"Take a deep intravenous blood sample and send it to the Medical Laboratory Department. Smear test for amniotic fluid embolism." When Fang Pingzhu saw the patient, she immediately asked the nurse to send the amniotic fluid embolism test.
For obstetrics and gynecology, amniotic fluid embolism had the highest mortality rate.
Amniotic fluid embolism refers to a series of serious complications such as acute pulmonary embolism, anaphylactic shock, kidney failure, and sudden death during childbirth when amniotic fluid suddenly enters the mother's blood circulation.
This was because amniotic fluid contained a large amount of fetal hair, keratinized epithelium, fetal fat, and meconium. Once it entered the blood circulation, it would immediately cause damage to the balance.
In the First Department of Obstetrics and Gynecology of Yun Hua Hospital, Fang Pingzhu's policy was to immediately collect venous blood for a quick diagnosis upon seeing symptoms such as massive bleeding.
With such a policy, the capture rate was naturally not very high. However, from Fang Pingzhu's perspective, if amniotic fluid embolism could be diagnosed a few minutes earlier, the patient's survival rate would be greatly increased.
However, this policy, which was originally used in obstetrics and gynecology, was currently only effective in obstetrics and gynecology.
The department directors of the Department of Obstetrics and Gynecology and Gynecology had their own priorities at the moment. They were not willing to spend a lot of manpower, time, and money on screening for amniotic fluid embolism. This was also one of the reasons why doctors had to think of a way to become a department director after they reached a higher level. They were willing to shed all pretenses of cordiality and fight until both sides were severely injured in order to become a department director with power.
Only when he became the department director with power could he decide the direction of the department. In other words, he could make all the people in the department and all the money in the department revolve around him. He could make all of them run towards the fields that he was interested in, good at, or learned before. In obstetrics and gynecology, other than amniotic fluid embolism, there were also high-risk pregnancies, prenatal diagnosis, placental abruption, and other fields that could be involved.
Ling Ran did not have any experience in obstetrics, so he did not judge the probability of amniotic fluid embolism.
He followed the stretcher trolley for a while and let Fang Pingzhu give the orders first. When he entered the operating theater, he asked, "How much is the bleeding?"
"Vaginal bleeding of 400 ml," the nurse reported solemnly.
After working in the hospital for a long time, the nurses were familiar with the main diseases and symptoms in the department. When they saw the patient who had just been carried to the bed, they were not optimistic. They were both women. She had just given birth to a baby and was about to die … Other than maintaining a serious expression, she didn't know what else to do.
Department Chief Hong did not follow them in. He turned his head and comforted his brother and sister-in-law outside the operating theater.
He was an internist, so he could not perform surgeries. Even if he could, Department Director Hong would most likely not perform them. If the director of the Obstetrics Department and Ling Ran were on the same stage, they would not be able to save the patient. The other surgeons would probably not be able to do anything either.
"Exploratory laparotomy?" Ling Ran sounded as if he was asking Fang Pingzhu for her opinion, but he was actually quite certain about it.
The anesthetist could not help but look at Fang Pingzhu.
This was the operating theater of the Obstetrics Department, and Ling Ran did not bring anyone with him. Whether or not Fang Pingzhu could operate on the patient depended on her.
Fang Pingzhu nodded lightly. From the moment she allowed Ling Ran to come over, there was no room for her to reject him.
General anesthesia was prepared. After a while, Ling Ran pressed on the patient's skin a few times and said, "Laparotomy. Exploratory laparotomy."
After that, he asked for a scalpel and used the bow-holding posture to make a long incision in one breath.
Fang Pingzhu and the other doctors in the obstetrics and gynecology department gasped.
Most of the surgeries performed in the Obstetrics Department were Cesarean sections. It was a horizontal cut. It was not good to cut too little, but if it was too much, the patient would definitely be unhappy. Some women would discuss the length of the incision when choosing a doctor for a caesarean section.
However, even the most careless obstetrician would not dare to make a long incision in one breath like Ling Ran did. If this was not handled properly, it would cause a doctor-patient dispute.
"Doctor Ling, you're quite bold to perform exploratory laparotomy," Fang Pingzhu said in a euphemistic manner.
The female doctor who was the third assistant thought that the department director wanted to point out Ling Ran, so she quickly said, "Doctor Ling, if you make such a long incision, be careful that people will block the office and scold you."
