[Comprehensive] First Love Trainee

Looking at the appearance of this old gentleman who is not convinced, he really wants to refute one or two, but Maki has no time to chat with them anymore.

The announcement of the helicopter dispatch had already sounded on the radio, and the communicator in his pocket began to vibrate crazily.

"Sorry, the next precautions will be given to you by the nurse, I'll go first." Jumping up and running towards the tarmac, Tezuka stared at Maki's back with wide eyes in surprise.

I remember she didn't run so fast before...

"This is...?" Tezuka Kuniichi asked the nurse beside him a little puzzled when he saw the helicopter doctor dispatched for the first time.

"Ah, please don't worry about it." After writing down the list of life taboos in the consultation booklet and handing it to the patient, the nurse explained with a smile, "Dr. Asai is a doctor in the emergency center and is also in charge of the medical helicopter business. She is on duty today. "

In the past few years, I have seen a medical helicopter a few times, but Tezuka Kuniichi is not a person who likes to join in the fun, and he didn't go up close to see how the mission was carried out.Although the current Metropolitan Police Department has cooperated with the police hospital and several university hospitals, rescue helicopters and flying medical services have begun to provide convenience for police officers, but when he was active as a policeman on the front line was 20 years ago, when flying medical services It is not as convenient as it is now. If a policeman is injured at the scene, he has to wait for an ambulance. Some colleagues who were shot lost their lives because of untimely treatment.

If the current conditions were available at that time, those colleagues might not have to make sacrifices.Seeing that the helicopter took off in less than 3 minutes, even the retired policeman who was vigorous and resolute couldn't help but praise him for his swiftness.

"Excuse me, how many times do helicopter missions like this happen a day?" Tezuka thought of the faint coffee aroma that Maki had brought into his body when he first entered the consultation room, and wanted to frown again.

"It's hard to say." The nurse showed an admiring expression, "Sometimes more and sometimes less, but at least twice a day. Today is too much, and I flew three times in the morning. It was just after noon and another One dispatch. It's hard work, doctors."

The accident happened by the Tonegawa River when a motorcycle traveling at high speed hit a bicycle. Both the motorcycle rider and the female cyclist fell to the ground, sustained head injuries and lost consciousness.

This is a high-energy injury patient. Severe impact may cause fractures, brain damage, and even a large number of pneumothorax, and must be treated as soon as possible.The condition of the two patients is also critical. Now Miura Kanna and Kosugi Masanobu are both undergoing surgery, and sending them back to Dongda Hospital at the same time may lead to insufficient rescue personnel.The best solution is to find a trauma hospital near the accident site for admission.

"Mihama General Hospital has an operation and cannot receive it. Morita Medical Emergency Center said that it cannot handle patients with high-energy injuries." The result of the contact came from the command center, "The ambulance will arrive at the rendezvous point in 3 minutes, and I will try my best before then Contact other hospitals."

"There's no time." Lan Ze shook his head, "Both the wounded were sent back to Dongda University for the training of doctors to prepare."

The emergency center that received the contact acted quickly.The ultrasound room, CT and MRI examinations all need to be contacted in advance, and the nurses trotted in the corridor to contact the work.

Tezuka and his grandfather walked out of the consultation room, and saw several young doctors in blue emergency suits rushing into the primary consultation room, confirming the preparations for each other.

"Drip OK."

"The CT room is OK."

"Ultrasound OK."

……

"The helicopter came to contact you." The nurse in the initial consultation room announced the news loudly, "The male patient was sent to Fushimi East Hospital by ambulance, the female patient was 37 years old, hemorrhagic shock, pelvic fracture, pulse 120, radial artery pulse weaker than 25 minute."

"Understood. Prepare external fixator and TAE."

"Turn on ultrasound and prepare for bedside arterial catheterization."

"Yes."

The entire emergency floor was busy and orderly, and various sounds mixed together to form a tense and vivid movement.Tezuka remembered the back of Maki who jumped up and ran to the tarmac without looking back, looked at the doctors who were busy preparing to rescue the patients in front of him, and recalled the night when he saw Maki in Brompton a few years ago.

At that time, he just watched from a distance, and he didn't feel as deeply as he does now.

This kind of battle against death is going on every day. How strong a person's heart must be to withstand the test of life?How gentle do you have to be to always be serious and gentle to every patient who comes to ask for help?

The stretcher bed was pushed in from the outside, Lan Ze followed the bed, and quickly explained the information of the injured: "Another child was found, who was hit by the impact of the car crash and hit the river. It is speculated that he had drowned for more than 45 minutes, and his breathing and heartbeat had stopped. Asai Following the ambulance, the helicopter is now returning to pick them up. Prepare infrared lights and blankets, turn up the temperature of the air conditioner."

"Yes."

"Doctor Matsudaira, Aoki, and Yasuda came to help, and the rest went to pick up the helicopter."

"Drowning for more than 45 minutes, I'm afraid it will be difficult to revive." Dr. Songping put on his gloves and said in a hopeless tone.

"The water temperature during the day is about 3 degrees. It's not impossible. Let's give it a try." Even so, Dr. Yamazaki also felt that there was little hope. As a doctor, he would never give up until the last moment. That's all.

