The Enhanced Doctor-Chapter 719: The lactate level of is a bit high
"Why have so many people suddenly arrived? Is there someone important among the patients?" Liu Banxia asked after approaching Ma Limin.
"Four cars, five families. They all came as soon as they heard the news," Ma Limin replied.
"How is the driver with the neck injury? She might have missed the entrance to the expressway while driving. The seven-seater following behind swerved to avoid her, but it was still rear-ended and tipped over."
"A passenger was thrown from the front passenger seat of the third vehicle and run over by the fourth. The doctors in the ambulance at the scene said his leg might not be saved. Did they operate?"
Liu Banxia nodded. "He has already been sent to the operating room. His leg should be saved, but it will require a long recovery period and will be costly."
"The male driver, the first one brought in, can basically be determined as brain-dead. Was the first vehicle fully at fault? If so, the compensation will be a hefty sum; the insurance coverage definitely won't be enough."
"Traffic accidents are always costly, let alone one of this magnitude," Ma Limin commented.
"Fortunately, it wasn't on a highway; otherwise, the accident might have been much worse. Ah... why can't people be more cautious while driving, instead of making aggressive lane changes?"
"You start by helping to restore some order here," Liu Banxia said. "I need to check on the injured. There's one brain-dead patient and three surgeries in progress. We also have one with a radial fracture; I'll see if it can be reset directly to avoid another operation."
"This accident is serious; it has occupied all our operating rooms at once. Our anesthesiologists have to rush between operating rooms to keep up with so many surgeries."
"Dr. Liu, can I watch you set the bone? Wang Chao says you are very skilled at it," Ma Limin asked.
"Why not? We're not in a rush. Have the families settle down first. After confirming their identities, have them wait outside the operating room," Liu Banxia suggested.
Ma Limin nodded and quickly went to inform the patients' families.
"Brother Wei, how is it going?" Liu Banxia went over to Wei Yuan.
"After my examination, the patient with the radial fracture has gone for X-rays. The other patients who arrived later were from the other vehicles, but most only have minor scrapes and bruises."
"Good, let's work together on this," Liu Banxia said. "I'll take this patient for debridement. Call me when the patient with the fracture returns from their X-rays. I want to see if I can manually reset it."
"Sure." Wei Yuan nodded, showing no hesitation.
The sooner these patients were treated, the better. Once they were treated and the necessary tests were done, their family members would also feel more at ease.
A brawl the night before last, and now this chain-reaction car accident today, were really putting the emergency center to the test.
Having the necessary equipment didn't mean they could handle all situations; the circumstances also mattered.
Luckily, today many doctors had just finished their surgeries, so they were available. Otherwise, they would have had to call in more staff, and some patients simply couldn't wait that long.
While Wei Yuan was performing basic checks on other patients outside, Liu Banxia led a patient covered in shards of glass to the treatment room.
"How do you feel? Are you dizzy?" Liu Banxia asked.
"I'm okay. Is Old Wu done for? Brain-dead?" the patient asked.
Liu Banxia nodded. "Were you in the same vehicle? How did you get these injuries?"
"The car rolled over. I wasn't wearing my seatbelt and was thrown out through the windshield. We were just going out for fun when this happened," the patient said.
"Nobody wants to find themselves in this situation. Bear with it for a while; you have pieces of glass embedded in your skin. Fortunately, it's this type of glass, so the injuries aren't too severe," Liu Banxia said.
The patient nodded and lay down on the examination table.
Liu Banxia then started cleaning the wounds. There were thirteen pieces of glass, in addition to a few abrasions and compound wounds. But those were all superficial; there were no apparent internal injuries.
Even so, a brain CT scan was still required to check the condition of his head.
Today, a brain CT scan had become almost standard procedure for all these car accident victims; everyone got one. Bumps and knocks were very common in car rollovers.
Once Liu Banxia finished treating this patient, he stepped outside just as the patient with the radial fracture returned with his X-ray images. 𝒇𝒓𝒆𝒆𝙬𝒆𝒃𝓷𝒐𝓿𝙚𝙡.𝒄𝓸𝒎
"Come here, let me have a look," Liu Banxia beckoned.
After a careful examination, the problem didn't seem too serious; there was just some misalignment.
"You have two options," Liu Banxia explained. "One is painless: go to the operating room for repair. The other is manual reduction, which I can do now. It will hurt, but there's no surgery."
"Doctor, will there be a big difference in cost? How much will it hurt?" the patient asked.
"There will be a big difference in cost. Yes, it will hurt a lot, but it will be brief," Liu Banxia answered.
