Other vehicles carefully gave way to the ambulance when they heard the caterwauling.
However, even though most people knew the importance of giving way to an ambulance, it had to be done slowly due to the icy road surface.
It was normally five minutes away, but at such a snail's pace, the ambulance finally reached the crash site more than ten minutes late.
Scanning the scene… They saw a long metal dragon of approximately thirty to forty cars crushed together with different degrees of damage; most of the vehicles made of thin sheet metal had been deformed.
The inertia of the vehicles sliding off the bridge had caused this huge accident.
The doctor quickly jumped off the ambulance, but he accidentally slipped and fell to the ground. The first aid kit in his hand flew out, gliding along the icy pavement before coming to a halt nearly twenty meters away.
"Little Song, are you alright?" asked a nurse out of concern as she carefully stepped out of the ambulance.
"Yes, I'm fine," replied Doctor Song with a grin, enduring the pain that burned his hands and cheek.
It was obvious that the large abrasion on his face was equivalent to disfiguration, but fortunately, he was a man. If a female doctor had suffered from such an injury, she might have committed suicide after sending patients from the crash site back to the hospital.
Slowly and cautiously, he moved to the first aid kit, picked it up and started making his way toward the crash site.
"Doctor, here! I'm here!" someone shouted at the top of his lungs.
"I'm dying, please save me!" Doctor Song ignored the man after stealing a peek at him.
He followed his judgment and walked straight towards a heavily deformed car.
Eighty to ninety percent of those who could scream for help were fine due to their ability for articulation, but of course, "fine" only meant they were not on the brink of death. Doctor Song had even encountered a tough guy who had driven hundreds of kilometers on his motorcycle with a fractured tibia.
He noticed bloodstains on the door of the contorted car as he neared. Silence reigned inside the car and not a single wounded person could be seen around it. Moreover, he could vaguely outline a man lying in the passenger seat even from afar.
Something must be wrong!
"Doctor, help!" Lots of people cried for help along the way.
A choice had to be made at this moment. Doctor Song could always randomly send a victim back to the hospital as it was the most convenient and acceptable way to do so. In addition, he would not even need to risk fall-related injuries by climbing on the icy pavement.
Even so, he insisted on doing the right thing as a critically wounded victim would not survive until the next ambulance's arrival. In that case, he had to send the victim with the most severe condition back to the hospital first.
After tumbling a few times, Doctor Song, whose face had become swollen and bruised, finally reached the deformed car.
The car door had fallen to one side. The driver, who had blood all over his face, was lying with his thoracoabdominal area resting on the steering wheel; it was impossible to tell if he was alive or dead.
Without hesitating any further, Doctor Song quickly grabbed the car door to stabilize himself so that he could pull the patient out of the car.
To his surprise, the door was so heavily deformed that a sharp metal edge sliced open his hand.
Crimson fluid oozed out instantly.
There was no time to deal with such a "minor injury". Doctor Song firmly planted his feet on the pavement, grabbed the patient, unfastened his seatbelt, and yanked him out of the car with all his might.
Going down the slippery pavement was much more difficult than climbing up.
Doctor Song glanced at the ashen-faced patient and felt his thready pulse, which suggested internal hemorrhage. Staring desperately at the medical personnel—the nurse and paramedics carrying an empty stretcher trolley—still struggling to climb up the bridge, he instructed them to return and wait for him. Then, he lay down and stabilized himself with his feet before pulling the patient with him.
Just like that, Doctor Song slid down the black ice along with the patient.
Chapter 91 - An Unconventional Rescue Operation
Doctor Song hugged the patient tightly while his feet continuously searched for support in an attempt to increase friction.
However, he was at the mercy of the icy pavement.
This sort of rescue was definitely illegal, but special circ.u.mstances required special solutions. Were he to follow the standard procedure, the patient would be long gone by then.
Two paramedics used their bodies as a barrier and finally stopped the downward momentum of the duo, but it came at a price. The impact at that speed was almost the same as a full-force kick on the body.
Doctor Song was covered in red, a mixture of both his and his patient's blood. Ignoring the pain, he carried the victim, who had not suffered any secondary injury, onto the stretcher trolley and slowly pushed him into the ambulance.
Blood pressure readings came back at 80/40mmHg, which meant that the patient was in hemorrhagic shock. He was given supplemental oxygen and medications to induce hypertension after establishment of venous access. The siren sounded even more dreary as the ambulance rushed back to the hospital.
Every vehicle tried to give way to the ambulance as it was the only green channel between life and death.
In the ambulance, aggressive fluid resuscitation and drug administration were performed to maintain the patient's vital signs. Doctor Song ignored the wounds on his body and thoroughly examined the patient for signs of trauma while constantly reporting his condition to the emergency department so that early preparations could be made.
Twelve minutes later, the ambulance finally arrived at Sea City General Hospital emergency department.
Zheng Ren had been waiting for a long time at the main entrance.
The nurse in the ambulance handed over a few vacutainer tubes of freshly drawn blood for laboratory tests, mainly blood group and screening tests for HIV and syphilis. This was a necessary procedure as severely wounded patients desperately required blood transfusions.
