White armor

Chapter 37 Blood is raining down

"Go and ask the pharmacist to call Wen Youren and ask whether the drug instructions should be handed over to him personally tomorrow morning or handed over to the doctor on duty tonight."

Luo Hao explained very seriously.

Chen Yong is also very clever. He knew why he did this as soon as Luo Hao mentioned it.

Avoid alerting the enemy, and use Wen Youren's reply to judge whether this guy is going to dig a hole.

Chen Yong sighed, "To treat a disease, I have to be careful about this and that. It's tiring."

"It's the same everywhere." Luo Hao didn't smile and explained with a serious expression, "It's pretty good now. I heard from the teachers that the chaos in the past few years was even more extreme."

"Oh? What's the matter?" Chen Yong asked casually.

"For example, the old director of the thoracic surgery department of a hospital in the Imperial City was about to retire. Two young competitors fought fiercely with each other, and in the end one of them beat the other and disabled him."

"Holy crap! No sentence?" Chen Yong was surprised.

"Why do you have so many questions? Go, go, go." Luo Hao was too lazy to say anything to Chen Yong.

Chen Yong was like a piece of wood when talking to himself, not as lively as when talking to girls.

After Chen Yong left, Luo Hao was not in the mood to eat. He found the medication instructions on the Internet and twirled his phone in thought.

The instructions for iodized oil do not even mention that it is used for interventional treatment of liver cancer. This is simply ridiculous.

Luo Hao was also new to interventional surgery. Although the surgical level was forcibly upgraded by the system, he still lacked some detailed knowledge.

But Luo Hao was exposed to interventional surgery when he was a trainee in school. Whether it was Imperial Capital, Magic City or other hospitals, iodized oil was used for interventional surgery to treat liver cancer.

After thinking for a long time, Luo Hao couldn't figure out why such a ridiculous thing happened. After straightening out his thoughts, he didn't rush to make a call, but quietly waited for Chen Yong to come back.

Half an hour later, Chen Yong arrived late.

This guy must be talking and laughing with the pharmacist, and he must be very happy, Luo Hao thought to himself.

"Luo Hao, Wen Youren said he would pick it up by himself early tomorrow morning and was not allowed to send it to the department." Chen Yong said after returning.

Sure enough, Luo Hao confirmed his suspicion.

"Luo Hao, what should we do? Stop the operation first?" Chen Yong suggested.

"Don't worry." Luo Hao shook his head, "I'll give it a try."

try...

What a try.

This word reminded Chen Yong of the moment when Luo Hao was showing off in the first hospital of the Medical University.

"Can you change the instructions? Don't talk nonsense. Do you know how troublesome it is to modify the instructions? It's more difficult than launching a new drug." Chen Yong felt uncomfortable seeing Luo Hao's pretense and retorted directly.

"I said try it, but I didn't say change the instructions."

Luo Hao was not in a good mood and his tone was very harsh.

"Why are you like this? You can't say nice things well." Chen Yong despised.

Luo Hao suddenly remembered Chen Yong's "casting spell" in the corridor of the emergency department of the First Hospital of Medical University.

Chen Yong can be regarded as a magician with a professional background!

"Chen Yong, does it cost a lot for you to cast a spell?" Luo Hao asked with a gentle tone.

"That's... that's not casting a spell! Why do you like to pretend to be a ghost? If you really like it, you can study for a master's degree in magic and mysticism. I don't believe that a Ph.D. from Concorde University can't meet the requirements." Chen Yong was unhappy. replied.

"How about you try again?" Luo Hao said with a smile.

Now Chen Yong can no longer look directly at the word "try".

"try what?"

"Let's see what Director Wen wants to do, or look at the future."

"Are you kidding me! How could I do this?" Chen Yong looked at Luo Hao as if he were an idiot.

"Let's give it a try. I feel more at ease. It feels bad to be coveted by others, and I feel a little panicked." Luo Hao made an exaggerated gesture.

"I don't see why you are panicking." Chen Yong said impatiently.

His attitude when talking to Luo Hao was completely different from how he talked to nurses and pharmacists.

Luo Hao gradually got used to it and became accustomed to it.