The helicopter landed on the apron, and the patient was unconscious. Shinji pushed the stretcher bed and ran to the consulting room with everyone, while doing cardiopulmonary resuscitation continuously.

"A boy aged 7 or 8, weighing 14-15 kilograms, whose heart rhythm has not yet recovered, underwent bone marrow puncture in an ambulance, with a body temperature of 27 degrees and a cardiopulmonary resuscitation time of 35 minutes." The broken hair was wet with sweat, and it was tightly attached to the face, and even the back of the first aid suit was half wet.The prolonged chest compressions made her somewhat exhausted, and she was out of breath while speaking, but the intensity of each compression still did not decrease. "Is □□S ready?"

"□□S doesn't have such a thin catheter." Dr. Yamazaki rejected the request, "And the child's artery is too thin, so there is no guarantee of successful catheter insertion."

The warming infusion catheter could no longer be inserted from the forward direction. Kenji Yamazaki switched hands and operated from the reverse direction. The temperature on the body temperature monitor barely rose by 10 after 0.2 minutes.

The hypothermia has been over 40 minutes, but the body temperature still has not risen to 30 degrees Celsius. The situation is urgent.

"If you don't think about it, he will die." Lan Ze's urging voice came from the side.While fixing the pelvis of the female patient, he said coldly. "Asai, you're from cardiothoracic surgery, right? Think about it."

Thinking... Her brain is almost out of order now!Maki almost collapsed, she took a big breath, and her brain quickly sifted through one case after another.

Children, drowning, hypothermia, cardiac arrest...Calm down, don't panic, there will definitely be cases that fit the situation that you have studied.

Got it!

"You can try to open the chest." She took a deep breath, and under the urging of Aizen almost forcefully, her brain calmed down abnormally, "Put the patient in a bathtub filled with hot water when the chest is opened, and let the warm water flow directly Into the chest, it can heat up the inside and outside at the same time. There was a case at Columbia University Medical Center, and an 8-year-old boy was rescued."

"Then you try." Lan Ze's voice was calm.

Kenji Yamazaki raised his head in surprise.

It is not surprising to know such a case, but he is surprised that Maki Asai still has the leeway to think and the courage to try at this time.

Based on his more than ten years of experience in first aid work, it can be seen that this child has been in shock for too long, even if he is rescued, it is impossible to recover from brain hypoxia for such a long time.He didn't believe that with Aozawa's farming experience and technology, he wouldn't know, so why let Asai make such a pointless attempt now?

……

The blood-stained surgical gown and gloves were thrown into the medical trash can, and Maki dragged his legs, which were almost unbearable, to the safe passage, and sat on the stairs exhausted.

Half of her hair was loose, stuck together with sweat from her cheeks and neck, and the front and back of the first aid suit were wet.

After more than 40 minutes of continuous chest compressions, plus continuous heart massage in the spa room, her arms are now involuntarily convulsed, and she has no strength to raise her hands to stop the loose hair.

The hydrotherapy did raise the temperature, and the defibrillator stopped the ventricular fibrillation.

She thought the rescue was successful.

However, the boy's pupils were still dilated and he did not respond to light. Although his heartbeat recovered, he fell into post-resuscitation encephalopathy due to the long time of cerebral hypoxia.

The safe stairwell was so quiet that Maki could even hear her own breathing and heartbeat.She stared blankly at the front, her brain was so blank that a blurred screen appeared, and the trend of the electrocardiogram on the monitor was repeatedly played back in front of her eyes.

She had done everything she could, but the frustration of being unable to change the ending made her body functions drop to the lowest level.

She thought of Megumi Shiratori's depression after Dr. Kuroda's hand injury many years ago, and suddenly felt empathy like traveling through time and space.

Wouldn't it be different if we could do a little more?

"What are you doing?" A voice so cold that there was almost no warmth came from behind, Aozawa stood beside the security door, pushed open the door with one hand, and looked down at Maki. "After the operation, there are still a lot of paperwork to be filled up quickly, so don't be lazy."

Maki sighed deeply, struggling to get up with his limp body: "...Yes, I understand."

With her head lowered, she followed Lan Ze, but she remained silent.On the one hand, I really don't have the strength to speak out, and on the other hand, I really don't have the mood.

However, the team leader who walked in the front spoke first in an abnormal manner: "In an emergency situation, you can calmly think of the case of Columbia University and start to implement it. You did a good job. It is already very good to do these things in that situation. That's it, then we just need to carefully monitor the breathing situation."

After a pause, Maki asked softly, "Did you already know this would happen?" Otherwise, Lan Ze would not be so relaxed, acting like a normal person.

"After all, the drowning time is too long." Although there was no direct answer, it was tantamount to an admission in disguise.

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Note:

1. TAE: transcatheter arterial embolization.A catheter is inserted through the artery to the lesion, and drugs are injected to embolize the blood vessel to stop bleeding.

2. □□S: Percutaneous cardiopulmonary assistance, simplified artificial heart.Blood from the right atrium is oxidized by the catheter to the extracorporeal artificial lung and then sent back to the artery.

3. Ventricular fibrillation: Ventricular fibrillation.It is one of the common causes of sudden cardiac arrest.

4. Post-resuscitation encephalopathy: After cardiopulmonary resuscitation, the state of brain dysfunction caused by brain injury.