[Comprehensive] First Love Trainee

Immediately sent a follow-up call to the emergency center, ordering to prepare wheelchairs, stretchers, and immobilizers, and to contact imaging examinations and brain surgery consultations. Prevent him from touching the iron stick on his neck with too violent movements, causing secondary damage.Maki opened the car door and helped the female patient in the back seat out of the car, desperately restraining her waving hands, smelling a strong smell of alcohol.

"This person may have just taken drugs." Tezuka frowned, and firmly grasped the male patient's two hands to firmly restrain his movements. During the struggle, there were dense pinholes on the exposed forearm of the patient.

"Be careful, don't let him scratch you." Zhen Ji's face turned cold when he heard this, and he immediately ordered.

If you are an injecting drug addict, there is no small possibility of HIV infection.Now the patient has an open wound on his body and is in the excitement after taking drugs. If he is scratched and exposed, it will be troublesome.

The first-aid colleagues ran towards the parking lot, and everyone worked together to put the three patients on the movable bed. Zhenji immediately informed Aozawa of her preliminary judgment.

"Young male patients are suspected to have the habit of injecting drugs. It is recommended to give priority to HIV screening and liver function testing. If the female patient is drunk, the above two should be sedated immediately."

The nurse hurriedly pushed the medicine, and the colleagues rushed to send the three injured back to the emergency center. Maki remembered that Tezuka's arm seemed to hit the steering wheel when he rear-ended just now, but at this time the first aid was overwhelming, and there were still two heights. If a dangerous patient is really determined to be a drug addict, the hospital has the responsibility to call the police immediately.In this case, it is not suitable for more people to see Tezuka appear here.

"You go first. It's not good for the police to see you later." He is an athlete and a public figure. If it is rumored that he is associated with words such as accidents, drug abuse, alcoholism, and serious trauma, no matter what the truth is, It would be a serious blow to reputation.Even if the rescue of these three patients is successful, there will still be many legal issues to be dealt with in the follow-up. Tezuka will set off to participate in the China Open at the end of the month, so there must be no extra problems.

"Go to the hospital you trust to check the trauma, I will go back to the first aid first." After quickly explaining a few words, Maki ran to catch up with the colleagues in front of him, and immediately took over a hospital bed. The team members quickly exchanged information about the situation of the injured, and soon Quickly disappear behind the gate.

"Tadao Yaguchi, male, 57 years old, tension pneumothorax caused by vehicle collision, pulse 127, blood pressure 147/95."

"Yaguchi Chiyo, female, 53 years old, fell while drunk, causing a fruit knife to be inserted into the head, pulse 113, blood pressure 124/89."

"Yaguchi Kenji, male, 28 years old, unconscious after taking drugs, an iron swab was inserted in the neck, pulse 120, blood pressure 160/110. Blood has been drawn for HIV screening and liver function tests, contact angiography as soon as possible."

"Have you contacted the brain surgery department? Ask them to help. Hurry up."

"Dr. Ninja will be here soon. The angiography room will be in another 20 minutes."

"Take Ms. Chiyo to take a head CT first."

The emergency room was busy. Three seriously injured patients were brought in at the same time. Two of them were still injured in the neck and head. Whether the fruit knife and iron swab caused other damage to the brain tissue and carotid artery was not checked in detail. I couldn’t tell clearly when I was there, so Yaguchi Kenji injected the sedative first and waited for the results of angiography and HIV screening. Maki took Miike and Aoki to deal with Yaguchi’s tension pneumothorax and physical trauma. Aozawa and Matsudaira were in charge of Yaguchi Chiyo, Miura and Kosugi still had patients sent by ambulance, so they could only let Kobayakawa and Yasuda monitor the situation of Yaguchi Kenji temporarily.

Aoki intubated Yaguchi, and the rest only needed to open the chest and insert a chest drainage tube. The pneumothorax could be relieved after successful degassing. However, the blood oxygen saturation not only did not rise after the intubation, but continued to decline.

"It's already been intubated!" Aoki and Miike looked at each other in blank dismay, "Is it better to change to circumthyroidectomy?"

"No, the intubation has been successful, and it's not a respiratory problem." Heart sounds could not be heard in the left and right chests, the patient continued to sweat coldly, had difficulty inhaling oxygen, and the pressure on the ventilator was also high.Under ultrasound examination, a white mass that had never been seen before appeared next to the patient's lung, and the entire lung could not be seen.The hyperechoic part and the hypoechoic part are mixed together, and even intubation cannot breathe. "It's a ruptured diaphragm."

On another hospital bed across a curtain, lay Ms. Chiyo with a fruit knife stuck in her head.Her test results showed that long-term alcohol abuse had caused abnormal liver function, and she could not use sedatives. Now she is still in a state of drunkenness and is extremely noisy. It takes three or four nurses to restrain her.

Even so, she was still very noisy, the whole consultation room was full of her yelling, scratching Dajiang's hand with her waving hands, and the hair of several nurses next to her was scratched.

When the head CT results came out, Aozawa freed up one hand to watch the film, and just turned around to take the tablet, Yaguchi Chiyo broke free from the nurses' grip with amazing strength, shouting, "This is a small injury□□ It's over." He pulled out the knife on his head very quickly and easily.

