System Came When the Doctor was Thirty

Emergency rescue is a comprehensive procedure, not a solo performance. Just a few trauma emergencies can keep you fully occupied.

The emergency department at Long County People’s Hospital is understaffed. With eight or nine trauma emergencies, specialized personnel need to be dispatched and arrangements coordinated!

A batch is needed for patient reception, another for medical orders, one more for emergency rescues, and a team for surgical preparations in the operating room.

Lu Cheng is familiar with many types of surgeries in the surgical ward, but has yet to experience emergency rescue work. Hence, Lin Qianlong has placed Lu Cheng in the operating room for reception duties.

Besides Lu Cheng, Tian Zhuang has also been called to the department and instructed to follow Lu Cheng.

After quickly washing hands with Lu Cheng, Tian Zhuang asked, ”Brother Lu, which operation are we likely to perform?”

”Not sure yet. There are many tendon ruptures today, so Director Lin is likely to send several tendon suture cases our way.”

”It’s a matter of saving lives; probably Professor Chen will be called into the operating room... Otherwise, with only Director Lin and the others, they might not be able to ensure the safety of all those people outside.”

Fights become so intense that anything can happen.

Knife cuts are secondary; indiscriminate stabbing is the real killer.

We can only speculate that there’s no stabbing of the abdominal aorta; if there was, the person might have already died on the spot without even reaching the hospital.

Lu Cheng continued by asking, ”Tian Zhuang, how’s your practice with the improved Kessler Suturing Technique? If it’s good, you may have to independently handle wound closures shortly.”

”Given today’s situation, Professor Tong Yuan’an from orthopedics probably won’t be here. It’ll just be me and Peng Kun, and we can’t handle that many tendon ruptures quickly.”

”Even with Director Peng included, it would take a lot of time. Tendon rupture is a time-sensitive surgery that must be handled as promptly as possible.”

Before Tian Zhuang could respond, a call from Professor Chen Song came in, with instructions that he was outside and advised Lu Cheng not to perform general external surgeries because, with Lu Cheng’s current skill level, he couldn’t yet manage completely.

”Okay, Teacher Chen, I understand.” Lu Cheng responded immediately, hung up the phone, and then resumed disinfection and began washing hands again.

Tian Zhuang replied honestly, ”Not very skilled yet...”

After speaking, Tian Zhuang added, ”Sorry, Brother Lu, about the trouble my brother and sister-in-law caused you last time.”

Lu Cheng smiled and didn’t reply further.

Domestic matters are hard to judge fairly; Lu Cheng preferred not to get involved with Tian Zhuang’s family issues. If Tian Zhuang could handle it, he’d do so; if not, Lu Cheng couldn’t help.

Soon, patients with simple trauma or tendon injuries were brought in from outside.

The person handing over the case was Brother Zhang Tiesheng: ”Xiao Lu, this patient has multiple tendon injuries, multiple muscle injuries, and multiple superficial tissue traumas. You and Tian Zhuang start with him.”

”It’s best to handle tendon suturing and wound cleaning first. Director Lin will arrange for others to assist you shortly.”

”According to Vice Director Zeng Long’an’s directive, your main responsibility today is all tendon rupture rescues in emergency care.”

”Professor Chen Song is in charge of the life-saving surgeries in the rescue room. Routine other traumatic cases will be handled by Director Peng, Director Liu, and our Director Lin.”

”General external related conditions will be managed by Director Du and Director Ding from general surgery, who report directly to Professor Chen Song. Avoid complications.”

”In emergency situations, be decisive! Obey orders strictly.”

Lu Cheng nodded, ”Understood, Brother Zhang.”

”Then this patient is in your care first. Begin with tendon suturing. As per Professor Chen Song’s perspective, tendon rupture isn’t fatal but significantly affects post-operative function.”

”Professor Chen and others outside are assessing the severity of life threats. Once screening is done, you’ll be responsible for assessing the severity of tendon damage, appoint the chief surgeon as per the actual situation, and oversee the surgical quality review.”

”This is also very important work.” Zhang Tiesheng finished explaining and left.

As Zhang Tiesheng spoke, the patient was already transferred by Lu Cheng and the anesthesiologist onto the operating table.

The patient’s hair was dyed bright red, concealed under a surgical cap. As they entered the operating room, the shadowless light blurred vision, making them nervously ask, ”Doctor, my hand won’t really be disabled, right?”

Prior to entering the operating room, they signed papers with considerable aggressiveness.

”Firstly, surgery is necessary; secondly, the hand might end up disabled—sign the papers, and that’s it!”

No informed consent or refusal was obtained from him; the emergency process was defined directly by the general duty officer, hospital medical department, and police.

Very little was communicated during the urgent rescue.

”Scared now, are you? Didn’t care as much when you were wielding the knife, did you?”

The anesthesiologist rolled their eyes and retorted, ”Whether your hand will end up disabled is another matter. Once your surgery is done, there won’t even be a bed for you in the ward.”

The young patient seemed under twenty, responding with a strained voice, ”I was called by my buddies to back them up, never thought the other side would actually use knives.”

”If you hadn’t gone, nothing would’ve happened. Buddy, buddy indeed, sending you to lockup—is that your buddy?”

”This one action, not only is your life altered forever, but even your children or nephews will struggle to join military academies or become civil servants—it’s no joke.”

”Some buddy you have...” The anesthesiologist grumbled, ”Lie down properly; you’re about to get anesthesia.”

”General anesthesia will be quick!~” Due to multiple injuries, the anesthesiology department couldn’t provide enough anesthesiologists for detailed brachial plexus block anesthesia. Straight to general anesthesia!

They had prepared medication in advance and administered it after asking the patient’s height and weight.

Lu Cheng and Tian Zhuang then commenced standard pre-surgical procedures like disinfection and flushing.

After disinfecting and draping, Lu Cheng took a more detailed look at the patient’s injuries.

”Left forearm palm side, right upper arm lateral side, and left thigh front all have knife wounds.”

”The thigh side wound is smallest, with injury depth reaching just the muscle layer, quite straightforward to deal with.”

”The left forearm has muscle and tendon damage—it’s a V zone flexor tendon rupture; I will handle suturing shortly.”

”The right upper arm lateral side features a partial muscle layer rupture, suitable for direct suturing.”

”Tian Zhuang, you don’t work on the tendons for this patient yet. After I complete tendon suture and wound cleaning, you proceed with muscle suture and skin closure.” Lu Cheng swiftly did a basic assessment of the patient’s condition.

Because it’s brief, and there are many wounds, the patient was brought into surgery in advance.

”Okay, Brother Lu.” Tian Zhuang trusted Lu Cheng’s judgment.

Though he was less articulate, he learned earnestly, memorizing the reference materials Lu Cheng provided. Understanding that V zone flexor tendons require circular embedding technique and Pulvertaft weaving, which he hadn’t mastered.

Tian Zhuang also recognized that his tendon suturing technique, though competent for tending some tears, was extremely narrow in scope.

Tian Zhuang earnestly took the assistant role, attentively aiding Lu Cheng’s wound cleaning process, eyes filled with admiration.