Surgery Godfather

Chapter 75: Chapter 0073: Lightning Action

Practical experience and accumulated knowledge play a crucial role at this moment.

“Transfusion allergic shock!”

After filtering through a series of potential diagnoses, Director Tian quickly makes a decision.

Even before he utters these words, Yang Ping quietly says, “Transfusion allergic shock.”

Director Tian glances at Yang Ping and promptly orders the anesthesiologist, “Check the skin complexion!”

The anesthesiologist quickly complies, responding, “Facial redness, swelling around the eyes!”

“Transfusion allergic shock! Stop blood transfusion, rehydrate quickly, even remove the blood transfusion tubing!”

Director Tian’s voice is loud and clear, yet calm and collected. He glances at the monitoring screen and the anesthesia machine. The patient’s heart is still beating, there’s no need for cardiopulmonary resuscitation; as for respiration, the patient is on an anesthesia breathing machine, so there won’t be any breathing problems.

The anesthesia doctor is doing fine, but the patrolling nurse is slightly overwhelmed. Having a transfusion allergic shock on one hand and significant bleeding on the other, either condition can be deadly, but now both are occurring simultaneously.

The watching doctors’ hearts are pounding in their chests.

“0.1% adrenaline, 0.5 milliliter, intramuscular injection!” Director Tian commands firmly.

Normally adrenaline is injected subcutaneously, but now intramuscular? The patrolling nurse questions with slightly hesitant eyes.

“Intramuscular!” Director Tian repeats harshly.

Under the authority of the professor, the anesthesiologist and the nurse no longer question how he diagnosed a transfusion allergic shock or why he ordered an intramuscular injection of adrenaline. Time is life; all that matters now is fast execution.

Bleeding and adrenaline present a contradiction. Adrenaline can exacerbate hemorrhagic shock and bleeding can intensify the allergic shock. The two are intertwined dilemmas.

While directing the rescue, Director Tian continues working without pausing; rescue operations must be swift as allergic shock is extremely dangerous. It only takes a few minutes to see who lives or dies.

“Scalpel, open the abdomen, prepare a rubber strip to temporarily block the abdominal aorta!”

Temporarily blocking the abdominal aorta is a drastic procedure; generally, people wouldn’t dare to do it. Director Miao now has no clue what to do, he can only fret on standby.

“Prepare a rubber strip!” The patrolling nurse struggles to keep up with Director Tian’s pace.

The gloves are taken and started cutting the rubber strip. Director Miao assists by cutting together.

The incision is extended along the original cut. Yang Ping’s retractor is already in place to help expose the tissue. After cutting through the skin, subcutaneous tissue, and deep fascia, then the three layers of abdominal muscles, they enter the abdominal cavity and successfully locate the abdominal aorta.

The thick abdominal aorta pulsates in the abdominal cavity. The pulsations aren’t as strong as they would be under normal conditions due to the shock, yet they still give a strong visual impact. This is the main artery supplying the whole lower half of the body.

A clamp is passed behind the abdominal aorta, and Yang Ping feeds the rubber strip accurately.

Once the rubber strip is stretched, Director Tian tightens it and Yang Ping instantly clamps the strip, forming an elastic ligation around the abdominal aorta. Without the need for verbal communication, Yang Ping can always anticipate Director Tian’s actions, never making a mistake, never arriving late.

The major source of bleeding has been successfully blocked.

Temporarily blocking the abdominal aorta cannot endure for very long, but can hold for forty-five minutes, which gives Director Tian enough time to find the ruptured vessels.

“Continue the surgery!” Director Tian orders.

Pausing the surgery now bears a greater risk; it’s like a ship entering a whirlpool, either it gets swallowed or it breaks free.

The suction device delicately inserts into the fracture gap, clears the accumulated blood, and attempts to find the deathly artery that’s bleeding. It’s a challenging task.

“Do we have the interventional department?” Song Zimo asks from below the operating table presenting an idea as an observer.

Director Tian decisively replies, “No need.”

It would take at least half an hour to get the interventional department involved. The many bleeding points shown on CT angiograms are a mess, which the interventional department can’t accurately embolize. The only option would be to riskily perform mainstem embolization, which can lead to serious ischemic consequences. They’d only consider this if there were no other options left.

The bone fragments are carefully turned over. An assistant’s hemostatic forceps have already clamped a vessel. Gently pulling it out, Director Tian looks up and locks eyes with Yang Ping, whose gaze is steady and confident.

“Number 4 silk!”

