Chapter 661: Cardioplegia
Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation
To the Emergency Department, myocardial infarction and cerebral infarction were serious matters. If anyone went to the Emergency Department in a hospital, certain noticeable places would often have words such as [If you have chest pains, treat it] or [Chest Pain Center] pasted over it.
Chest pains might not mean myocardial infarction, but from the perspective of the Emergency Department, any patient with chest pain could be a high-risk patient, and they should not miss out on treating them.
They should also absolutely not have doctors from other hospitals point out that they missed treating these patients.
The doctor who was giving consultation to other patients turned around and stared at the middle-aged patient for a while before he walked forward. Regardless of the situation, he should ask first.
The nurse beside him was still young, so she explained in a rather childish manner. “He just injured his hands. Previously, he did his dressing at our hospital, and now, he is here to change the dressing. Since there are many people today, I let him wait.”
A few doctors and the senior nurse in the room did not say anything. The disease that the patient had was real, and it would not pass just because of a simple explanation. In this situation, it would naturally be the best if it was not a heart attack, and they would just need to scold… this overly good-looking doctor from another hospital for being a busybody. However, if the patient was diagnosed with a heart attack, what they said now would make them get scolded later.
A few doctors in the Emergency Department walked closer, and this made the patient who sat on the long bench feel puzzled, and he wanted to stand up using the chair armrest as his support…
“You can just take your seat.” The attending physician from the Emergency Department at Donghuang Regional Hospital, Jin Xiongteng quickly walked forward and stopped the patient.
As he walked closer, he managed to see the problem. This patient’s head was full of tiny droplets of sweat. It did not quite make sense to say that it was due to the pain in his hand.
“Which part hurts?” Jin Xiongteng asked directly.
“There is something wrong here.” The patient pointed at the region at the center of his chest.
It was basically a definite diagnosis. Jin Xiongteng used his hands to touch the patient’s clothes. Then, he realized that the patient was covered in sweat.
“Go and get nitroglycerin. Push the gurney over and get his electrocardiogram. Faster. Young Liu, go and make a call to inform the Department of Interventional Services.” Jin Xiongteng started to sweat too. He lowered his voice and made his orders. Then, he immediately turned around and asked the patient, “Have you received any surgery recently?”
The patient pointed at his hand, and he said slowly with difficulty, “I injured my hand…”
“And?” Jin Xiongteng fought for time and asked.
The middle-aged man who was sweating shook his head a little. “No.”
“Do you have hypertension?”
“No.”
“Recently, did you lie on the bed for a long period of time? Try to think, did you have flu or fever?” As Jin Xiongteng spoke, he ordered the nurse to measure the blood pressure on both arms. The entire process was tense and… chaotic.
Since Ling Ran was very familiar with Yun Hua Emergency Medical Center, the standard of Donghuang Regional Hospital Emergency Department appeared rather average to him. The experiences of their doctors and nurses were obviously not comparable to those in Yun Hua Hospital.
The main difference was that most of the manpower in the Emergency Department was shifted over for just a patient with chest pain. Anyone who looked over would see at least three nurses collecting things in the room while pushing the gurney, whereas two other nurses were measuring the patient’s blood pressure on both arms. Another nurse wanted to help but failed to do anything. Only two doctors came over because there were only a total of three doctors on duty in their Emergency Department.
At this time, if there was another patient suffering from chest pain, the patient might be neglected. It was not on purpose, but the medical staff that was busy would obviously pay less attention and focus on handling that patient.
However, if there was only this patient with chest pain, it would not be any problem for the people including Jin Xiongteng to handle him, though they would just be using up a little more manpower than necessary.
Yet even if they followed the standard operating procedures, it did not mean that the patient’s condition would progress accordingly.
Ling Ran observed for a while. Then he saw that Jin Xiongteng confirmed that the patient did not suffer from aortic rupture. He turned around and said to the young doctor who smiled like a Pekingese, “Get me a white coat.”
The young doctor hesitated and said, “Um… didn’t Doctor Jin take over?”
“Get me one first.” Ling Ran did not say much. He had stayed for too long at the Emergency Department, so he knew the importance of equipping himself. When a doctor wore a white coat, he would have an easier time dealing with things instead of having people doubt him all the time.
The young doctor slowly got a white coat and passed it to Ling Ran, “I don’t know if it fits you.”
“Alright, thanks.” Ling Ran took it and put it on.
The white coat did indeed not quite fit him, but he was still very handsome after putting it on.
