Chapter 408: Autonomous Regulation of Cardiac Rhythm
Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation
“Autonomous regulation of cardiac rhythm,” Nurse Niu shouted.
She had been a nurse for twenty years. If anyone made any calculations, they would find that she was even older than some of the doctors on the spot. Although she had rarely seen a CPR performed for more than an hour, it did not affect her understanding on the patient’s condition.
This time was the most critical period for the patient.
Lu Wenbin got a little excited, “It’s a QRS complex[1], slightly too wide…”
Ling Ran silently nodded and said, “Touch the aorta.”
His own hands were cramped and numb, so he was worried that he could not feel anything.
Right after he finished speaking, Nurse Niu held the patient’s artery and said, “Very weak.”
Weak was better no signs.
At this time, even if the patient showed signs that were normally unacceptable, it was a good thing.
Ling Ran continued external chest compressions and said, “Inject more lidocaine and epinephrine, and add 0.5 ounces of dexamethasone.”
Nurse Niu immediately executed the instructions. If she doubted Ling Ran a few hours ago, now, that doubt had turned into admiration.
CPR was actually a matter mixed with both despair and hope.
If a CPR was performed for a normal individual, it would be exhausting to be continuously performed for five sets, and each set took about two minutes.
During some medical licensing exams, only three sets of CPR was needed. The last two sets were only conducted through oral test because the examiners had to consider the stamina of the students during the medical licensing exams.
But in reality, there were many doctors who could complete a CPR alone for one to two hours.
Most hospitals would say that they had a doctor who could continuously perform CPR for thirty to forty minutes.
These stories did not always involve healthy doctors with strong staminas, but most of the time, it was because they were willing to sacrifice themselves to save a life.
If they persisted for another ten minutes, perhaps the patient could be saved…
If they persisted for another five minutes, perhaps the patient could be saved…
Another two sets, just another two sets, then the results will show…
Just another set, maybe it would work…
Just persist for a while more…
When a doctor performed CPR, they always harbored the greatest hope, but they usually were faced with the greatest disappointment.
It was especially so for prolonged CPR.
Perhaps only one out of one hundred patients who received prolonged CPR could regain autonomous regulation of cardiac rhythm. They might only run into a person who would regain consciousness after they performed two hundred prolonged CPR on patients.
But if two million people received prolonged CPR, then ten thousand could stay alive and be discharged from the hospital.
If there were twenty million cases of prolonged CPR, one hundred thousand could regain consciousness.
But if they looked at this from another point of view, this kind of effort filled with hope would actually generate a greater disappointment.
At Nurse Liu’s age, she was no longer hoping for miracles.
She just wanted to complete her daily routine. She felt happy when a life was saved, yet she would not feel sad for being unable to save a patient. When she went back home, she would just leave behind her feelings and let them go together with her white coat…
However, Nurse Liu still longed to see a doctor like Ling Ran.
She asked herself, if she really met with terrible incident, she really hoped that there would be a doctor who would try his best to save her even if she only had 0.01% of a chance to survive.
“Magnesium and calcium. Inject those into the patient.”
Ling Ran voice was clear, and the order was firm.
When Nurse Liu was about to turn around and perform the task, she saw that there was already a young nurse beside her who completed the task.
She was surprised when she turned around. Then, she saw Huo Congjun, Chief Physician Tao, and at least twenty to thirty medical staff surrounding them.
Many had witnessed prolonged CPR before, but not many of them ever saw a successful prolonged CPR.
Ling Ran tilted his aching and tired neck. He gently removed his hands from the patient’s chest as his chest wall returned to position.
“Cardiac rhythm 130, autonomous regulation of cardiac rhythm… Blood pressure 120/74…” Nurse Niu read out the figures on the monitor.
Ling Ran used his shaking fingers to touch the patient’s aorta. His emotions were surging as well, but the main reason behind why his fingers were trembling was because he had been performing chest compressions for too long.
The time was so long that his muscles had started to ache.
“How was it?” Huo Congjun asked with hope.
“There’s an obvious beat,” Ling Ran replied hoarsely.
“Was he successfully resuscitated?” Huo Congjun was not the one who spoke this time, but a government servant. He was also wearing a white coat, and he looked very anxious. He had eyebags and dark eye circles.
“We still can’t be sure yet,” said Ling Ran. He then said, “Continue to transfuse plasma and colloid. Give him an ice-cap… refill sodium bicarbonate.”
Every single time he said something, a nurse would immediately carry out his order.
When a miracle appeared in this long night, it touched everyone’s hearts.
“Old Hu, Old Hu…” the chubby woman shouted again outside the glass door.
“The patient is still unable to hear you.” A nurse reminded her.
