[Comprehensive] First Love Trainee

The command center calculated the nearest place where the ambulance and the helicopter would meet, and 15 minutes later, the comatose patient was finally safely sent to the initial consultation room.

In the initial consultation room at this time, there was a drowning patient brought back by Aozawa. When he was found, his breathing and heartbeat had stopped, and he recovered after being treated on the plane. He is still in a coma. Dr. Yamazaki is taking two trainee doctors for treatment. .The rescue team member Kurata Mitsuru who was sent in later had a high degree of difficulty in dealing with pelvic fractures. Aozawa came to take over and Maki assisted.

Everyone was busy scoring points|I was exhausted, so at this time, the nurse who had arranged for Xincheng Shenyi to go through the discharge procedures in the morning ran into the primary consultation room to report bad news.

"Doctor Asai, Xincheng-kun is unconscious."

In the current first aid, Dr. Kosugi and the trainee doctor Miike are performing the nail removal together with the brain surgeon. Dr. Matsudaira and Dr. Miura are taking the trainee doctors Aoki and Yasuda to perform the amputation. No one can come out of the two operating rooms.Among the remaining doctors, Lan Ze was dealing with pelvic fractures, and Yamazaki and the trainee doctor Oe were dealing with shock patients after drowning.

Aozawa glanced at Maki from the top of the mask, and said calmly, "Asai, take your name to take a look, and Kobayakawa come over to change." It seemed that she had already regarded her as a senior doctor who could guide her training in medicine.

With a promise, Maki stepped back to leave space for Kobayakawa, who took over, and quickly ran towards the ward with Natori.

When he arrived, Shinichi Xincheng was in shock, and ultrasound examination showed that a pseudoaneurysm was found at the hilum of the spleen, which ruptured and caused intra-abdominal hemorrhage.Maki asked the nurse to contact the radiology department for angiography, and at the same time quickly infused FFP and red blood cells into the patient, and used arterial embolization for treatment.However, it took 20 minutes at the fastest for angiography to leave the clinic, and the symptoms did not relieve after rapid blood transfusion.

"This is second only to the difficulty of AAA patients, and we can't handle it by ourselves." Mingxiang, who came with Maki, was a little flustered.Intra-abdominal hemorrhage itself is very dangerous, and one-time treatment has no obvious effect, and laparotomy is likely to be required.Asai Maki was the same age as him, and even with a good resume, this kind of surgery was not difficult for ordinary young doctors to do.

They need to contact the superior guiding doctor for help.

"Dr. Yamazaki's patient's drowning hypothermia caused resuscitation encephalopathy, and it took at least 20 minutes for my pelvis to clear up." Aizawa answered the phone with an inorganic and calm voice, and he put steel nails on Kurata's sagging pelvis , while giving instructions to the other end of the phone.

"Asai, what is the patient's current condition?"

In the alarming sound of the instrument, Maki's voice was rarely calm: "10 units of red blood cells and 200ccFFP have been transfused, and arterial embolization has been tried, but it is ineffective. Now the aneurysm has ruptured for the second time, the intra-abdominal bleeding has intensified, and the blood pressure has dropped to 73, the patient is in shock."

"Doctor Aozawa, there is no time, we can't wait."

"Can it be dealt with?" If it weren't for the successive alarms from the equipment, Aozawa's voice alone would not tell that he was facing such an urgent situation, and it is rare that Maki Asai did not panic, and the attitude of the two of them made him feel Ming Xiangtai's heart also calmed down involuntarily.

He took a deep breath and looked at Maki Asai.

The young female doctor pondered for a moment: "REBOA can be used."

"The patient is only 12 years old!" Natori was shocked, "How can such a young child perform surgery?"

"Try using the thinnest catheter." Under the ultrasound, the intra-abdominal bleeding has increased, and two fast-track high-flow infusions have not relieved it. The situation is imminent. "I will take responsibility."

"Give it a try..." Natori was about to go crazy, "You're not sure why you said that? If you fail, it's a life! Don't think that you are a high-achieving student who returned from studying abroad and you can try surgery just because of your interest." ! You just want to show off your skills? It's easy to say, how are you going to be responsible?"

"Just watch him die no matter what." Maki put on two layers of gloves, put on a sterile suit, and his eyes above the mask were firm, "Dr. Aozawa, there is no better way, let me do it! I Will do my best."

The male voice on the other end of the phone paused for a second, and then came a cold voice: "You make your own decision."

"Prepare a No. 7 balloon catheter." The patient is only 12 years old, and the width of the artery is incomparable to that of an adult, so the thinnest catheter can only be used to block the aorta.

The nurse quickly prepared the surgical tools, but the patient's blood pressure continued to drop, he could not feel his pulse, and his heartbeat became slower and slower, and there was a possibility of cardiac arrest at any time.

Natori's hand holding the scalpel was trembling: "In this case, even if the blood vessel is cut, the catheter cannot be placed. What should I do?"

This is also the first time for Maki to use REBOA independently. The subject is still such a young boy, and his physical condition is not good. It is no longer possible to use conventional procedures for catheter placement.

She took a deep breath, trying to calm herself down.