The stretcher trolley was speedily pushed into the resuscitation room. Zheng Ren then inserted a central venous catheter into the subclavian vein while another doctor performed a B-scan ultrasonography on the patient.
At the same time, a nurse performed nasogastric tube insertion, urinary catheterization and preoperative skin preparation.
The senior consultants, highly experienced doctors from various departments—general surgery, orthopedic surgery, neurosurgery and urology surgery—had been waiting for the patient on high alert, so they knew what to expect after seeing the patient's condition.
The provisional diagnosis was traumatic hepatosplenic rupture complicated with hemorrhagic shock.
Fortunately, the tall patient had owned a small car, so there was no impact on the c.h.e.s.t.
Chief Surgeon Sun said seriously, "Little Zheng, you're young and fast, so go ahead."
Zheng Ren nodded in response as this was not a good time for modesty. The emergency operating theater had long been prepared and they could save at least five to ten minutes of precious time by performing the emergency surgery here.
Whether the patient lived or died could depend on these few minutes.
"Get him to the emergency operating theater and prepare for surgery," instructed Zheng Ren.
"Old Chief Physician Pan, I'm going to perform the emergency surgery. Please take it from here," he said to Old Chief Physician Pan before he departed.
"I'm guessing there'll be lots of casualties." Old Chief Physician Pan frowned and added, "Off you go. I'll call the operating theater if something happens."
The conversation was short and simple. There was nothing else to say at this moment.
Chief Zhou of the medical administration division had also arrived a long time ago. Without demanding Zheng Ren's presence, he began r
ecording the current situation and authorized the emergency department to handle the emergency surgery on behalf of the hospital.
The System's robotic female voice rang out in Zheng Ren's ears as he quickly walked upstairs to the emergency operating theater.
[Emergency Mission: Pileup Crash.
[Task: Rescue the injured patients in the multiple-vehicle collision.
[Reward: Unknown.
[Time: One day.]
The System could not provide any details about the mission reward, presumably due to the fact that this was an unexpected occurrence with an unspecified number of casualties.
Zheng Ren had gradually figured out the System's behavior. The fickle-minded System could either predict the future, although only to a certain extent, or simply felt reluctant to give further information about it.
The liver surgery experience the System had awarded him should be enough to deal with the emergency case at hand, but he lacked knowledge in splenectomy since he had performed it only once.
If he exchanged 14920 experience points for surgery intensive training time, he would have little over four hours to practice.
Splenectomy was relatively simple compared to liver repair surgery.
More than four hours of surgery intensive training time should be just enough for Zheng Ren, who had achieved the Expert rank in general surgery.
It could be inadequate for being proficient in the surgical repair of a ruptured spleen, but he could definitely master splenectomy in that short a time.
Zheng Ren trotted all the way to the emergency operating theater. Xie Yiren was preparing the surgical instruments and the Chu sisters were preparing general anesthesia. Even the frequently absent and quiet anesthesiologist responsible for training junior doctors had also appeared in the operating theater and was silently assisting the ladies with preparations.
Since the surgery preparation was still ongoing, he figured it was time to change his attire and mentally prepare himself for the surgery.
After reaching the locker room, Zheng Ren exchanged his points for surgery intensive training time and began practicing splenectomy.
In a sense, a splenectomy was even simpler than an appendectomy.
In a complicated case of appendicitis, the inflamed appendix could be in an ectopic position, a huge headache for all surgeons, but the spleen was rarely ectopic.
It was basically location, dissection, clamping and removal. There was nothing difficult about it as long as the arteries, veins and ligaments were clearly visible.
Zheng Ren practiced forty-three splenectomies in 4.14 hours, averaging less than six minutes per surgery.
He would never complete the surgery so rapidly in reality, but in the System, all he had to do was cut through the abdomen, face various types of splenic ruptures and excise it without worrying about irrigation or abdominal wound closure.
The most difficult part of the surgery was the careful maneuvering around the abnormally developed short gastric arteries when handling the gastrosplenic ligaments to prevent damage to the gastric wall. Secondary to that was the location of the splenic artery and vein; if the anatomical structures could be clearly visualized, the chance of surgical failure was close to zero.
Zheng Ren even resolved several complicated cases of splenic tuberculosis, and the overall process was performed smoothly.
When his time was finally up, Zheng Ren glanced at his skill trees.
Based on his calculations, his general surgery skill tree should have increased from 2044 to around 2200 skill points after his revision, completing actual surgeries and the splenectomy intensive training.
However, he was flabbergasted upon seeing the skill tree.
The skill tree had grown directly from 2044 to 3154 points!
What the hell had happened?
After recalling recent events, Zheng Ren assumed that the tremendous growth in his skill tree was related to the three hundred liver surgery experiences the System had awarded him.
Whatever the case, it was good news.
Zheng Ren also decided to keep a closer eye on his skill trees from now on.
With 1529 skill points still in his inventory, he still needed a little more than 300 skill points for a skill upgrade from the Expert to Master rank.
