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"Okay, remember to do a cardiac echocardiogram for her! I've got work to do, I'll contact you later!" Lin Feng dropped a line, hung up the phone, and turned to the nurse: "What's the situation?"
"Man, why is he always so busy during the nightshift? Even busier than us in the emergency department!" Shen Congwen shook his head and hung up the phone.
Tonight's night shift was Shen Mei.
"Just now, when I was doing nursing care, I turned patient number nine over and then discovered fresh red bloody fluid draining from the drainage tube! Doctor Lin, you better go and take a look!"
Shen Mei was an experienced nurse and was the charge nurse on duty tonight. She sharply sensed that the patient's abdominal cavity was bleeding!
"Let's go, let's have a look!" Lin Feng immediately stood up and walked towards bed nine.
On the bed lay an elderly lady, roughly 60 years old, in pain, with a pale complexion, and moaning weakly.
The patient in bed nine had biliary obstruction and jandice, underwent a pancreatoduodenectomy. The patient's vital signs had been relatively stable since the second day post-operation.
"The drainage tube is discharging bloody fluid! When did it start? Why didn't you report to the doctor?" Lin Feng frowned and asked the young nurse Li Lin beside him, who was in charge of bed nine.
Upon hearing this, Li Lin hurriedly said: "This just happened, less than ten minutes ago!"
Lin Feng looked up at the data on the monitor: heart rate over 110 beats per minute, blood pressure 80/53 mmHg, and it seemed to continue dropping.
"Immediately draw blood for blood gas analysis and ultrasound to investigate the abdominal cavity! Measure central venous pressure!" Lin Feng didn't pursue the issue of responsibility, but quickly ordered.
Li Lin, who had just graduated from nursing school this year, was flustered by the situation, unsure of what she should do!
Seeing this, Shen Mei couldn't help but give Li Lin a disapproving glance and scolded in a low voice: "What's the panic? Hurry up and take the patient's blood gas!"
Li Lin then said "Oh," turned around, and went to look for the blood gas needle. Shen Mei wasn't idle either, she went immediately to the nurses' station, picked up the phone, and dialed a number: "This is the General Surgery Department, we have a postoperative patient with acute bleeding, we need you to come and do a bedside ultrasound as soon as possible to confirm!"
One minute later.
"Doctor Lin, hemoglobin is only 68 g/dl!" Li Lin reported to Lin Feng with the blood gas results in her hand.
"Looks like it's indeed bleeding!" At this point, Lin Feng didn't wait for the ultrasound, immediately called the senior doctor, then contacted the blood transfusion department to prepare blood, followed by contacting the anesthesiology department in the operating room to prepare for surgery.
After a pancreatoduodenectomy, pancreatic fistula and bleeding are the most common complications. Normally, it can be treated with interventional therapy or conservative medical hemostasis, but the patient's condition is now critical, and the interventional department would definitely not take such a risk to perform treatment, and conservative medical therapy has poor effects. The only option now was emergency surgery, though often the bleeding point couldn't be identified during emergency surgery, and the only solution would be to dismantle the anastomosis and redo it.
"Doctor Lin, it's bad! Bed nine's blood pressure can't be maintained anymore!" Li Lin, her face filled with panic, ran over to Lin Feng just after he had finished contacting the operating and anesthesiology departments.
Lin Feng's expression darkened, and he quickly approached bed nine, only to see the blood pressure displayed on the monitor: 50/35 mmHg.
The patient had already fallen into a coma at this point.
"30 ml of Hemostatic Fang Acid, plus 40 ml of Hemostatic Min, and add Vitamin K1, mix in 100 ml of saline, rapidly infuse intravenously!"
"2 KU of Snake Venom Coagulase, drop into the funnel!"
"Shen Mei, urge the blood transfusion department again, when can we get the blood?" Although Lin Feng was tense, he was not at all frantic and continued issuing medical orders.
Seeing Lin Feng's calm and collected demeanor, Li Lin felt her panic subside somewhat and quickly began to prepare the hemostatic drugs as instructed by Lin Feng.
Whether it was Hemostatic Min, Hemostatic Fang Acid, or Snake Venom Coagulase, all were types of hemostatic drugs, now combined in hopes of stopping the bleeding.
