and quite developed, some places did not even have public carriages.It is not impossible to use private and rental carriages, but the space for each four-seater is really small.

The coachman and the doorman helped the man out of the car, and Karen, who was standing aside, made the first rough assessment according to Carvey's request.That is, the same as the front line of the battlefield, use the villain to mark the burn location.The proportion of burnt skin on the body surface is calculated by Heman.

"The back and torso is 13, the bilateral upper arms are 7, and the double forearms are 6. The single arm is 6.5 for a whole day, and the total calculation accounts for 20% of the overall surface." Herman is new to surface area calculation and is still very unskilled. It’s complicated enough, even including the area of ​​perineum, hands and feet.”

"Why do you have to calculate so carefully?" Bergett helped carry the patient onto the stretcher, and then took the medical form from Herman, "Karen, can you give the infusion to the nurse here?"

"I've taught it several times and it's good to have three nurses."

Herman patted Bergt on the shoulder: "This is to calculate the amount of fluid to be replenished, and the amount of fluid to be replenished is different for each person. Since it was Carvey who said it, there is naturally a reason for him."

"But I remember that the burns just need to apply some ointment and wait for it to heal slowly. He was not so strict in Olmitz."

"The battlefield is different. The battlefield itself has a lot of blood loss, which requires a lot of fluid replacement and even blood transfusion, which may have downplayed the concept that burns need fluid replacement." After all, Heman has more than ten years of experience, so he understands it better, "Send people to the debridement room Give it to Dr. Damirgon Paeon, come and help!"

"coming!"

“下一位，头颈3，后侧就是1.5；背部13，上半部分就是1/4，6.5；双臀5，单臀2.5；双大腿21，单腿的外侧就是5.25；双小腿13，单腿外侧就是3.25。1.5+6.5+2.5+5.25+3.25=多少？”

Peon was listening in a daze, who would have thought that the first thing to do when dealing with burns was an arithmetic problem: "Uh"

Herman immediately wrote "19" on the paper: "Follow Bergert to the debridement room, the next one!!!"

"It's a child." Kallen's pen stopped suddenly.

Herman frowned, instinctively telling him that children's calculation methods might be different from adults': "Why are there still children? Are children the same as adults?"

"Forget it, I'll simply mark it and let Carvey do the calculations." Karen still gave the person and the paper to the next doctor based on the principle of speed first, "Hurry up and send them in."

Considering the number of wounded that may overflow, the Main Palace Hospital chose the simplest stretcher as a means of transportation between the door and the ward.

Before the tents were put in place, Carvey asked people to integrate the only three surgical wards, freeing up 8 beds, and then consulted with the internal medicine department to get 13 beds.But even counting the gap between the beds, it can only accommodate 30 people.

Burns require a clean environment, as well as ventilation. Too many people are not conducive to dressing changes or recovery of patients. Compressed wards are not feasible.

Theoretically speaking, 20 beds can already withstand the first wave of wounded, and then as long as the tents are in place, the pressure can be relieved.However, when coordinating hospital resources, it is necessary to plan ahead. The issues to be considered are not only immediate, but also the near future.

The surrounding hospitals can share a lot of wounded, but their capacity is limited after all, and in the end those patients with ulcerated wounds still have to be sent here.Maintaining a certain number of empty beds at all times can increase the flexibility of the hospital to deal with such emergencies.

In addition to this, Carvey also needs to consider the weather in Paris.After all, the tent is placed outdoors. Once it rains, it may cause impact, and the ward becomes the only hole card to make up for the impact.

So before the carriage arrived, Carvey went to the warehouse to discuss with Laura, hoping that she could move out and make room for the hospital.

If it was Laura before the operation, as long as Carvey could operate on herself, she would agree to anything, and it would be nice to be able to live in the ward.

But now that the operation has been completed, and the new breasts are in good shape, the request disappears.And Edward's admiration comes first, and after learning that Kavey's fame has a lot to do with Edward, her attitude will definitely change.

Laura tactfully rejected Carvey's suggestion, and put all the reasons on Edward: "This ward was ordered by Mr. Edward, and I can't make the decision."

"He decided? It wasn't after he discussed it with me"

Carvey blinked, understood what she meant, and immediately changed his words: "Your surgical incision has almost healed, and you can be discharged from the hospital as long as you stay in less than a week. You don't have to worry about Edward, as long as you nod, is he okay?" Will care about these things.”

"Yes, but I'm just a patient who hasn't recovered yet, and you know my identity. Really, I'm afraid that he won't be happy." Laura still refused, "Why don't I use it in other wards and wait for Mr. Edward to come tomorrow?" Shall I talk to him again?"

The relationship between Carvey and Edward is very simple, and they don't know much about it, but at least they are not a person who will care about this kind of thing.

It's just that his weakness is also obvious, that is, he is lustful. He has suffered a big loss in Vienna, and now he has successfully returned to Paris and is having so much fun.First, they recruited new female stars, and now they recruited Laura. I don't know how many women they have called in the past half a month.
"Doctor Carvey, the wounded have arrived."

"How many have you come?"

"I heard that all the public carriages have been dispatched. There should be three of them in the first batch. Each carriage can transport 7-10 wounded."

"Okay, you go and deal with it as I said before, and I'll be right there."

The first wave alone has already exceeded 20 people. Carvey can’t help it. Since he can’t do it softly, he will come hard: “There is an urgent need for beds. Even if the beds are really enough, we still need more debridement rooms. Don’t think that Mr. Edward I will blame you, if something really happens, just say that I enforced it."

After all, without letting Laura say any more, two strong men came in outside the door, and began to move things under the instructions of Kawei.

"You, what are you doing?"

"It's a last resort. If Mr. Edward blames him, let him come to me." Carvey waved his hand, turned and left the ward.

In fact, the two of them didn't know that Edward was going to the Paris Opera House tonight. He said that he had something to do, but he was actually looking for Sharana to have fun.However, not long after he was happy, he was buried in the sea of ​​flames. I am afraid that even the body will be difficult to find afterwards.

Regardless of whether Edward will show up the next day, Carvey has no time to take care of that woman, and now he needs to focus on treating the wounded: "Has the hydrogen peroxide from the Chemistry Institute arrived?"

"not yet."

"Take out all the stocks, there are 2 barrels in total, let's use them sparingly." Carvey commanded, "After the person comes, you need to rinse the burn wound with clean water, pay attention to it three times! Then disinfect it with hydrogen peroxide, just pour it on it directly .Wait until the bubbles subside, then rinse with saline!"

"understood!"

"Gather all the tincture of ya flakes in the hospital, every wounded needs it." Carvey remembered another medicine that Cedieu had said to himself before, "By the way, take all the morphine and ether you have kept Get it out. We need strong pain relief or a lot of people won't be able to make it through."

"understood."

Carvey looked at the first wounded person who was sent: "20% of the burn area, did you weigh it?"

"80kg."

"3600ml rehydration volume, infuse 8ml in the first 1800 hours." After a simple calculation, Carvey put on gloves and a mask, and took out a sponge from the carbolic acid basin to wipe. "Hurry up, I have to debride him after rinsing!"

(End of this chapter)