Great Doctor Ling Ran Chapter 561

562 Abdominal Bleeding

"Doctor, help… help…" The second batch of car accident victims arrived at Yun Hua Emergency Medical Center right on time.

Ling Ran changed into a new pair of scrubs. As he was putting on gloves, the patient's family member, who was with the patient in the ambulance, had already rushed over and started shouting at Zuo Cidian. 

She was a middle-aged woman in her forties. Her hair was messy, and she was a rather terrifying sight to behold at night. 

However, she looked worried and cowed, judging from her expression. 

Zuo Cidian showed Ling Ran a resigned expression with his face, one that was as rough as a Mandarin orange. Then, he whispered to the woman, "Please don't be anxious. The patient has arrived at the hospital. You can stand by the side first. Don't delay the patient's treatment. Let the doctor think of a way to handle it."

After he said that, the patient's family immediately gave way.

Ling Ran raised his arms vertically over his chest as he walked in. 

"The bones of the left arm and left leg are fractured. Not much bleeding… Blood pressure is still stable…" Ling Ran immediately checked the patient's body and verbally mentioned a few key points that were valuable for the doctors before they gave medical advice. Then, he whispered, "Ask the doctor from the Orthopedics Department to come for a consultation and pass this patient to them. Send the patient to the operating theater first."

Two nurses pushed the patient into the operating theater. The houseman who had just received the checklist nodded dumbly before he turned around and left. 

Zuo Cidian could not help but follow him when he saw the houseman's expression. He whispered, "The Orthopedics Department may not want this patient. You just need to tell them that if they want to take over the patient, the patient will belong to their department. Otherwise, we will take over, understand?"

The houseman was a newcomer this year. He dubiously asked, "Why should we let them choose?"

"Because the right of making the choice is with them." Zuo Cidian shook his head helplessly and said, "If the Orthopedics Department does not want to take over, are you just going to leave the patient in the building of the Orthopedics Department?"

A large-scale tertiary Grade A hospital like Yun Hua Hospital had totally different ecological modes as compared to a normal tertiary Grade A hospital or even hospitals with lower ranks. 

The departments of a normal tertiary Grade A hospital or even hospitals with lower rank were usually grabbing patients throughout the year. If they did not pay sufficient attention, the business in each department would be unsustainable. A large-scale tertiary Grade A hospitals usually had too many patients, and this caused the specialist departments to reject the patients from the Emergency Department. However, the limited hospital beds was another very real problem. If they did not limit the number of hospital beds and kept receiving more patients, once the hospital beds were fully occupied, they would not be able to receive any patient.

This emergency case was considered an optional case for the Orthopedics Department. Therefore, Zuo Cidian had deliberately reminded the houseman of this fact just now. 

The houseman was at a loss. "What if they…"

"Enough. Run along now. Just make sure that you're good with your words." Zuo Cidian urged him to move. 

The houseman stiffened up. "I… I'm not good at speaking."

"You want me to teach you that?" But even though Zuo Cidian said those words, he felt happy in his heart, for some strange reason. He patted the silly houseman's shoulders before he said, "If you really do not know what to say, you can just say, 'Ah, great job on the weight loss. Your waist looks slimmer.' Do you get it?"

"Oh… I understood." The houseman quickly ran. After a few steps, he came back again. "Excuse me, what if I meet doctors that I've never met before. If I say that…"

Zuo Cidian shook his head while he felt a headache build in his head. "You are a houseman. If I put a nicer title on you, you are a doctor-in-training, but even if I call you a student in training, there is nothing wrong in that as well. Do you think that the orthopedists that you've met before will remember you?"

The first-year houseman finally understood and said happily, "That's good, then. I don't have any problems now."

He ran a few more steps before stopping. He seemed to have thought of something to add… 

Zuo Cidian waved his hands. "Hurry up. The patient is waiting for you."

"Oh, oh." The first year houseman finally ran away. 

"They get worse year by year." Zheng Pei sighed heavily and said with an experience tone, "When we were housemen, it was important to be observative and act fast. Children nowadays seem to have something in their diet that ended up making them stupid…"

Zuo Cidian turned back and gazed at Zheng Pei as if he was looking at someone stupid. "Speaking of age, Doctor Ling should be a houseman right now."