“Vegetative patients can hear-I mean, my Old Hu can hear me… Old Hu, Old Hu…”
Ling Ran was so tired that he was unable to speak. He found a bench against the wall and sat down. He did not want to move anymore.
Huo Congjun took out a torch, opened the patient’s eyes, and swung it at his pupils a few times.
“Slight response to light.” Huo Congjun nodded. Naturally, the level of mydriasis[2] was still very high, but he did not mention it.
Ling Ran looked at the ECG monitor and hummed. Then, he said to Lu Wenbin beside him, “Give me a glass of water.”
“Dextrose.” The young nurse at the side immediately passed him a small cup printed with Doraemon and said, “The cup was disinfected with high temperature.”
Ling Ran showed a small and faint smile. Then, he drained the sweet dextrose in the cup.
He also drank a bottle of Energy Serum at the same time.
Within a few seconds, Ling Ran felt that the energy and stamina largely recovering.
“Ling Ran, take a rest first,” Huo Congjun said in a low voice. He then talked to the doctor next to him, “Send the patient to the ICU and ask the Neurology Department for consultation.”
Ling Ran stood up and wanted to say something, but he remained silent.
CPR did not just end when the patient’s heart started beating again. After receiving CPR for such a long period of time, all parts of the patient’s body would be damaged. This was just like how an army was near the verge of collapsing after losing logistics support. Much work would be needed in order to restore the organization and system.
Ling Ran had some insight and experience on this matter, but he needed more detailed conditions and performed even more detailed analysis. So, he did not need to give too much comments at this moment.
The ICU and Neurology Department in Yun Hua Hospital were not weak teams, and both departments had the experience of taking care of patients who survived prolonged CPR.
“Old Hu, Old Hu…”
Hu’s wife watched the medical staff move the gurney where her husband lay while she remained outside the glass door. She also could not help but move as well.
Her son and mother-in-law stood behind her, and there were also several friends and colleagues who had just heard about the news.
After receiving such a long period of CPR and receiving the notice of critical illness, everyone knew what was happening clearly.
Now, they could only express their gratitude toward the Gods and thank them for the miracle. At the same time, they expected another miracle to happen again.
“Doctor, thank you very much.” When they walked to the elevator, the chubby woman suddenly thought of something before she turned around and shouted her gratitude.
Ling Ran was still sitting on the bench to rest, and he could not help but smile. He then got up and nodded at them.
“Doctor, what’s your name?” Hu’s wife could not enter the resuscitation room, so she asked through the door.
Ling Ran glanced at Huo Congjun before he turned around and said, “Ling, Ling Ran.”
“Doctor Ling Ran, thank you.” Hu’s wife forced herself to smile. She wanted to say something, but she did not know what to say. The elevator came at the right time. So, she cast a glance at Ling Ran again before she turned around and left.
After entering the elevator, Hu’s wife patted her son’s shoulder and said, “If your dad can recover from this, we will go back to our hometown, buy two pigs, and send them over to thank the doctors.”
Her nine-year-old son nodded with a dumbfounded expression.
“Did you remember his name?”
“Ling Ran.” Her son pronounced perfectly.
Hu’s wife was so tired that she leaned against the elevator wall, and the elevator shook slightly.
The mother-in-law did not want to argue with her daughter-in-law at the moment. She secretly prayed to many gods. ‘God, please protect us. Ancestors of the Hu family, please protect us. If my son Hu Qiang can get through this and live healthy, I, Zhu Xiulan, will sacrifice cattle, sheep, and pigs as an offering to the temple for three days and nights… Even if there is any sequela, I will also sacrifice three fat pigs and invite someone to sing an opera for three days and three nights… If my son regains consciousness and can take care of himself, I will also sacrifice two fat pigs…’
When the door to the elevator opened, Zhu Xiulan held her rough fingers together and prayed more earnestly when she saw the situation inside the ICU. ‘As long he can regain his consciousness and is able to move around, I will buy the pig our neighbor, Old Wang, keeps for Chinese New Year and offer it to you… If that’s not enough, all of you can just take away my life because I’m an old and lonely lady now. I can’t live without my son…’
Zhu Xiulan was more sorrowful as she thought about this. In the end, she could not help but sit on the floor and start to cry.
Translator’s Note:
[1] QRS complex: a name for the combination of three of the graphical deflections seen on a typical electrocardiogram (EKG or ECG). It is usually the central and most visually obvious part of the tracing; in other words, it’s the main spike seen on an ECG line. It corresponds to the depolarization of the right and left ventricles of the human heart and contraction of the large ventricular muscles.
[2] Mydriasis: dilation of the pupil of the eye.
