System Came When the Doctor was Thirty

Problems tend to pile up rather than appear sequentially.

In the past, the emergency surgery department didn’t have to deal with fractures at all; they directly contacted the trauma surgery department.

Now, with the trauma center established independently, the hospital naturally doesn’t want patients visiting the hospital to leave without treatment.

”You should have woken me up earlier,” Lu Cheng said, furrowing his brows tightly and turning away.

Chen Fang explained, ”Brother Lu, you didn’t sleep well last night. Anyway, it’s just a fracture patient; no matter where they go, they have to wait.”

”Thank you,” Lu Cheng replied earnestly as he turned and left the lounge.

Upon reaching the emergency department area, Lu Cheng was immediately grabbed by the on-duty doctor in the emergency surgery office: ”Lu Cheng, you’re just in time; we have two fractures here.”

But the doctor didn’t catch Lu Cheng at all, as Lu Cheng slipped past the surgery office like a loach, heading straight to the resuscitation room, calling back, ”Brother Liang, I’ll head to the resuscitation room and be back in a bit.”

This month, the emergency office brought in a new batch of rotating doctors, with Liang Duolin as an experienced thoracic surgeon.

”Okay...I...” Liang Duolin had no choice but to turn around and explain, ”You’ll have to wait a bit longer; the specialized doctors are very busy now.”

”This is the emergency department, and we still have to wait? How long will this take?” The two patients were particularly impatient, and the pain from the visible fractures was not feigned.

”You’ll have to wait until the doctor is available. The trauma surgery doctors are in the operating room, and Dr. Lu from the trauma center has gone to the resuscitation room. It’s all very urgent,” Liang Duolin appeased and explained.

One elderly man among the patients raised his chin: ”Your hospital doesn’t have more than these two doctors?”

”The emergency shift handles fracture patients for emergency cases and emergency surgeries. Routine surgeries in the wards are elective and can’t be shifted,” Liang Duolin said.

A kidney stone patient waiting to be seen arched his back like a shrimp, urging, ”Doctor, when will you see me? I’m in so much pain I’m about to die...”

”We’ll be right there...” Liang Duolin flashed a smile at the fracture patient.

This was also his first time stepping out of his specialty to rotate in the emergency department, and he was quite overwhelmed.

...

In the resuscitation room, as soon as Lu Cheng entered, he immediately slipped into the crowd. Knowing he was going to be involved in the rescue, he had already put on sterile gloves on his way in.

After a rough scan of the patient’s abdominal situation, Lu Cheng’s hands reached in, starting to explore.

The abdominal hematoma in medicine adheres to the principles of physics.

If the bleeding is not connected to the extraperitoneal, there will be no pre-peritoneal hematoma. If there’s a pre-peritoneal hematoma, it’s likely connected or due to ruptured intra-abdominal vessels.

Thus, Lu Cheng’s probing was quite precise.

Lifting his head, he recognized Tian Zhiliang: ”Director Tian, pass me the hemostatic forceps.”

”Kidney dish!” Tian Zhiliang handed the kidney dish gratefully over.

Lu Cheng, standing over 1.8 meters tall, bent forward, his left hand in the pool of blood, while his right hand reached for the hemostatic forceps, reaching into the hematoma one at a time.

After the clinking sound rang four times, the hematoma plane began to descend.

After six times, an effective vacuum suction removed most of the hematoma, exposing familiar intra-abdominal fats and intestines.

Finally, the bleeding could be clearly identified.

Lu Cheng withdrew his hands and began identifying the bleeding points. The resuscitation room lacked electrocautery tools, so he could only mark them with hemostatic forceps after suturing them with thread, for specialized doctors to handle later.

”The blood loss is significant; urge the blood bank for blood!~” Lu Cheng instructed while operating.

”It’s already on its way.”

The blood from the blood bank is prioritized for the operating room and emergency department, ICU next, and when specialists apply for blood, they have to check with the blood bank’s availability.

”Add some more gauze; this patient doesn’t have any substantial organ damage or rupture; likely an aneurysm burst from external force.”

”Call someone from cardiothoracic surgery to come over and deal with this.”

”This isn’t under our trauma center’s jurisdiction,” Lu Cheng meticulously instructed Tian Zhiliang.

The resuscitation room was very quiet.

Internal medicine’s Deputy Director Wu Yuqiang looked at Lu Cheng with a rather subtle gaze.

Previously, when Tian Zhiliang was present, faced with such situations, he would be eagerly anxious, frantically stuffing gauze and cotton pads.

Hemostasis was ineffective, and the patient’s blood pressure continued to plummet, nearing shock, even under vasopressor maintenance.

