Chapter 601: Diagnosis
Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation
“Collect blood from the deep vein, send it to the dical Laboratory Departnt, and check for amniotic fluid embolism.” When Fang Pingzhu saw the patient, she imdiately asked the nurse to send for a request for an amniotic fluid embolism examination.
For the Gynaecology Departnt, the highest mortality rate ca from amniotic fluid embolism.
Amniotic fluid embolism ant that during the labor process, the amniotic fluid had suddenly entered the mother’s bloodstream, subsequently causing a series of severe complications such as acute pulmonary embolism, anaphylaxis, kidney failure, and sudden death.
Due to the high amount of fetal hair, cuticular epithelium, vernix caseosa, and conium in the amniotic fluid, once the amniotic fluid entered the bloodstream, it would imdiately cause damage to the balance of the body.
While in the First Division of Yun Hua Hospital’s Gynecology and Obstetrics Departnt, Fang Pingzhu’s policy was to imdiately collect blood in the vein and do a quick diagnosis when she saw symptoms like massive bleeding.
This policy naturally did not provide a very high rate in catching on whether it was truly amniotic fluid embolism when massive bleeding occurred, but, from Fang Pingzhu’s perspective, confirming the diagnosis of amniotic fluid embolism a few minutes earlier would greatly increase the patient’s survival rate.
However, this policy which was originally implented in the Gynaecology Departnt was only effective in the Gynaecology Departnt right now.
The departnt directors of the Second Division of Gynecology and Obstetrics Departnt and the Third Division of Gynecology and Obstetrics Departnt had their respective focus, so they were not willing to spend high amounts of manpower, ti, and money on the examination of amniotic fluid embolism. This was one of the reasons for the doctors to strive for the position of a departnt director who owned authority when they reached a higher standard, even though they might offend others to the point that both sides would end up losing a lot.
Only when they beca major departnt directors who owned power could decide the direction of the departnt. In other words, he could make the people and money in the whole departnt focus on him and the field that he was interested in, good at or learned. In the Gynaecology Departnt, besides amniotic fluid embolism, there were also fields like high-risk pregnancy, prenatal diagnosis, and placental abruption which they could focus on.
Ling Ran did not have any experience in the Gynaecology Departnt, so he did not judge whether this might be a case of amniotic fluid embolism.
He followed the gurney for a while. He first let Fang Pingzhu give her instructions before he asked after entering the operating theater, “How much is the blood loss?”
“Vaginal bleeding for 1.3 ounces.” The nurse reported seriously.
After working in the hospital for a long ti, the nurses were all familiar with the main diseases and the display of the patient’s symptoms in the departnt. When they saw the patient who had just laid down on the operating table, they did not really believe that she had a high chance of surviving. They were all won. When the nurse thought about the patient possibly passing away right after giving birth to a baby… Instead of showing a serious expression, she did not really know what else to show on her face.
Departnt Director Hong did not enter the operating theater, instead, he stood outside the operating theater to comfort his brother and sister-in-law, who had just co.
He was an internist, so he was unable to perform this surgery. Even if he could, he would most likely not perform it. If the departnt director of the Gynaecology Departnt and Ling Ran could not save the patient even if they worked together, the other surgeons might not be able to do anything about it as well.
“Exploratory laparotomy?” Ling Ran’s tone made it sound as if he was asking Fang Pingzhu, but in truth, he was already very certain that he wanted to perform the exploratory laparotomy.
The anesthetist could not help but look toward Fang Pingzhu.
This was the operating theater of the Gynaecology Departnt, and Ling Ran did not bring anybody over. It all depended on Fang Pingzhu on whether they were to bring the knife on the patient.
Fang Pingzhu nodded slightly. From the mont she allowed Ling Ran to co over, she did not have any right to turn him down.
General anesthesia was ready. In a while, Ling Ran pressed on the patient’s skin and said, “Perform laparotomy for exploratory laparotomy.”
When he finished speaking, he asked for a scalpel and made a long incision with the fiddle bow hold.
Fang Pingzhu and the other doctors from the Gynaecology Departnt took a deep breath when they saw it.
The surgery that the Gynaecology Departnt usually perford was the Caesarean section. When they made the horizontal cut, short cuts would not allow them to be successful, but if they made the cut too long, the patient would be unhappy. So won would want to discuss the length of the incision when they chose the doctors for the Caesarean section.
However, even a careless obstetrician would not dare to make a long incision like Ling Ran. If this were not handled well, it would cause a doctor-patient dispute.
“Doctor Ling, you’re quite brave in performing exploratory laparotomy, huh?” Fang Pingzhu said very “tactfully”.
The female doctor who was the third assistant thought that the departnt director wanted to give Ling Ran a reminder, so she imdiately added, “Doctor Ling, such a long incision will make you get blocked and scolded by people in front of the office.”
