Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation
[Mission: Treat the Wounded and Sick]
[Mission Details: Resuscitate 10 patients in the ICU (1/10)]
[Reward: Cardiac Trauma Repair (Master Level)]
Ling Ran read the notification of the system and nodded slightly.
Regardless of whether it was an emergency rescue or rescue inside the ICU, an entire team was needed to work together. Working as the assistant could also help him progress the mission, and this part of the system was reasonable, at least.
‘Put it away,’ Ling Ran thought. Then, the system panel disappeared after flashing twice.
Ling Ran turned around and got ready to continue with his ward round, but the alarm in the monitor rang again…
Once a monitor started to ring, the other monitors would also ring. In the ICU, this was like a metaphysical equation. It always happened, causing people to become interested in studying it in the beginning, and later on, become numb to it.
Ling Ran was still the first who arrived at the rescue position.
Behind him, the ICU doctors moved faster because of Ling Ran’s actions, but they obviously were not as sensitive to the monitors as Ling Ran was. When the alarms in the monitors in the emergency room blared, it was as if the signal for a charge had been fired, while in ICU, it only gave the doctors inside the same level of urgency as a ringtone.
“Defibrillation.” At that time, Ling Ran completed the examination, so he made the decision faster than the doctors from the ICU.
The nurse by the side also responded at the first moment, her hands left the patient’s body.
“External chest compressions.” As Ling Ran said this, he started CPR on the patient, who laid flat on the bed.
In-hospital emergency treatment had a much higher success rate than the out-hospital emergency treatment because of timely judgment as well as speedy and high-quality rescue measures. Take CPR as an example, the average number of patients saved in the hospital was much higher than the number of patients saved using CPR outside the hospital.
While in the ICU, CPRs were performed every day, and it was always done at the prime time. The patients in the ICU could live longer because of this.
However, CPR was tiring. At this moment, since Ling Ran was willing to do it, the doctors who came later would not fight for the chance of performing CPR with him. They looked at Ling Ran’s shoulders as they moved up and down, and they thought that the sense of rhythm in his motions was very strong. However, they did not make any deliberate effort to understand it well.
Even if Ling Ran had Perfect Level Cardiopulmonary Resuscitation Skill, the movement for external chest compressions was still just mechanical. Having the perfect level in performing CPR just meant that he was more accurate in searching for the location to perform external chest compressions, had a more stable frequency when performing external chest compressions, and had a better rhythm.
“Epinephrine,” Ling Ran made the order in a low voice.
A few seconds later, the epinephrine entered the patient’s body.
“Defibrillation.” Ling Ran then removed his hands from the patient’s chest, and a silent shudder in the patient’s body immediately followed.
“Heart rate has recovered.” The ICU doctor watching at the back smiled. He buttered up to Ling Ran like compliments were worth nothing and said, “Doctor Ling, you are really adept in catching timing.”
Ling Ran showed a faint smile that the doctor had been expecting for a long time. Before he said anything, an alarm rang.
“Your turn.” Ling Ran did not rush to get started since he had just performed CPR. Instead, he humbly gave the chance to the attending physician from the ICU.
The attending physician in his thirties subconsciously felt happy, so he took one vigorous stride before he arrived in his position. Then, he immediately started with the rescue process he was familiar, but there was something different from this rescue process to the ones before, the attending physician today suddenly felt energetic, and that energy… was born from the urge to show off.
Yes, this area was his forte, and he did things Ling Ran could not do… At least, he could do better than Doctor Ling…
The attending physician saw the old and fierce nurses by his sides. Although he did not have any feelings for them, his urge to show off was already uncontrollable.
After performing some examinations, the attending physician ordered, “Mannitol. Do tracheal intubation.”
The nurses started preparations according to what he said.
Another senior nurse walked over and described the situation to Ling Ran, “The patient has brain metastasis from nasopharyngeal carcinoma. Previously, he had headaches, cerebral edema, and always fell unconscious, but he was still able to have spontaneous ventilation…”
Ling Ran nodded slightly. The ability to have spontaneous ventilation meant that the patient was in a better condition in the ICU, but the chance of saving a patient with brain metastasis was nearly zero, so it depended on the patient and his family’s view of life and how urgent the situation was for them to determine whether they wanted the patient to continue staying in the ICU.