Zheng Pei coughed heavily. 

"You can lie down over here too. Let me do a check up for you." Ling Ran looked at the patient's family and frowned. 

The woman smiled and rejected his offer. "I'm fine. I was sitting at the back when the accident happened. You can check my brother and sister-in-law first. I only have some bruises, and they are not painful…"

Ling Ran stared at the woman and said, "Do the check up first and talk later."

"I'm okay…" the woman said again before she looked in the direction of the operating theater and asked, "Can my brother be treated? Please don't hesitate in using medicine. We are from Yun Hua City and we can still pay for the surgery…"

Ling Ran waved at Zuo Cidian and said, "Do an ultrasonography for her."

Zuo Cidian jogged over, smiled, and said, "Since you are already here, there is no harm in doing a check up. Come, come, come…"

As Zuo Cidian continued to persuade her, the middle-aged woman could only lie on the examination table. 

Zuo Cidian wiped some oil on her stomach and dragged the ultrasonography device over. In just a few seconds, Zuo Cidian's expression changed. 

"Abdominal bleeding." Zuo Cidian pressed on the woman's shoulders and asked her not to get up. He reminded her again, "Your abdomen is now bleeding, understand? There is bleeding inside the stomach, so don't move."

As he spoke, Zuo Cidian quickly shouted for Ling Ran. 

"Send her to the operating theater." Ling Ran knew something was wrong with this family member of the patient when he first saw her face. In more professional terms, he had felt that something was wrong with her through visual inspection, and now it was diagnosed using ultrasonography.

"Do you need… to call more people over here?" Zheng Pei felt worried. 

"It seemed that during the accident, her liver was injured. Let me open her up and take a look first. Then, we will make judgments if there are more injuries." Ling Ran's greatest confidence would be his full set of bleeding control skills.

With Perfect Level Barehanded Bleeding Control and Perfect Level Hemostasis by Heat, he could handle a normal trauma and blood loss case. Even if there were any unforeseen circumstances, he could still call for help. 

"I'll work with Doctor Ling. You handle the next case." Zuo Cidian quickly spoke to Zheng Pei and followed Ling Ran to rush into the operating theater. He washed his hands and put on gloves. 

When he entered the operating theater again, Ling Ran had already opened the patient's abdomen. 

"Yes. The liver is injured… Just a small piece will do…" Ling Ran said and started to move his scalpel. 

"Hepatic segmentectomy?" Zuo Cidian stood across Ling Ran. When he saw the blood accumulated in the patient's abdomen, he was fired up.

He rarely saw such hepatectomy performed on such a small area in the surgeries he observed. 

"Let's not do regular hepatectomy, we'll just cut the injured part." As Ling Ran spoke, he lowered his head and started the operation. 

As compared to his previous emergency hepatectomy, this patient had a much slower rate of blood loss, so Ling Ran was not in a rush to remove her liver. He slowly separated it from the hepatic portal, cut off the blood flow, and started the slow yet careful hepatectomy. 

If he used this method, the patient would have more blood loss compared to if he cut it straight away. It was normal to have 50 ounces to 67 ounces of blood loss throughout the surgery. 

But having more blood loss would produce a better prognosis compared to the crude treatment in emergency hepatectomy. 

"We lived through this night rather substantially, don't you think?" Ling Ran had successfully completed the surgery, and his mood was very good. 

He felt that he did not suffer for nothing, since he performed two hepatectomy, one splenectomy, and one orchiectomy.

"It's good that you like it. Do you want to get supper?" Once Zuo Cidian finished watching the most exciting part, he started to shake his body. 

"Check the intestines. If there isn't any problem, I'll get people from the General Surgery Department to come over," Ling Ran said and looked at the two nurse beside him and said, "I'll treat you to supper, what do you all want to get?"

"Anything is fine."

"Doctor Ling, you can make the decision."

Ling Ran thought about it and said to Zuo Cidian, "There is a 24-hour Beijing-flavor restaurant in front of hospital. I'll get bittern flapjack [1] and fried liver."

Zuo Cidian lowered his head and touched the patient's intestine. "Then, I'll get a bittern flapjack as well. Ask them to put in more small intestines. The small intestines cooked by that restaurant is quite unique."