Soul to the Rhine

Chapter 9
Corresponding heart murmurs can be heard in the precordial area, which should indicate damage to the heart septum or heart valves. The heartbeat is not blocked and the heart conduction system is intact.

As soon as Rosia finished listening, two nurses on duty rushed over. They already knew the basic situation from the girl who sent the message. When they saw her holding a stethoscope, they didn't say anything and came directly to check on the injured.

Rosia raised her hand to stop them and asked, "Which of you knows anesthesia? Have you ever participated in an operation before?"

The two nurses nodded subconsciously. One of the nurses, who had taught them the characteristics of infectious disease cases, recognized Rosia and was a little surprised: "Do you want us to operate on him?"

Rosia shook her head: "I need an operation, but unfortunately, it's not you. There are no shrapnel, sharp knives or other trauma on Instructor Katzir's body, which can rule out injuries caused by high-speed foreign objects. Considering Instructor Katzil's health, and It hit the building first. Based on his current performance, we have concluded that the injury was caused by a broken sternum or ribs that violently moved inward and penetrated the heart. The specific room where the injury is located needs to be examined in detail."

The nurse listened to her long words and finally understood: "You want to be the surgeon?"

Rosia nodded. Considering that the wounded could not wait any longer, she had to put an end to all meaningless interference. She said directly: "I advise you not to make any move to question my level. The operation will begin in a while and do your best to cooperate with me. I have asked you to Please notify the person in charge of the military school, you just need to ensure your condition."

The two nurses had never experienced the feeling of being commanded by a student, but the serious expression on the student's face prevented them from raising any doubts.

Rosia assigned them respective positions based on their situations. Teacher Gilica, who taught her cases, had studied anesthesia and was considered a half anesthesiologist. The other one was good at suturing, so she was assigned the position of first assistant.There was still a need for someone to deliver the equipment. Rosia scanned the girls twice and pointed at one of them: "Elana, come here."

Ilana was stunned for a moment when her name was called. After she figured out what they were going to do, she became extremely nervous, and the pupils in her blue eyes completely contracted.

Rosia was not as tall as her, so she could only pat her on the back and said: "Elana, believe me, the position I arranged for you is absolutely suitable. Please also believe in yourself, your work is very important in this operation."

Ilana was still a little frightened. She had touched these instruments in class, but she never thought that she would have to take them into the operating room now.

After finishing the arrangements, Rosia walked to the door and said to the group of stunned girls: "Your mission is to kill all the unstable factors that hinder the success of this operation."

She said it easily, which made Elana and the girls relax a lot.

Rosia walked back: "It's time for you to change clothes, and then proceed to the next examination." She looked at the two nurses sincerely: "I hope the two teachers can do their best to help me later."

The Germans in this period have a very good habit, they don't look down on young people, they don't deny the great potential of any young people, because it is extremely blind and stupid, most of the famous people in history were young A huge achievement was achieved.

In fact, Hitler also relied on his group of young and outstanding officers and young soldiers to launch World War II and win many victories.

Although the militaristic tradition of the Third Reich gave them a serious preference for boys over girls, fortunately, except for seriously injured patients, there was no male here.

Meeting Rosia's very sincere eyes, the two nurses looked at each other, looked at the injured hesitantly for a while, and then nodded solemnly.

They are willing to try to believe this young man from the East, because there is no better way at the moment.

Rosia breathed a sigh of relief.

Several people quickly changed their clothes, washed them, and then carried out the next inspection.

The injury was indeed caused by a broken rib, and the injury was to the right ventricle. The wound was large, but the extent of the pericardial rupture was still within control.

Rosia was relieved. Traffic accidents are frequent in modern times, and there are often patients with penetrating cardiac trauma due to impact. This was the first operation she underwent in the thoracic surgery department. As long as they can cooperate well, the operation can be done. The chance of success is still very high.

Based on the examination, Rosia explained the symptoms to them in detail to avoid panic during the operation and cause unnecessary trouble: "Now the patient has developed acute atrial tamponade, and the vena cava and atrium will be compressed first, causing central vein The blood pressure and end-diastolic blood pressure are elevated...Without blood elimination from the heart, unless fluids are given quickly to increase the venous pressure, shock symptoms will soon enter."

Ilana didn't understand it at all, but she was handing over the equipment, and Rosia didn't have high demands on her.After listening to her series of analyses, the two nurses gradually came to believe in her professionalism, but the difficulty of atrial tamponade still made them feel a little embarrassed.

Rosia glanced at them and continued: "Although acute cardiac tamponade reduces cardiac output and affects the blood supply of coronary arteries, causing myocardial hypoxia and failure, on the other hand, cardiac tamponade in the early stage It can delay fatal bleeding or temporarily stop bleeding from myocardial tears, providing us with very precious rescue time."

The two nurses took two deep breaths and continued to listen to her: "Cardiac arrest may occur before the operation. Don't panic. I will be responsible for treating the ribs. Teacher Mel will perform a large amount of blood transfusion first, and Teacher Gilika will intubate." General anesthesia, a small amount of light anesthesia at the beginning of the operation.”

"During the operation, I will make a midline incision here, push open the pleura on both sides, make a small incision in the diaphragm, and put in a decompression drainage tube. When I remove the blood clots and blood accumulation in the pericardial cavity, the teacher will immediately suture the heart tear , to control the bleeding. Teacher Gilika always pays attention to the condition of the injured and keeps breathing smooth. If any shock occurs, place the pressure measuring tube as soon as possible to replenish the blood volume."

"When the circulation stabilizes, I will repair the wound. Teacher Mel will follow up with interval suturing, and Teacher Gilika will apply local anesthesia."

Both nurses understood it, and Ilana also found that she seemed to just have to hand over the equipment, and she felt much more relaxed.

Everything is arranged and the operation is in progress.

The girls outside have not yet gone home. They are gathering around the door of the operating room or standing at the door of the medical school, but few of them have gone home.

Today is the end of February. The medical school is not as strict as the military school. They only need to attend half a day of class before going home, and the doctors can also take a rest on this day.That's why so many girls go to watch the military school classes.

This time, something unexpected happened. The classmates and the nurse on duty entered the operating room to perform an operation on the instructor. Although it was strange, they still hoped that the operation would be successful. They also remembered Rosia's instructions and stood guard at the door.

(End of this chapter)