"With manual reduction, recovery will also be faster. Surgery requires an incision for reduction. If we do a manual reduction now, we just need to apply external fixation afterward."
"Then let's go with the direct reduction. Even with insurance this time, I'm not sure about the medical expenses. Saving any bit helps," the patient said.
"Alright, steady yourself and prepare mentally," Liu Banxia nodded.
"Teacher Liu, this is the blood test report for the patient with the injured maxillary artery," Xu Yino said, running over.
Liu Banxia took it and frowned as he read it. Most of the values seemed fine, but this particular patient's lactate level was somewhat high, reaching 6mmol/L.
"Did you send this report to the operating room?" Liu Banxia asked.
Xu Yino nodded. "I've already sent it, including the blood cross-match results and other related reports. These patients who need surgery are all being processed urgently."
"Teacher Liu, do you think her high lactate concentration is a physiological increase, or is it because of some underlying disease? If there is an underlying disease, would our personal responsibility be lessened in the future?"
Liu Banxia looked at her. "Her values are indeed a bit high. Let me think about it. But determining responsibility isn't our job."
This time, the losses are quite substantial. Brain death—how much compensation will that involve? And the one with the leg fracture, and also... Oh, I forgot, how did Old Chen's thoracotomy go? Was the patient saved?
He had been so busy that he had forgotten. Perhaps it was also due to his confidence in Chen Xuehai's abilities that he forgot to ask after finishing the debridement.
Xu Yino nodded. "After the thoracotomy, the patient suffered cardiac arrest. Doctor Liang performed cardiac massage. It turned out to be a tear in the proximal aorta. Once it was clamped, the patient's blood pressure and cerebral blood flow stabilized, and they were immediately sent to the OR."
"My... how fortunate. If we'd been delayed even two minutes more, this patient would have died on our hands," Liu Banxia said with a sigh.
Although Xu Yino had summed it up in a few sentences, he could imagine how dangerous the situation must have been.
Emergency surgery was like that; sometimes it was a game of heartbeats, a race against time.
If they had hesitated with the diagnosis or worried about potential future complications from performing a thoracotomy directly in the resuscitation room, this patient would have been in grave danger.
He didn't need to worry about this patient's condition; with Chen Xuehai there, it would be fine.
What he was focusing on now was this driver's high lactate level. A value of 6 is quite high, considering the normal human range is 0.4-1.8 mmol/L. That's a significant difference, isn't it?
He picked up the lab report again and glanced at the patient's blood pH value.
This was somewhat problematic; the patient's blood pH value was exactly 7.35. The normal range for humans is 7.35-7.45, indicating slight alkalinity.
If the patient's blood lactate was this high and their pH value was below 7.35, he could diagnose it as lactic acidosis.
「DING! High Lactate Patient. Open Task: Patient presents with elevated lactate levels, but blood pH is within the standard range. Host cannot make a definitive diagnosis and requires further investigation. Task reward will be issued based on the final diagnosis.」
"Doctor, can you fix my arm? The longer I wait, the more it hurts," the patient with the arm fracture called out to Liu Banxia.
"Right away," Liu Banxia answered, then waved at Ma Limin in the distance.
"Dr. Liu, the relatives of all these patients have been informed," Ma Limin said as she ran over.
"Good. This patient is about to undergo an arm fracture reduction. Do you need to ask any further questions?" Liu Banxia asked seriously, looking at Ma Limin.
"Dr. Liu, I'm only in charge of maintaining order here; specialized colleagues will handle other matters," Ma Limin said.
This brief exchange also gave Ma Limin an opportunity.
"Are you really mentally prepared?" Liu Banxia asked, moving to the patient's side and supporting his arm. "It's not too late to change your mind."
"Doctor, just go ahead. If we wait any longer, I'm afraid I'll regret it," the patient said.
"Which car were you in?" Liu Banxia asked.
"The third one, I think. Such bad luck. Luckily, it's only a fracture and some abrasions. I really slammed on the brakes. Otherwise, I would have... GASP..."
As the patient spoke, his words choked by lingering fear, he suddenly felt a sharp pain from the fractured bone, making him draw a sharp breath.
At this moment, Liu Banxia picked up a small splint from the side and secured his arm. "Let's get another X-ray to check the alignment of the reduction."
"Doctor, is that it?" the patient asked.
Ma Limin, standing nearby, also turned to look at Liu Banxia, equally incredulous.
From her perspective, Liu Banxia had merely placed his hands on the patient, given a slight tug and a twist, and that was it? Was that really bone-setting? She didn't understand bone-setting, but on TV, it always involved grand movements and a series of cracks and pops. Weren't Liu Banxia's actions a bit too subtle?