"Try it, try it. You try it once, and I will help you perform the operation whether it is successful or not. If it is really accurate, I will help you perform ten operations! If you are up to it, you will be the surgeon and I will be your assistant."

Luo Hao threw out his trump card.

Chen Yong couldn't refuse, so he concentrated, took out the necklace and started mumbling something that Luo Hao couldn't understand.

After a few minutes, Chen Yong sighed, "I don't know, I said I'm not good enough."

"You are a graduate student, a graduate student in magic and mysticism." Luo Hao emphasized.

"Medical graduate students are like little Karami when they come to clinical practice. Can they perform level 4 surgeries? Are you kidding me?"

Luo Hao thought about it too.

"It's not that I don't have any feelings at all. I subconsciously felt that you asked the old director Guohua to go home to raise his grandson. Damn, I said it was unreliable, but you insisted on me watching."

Chen Yong also knew that his "prediction" was not considered, so he quickly explained.

"!!!" Luo Hao felt that Chen Yong was really unreliable.

[People say that a man will be a boy until he dies, but how can there be a boy...]

The phone rang, it was Lin Yuming calling.

"Director Lin, please give me instructions." Luo Hao answered the phone and said with a smile.

"Are you in the hospital?" Lin Yuming asked seriously.

"Here." Luo Hao also became serious.

"In the emergency department, there is an unknown person who is vomiting blood. Go and see him. If he can still be cured, you will be responsible for presiding over the rescue."

"Okay!"

The so-called presiding over the rescue does not mean that Luo Hao actually does the rescue, but that he exempts the medical staff from liability in the name of the medical office, allowing the clinic to free up their hands for rescue.

What Luo Hao has to do includes but is not limited to some operations that require signatures, but the nameless person does not have family members around, causing delays in rescue and so on.

The past ten years have been a mess, and people's hearts are not as good as they used to be.

Some family members of patients after successful emergency rescue came to ask for compensation for the damaged clothes. Some family members of patients who failed to rescue came to cry and find someone to take responsibility.

Even if the rescue fails, it is easy to say, but if it succeeds, it will be more troublesome. Especially those patients who are expensive to stay in the ICU are extremely prone to accidents.

At this time, the medical office needs to send someone to take charge.

Of course, not all hospitals are like this. The Mine General Administration has declined greatly in recent years. Lin Yuming tried his best to not let the medical staff feel cold, so many responsibilities were borne by the Medical Department.

Most hospitals let things go their own way and put the responsibility on clinical care.

Luo Hao tidied up his white clothes and strode out.

"Vomiting blood? Usually there are family members of patients who vomit blood. Could it be that the medical history is wrong? Luo Hao, do you think it is trauma?" Chen Yong followed Luo Hao and asked.

Are you a young doctor who is interested in emergency rescue? If you have worked in a hospital for more than two years, you can hide as far as you can when encountering emergency rescue as long as it has nothing to do with you.

During the emergency, Chen Yong obviously talked more to Luo Hao.

"Don't you dare be more unreliable?"

"I just went to see if it was a general surgery patient. How unreliable is this?" Chen Yong was puzzled.

"I said you just said - I told the old director Guohua to go home and have his grandson. Dr. Chen, I respect the old director Guohua very much, and I will never say such things." Luo Hao emphasized.

"The more something is lacking, the more emphasis will be placed on it." Chen Yong muttered in a low voice.

"What did you say?"

Chen Yong remained silent and followed Luo Hao to the emergency department.

Turning the corner, a strange smell hit my face.

This is the "special" smell of the emergency department - disinfectant water mixed with the smell of vomit and blood, which makes people inexplicably irritated.

At a glance, there were a bunch of people gathered at the door of the emergency room. They seemed to be watching the fun, not the patients' family members.

After all, Lin Yuming had already said that the patient was anonymous.

Luo Hao strode over and separated the crowd. Before he saw the patient, he heard a sound of "vomiting" coming from inside the room.

The sound came first, followed by the strong smell of blood.Luo Hao's body instantly secreted a large amount of adrenaline, and his whole body went directly into a tense rescue state.

An elderly male patient was lying on the emergency bed, and a nurse "turned" his head to one side.

This is to prevent vomitus from filling into the airway and causing the patient to aspire.

The emergency bed was filled with black and red blood, which was shocking.