Ling Ran stared at the surgical area in front of him and said calmly, “If the patient can block and scold at the office, this incision will not be a waste.”
The female doctor who was the third assistant could not help but be stunned.
“Pull the retractor.” Ling Ran reminded her.
“Oh, oh… Okay.” The female doctor peeped at Ling Ran and could not help but think. ‘Those n whom I t during the matchmaking sessions were not as handso as Doctor Ling, and their kindness is not even one-tenth of Ling Ran’s. No. One percent, no, it should be one in ten thousand…’
Fang Pingzhu also praised what Ling Ran had just said in a low voice, “We won’t ntion the standards of the doctors Departnt Director Huo taught, but their dical ethics are good. Save the life first before treating the patient, right?”
Huo Congjun had been in Yun Hua Hospital for many years, so his famous quotes were rembered by everyone.
Ling Ran smiled.
Fang Pingzhu continued to say, “The environnt now is way different from the ti Departnt Director Huo worked actively in the frontlines. During that ti, when we t ergency cases, we would sotis push them into the operating theaters and perform the surgery without waiting for the family mbers to sign the forms. There were countless won and children who had been saved. Now, who would dare to do so? So doctors are worried when they see that there was only one signature, so they wanted both husband and wife to sign before the surgery. Say, how would you choose between treatnt and saving a life?”
Ling Ran only smiled as usual. He was not interested in discussing this kind of topic at all.
Ling Ran just wanted to perform the surgery seriously.
“Speed up the aspiration.” While Ling Ran spoke, he pushed his hands into the patient’s abdon.
The abdominal cavity was accumulated with blood. So, he could only use his hands to detect the bleeding point, as this was a strategy to fight for more ti. A normal doctor would not be able to do so. When they saw the amount of blood flowing out, they knew that the patient’s abdominal cavity was a ss. It was quite amazing to even think about using their hands to figure out the condition of the tissues inside the abdominal cavity.
However, it was precisely because the condition in the abdon was not known that they had to quickly explore the abdominal cavity once they perford laparotomy after they reduced their pressure.
This was just like the battle between two armies. The reconnaissance forces would definitely have to suffer losses, but if the recon squad was not sent out, they would suffer a greater loss.
Fang Pingzhu was anxious when she watched from the side. Now, she knew why Departnt Director Huo wanted to ask Ling Ran to help.
She had heard that Ling Ran was very skillful, but she only learned of his true strength when she witnessed it with her own eyes.
There might only be a few organs in the human body, but the doctors would not be able to recognize the tissues of the organs had changed, and it was incredibly difficult for them to search for the bleeding point in a pool of blood.
Fang Pingzhu could not help thinking. ‘If there is soone who can actually save this patient under this kind of condition, that person might just be Doctor Ling, who is a little too young.’
Ling Ran’s moving arms stopped for a while.
Fang Pingzhu could not help but show an expectant face.
Ling Ran slowly raised his head. He looked at Fang Pingzhu before he glanced at the others. “No bleeding point. ”
Fang Pingzhu was stunned, then she instantly felt resigned. ‘If there’s no bleeding point, why are you behaving so seriously?’
But Ling Ran still looked very serious. “This ans that it’s not the exposed organs that are bleeding.”
“Maybe you just did not find it.” Fang Pingzhu refuted.
“Impossible.” Ling Ran shook his head firmly. If he could not find the bleeding point with his Perfect Level Barehanded Bleeding Control, it was impossible for there to be such a huge amount of blood accumulated in the patient’s abdominal cavity.
From this point of view, his barehanded exploration already eliminated a lot of possibilities.
“What do you think?” Fang Pingzhu did not feel unhappy because of Ling Ran’s attitude. In the hospital, the Gynaecology Departnt was always known for doing work crudely. Forget about comparing their work with the complicated procedures from the Departnt of Hepatobiliary and Pancreatic Surgery, even if the Gynaecology Departnt were to be compared with the General Surgery Departnt, the difficulty in the surgeries of the Gynaecology Departnt was still low. People always said that when a person was old, they could not compare their strength with others. Therefore, it was not wrong if the Gynaecology Departnt did not compare with others in terms of their skills.
Ling Ran was not concerned with the assistants’ ntal processes. He just thought for a short while and said, “There’s no bleeding point on the surface of the organs. By considering the patient’s condition… There is bleeding in the uterus due to disseminated intravascular coagulation.”
“Then, the uterus must be removed.” Fang Pingzhu did not give any comnt on Ling Ran’s diagnosis. A re diagnosis was aningless, the important thing was in how to verify the diagnosis and how to provide the correct treatnt.
Ling Ran shook his head slightly. He had not removed a uterus before. So, unlike those obstetricians who would remove the uterus for practically all surgeries, Ling Ran extended his hand and said, “Absorbable suture.”
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