When Lu Cheng arrived, he handled it in an organized manner.

Wu Yuqiang didn’t think it was Tian Zhiliang showing off but rather felt there was an insurmountable gap in their emergency rescue capabilities between him and Lu Cheng.

”Director Wu, the intravenous access is established. Colloid solution is being administered,” a nurse responded with a heads-up.

”Adjust the carbon dioxide level a bit to avoid oxygen toxicity. Draw blood and check electrolyte and lactic acid levels.”

”Maintain the blood pressure monitoring rate at every half-minute, and pay attention to blood oxygen levels...” Wu Yuqiang instructed decisively and meticulously.

”Xiang Xiaonian, go issue the medical orders.”

”On it!~” Xiang Xiaonian, the attending, was there, ready for chest compressions and rescue at any time.

Now that the initial bleeding was controlled, the focus was on preventing cardiac arrhythmic sudden death.

This required medication correction and attention to imbalances in electrolytes, water, and salts that could lead to arrhythmias, etc...

Lu Cheng stepped back several steps and observed for another two to three minutes. Seeing the patient’s blood pressure rebound by 5mmHg, he said, ”Director Tian, I’ll go see the fracture patients now.”

”From here, it’s the specialists’ domain.”

Tian Zhiliang looked up, still somewhat tense and uncomfortable.

It was just Lu Cheng’s second day after moving from the emergency department, and he felt uncomfortable, while Lu Cheng at the trauma center remained composed.

This made Tian Zhiliang somewhat annoyed - he shouldn’t have let Lu Cheng split off.

”Are you handling fracture patients as well?” Tian Zhiliang muttered.

”The trauma surgery is overwhelmed. They’ve asked for my help...” Lu Cheng had already taken off his gloves.

”Thank you, Director Tian.”

Such direct trauma cases should fall under the trauma center’s scope, but the resuscitation room continued to treat them to support the fledgling trauma center.

Lu Cheng immediately headed for the emergency surgery office.

Liang Duolin’s expression relaxed, ”Dr. Lu is here; follow him. He’s professional at handling fractures.”

”Dr. Lu.”

”Dr. Lu.” Patients coming to the hospital, apart from a few eccentrics who think they rule the world, are mostly courteous, wanting patiently to have their health issues resolved.

Lu Cheng quickly asked, ”Sorry to keep you waiting. You’re both wrist fractures, right? Your legs are fine?”

”We can walk.” The two nodded.

”Let’s go over to the trauma center where I’ll assess your fractures. If surgery is needed, I’ll arrange your hospitalization. If we can attempt manual reduction, we’ll give it a try.”

”No rush.” Lu Cheng reassured them while leading the two out of the office.

But there were quite a few people waiting outside the office, creating a path for the two: ”Excuse us, please, make way. We have fracture patients. Let’s not bump into them, shall we?”

The crowd graciously made way, creating a path.

Lu Cheng gently led the middle-aged man and the young man towards the trauma center.

...

When Liang Shuhao, the attending from trauma surgery, stepped out of the operating room, the sun was already setting, and he instructed his resident to go issue the medical orders and then rushed to the emergency department.

After finding out in the emergency surgery office that all the fracture patients had been taken to the trauma center, Liang Shuhao called the on-duty nurse in his department, asking, ”Sister Le, how many emergency inpatient cases do we have today?”

”I only saw one hospitalization record in the group,” Sister Le replied with amusement. ”Just one; you’re on duty, don’t you know?”

Liang Shuhao’s expression instantly turned grim, and his tone was slightly stiff: ”Got it, thank you.”

After hanging up, Liang Shuhao felt a chill on his scalp: ”Five fracture patients, and only one was sent to trauma surgery.”

”Let’s hope nothing goes wrong.”

Liang Shuhao wasn’t concerned that Lu Cheng was targeting trauma surgery, but worried that if Lu Cheng’s reductions were off, there might be trouble.

He had performed open fracture surgery, but the emergency patients couldn’t eat and required transfer.

He had assumed that Lu Cheng would send a few more patients to trauma surgery, but 80% were retained by Lu Cheng.

Concerned, Liang Shuhao decided to visit the trauma center.

Half an hour later!

When Liang Shuhao left the trauma center, he was taking deep breaths repeatedly, muttering softly under his breath: ”Sending fracture cases to the trauma center is like throwing a bun to a dog, with a high likelihood they’ll never return.”

”But Lu Cheng is something else, huh? Daring to attempt reductions on these fractures?”

”Isn’t he afraid?”

”And he actually managed to reduce them successfully?”