"Ronald, the patient may be dying," the emergency physician said hurriedly.

The blood pressure displayed on the ECG monitor has dropped to 60/20 mm Hg, the heart rate is 160 beats/min, the blood oxygen saturation clip has no time to clip, and the value cannot be seen.

"Why haven't you given the infusion yet?!" Luo Hao asked with a frown.

"If you can't get it in, the blood vessels will be gone when you come in." The emergency medicine doctor said helplessly.

If there is excessive blood loss and insufficient blood volume, the blood vessels will collapse like a piece of paper. Indwelling intravenous access is a difficult problem.

In this case, it is difficult to hit the nail on the head. Even the most experienced nurses cannot say that they can do this [-]% of the time.

Luo Hao saw that the patient's limbs were constantly twitching, his face was pale, and more than half of his body was already on the Naihe Bridge.

An old nurse was bending over to retain a needle for a patient, but as soon as the needle pierced the skin, the patient would twitch, making it exponentially more difficult to retain the needle.

Luo Hao saw that she had tried to retain the needle twice in a short period of time and both ended in failure.

"I'll keep the needle, you guys help me hold the patient down." Luo Hao turned around and grabbed a pair of sterile gloves, tore open the outer packaging with a "sting" sound, took out the gloves and put them on.

With a "pop" sound, the rubber band of the glove collapsed on Luo Hao's wrist.

Unlike Chen Yong who plays cool, Luo Hao just wants to be faster, even if it is only one second faster.

Take the puncture needle from the nurse and ask the nurse and emergency physician to hold the patient's arm.

Luo Hao held his breath and concentrated before entering the system operating room to try.

Sure enough, the general teacher in the system operating room was the same as the patient in front of him.

After trying three times with very little surgical training time, Luo Hao felt at a loss.

The patient twitched suddenly after the infusion needle pierced the skin at an angle of 37°, but the needle in Luo Hao's hand seemed to move along with the patient's twitching.

The next second, Luo Hao pressed the infusion needle with his left thumb, "Saline water!"

"Going in?!" the old nurse asked in surprise.

She understood a little bit of what Luo Hao did just now, but she didn't understand it at all.

Although someone was pressing, the patient's muscles still twitched.

In addition, the condition of the blood vessels itself is extremely poor. If it is in a static state, it may be successful if a few more needles are inserted. However, when it is stimulated, it moves and the blood vessels shift. In the eyes of the old nurse, it is impossible to hit the nail on the head.

"Salt water!!" Luo Hao repeated.

"Oh oh oh." The old nurse quickly connected the infusion tube and opened the normal saline solution that had been hung up to the maximum.The infusion speed is extremely fast, and there is no sign of resistance due to the needle puncturing the blood vessels and allowing the fluid to enter the subcutaneous tissue.

really become?

It really did!

"Connect the three connections and prepare the deep vein puncture bag." Luo Hao said in a deep voice.

"Ronald, there are no deep vein puncture kits in the emergency department..." the nurse whispered.

Md!

Luo Hao cursed in his heart.

High-value consumables have become a forbidden area in the medical field. Deep venipuncture kits are also a type of high-value consumables. Are they not even available in emergency departments now? !

Although he was scolding his mother in his heart, Luo Hao remained calm.

If this road doesn't work, then take the next road.

"Prepare to cut open the bag and take off the patient's pants."

Nowadays, middle-aged doctors, that is, doctors of Jiang Wenming's age, basically don't know how to perform venous dissection. This is a "legendary" procedure.

Because deep venipuncture kits were available more than ten years ago, they are simple, worry-free, and far more convenient and faster than phlebotomy.

But no one expected that one day the emergency department would not be able to find a deep venipuncture kit.

The emergency physician was stunned for a moment and said, "Ronaldo, do you know how to open a vein?"

"Stop talking nonsense, hurry up!" Luo Hao replied stiffly.

The sunshine-like smile that had always been on his face had long since disappeared, and Luo Hao was as serious as a stone.

The emergency physician quickly called the nurse to expose the patient's groin. When the nurse turned around to get the leather bag, Luo Hao had already installed the blade, sterilized the area, and simply prepared the skin with a scalpel.