Ling Ran stared at the operating theater in front of him and said calmly, "If the patient can block the office and scold me, this incision will not be in vain."
The female doctor who was the third assistant could not help but be stunned.
"Retract the retractor," Ling Ran reminded her.
"Oh, oh … okay." The female doctor stole a glance at Ling Ran and could not help but think in her heart, 'The men I went on blind dates are not as handsome as Doctor Ling, and their hearts are not even one-tenth as beautiful as him. No, one-hundredth, no, one-ten-thousandth …'
Fang Pingzhu also praised Ling Ran's words in a soft voice, "Let's not talk about the standard of the doctors taught by Department Director Huo, but their medical ethics are still good. Save a life first, then treat the disease, right? "
Huo Congjun had been in Yun Hua Hospital for many years, and his famous words had long been remembered.
Ling Ran smiled.
Fang Pingzhu continued to say, "The environment now is different from when Department Director Huo was in the past. In the past, when we encountered emergencies, sometimes we did not wait for the family members to sign, and we just pulled them over and performed the surgery. We saved countless women and children. Now, who would dare to do that? Some doctors are not at ease when they see a signature, and they insist that both the husband and the wife have their signatures. Tell me, when it comes to treating patients and saving lives, how do you choose? "
Ling Ran still only smiled. He was not interested in such a topic at all.
Ling Ran performed the surgery seriously.
"Speed up the aspiration." As Ling Ran spoke, he inserted his hand into the patient's abdominal cavity.
The abdominal cavity was full of blood, so he could only use his hand to feel it. This was a strategy to race against time, and ordinary doctors could not use it at all. Just by looking at the amount of blood that was being drawn out, he knew that it was definitely a mess inside. It was really a little inconceivable to use his hand to feel the state of the tissue.
However, because he did not know what the situation inside the abdominal cavity was, now that the abdominal cavity was cut open and the pressure was relieved, it was even more important to explore as soon as possible.
It was like a confrontation between two armies. If the scouts were sent out, they would definitely lose, but if they were not sent out, the loss might be even greater.
Fang Pingzhu just watched by the side, and she felt nervous. Now, she kind of understood why Department Director Hong asked Ling Ran to take action.
She had heard before that Ling Ran was very strong, but when she really met him, she only knew how strong he was.
Even though the human body was so small, many doctors might not be able to recognize it even if they changed its tissues and organs. How difficult would it be to search for the bleeding point in a pool of blood?
Fang Pingzhu could not help but think that if there was someone who could save this patient in this state, it might really be this overly young Doctor Ling in front of her.
Ling Ran's moving arm stopped for a moment.
Fang Pingzhu could not help but show an expectant look.
Ling Ran slowly raised his head, looked at Fang Pingzhu, and then looked at the others. "There is no bleeding point."
Fang Pingzhu was stunned, and she immediately felt helpless. 'If there is no bleeding point, why are you so serious?'
However, Ling Ran's expression was solemn. "This means that it is not bleeding from the exposed organs."
"Maybe we didn't find it," Fang Pingzhu refuted.
"Impossible." Ling Ran shook his head firmly. If the bleeding point could not be found even with Perfect Level Barehanded Bleeding Control, the patient's abdominal cavity could not have accumulated so much blood.
From this point of view, his barehanded examination just now had already eliminated many possibilities.
"What do you think?" Fang Pingzhu was not unhappy because of Ling Ran's attitude. The Obstetrics and Gynecology Department had always been known for their rough work in the hospital. Not to mention compared to the complicated Department of Hepatobiliary and Pancreatic Surgery, the difficulty of the Obstetrics and Gynecology Department was not high when compared to the General Surgery Department. There was nothing wrong with the fact that the Obstetrics Department did not rely on their skills.
Ling Ran did not care about the psychological activities of his assistants. He only thought for a short while before he said, "There is no bleeding point outside the organs. Considering the patient's condition … It is bleeding in the uterus caused by disseminated vascular coagulation."
"Then we will have to remove the uterus." Fang Pingzhu did not comment on Ling Ran's diagnosis. A simple diagnosis was meaningless. The key was how to verify the diagnosis and give the right treatment.
Ling Ran shook his head slightly. He had never done a uterus removal, so he was not like the doctors in the Obstetrics and Gynecology Department who always wanted to remove the uterus. Ling Ran extended his hand and said, "Absorbable thread."
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