CHAPTER 322: 322, RESTORING BLOOD FLOW IS CRITICAL

"I regret it so much. I should’ve stayed downstairs with Teacher Liu to treat the ears," lamented Xu Yino, who had just finished surgery.

"What’s there to regret? You didn’t see the child’s condition then; we were all heartbroken," said Liu Banxia.

"Today, I’m really grateful to Doctor Peng. Otherwise, who knows how many detours I would have taken. Most likely, I would have ordered numerous tests for the child and then sent him home."

"At first, I had absolutely no clue; I was just guessing wildly. What Doctor Peng did, now *that’s* a proper diagnosis. It’s on an entirely different level."

"Teacher Liu, can we not be so humble, not so coy?" Liu Yiqing sounded somewhat helpless.

She now felt the same way Liang Xiaolin used to, thinking that sometimes Liu Banxia’s diagnostic insights seemed to come out of nowhere, like lucky guesses. But if you thought about it carefully, everything was traceable.

Take today’s child, for instance. If Liu Banxia hadn’t observed the subtle differences and distinguished them from schizophrenia, the case would have simply ended with sutures after the initial diagnosis.

Not every case presents all symptoms clearly, allowing for an easy diagnosis. And that teratoma from earlier, was it really so easy to diagnose?

Both patients had medical histories, so why weren’t their conditions diagnosed during previous hospitalizations? Were those doctors really less skilled than Liu Banxia?

That wasn’t it. Liu Banxia is a surgeon; his main job is cutting and stitching. So how does he manage to notice such subtle signs in patients? That’s real skill.

"Why are you all looking at me like that?" Liu Banxia asked, thoroughly enjoying a chicken leg he was chomping on.

"Nothing. Little Yiqing was right; our Teacher Liu has a real talent for being coy. How did we never notice it before?" Xu Yino said.

The other male interns all nodded in agreement. Although they didn’t dare say it directly, not being as bold as Xu Yino and Liu Yiqing, they showed their assent.

Liu Banxia shot them a look. "Focus, everyone. I need to rest tomorrow. I’m going out to earn some extra cash. Otherwise, where would I get the money to buy you chicken legs?"

"Teacher Liu, what kind of surgery?" Miao Rui asked curiously.

"Two appendectomies, one cholecystectomy, and one liver cyst. I’ll have to work hard all day tomorrow. When I get back, I’ll bring you some sizzling plate dishes; they’re delicious," Liu Banxia said.

"Teacher Liu, can we take a short leave and go with you to watch?" Xu Yino asked tentatively.

"Just stay put here. You’ve seen plenty of appendectomies and cholecystectomies. The liver cyst surgery is possible because it’s a collaboration with Jinshui District Hospital, and I have to work with their doctors," Liu Banxia said with a smile.

"After all, I’m going there to work for them, so I have to follow their arrangements. Making a little money is really tough, and I still have to pay for your chicken legs."

Hearing Liu Banxia’s words, the interns were somewhat disappointed. For them, liver cyst resections were indeed a rare sight.

But Liu Banxia had a point. It was a significant favor that Jinshui District Hospital kept such a major surgery case and called him in to perform it.

"Just keep up the good work and always be prepared. Tests are everywhere. I might ask General Surgery for an appendectomy case for you at any moment. Whether you shine or embarrass yourselves, whether you get blamed by others, that’s all up to you. And who knows who the lucky one will be," Liu Banxia added with a grin.

Hearing this, the interns tensed up again. Liu Banxia was really capable of doing something like that. This Teacher Liu was very unpredictable and spontaneous.

If they really messed up, the next person in line would have their rotation postponed by a month. There wasn’t much internship time left. At that rate, some might not even get a chance to operate.

Seeing their expressions, Liu Banxia felt a great sense of accomplishment. This pressure had to stay with them. Only under pressure would they grow faster.

Take himself, for example. Even with the System, he wouldn’t have achieved his current performance without pressure.

Their fundamentals were good. Even though they were still interns, they weren’t much different from how he was before he got the System. As long as no major issues arose in their careers, they would all become outstanding chief surgeons in general surgery.

They didn’t eat at the usual time today. By the time everyone finished, it was already two in the afternoon. Just like getting off work, you really couldn’t expect meals to be on time.

However, for Liu Banxia and his team, this was already a familiar routine. As long as there was food, that was good enough. If there wasn’t, they’d just have to endure, wouldn’t they?