"Doctor Lin, I contacted the blood transfusion department, it will still take half an hour before the blood is ready!" Shen Mei put down the phone and said.
"Half an hour! We don't have that much time, we have to get to the operating room now!"
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Lin Feng knew that given the patient's current rate of bleeding, it was definitely a vascular rupture. If emergency hemostasis wasn't performed quickly, it was very likely that the patient would die from hemorrhagic shock within twenty minutes!
"Without blood, the surgery is very dangerous!" Shen Mei couldn't help but speak out as a reminder upon hearing this.
Lin Feng remained silent.
It was a completely different concept to have a patient die in the ward compared to dying on the operating table.
Families might accept a death in the ward, but it's much harder to accept one on the operating table.
Similarly, for a doctor, if their own patient died on the operating table, that too was a rather dismal affair.
Seeing the patient's heart rate continuously drop, Lin Feng knew if the heart rate also fell, there would truly be no hope left.
When human blood pressure is low, the heart will beat faster reflexively, to satisfy the minute's effective blood supply demand. But when the body lacks blood and the heart rate drops, it indicates excessive blood loss and that the heart is also in ischemic condition, unable to beat and supply other organs with blood. This also heralds the patient's imminent danger.
"We can't wait any longer! Otherwise, the patient won't have any chance of surviving!" Lin Feng immediately clenched his teeth and said.
At this critical moment, Qi Luyi suddenly spoke up, "Kid, what's the rush? Isn't it just a patient who is bleeding after surgery? Have you forgotten the person I saved on Panshan Road today?"
Upon hearing this, Lin Feng's eyes lit up.
"Reverse Needle Technique!" exclaimed Lin Feng, his heart filled with joy.
The Reverse Needle Technique itself was an unconventional method of acupuncture, going against the normal course to achieve unexpected results.
"Not too dumb, you lad! This person suffers from a postoperative pancreatic leak, which corroded a branch of a small artery, causing intraperitoneal bleeding. Now, you must use the Reverse Needle Technique at the Jiuwei acupuncture point, the Guanyuan acupoint, the Shenque acupoint, and the Qihai acupoint, these four acupoints!" Qi Luyi's tone was indifferent, clearly not taking such bleeding to heart.
"Alright! Then please lend me a hand, elder!" Lin Feng said immediately.
"Damn! You're quite direct, young man. Now you need me, so you call me elder. When you don't need me, you call me an old swindler. Young people these days, tsk! The moral decline, the moral decline!" qi luyi sighed heavily.
"Cut the crap! Hurry up and get to work. If we wait any longer, the patient will die from excessive blood loss!" At this moment, Lin Feng had no time to banter with Qi Luyi. Seeing Qi Luyi's leisurely pace, Lin Feng wished he could give him a few smacks to vent his frustration.
"I cannot personally take action this time." Qi Luyi refused.
"What the hell! What did you say? If you don't take action, who will? Me? Besides you, who else knows the Reverse Needle Technique?" Lin Feng's forehead showed lines of irritation.
"Exactly, this time you do it!" Qi Luyi's tone suddenly became serious: "The Reverse Needle Formation is marvelous, only by practicing it yourself can you possibly fully master it! This is the perfect opportunity for you to practice!"
"Old swindler, are you saying you want to pass the Reverse Needle Technique on to me?" Lin Feng felt his throat go dry.
"What? Don't want to learn?"
"Of course not!" Lin Feng quickly denied: "But based on your earlier conversation with Tong Kai, the Reverse Needle Technique is a mystery not shared lightly. Are you really passing it on to me just like that?"
"Hmph, you're so dense! Even Tong Kai knew; how could I not tell you! Besides, it's just a Reverse Needle Technique. What's so great about it? I know plenty of things!" Qi Luyi's tone contained a hint of smugness.
"Heh heh!" Lin Feng secretly rejoiced. The old swindler was willing to teach him, which was like finding a treasure!
"Alright, you silly boy, what are you grinning about? Get moving and save the person!" Qi Luyi reminded him aloud.
Lin Feng nodded at the words, then took out a silver needle, undid the patient's abdominal band, and raised his hand to administer the acupuncture.
Just at that moment, there suddenly came an angry outcry: "Lin Feng, what are you doing? Stop right now!"