System Came When the Doctor was Thirty

Mu Nanshu rolled her eyes at Lu Cheng, speaking in a teasing tone: ”Do you have to be so childish?”

Lu Cheng blushed slightly and said: ”Today and yesterday, I specifically studied the common cases in the emergency department of the State Hospital!”

”I found out that it’s not easy to plug the loopholes here. And here, there’s basically no possibility of further upward referrals.”

”In this situation, if you still want to do something, you’ll have to think of other ways.”

Mu Nanshu asked: ”Can you speak more specifically?”

”Hospitals in prefecture-level cities are different from county hospitals. The State Hospital can handle all routine surgeries and core specialized surgeries in each department.”

”In such a situation, there’s no opportunity to grab surgeries from specialized departments, it’s just a question of quality.”

”Each department has many doctors, and not only can they handle the cases, but there’s also almost not enough cases for them.”

”So, it seems like only some rare elective, non-urgent cases are worth considering.”

Lu Cheng said: ”This is based on the reality that patients needing referral from Ji City generally go to hospitals within the province, and Ji City is quite far from Sha City.”

”Even though there’s a high-speed train, it’s not easy for patients to travel back and forth.”

Mu Nanshu replied: ”And what does this have to do with what you said earlier?”

”Liver rupture.”

”Currently, the specialized treatments for liver and gallbladder rupture, gallbladder rupture include cholecystectomy, and full hepatic resection is rarely considered for liver rupture.”

”The entry threshold for Liver Preservation Surgery is quite high, so I’d like to try it out,” said Lu Cheng.

Among the corresponding surgeries in general surgery, apart from vascular-related diseases, liver and gallbladder ruptures of solid organs are quite dangerous.

”Previously, Professor Chen told me that the core emphasis of Liver Preservation Surgery is not on sutures, but on blood flow interruption, which is the flexible application of the Hemostasis Technique.”

”Therefore, the two most essential skills in the emergency department are Hemostasis Technique and Incision Skill.”

”Incision Skill is about quick exposure, timely identification of the lesion, and timely response and treatment.”

”The Hemostasis Technique involves preserving the patient’s circulatory blood volume at the first moment.”

”But there’s another problem at the State People’s Hospital; no one can perform ECMO, which is the biggest shortcoming in rescuing major trauma patients.”

”I want to learn how to establish ECMO! The emergency department at Xiangya Second Hospital has a professional ECMO team.”

Mu Nanshu knows that ECMO, Extracorporeal Membrane Oxygenation, is mainly used to provide continuous extracorporeal respiration and circulation for patients with severe heart and lung failure to sustain life.

It is a life-saving device in emergency rescue, which can extend the rescue timeline for patients.

”Hmm... so you still need to go for further training?” asked Mu Nanshu.

Lu Cheng smiled: ”We don’t need to train for that long. If we learn quickly, a high-level training course can solve many headaches.”

”But the tricky problem is that the cost to activate ECMO is very high, even if introduced, not many people in our hospital can afford it.”

Mu Nanshu took a deep breath, suppressing her dissatisfaction with Lu Cheng’s arrogance: ”Being able to afford it and having access to it are two different dimensions, right?”

Lu Cheng said: ”Actually, I hope that technology and equipment can be affordable for everyone.”

”That won’t happen unless ECMO becomes domestically produced. Otherwise, due to medical companies’ need to recoup R&D costs, the price cannot be lowered, not even with bulk purchase.”

Mu Nanshu said: ”Didn’t they say that domestic ECMO has already been launched? It was applied in January last year.”

Lu Cheng said: ”I understand in more detail, the core components of ECMO include the oxygenator and blood pump, which have extremely high material and process requirements.”

”Imported brands use inactivated heparin-coated coatings, currently exclusive, allowing continuous use for over 14 days.”

”Domestic brands are certified only for 5 days of continuous use.”

”The oxygenator employs a square braiding technology, whereas domestic brands use circular ones. The square shape is more beneficial in reducing resistance, minimizing blood destruction, and protecting blood. Imported brands have deep accumulation in these key technical fields, while domestic ECMO has certain gaps in some high-end materials and precision manufacturing processes.”

”Additionally, once activated, the consumables for domestic products are actually more expensive than imports. During long-term clinical treatments, using imported products can reduce costs and ease the economic burden on patients.”

”Do you find that funny?”

Mu Nanshu really didn’t know the corresponding prices.

On a comprehensive basis, the burden of imports being higher than domestic products is a bit distressing.

But Mu Nanshu is smart enough: ”So, your notion is that if ECMO can be used in the emergency department, you can bypass the liver’s circulatory system, extend the rescue time for patients with liver rupture, and use that as the basis for Liver Preservation Surgery?”

”Yes!” Lu Cheng said helplessly: ”The Spleen Preservation Surgery is relatively simple to apply, because even if you entirely remove the spleen, it doesn’t matter; you can immediately perform mechanical hemostasis without affecting the patient’s vital signs.”

”But the liver system is the largest metabolic system in the body. Without extracorporeal circulation assistance, if the liver stops functioning for a period of time, metabolic waste might take the patient away.”

”You can refer to liver and kidney failure, which can easily lead to multiple terminal conditions like hepatorenal encephalopathy.”

”So, to perform Liver Preservation Surgery, ECMO technology must be established first. However, I haven’t brought up these ideas to Director Xiao yet.”

”After all, it’s my first day at work, and if I immediately say so much, it might seem a bit hasty.”