A hemostatic forceps carrying silk sutures is handed over. Director Tian wraps it around and ties a deft surgical knot.

“Suture!”

He sutured another one, a suture, a ligation. With two sutures, it should be safer.

Director Tian released the rubber band of the abdominal aorta, and blood gushed out from the surgical area. He hurriedly fastened the abdominal aorta again and Yang Ping’s vascular clamp went up again to secure the rubber band.

Could it be that the artery he ligated is not the lethal artery? Or are there two lethal arteries?

He looked at Yang Ping, who seemed to have guessed his thoughts and nodded, “There should be two lethal arteries, and both the proximal and distal ends need to be ligated. In essence, we have to find and ligate four blood vessels. They have formed a loop, ligating just one end is pointless.”

What he said was right, more accurate than himself. He also found the first lethal artery faster than him.

“Hand me the suction! Your turn!” Director Tian took the suction from Yang Ping’s hand and started to suck the blood.

Even though he was confident, speed was of the essence at this moment! The faster, the better. He would not risk the patient’s life just to save face. If he could be one minute faster now, there would be more chances of success.

The second blood vessel was located.

Ligation, suturing! Another two procedures.

The third one, the fourth one!

Two blood vessels, all four ends were found and sutured, as well as ligated.

He released the rubber band of the abdominal aorta again, and no more blood gushed out from the surgical area.

Director Tian thought, Yang Ping was faster in making decisions, and his movements were also quicker than him. No wonder Director Han asked him to bring Yang Ping along. He couldn’t help casting an appreciative glance at Yang Ping, who took the suction back from him.

These small movements on the operating table couldn’t be seen by the people below. Director Miao was now focusing on the patient’s vital signs and had no time to watch the surgery.

Director Tian hesitated, wondering if he should let him continue to finish the surgery. Yang Ping’s eyes were full of encouragement.

Director Tian smiled, continuing. Having passed the risky point of the lethal arteries, they could take a breather now. It was important to control the pace of the surgery. They had risked continuing the surgery earlier to resolve the conflict between epinephrine and bleeding. But now, they could finally relax.

The allergic shock came fiercely, but it also ended quickly. The patient’s vital signs had stabilized and the blood pressure had come back up.

In fact, during an allergic shock, there are only a few golden minutes left. If the rescue is successful, the patient lives. If not, the patient will never wake up.

The blood bag and transfusion tube from earlier were preserved to find out the cause.

Even though they had faced a critical situation, Director Tian went through the entire process without any panic. Once again, it confirmed that his judgment was correct as he confirmed the patient’s stable vital signs.

“Continue!”

The doctors below have just gone through a lifesaving roller coaster ride, and their emotions were still unsettled. But now the surgery continues. The professor really was a professor, with the demeanor of a general.

The anterior column of the acetabulum was fixed, next came the iliac wing, then the sacral fracture, and finally the sacroiliac joint dislocation was treated.

Any single one of these fractures would be a difficult surgical operation, let alone a mixture of several at the same time.

Fixation of the fractured iliac wing, fixation of the sacral fracture, and finally, the sacroiliac joint was restored back into position and fixed!

The remaining tasks were smoothly handled by Director Tian, even when facing the complex venous plexus near the sacrum. With the cooperation of the two, very little blood was lost.

X-ray imaging, perfect fixation.

Rinsing, placement of drainage tube.

Director Tian began suturing, Yang Ping cut the thread.

“Allergic shock, earlier that was so dangerous! Director Han and I have encountered it during surgery before.” Director Tian had completely forgotten Director Miao’s presence earlier, so he only remembered to explain now.

Director Miao was still in shock, as if waking from a dream, thankfully it was Director Tian conducting the surgery. To think, if it had been himself, either the allergic shock or the bleeding from the lethal arteries, would have made him extremely nervous. Let alone the occurrence of both at the same time, he couldn’t have handled it.

Thankfully, they had invited the professor to do it who remained composed throughout, otherwise the fear might have soaked his surgical gown entirely.

“Send the patient to ICU for at least 24 hours after the surgery. There was not much blood loss from the fracture, the main concern is the follow-up care and treatment for the allergic shock.” Director Tian instructed.

The doctors present were grateful for their experience of the rescue they had just witnessed. The professor’s composure on the stage, his accurate judgment of the patient’s condition, decisive rescue, daring continuation of the surgery, and finally getting through the danger, was certainly an experience to be remembered for a lifetime.

If only they could be just as competent.

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