This is not a routine operation, but it can save a lot of time in an emergency.

After simple skin preparation, Luo Hao pressed his hand on the patient's groin to determine the location of the femoral artery.

There was no blood from the incision, and it was as pale as a piece of white paper.The patient's blood pressure is extremely low, and the peripheral blood vessels have already contracted, supplying all the blood to the most important organs.

Separating layer by layer, Luo Hao used his left hand to separate the subcutaneous tissue, and reached in with the hemostatic forceps in his right hand to gently pick it.

A piece of "connective tissue" was picked out by Luo Hao.

But the next second, no one cooperated, and Luo Hao looked serious +1.

"Chen Yong, what are you doing!" Luo Hao scolded unhappily.

Chen Yong was still watching the excitement, but he didn't expect to reach out for himself.After being scolded by Luo Hao, he looked for gloves in a panic.

Luo Hao has a serious expression +2.

Chen Yong was useless, Luo Hao released his left hand and held the knife.

The tip of the knife tap lightly on the "connective tissue" picked up by the hemostat.

"Infusion tube."

Even the nurse was a little confused at this time.

Deep vein incision can be completed in less than 1 minute?Is the piece of connective tissue picked up by Luo Hao the femoral vein? !

Still no one cooperated, Luo Hao took a deep breath and suppressed all his anger.

Outside the door, there were patients and their family members who came to the emergency room to watch the fun, and it was not good for them to lose their temper.

As the saying goes, family scandals should not be publicized, but Luo Hao kept silent.

The emergency care in the emergency department really needs to be improved. The quality is far worse than that of the First Hospital of the Medical University.

After repeated urging, the nurse handed over the infusion tube.

Luo Hao asked the nurse to open the infusion valve and let the saline flow out. Without hesitation, Luo Hao directly inserted the infusion tube into the incised connective tissue.

There was no leakage of fluid, and it was determined that the infusion tube was inserted into the femoral vein.

Opening the infusion valve to the maximum, Luo Hao continued to feed the infusion tube in.

"Inserted into the lower cavity?" Chen Yong only then put on gloves to help.

"Suture." Luo Hao ignored Chen Yong and said coldly.

Chen Yong shivered.

This is an atypical Luo Hao.

Luo Hao is usually very gentle and never gets angry no matter what he says, as if he never has a temper.

The emergency rescue in front of them was the first time that Chen Yong and Luo Hao had encountered it. Unexpectedly, Luo Hao instantly entered the state of a senior doctor. Every word he said was like a whip hitting Chen Yong's back, making a crackling sound.

Fixing the infusion tube, Luo Hao carefully fixed two lines, and then began to sew the incision.

Two intravenous channels were established, and the liquid was slipped in. The first step of the rescue was successful.

But this is only the first step.

"How is the patient!"

A familiar voice came from the corridor, it was Wang Guohua!
Why is he here?Luo Hao was slightly surprised, but he was not distracted. He concentrated on watching the patient's condition, ready to rescue him at any time while thinking about the next treatment plan.

"Director Guohua!" The emergency medicine doctor seemed to have a backbone and said quickly, "Ronald has established an intravenous channel and has started to replenish fluids, but the situation is not optimistic. The patient may need..."

Heavy footsteps entered the room, and Luo Hao knew it was Wang Guohua without looking at him.

He stepped into the battlefield with rumbling footsteps like an ancient giant beast.

It was as if the entire emergency room was shaking.

"Femoral vein dissection? Did Ronaldinho do it?"

"Yes, 1 mg of epinephrine intravenously." Luo Hao responded, and then began to give the doctor's instructions, "200 mg of dopamine dissolved in 250 ml of normal saline, 30 drops per minute."

"Prepare the defibrillator."

"Aspirator, suck the blood from the patient's mouth."

Luo Hao blurted out the doctor's orders one by one and directed the rescue in an orderly manner.

This should be the biggest snub and disregard that Wang Guohua has encountered in the past 30 years.

In every emergency rescue operation before, Wang Guohua was the one taking command.

Each of the medical staff seemed to be stepping on hot wheels. If anyone was slower, Wang Guohua would scold him.

Even after several years of retirement, the medical staff in the operating room and emergency department still feared Wang Guohua.

however!
Unknowingly, Luo Hao had reached position C.