He felt a tinge of regret. If a rank upgrade was possible, he would definitely have obtained it to ensure the success of the rescue operation. Besides, even if he used up every skill point now, he could still regain them from missions in the future, right?
The System also notified him that the main quest had been completed. Zheng Ren gave this some thought and figured that the gangrenous appendicitis case had been equivalent to tier-three or four surgery, which had completed it sooner.
After accepting the reward—1000 experience points and 10 skill points, he noticed that there was only one bar left in the mission completion rate.
Zheng Ren ignored the rewards as they were not useful right now.
He summoned his mind back to reality and changed into surgical attire before proceeding to perform a surgical scrub.
When he walked into the operating theater after decontamination, Xie Yiren handed him a pair of large forceps and a kidney dish containing iodophor-soaked cottons.
During disinfection of the surgical site, Xie Yiren informed Zheng Ren that the blood bank had prepared 16U of fresh frozen red blood cells and 1000mL of fresh frozen plasma for the patient, and the circulating nurse was currently on her way to retrieve them.
'I don't think those are enough,' Zheng Ren thought while disinfecting and draping the surgical site.
He put on a surgical gown and stood under the surgical lighthead. Then, a sharp scalpel was handed to him.
Zheng Ren accepted it and the surgery officially began!
Chapter 92 - He's Faster, That’s All
The light reflected off the cold scalpel, radiating a bloodthirsty aura. Without hesitating further, Zheng Ren cut through the abdomen.
Instead of a standard incision, he chose to make a twenty-five-centimeter incision superior and lateral to the left rectus abdominis muscle.
This was completely different from his usual manner of surgery. Xie Yiren was momentarily stunned and grabbed a self-retaining retractor while staring attentively at his movements.
Chu Yanran, who was sitting beside the ventilator, fixed her gaze closely on the readings on the ventilator and various monitors while constantly spinning a pen in her right hand.
Standing opposite Zheng Ren, Chu Yanzhi asked, "Chief Zheng, do I scrub up and assist you?"
"No, the surgery will be over by the time you finish scrubbing up," answered Zheng Ren coldly without looking at her. After asking for a pair of medium-sized curved forceps and an aspirator with a suction tube, he plunged the aspirator into the peritoneal cavity as soon as the peritoneum was opened.
The dark red blood was quickly aspirated. A few seconds later, Zheng Ren instructed, "Chu Yanzhi, tell the circulating nurse to hurry up."
Chu Yanzhi nodded and ran out of the room like a scalded cat.
In Xinglin Garden, there were not many viewers in the live broadcast room.
It was morning now, the busiest time of day where every doctor was occupied with ward rounds, disease reports, surgery and so on.
Thus, "only" more than a thousand viewers were online at the moment.
[That's a severe hemorrhage. I can at least diagnose a splenic rupture in this case.]
[Blood pressure has dropped to only 60…]
[I hate emergency surgery the most, especially this type of rescue. Every time I'm done, my body will feel so sore that I need to rest for at least two days.]
Watching the turbulent flow of dark red blood in the suction tube naturally made every doctor in the live broadcast room feel the same way the commenter did.
The tension and suffocation of a rescue operation had subconsciously seeped into the viewers' hearts.
Only a few comments floated past the screen and most of them w
ere from the same talkative viewer.
This sort of doctor preferred to calm his nerves through conversation.
After aspirating for approximately ten seconds, the amount of dark red blood was considerably diminised. Without waiting for complete aspiration of blood, Zheng Ren directly opened the peritoneum and inserted his left hand into the peritoneal cavity.
Xie Yiren immediately put a kidney dish beside Zheng Ren.
He extracted several large blood clots and threw them into the kidney dish.
"Rubber drainage tube," said Zheng Ren to Xie Yiren; it was a rare request.
Xie Yiren acknowledged the instruction and handed the pre-prepared rubber drainage tube to Zheng Ren, taking the kidney dish away at the same time.
That near-perfect coordination was simply amazing.
Zheng Ren started searching for something in the peritoneal cavity.
[Wow, is he going to occlude the porta hepatis? Is the liver ruptured as well?]
[Sure looks like it. The host surgeon must be anxious to stop the bleeding as soon as possible, but I think it's better to expose the surgical field first. His manipulation is simply too risky.]
[Based on what I've seen these past few days, I'm waiting for the above commenter to get humiliated.]
In the live broadcast room, they watched as Zheng Ren inserted the latex drainage tube after a brief moment of discussion.
If the surgical site was adequately exposed, he should have been able to see the passage of latex tube through the hepatoduodenal ligament that was extended between the omentum and porta hepatis, but he was currently manipulating the instrument without any direct view of the surgical field at all.
Subsequently, Zheng Ren quickly performed a peritoneal protection and used a retractor to open the peritoneal cavity.
There was a clear four-centimeter wound with irregular, jagged edges on the spleen, and blood oozed out of it like a river overflowing a dam.
The patient's hypotension was the reason behind his slow flow rate.
However, everyone in the operating theater and live broadcast room knew that death was imminent if the hemorrhage continued for another ten minutes.
The Surgeon's Studio c1-799 Page 51