Blood gushed out of the blood hole in an instant, and the equipment connected to his body began to emit a sharp alarm.The medical staff nearby were stunned, watching helplessly as the knife was thrown out by the patient, and it fell on the door of the consulting room with viscous blood, almost scratching Ren Zuo's foot who pushed the door open.

"Oops, hurry up and give her a blood transfusion, open two channels, and speed up the infusion." Lan Ze dropped the CT scan with a headache, and Dr. Matsudaira pressed the patient's twitching shoulders from left to right, and looked around the emergency room. Situation, shook his head and consciously walked towards Kenji Yaguchi's bed.

Like this, probably no one has time to explain the situation to him, so I'd better ask the trainee doctor.

"I'm going to make an appointment in the operating room and call the digestive surgery guy."

The consequence of the rupture of the diaphragm is that the gastrointestinal spleen loses the blocking of the diaphragm, and all of it moves up into the chest cavity, squeezing the lungs so that the patient cannot breathe.In this case, intubation is useless, and a laparotomy must be performed immediately to readjust the position of the organs.

"The blood oxygen saturation has dropped below 90." The nurse reported the monitoring value.

"No, there is no manpower in the digestive surgery department..." Miike turned around helplessly after finishing the phone call and reported.

"The angiography room is ready." The nurse ran in to inform, and then directed the two trainee doctors to take Yaguchi Kenji for angiography first.The blood supply in the head and neck is rich, and image detection is necessary to formulate a surgical plan. Moreover, it is heard that the patient has a history of drug abuse, and detailed drug testing is also required to determine the drug use during the operation.

"Doctor Aozawa, then I'll start the preoperative preparation." Shinozu said hello to Aozawa, "Please come over as soon as possible after your end here."

After all, it is an emergency patient, contacting family members to sign a pre-operative consent form, etc., can not be decided by the brain surgery side.What's more, the outside of the brain also has its own surgery. If there is no need for assistants to come and follow the first aid, it will not be enough to rely on the outside of the brain.

"Asai, hurry up and go to brain surgery for cooperation." Aozawa ordered while stopping the bleeding on Yaguchi Chiyo's head, "Don't dawdle, just open the abdomen here."

"Understood." Yaguchi's blood oxygen saturation dropped to 85, and there was no room left to wait, "Give me the scalpel and dilator."

The boss said so, as trainee doctors, Aoki and Miike can only cooperate.

As a surgeon, in fact, many times you have to separate yourself from the cognition of being a human being, and treat patients and organs as simple objects. Otherwise, it is difficult for any normal person to see bloody organs and wounds without empathy. feel unwell.When Maki Asai is not working, she looks very gentle, friendly, and always smiling, but once she picks up the scalpel, she becomes calm and professional, like a different person, quite like the usual cold and serious Doctor Aozawa.

Although they are undisputed peers, Aoki and Miike feel that Asai Maki is very convincing, a person who is easy to trust and follow.

The internal organs returned, the lungs were reinflated, and the blood oxygen saturation rose to 96.Although after the internal organs were pulled down, the place where the diaphragm was connected to the back was damaged by about 8cm, but after the bleeding was temporarily stopped with gauze, there was still time to send it to the operating room and hand it over to the digestive surgery personnel for treatment. Aoki and Miike who participated in the treatment just now also followed Into surgery.

"Do you need my help?" After handing over the patients at hand, Maki saw that Aizawa and Matsudaira were still busy, so she stepped forward to ask.

"No, the knife passed between the temporal lobe and the frontal lobe, without injuring the brain tissue, no need for deep surgery." Lan Ze kept moving his hands, "You go to the brain surgery for consultation, and by the way, hurry up with the HIV screening results and Pharmacological detection and analysis.” Immediately after the image diagnosis, surgery will be performed, and doctors need to make corresponding preparations.

"Understood." Shinji took off his gloves and surgical gown, "Just now Kobayakawa said that she had contacted her, and no other relatives could come and sign." Kobayakawa contacted the police station and tried to find other relatives, but they couldn't find them.

"Forget it then. During the preoperative talk, check to see if your father is awake. If not, you can only do it for the time being. It's an emergency patient, and the situation is special, so it's understandable."

"Understood, I will let Kobayakawa try again. How will the surgery be arranged?"

"You take Oe to go." Ms. Chiyo's injury has been brought under control, and the manpower is not so tight. The two helping trainee doctors can remove one to go to the operation.Brain surgery is different from other surgeries. It is a difficult part for emergency doctors to learn. After finishing his internship as a flying doctor, Lan Ze also worked in brain surgery for five years before he could deal with various situations proficiently. For the trainee doctors, as long as he has the opportunity, he usually lets them take turns doing extra-brain surgery.

When Maki entered the radiography room, the examination was not over yet. Although he couldn't see his expression clearly while wearing a mask, he could tell from his eyes that the situation was not optimistic.

"What's the matter?" she asked softly.

"The bleeding point is in the left carotid artery, but the patient has a pseudoaneurysm, and I'm looking at the condition of the cerebrovascular situation now." When he was a student, Shinobu gave Maki a feeling that he was at ease, and he didn't often have the time to go all out. Even the game has a laid-back feel to it.Now that I am a doctor, although I still speak in an ambiguous Kansai accent, my attitude is much more rigorous.

But even so, this kind of serious tone rarely appears in Ninzuzu now, which only shows that the situation is much worse than it is said.

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The author has something to say:

These cases are adapted from real cases, so I really think medicine is amazing