"Try changing it to exposing blood vessels after incision and performing puncture directly." She recalled a public operation she saw in her graduate school days. "I saw a demonstration before."

Do you dare to try it after seeing it once?Before Natori could speak, Maki had already picked up the scalpel, and the hand that cut it was very steady, so it was hard to see how nervous she was.

The guide wire was slowly pushed in, the catheter balloon was gradually inflated, and Natori injected another 10cc of normal saline. Looking at the monitoring equipment, the blood pressure had risen to 100.

Only then did he hear the young female doctor on the opposite side let out a sigh of relief.

"...So that woman is really fierce and dares to try." At lunch time, the trainee doctors sat at a table to eat, and Mrs. Ming described the tense first aid in the morning to the five contemporaries, "and Maybe she really wasn’t bragging, she could do REBOA by herself, or directly puncture, and finally she also assisted in laparotomy after Dr. Aizawa came over.”

"Really? Are you the same age as us?" Yoko Kobayakawa, who didn't follow, half-believed, "Don't tell me you lied about your age?"

"I used to think of her as a bit of a misnomer. You know, she is the daughter of Professor Asai of the School of Medicine at the main school." Toshisaku Aoki was dumbfounded, "I thought she was making a big fuss when she insisted on sending Xincheng Shinichi to the hospital yesterday..."

"No, no, I too..."

"After all, even Dr. Matsudaira didn't see anything wrong..."

"Besides, who would have thought that just being hit by a tennis ball would cause a pseudoaneurysm to rupture?!" Oe Miyuki shrank her neck, "Generally speaking, it's hard to think of this, right?"

"Shh--stop it! Here she comes!"

Holding the dinner plate and finding an empty table to sit down, Maki first swallowed the vitamins, and then took a few big sips of water.

"Hey, I, who had a three-hour operation, look more energetic than you..." Ren Zuzu, who was eating together, twitched the corners of his mouth.

He was the chief surgeon of the iron nail removal operation that was combined with the emergency center this morning.

"Actually, I really don't know whether it's better to stand in place for three hours, or to fly a helicopter to rescue an emergency and remove half of the spleen." Zhenji's voice began to flutter.This is the first time she has performed such a difficult operation independently. Although she has practiced on human body models countless times during her student days and even participated in many operations, it is the first time for her to be the chief surgeon.

Renzu looked around and noticed that the trainee doctors gathered together and looked in this direction frequently, and probably understood what they were looking at.

Every newcomer in the workplace has to go through such a process of being scrutinized by everyone behind their backs.

"It's hard to say anything else, but I think the trainee doctors in your department will probably not pick on you again in the future." He observed for a while and came to a conclusion.From the expressions on the faces of those people, it could be seen that they might not believe it, but they should be admired in their hearts.

He had seen this kind of expression many times before from others looking at Atobu, so he was not unfamiliar at all.

The whispering among the trainee doctors continued: "Is that the Ninja doctor from the brain surgery?"

"Looks like. Do they know each other?"

"A classmate, right? I heard that Dr. Renzu also graduated from Cambridge."

"Huh? In a relationship?"

"No way... I've seen a blond beauty who always came to Dr. Ninzu before. Dr. Asai should be a classmate."

"If you want me to say, if we are in a relationship, we should stop looking for colleagues? Both of us are too busy to go home. Maybe we don't even have to make a phone call. It's too miserable."

"You think too much, first aid is not worthy of love."

She thought her voice was very low, but in fact all the gossip was picked up by Maki, who had eyes and ears, and she twitched the corners of her mouth uncontrollably.

No wonder Dr. Lan Ze looked disgusted when he mentioned training as a doctor. This attitude is really too loose.What about gossiping colleagues in public?The medical records are not well written, and the helicopter is not active at all. When encountering a difficult case, he backs off.

I heard that Mrs. Oki was also from a family of doctors, and her father was a well-known medical practitioner in the Tokyo area. He went back to work at his own hospital after the training period was over, so he was a bit perfunctory about his work.

It is also a doctor's family, but Renzu's family background is much better than Natori's. This person is really incomparable...

Maki picked up a piece of lettuce and complained in her heart.

Because of this, young doctors are always distrusted by patients, and they always hear complaints from outpatient doctors, saying that patients ask to be replaced by more qualified doctors.If everyone has a correct attitude, at least they won't be told that they are not good enough before seeing a doctor, right?

Next month, she will start working shifts in the outpatient clinic, and she prays in advance that she will not encounter patients who only talk based on their age.

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Note:

FFP: fresh frozen blood

AAA: Abdominal aortic aneurysm (Abdominal aortic aneurys) English abbreviation, a kind of arterial expansion disease, the incidence rate accounts for the first of all aneurysms.Characterized by the limitation and permanent expansion of the abdominal aortic wall, once the aneurysm ruptures, it is often impossible to rescue it in time and endanger life, and the mortality rate when ruptured is as high as 70%-90%.

REBOA: resuscitative balloon occlusion of the aorta, that is, through the intervention of the aorta near the groin, the arterial supply of the lower body is completely blocked from the aorta.

All cases are real and I really like medical dramas lol