The patient’s family members and the young nurses had been staring at Ling Ran since the beginning, and they felt like they had just watched a fashion show. They kept staring at Ling Ran without even blinking their eyes.
Meanwhile, Ling Ran stared at the patient without blinking.
The patient was sweaty and forced himself to talk, “Should I call my family members?”
“Let the nurse help you make the call,” Jin Xiongteng replied.
The patient then wanted to take his phone. He moved his arms for a while before they quickly fell down.
Jin Xiongteng was shocked. ‘Is this cardioplegia?’
“Push the moving bed over, get the patient on it, take off his shirt, prepare for cardiac pacing. Be quick.” Jin Xiongbo still sounded quite calm, unlike in the dramas where the doctors kept shouting loudly.
In fact, the doctors in the Emergency Department would only sacrifice their voice during accidents. Every patient whom they rescued was in critical condition. Even if they could shout for one or two days, it would be impossible for them to shout for three to five years.
Take Jin Xiongteng as an example. Since he had predicted that the patient was about to suffer from myocardial infarction, he did not need to shout. All he needed to do was following the operational guideline for myocardial infarction and perform it step by step.
The gurney at the side was pulled over. Once they stepped on the brakes, the patient was carried on it. His chest was exposed, and Jin Xiongteng took up the electrode pad…
After two continuous defibrillations, Jin Xiongteng climbed up on the gurney and started to perform CPR.
The other two doctors in the Emergency Department came over too, but they did not know what to do.
Ling Ran knew that aside from Jin Xiongteng, the other two young doctors might not have any related experience. Although Jin Xiongteng had certain experiences and skills, he may not have dealt with CPR for some time already.
Even in a big city like Beijing, there may not be patients with heart attacks being sent to the district hospital every month.
Ling Ran looked at Jin Xiongteng with a compassionate gaze. He then walked forward and said, “Open the airway, inject epinephrine, and open the second venous access pathway.”
The young doctor at the side was stunned a little as he stared at Ling Ran, then he looked at Jin Xiongteng.
Without waiting for them to reply, Ling Ran said, “I have experience in multiple prolonged CPRs. The longest was up to two hours.”
In short, prolonged CPR was the hardest among all CPRs. Even a single successful case could allow the doctor to boast for a very long period of time. Having multiple successful cases could only explain one thing… That person really knew CPR really well.
“Inject epinephrine and open the second venous access pathway.” Jin Xiongteng repeated the order, but he did not agree to open the airway.
Ling Ran then said, “Open the airway as soon as possible. That will benefit the following operation. High-end tracheostomy management can benefit all patients who need CPR.”
Jin Xiongteng continued performing CPR while saying, “This is in-hospital CPR, and there is no urgency to cut the trachea immediately.”
In-hospital CPR had a higher success rate than CPRs performed outside the hospital. Jin Xiongteng did not want to perform any operations that would harm the patient first, which was a normal mindset to all.
After all, many in-hospital CPRs would be effective in a few minutes.
Ling Ran shook his head gently, but he did not argue. He was not too sure if this patient could recover his heart rate in a few minutes. However, according to Ling Ran’s experience, if a man at the prime of his life like the patient suddenly had a heart attack, the underlying problem would be more serious.
In-hospital CPR had a higher success rate. This was mainly because the patient would soon receive treatment when he or she underwent cardioplegia, but that did not mean that there was anything special about the patient that allowed his or her quick recovery.
Many patients would suffer myocardial infarction outside the hospital. Some could be rescued through sufficient treatment given before reaching the hospital. Ling Ran had seen many cases where the paramedics gave the patients CPR on the way to the hospital, and most of them had also received good treatment.
But from Ling Ran’s perspective, the prerequisite for good treatment was that they had to accept that the current situation was bad.
It was true that the patient could wake up in a few minutes’ time. But Ling Ran did not agree with Jin Xiongteng putting his hope on this. If the airway was not opened now and the patient did not wake up, what should they do?
Time passed.
“It has been three minutes.” The nurse was calculating the time by the side.
“Replace me,” Jin Xiongteng shouted for another doctor to come over. Sweat had broken out on his face. He looked gloomy as he frowned and said to the nurse, “Get the tracheotomy pack.”
After he said that, Jin Xiongteng cast a glance at Ling Ran, and he noticed that Ling Ran had changed to the white coat of his hospital. He frowned once again and spoke with a Beijing accent, and asked, “You’re from our hospital?”