Wang Guohua silently watched Luo Hao preside over the rescue, and did not insist on returning to his original position.

Luo Hao's medical instructions were strict and prompt. At this moment, he didn't look like a young man at all, but an old director who had experienced many battles.

"Director Guohua, why don't you speak? Who is that little doctor? Why is he beeping all the time." A person following Wang Guohua asked in a low voice.

"Shut up." Wang Guohua scolded.

The person who followed him was stunned for a moment, and subconsciously closed his mouth without speaking.

After ten minutes, the blood pressure slowly rises as the liquid enters the blood vessels.The high pressure has returned to 75 mm of mercury. Although it has not reached the lower limit of normal values, it gives people hope.

But neither Luo Hao nor Wang Guohua's expressions were relaxed at all.

Luo Hao kept watching the ECG monitoring. Seeing that the situation had improved slightly, he turned around and asked, "Director Guohua, do you know the patient?"

"I know their village chief. The patient has a history of hepatitis B and liver cirrhosis for 30 years. The vomiting of blood is considered to be caused by gastric varices."

Wang Guohua knew very well what Luo Hao meant. He directly stated the medical history he knew without saying any nonsense.

"The portal azygos vein is to be devascularized, but you have seen the patient's current condition." Wang Guohua then said.

This sentence was said to the village chief beside him.

"Director Guohua, can you step down alive?"

"You are blind." Wang Guohua curled his lips and scolded him unceremoniously.

The old director had the majesty of the old director. Luo Hao and the room full of doctors and nurses were calmed down by Wang Guohua's words.

Is Wang Wanghua reprimanding the patient's family? !
Courageous!

"You didn't see him vomiting blood bit by bit. In this state, I guess he might not be able to withstand the anesthesia." Wang Guohua immediately said, "With surgery, there is a 90.00% chance of death. Without surgery, there is a [-]% chance of death. It's your choice. "

The village chief looked embarrassed.

"Director Guohua, what kind of skill is that? What does it mean?"

"After I tell you, will you go home and burn his head for seven weeks?" Wang Guohua continued to curse, "Whether you do it or not, tell me."

"Do it!" The village chief seemed to accept this trick and agreed without hesitation.

Luo Hao knew that the reason why Wang Guohua could speak like this was because of his relationship with the person next to him. That was all recorded in history books and could not be compared to others.

Maybe Wang Guohua lived in their village for a few years back then.

"Luo Hao, are you ready for blood?" Wang Guohua asked.

"Ready, Director Guohua." Luo Hao said, came to Wang Guohua and whispered, "I have something to do, let's find a place where no one is around to talk."

Luo Hao was also a little anxious. The patient seemed to be relatively stable now, but God knows when he would vomit blood and die.

So Luo Hao said this sentence relatively directly.

Wang Guohua said with a straight face, "Emergency first aid, you are the representative sent by the medical department. If you have any questions, just say it to your face. I will prepare for emergency surgery!"

"Director Guohua, portal azygos vein devascularization surgery is indeed curable and was once the first choice."

once!

This keyword was captured by Wang Guohua.

"The number one surgical procedure now is endoscopic ligation."

Wang Guohua knew that this technique existed, but he had never done it, and he had not seen Luo Hao do it.

In emergencies, time is worth money, so Wang Guohua would definitely choose portal azygos vein devascularization, which he had done countless times.

"No." Wang Guohua rejected Luo Hao's statement without hesitation, "I don't agree with your medical office's suggestion."

Luo Hao was also a little helpless. Although Wang Guohua wanted to learn minimally invasive surgery, he still chose the surgical method he was most sure of at the most critical and urgent time.

Wang Guohua said, came to the patient's side, stretched out his hand to lift the patient's eyelids and looked at the eyelids.

"Make preoperative preparations, notify the operating room, and ask the anesthesiologist to come down..."

"Yuck~~~"

The patient became agitated without warning and spurted out a mouthful of blood, spraying the blood on the roof in front of Wang Guohua.

Black and red blood rained down with crackling sounds.

In the rain of blood, the monitor's alarm sounded, and the electrocardiogram pulled out a straight line.

Cardiac arrest! !
(End of this chapter)