When the Doctor Uses A Hack

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This was the most critical patient Chen Cang had ever encountered in his life!

Without a doubt!

The most critical wasn’t the most serious, as many severe patients before Chen Cang simply had no chance of being resuscitated.

But at this moment, Chen Cang felt there was an opportunity!

Actually, taking an X-ray at this time would have been most appropriate to make a judgment, but… where was the time to go back and do it?

The patient’s blood pressure was almost gone, with a ruptured ascending aorta, accompanying heart tamponade, and it was still uncertain whether the heart was damaged. If things proceeded as usual, the patient might really be gone before reaching the hospital.

Recently, Chen Cang had intensely studied cardiovascular diseases, especially emergency treatments.

He clearly remembered reading the latest report, which stated that in last year’s traffic accidents in America, the incidence of thoracic aortic injury was about 15%, and among these, only five percent were ruptures of the ascending aorta.

Of this five percent, only ten percent had a chance to be transported to a hospital, and of this meager ten percent, only twenty percent could be successfully resuscitated!

What this implied went without saying!

Was Chen Cang unaware that surgery in the ambulance had a greater chance of infection?

Did Chen Cang not understand that diagnosis should be confirmed under chest radiography, SCT, or EBCT? Wouldn’t it be best to perform an angiography of the aorta to determine the location of the injury?

Yet, all this applied only under permissible conditions.

Now, let alone CT and angiography, there wasn’t even a chance for a chest X-ray!

Chen Cang clearly remembered!

According to the newest guidelines, if an aortic rupture was suspected with extremely unstable circulation, accompanied by direct signs of rupture and secondary penetration (hemothorax, cardiac tamponade), immediate surgical exploration and intervention was mandatory!

That’s why Chen Cang had now chosen to perform a direct thoracotomy to explore and stop the bleeding.

In moments when you’ve no other options, the guidelines are your reliance and also your legal basis!

Was he unaware of the risks associated with everything he was about to do?

He knew them all!

But at this moment, it was life that was slipping away; there was no time to delay!

Chen Cang decisively said, "Old Yang, stop the car ahead."

The driver, Old Yang, couldn’t help but become startled: ???

Through the rearview mirror, he saw Chen Cang was about to perform surgery, and his face instantly changed!

But without uttering another word, he found a suitable spot and stopped the vehicle promptly.

During the transport of patients in a 120 ambulance, the doctor’s words were like military orders, and Chen Cang was the leader of the rescue team.

Chen Cang looked up at the two patients and said, "Get off, hurry to the Provincial Second Hospital."

Both of their faces changed instantly. The bald man wanted to speak, but it was evident that Wang Qian didn’t give them the chance, sending them on their way.

Chen Cang took a deep breath, feeling a bit nervous.

This was the first time he had independently handled such a critical patient, and also the first time he was performing surgery in an ambulance.

In such circumstances, anesthesia needed to be stable, using little to no drugs that suppressed the circulatory system. For critically injured patients, the best approach was to commence the relevant surgery under local anesthesia first, and then induce general anesthesia or perform endotracheal intubation.

Given the circumstances, Chen Cang could only perform local anesthesia!

The local anesthesia took effect rather quickly, and in no time,

Chen Cang picked up the scalpel and made a direct incision in the center of the chest!

Wang Qian nervously said, "We don’t have many gauzes…"

Chen Cang nodded, then carefully retracted the sternum… and gradually saw a hair-raising scene!

It was a sea of blood.

Chen Cang turned to Wang Qian and said, "Draw blood!"

Wang Qian’s face also changed, but he immediately picked up the syringe and began drawing blood!

Meanwhile, Chen Cang’s eyes were intently fixed on the pericardial area, where the pericardium resembled an overstuffed bun full of blood, ready to burst. Chen Cang made a small incision, and a stream of fresh blood gushed out.

"Hemostat!"

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The bleeding site is now exposed—it’s at the start of the left ventricular outflow tract, a region that’s relatively fixed, which means it’s prone to rupture from violent impacts or sudden deceleration!

Fortunately... the ribs didn’t damage the heart.

Perhaps that’s the only thing to be thankful for.

Blood pressure is very low, and Chen Cang is left with no choice, but this is a battle without options—if he doesn’t make an effort, the patient will surely die.

Chen Cang decisively cut open the pericardium, revealing the hemorrhaging area completely.

"Do we have any non-invasive hemostatic forceps?"

Wang Qian was startled, then immediately shook his head: "No!"

Who would prepare such things in a rescue vehicle?

After hesitating for a moment, Chen Cang suddenly took up position with both hands, pressing on the area, pinching the tear closed—the bleeding stopped.

The blood pressure temporarily stabilized...

But the patient’s life, like the leaves of this season, still quivered in the wind.

Thankfully, after contact with the pericardial tamponade, the patient’s bleeding was under control, and the blood pressure was gradually rising.

Chen Cang spoke to Old Yang, "Back to the hospital!"

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Old Yang glanced at Chen Cang through the rear-view mirror, nodded solemnly, and started the vehicle steadily, pulling away toward the hospital.

Through his hands, Chen Cang could feel the force of the blood flowing out, could distinctly feel the trace of this life.

Minutes later, the vehicle stopped directly at the emergency department’s special entrance of the Second Provincial Hospital.

Chen Cang didn’t dare to move, while the driver Old Yang immediately jumped to the back and, together with Wang Qian, carefully laid the gurney down.

Down below, Li Baoshan, Tao Zi, Xia Gaofeng, and others were already waiting anxiously!

Chen Cang quickly said, "Straight to the operating room!"

The crowd didn’t question him, and at this moment in the operating room, Wang Kai’an, Zhou Xiaodong, and Zhang Wenfu from the cardiovascular surgery team had already dressed and were waiting for the arrival of the patient!

The transfusion department, the laboratory, the medical office, the anesthesiologist... everyone was ready, waiting for Chen Cang’s return.

With Chen Cang’s arrival, the rescue preparations officially began!

Everyone started their work in an orderly fashion!

Blood draw, urgent lab work, blood matching...

The medical office handled the contact, signatures, authorizations...

The anesthesiologist was Liu Jian, who, upon seeing Chen Cang had already opened the chest and was pressing down on the heart with his hands, couldn’t help but widen his eyes in shock.

The extracorporeal circulation machine was already being prepared.

At that moment, Wang Kai’an with a non-invasive vascular clamp in hand glanced at Chen Cang: "Let me take over!"

The voice wasn’t loud, but it was very firm.

Chen Cang nodded, carefully completing the handover.

When Chen Cang stepped out, Wang Kai’an began the related work with the three men and the anesthesiologist.

Intravenous cannulation!

Start extracorporeal circulation!

Liu Jian then started endotracheal intubation, preparing for anesthesia.

This kind of surgery needed to be performed with the heart stopped, and when everything was ready, Zhang Wenfu blocked the distal end of the ascending aorta to prevent blood from flowing through.

When Tao Zi and Xia Gaofeng saw the tear in the patient’s ascending aorta starting at the surface and running under the pericardium, they couldn’t help but feel shocked.

This... really was as Chen Cang had said, very difficult to have made it back to the hospital.

Thinking back to how Chen Cang and Wang Qian had returned covered in blood, considering how Chen Cang used his fingers to compress and stop the bleeding all the way back to the hospital...

Both felt a deep admiration.

Chen, truly an impressive figure.