Ling Ran stood in front of the hospital bed and looked at the attending physician opening up the trachea intubation bag, put on gloves, take out the laryngoscope, and start with intubation.
The attending physician looked slightly excited.
“Mild laryngeal obstruction,” the attending physician said, but he did not stop in his movements, and he was obviously ready to take up the challenge.
Ling Ran frowned slightly, but he did not say anything to stop the attending physician.
To describe it in terms of food, trachea intubation was like making noodles: there were all sorts of noodles, and there were also various difficulties in making them.
If he made judgments based on the Mallampati score, the soft palate, pharynx, palatine uvula, as well as anterior and posterior pharyngeal arch, could be seen in a Mallampati 1 airway, so it was as easy as cooking instant noodles!
However, in the case of a Mallampati 2 airway, only the soft palate, pharynx, and palatine uvula could be seen, so the difficulty level was increased immediately to the level… of cooking pasta.
When only the soft palate and the bottom of the palatine uvula could be seen, this was a Mallampati 3 airway, which meant that a real problem had occurred.
Generally, performing tracheal intubation for a Mallampati 3 airway was like making knife-cut noodles at home. Normal people would not make knife-cut noodles at home, and since that was the case, it was only logical that tracheal intubation for a Mallampati 3 airway would only appear in special situations. Take, for example, the current patient who had an obviously swollen head. He already had a laryngeal obstruction, so his starting grade was a Mallampati 3 airway.
Tracheal intubation for a Mallampati 3 airway was not as good as tracheotomy, but this also depended on the doctor’s decision on the spot.
This attending physician from the ICU was obviously very confident with tracheal intubation, so Ling Ran did not have the need to stop him.
This was just like when he performed surgery. He would also perform certain operations that were atypical. The outstanding chief surgeons would also have some maneuvers which were atypical.
Ling Ran understood this very well.
Naturally, if Ling Ran needed to choose, he would still prefer tracheotomy instead of tracheal intubation, and the reason was simple. His tracheotomy was at Perfect Level, and his tracheal intubation could only be considered to be at advanced Novice Level up to this date. He was not even at Specialist Level for that.
Therefore, forget about a Mallampati 4 airway, even if he encountered a Mallampati 3 airway, Ling Ran would also perform tracheotomy without any hesitation…
After all, it would cause death if tracheal intubation was not performed well.
When he thought about it, Ling Ran watched even more seriously.
Clinical medicine was such a big system that all doctors in the system would take up many years if they wanted to learn just the basic operations alone.
Even Ling Ran also needed to make full use of his time to learn the basics.
“Damn, I poked through the esophagus!” The confident attending physician cursed, and he made the atmosphere around the hospital bed to instantly plummet to the ground.
“Tracheotomy pack.” Ling Ran was ready to take over at the first moment.
This was also a very familiar scene to him. Attending physicians who failed in their operation, guitarists who failed in their performance, and athletes who failed to perform slam dunks had always appeared in his life inevitably, so it was not a strange thing to him.
Yet, the attending physician from the ICU was stunned.
He was really professional in performing tracheal intubation. Naturally, there was always a failure rate in this kind of operation, especially for Mallampati 3 airways, it was not easy for anyone to perform intubation for this sort of airway, but it was quite rare that people would insert the tube through the esophagus.
The attending physician secretly sighed, glanced at Ling Ran out of the corner of his eyes, and thought secretly, ‘I failed in showing off.’
Then, the other series of thoughts came like a tidal wave.
However, before the attending physician could compose himself, he heard Ling Ran’s instructions for a tracheotomy pack.
The attending physician was stunned and raised his head. He saw the nurse passing a tracheotomy pack to Ling Ran like a lioness who betrayed its lion for another.
Ling Ran had put on gloves a long time ago. He opened up the bag without saying anything, took a glance at the comatose patient, and without performing anesthesia, he picked up a scalpel and cut a longitudinal incision on the patient’s neck.
“So fast!”
“So handsome!”
“We’ll have to rely on Doctor Ling now.”
The scene where the nurses could not hold their desire to clap and dance was the scene that the attending physician wanted to see for himself.