"Huh? Where did Wang Chao go?" Liu Banxia asked after returning to the Emergency Center.

"You’re back just in time. He went out with an ambulance for an emergency call; there was a car accident," said Wang Ying.

Liu Banxia nodded. "That’s good. I thought our new ambulance would still be a few more days away. You lot, pay attention. When Wang Chao gets back, be ready to coordinate. Brother Wei, I’ll trouble you to keep an eye on things."

Wei Yuan smiled and nodded. "Don’t worry."

After about two more minutes, the phone rang again.

"Dr. Liu, there are three injured individuals at the scene. Doctor Wang said to prepare for surgery. He suspects internal bleeding in two patients and an open leg fracture in the third," the dispatch nurse reported after listening.

"My goodness, information update! Everyone, get ready! Doctor Qi, Li Hao, and Miao Rui, take one patient. Dr. Wei, Xu Yino, and Liu Yiqing, take another. The rest will assist Doctor Wang," Liu Banxia announced, clapping his hands.

"Prepare six units of O-positive blood. Contact the OR and have them prep for two surgeries. Notify the CT room to be on standby. If there’s time, get CT scans before they go into surgery. And call Dr. Wu from Orthopedics."

He hadn’t expected it; either no cases, or a major one like this when it came.

Wang Chao wasn’t just twiddling his thumbs. His on-site assessment was crucial and saved a lot of time.

After waiting nearly ten more minutes, three ambulances pulled up.

"Thirty-eight-year-old male, BP sixty over ninety, abdomen distended. Ruptured temporal artery, clamped. IV fluids started on-site," Wang Chao reported as they wheeled the patient out.

"Dr. Wei, straight to the OR," Liu Banxia said.

Wei Yuan, leading Xu Yino and Liu Yiqing, hurried to meet them.

"Second patient: twenty-three-year-old female, vitals stable, car driver. Complains of neck pain, wearing a cervical collar. Third patient: ten-year-old, vitals stable, open fracture of the leg," Wang Chao continued, introducing the next two patients.

"Doctor Qi will take the second patient. Doctor Wang and I will take the third. Trauma Room One and Trauma Room Two," Liu Banxia said, then started pushing the gurney inside.

"The first patient is the truck driver. A girl with her younger brother tried to cut in front of him; the driver didn’t see them and squeezed them. The scene wasn’t too gruesome, but the injuries are quite severe," Wang Chao explained.

Liu Banxia nodded. "You guys do the other checks. I’ll assess the child’s fracture. One, two, three, transfer!"

"President Liu, does he need surgery?" Wu Mingyu asked, rushing over.

"Surgery’s needed; it’s an open fracture. But I just checked, and there’s no pulse in the child’s foot. The artery might have gotten tangled by the fracture. Doctor Wu, will you take this one?" Liu Banxia asked.

"You do it. Your hands are more sensitive," Wu Mingyu said.

Liu Banxia didn’t hesitate. "Two milligrams of midazolam, twenty-five micrograms of fentanyl. I need to reduce the fracture and restore blood flow to the child’s leg first, then get an X-ray before sending him to the OR."

After saying this, he didn’t stay idle but began meticulously examining the child’s fractured leg.

What is an open fracture? Simply put, the broken bone is exposed. In this child’s case, the two segments of the broken bone were displaced, causing the blood vessels to become entangled.

Performing a reduction and restoring blood flow without any imaging to clarify the actual condition of the blood vessels was very risky.

The ends of a broken bone are very sharp. If not handled correctly during reduction, they could easily sever a blood vessel.

The child’s vital signs were currently stable, but if a vessel was severed, it could lead to massive hemorrhage.

But not restoring it wasn’t an option either. If blood flow wasn’t restored, the child’s foot could suffer ischemic necrosis, and amputation would then be necessary.

It was precisely because of this difficulty that Wu Mingyu let Liu Banxia take over. He wasn’t shirking responsibility but rather trusted Liu Banxia’s hands; he wasn’t very confident in his own ability for this.

At this point, the fentanyl took effect, and the child’s crying subsided somewhat.

Liu Banxia grasped the child’s foot, gently applied traction, then palpated the fracture site carefully before giving a gentle upward push.

After this, he checked the pulse in the child’s foot again.

"Okay, blood flow restored. No damage to the vessel. Wang Chao, how are your checks coming along?" Liu Banxia asked.

"The child’s very lucky. Only a leg fracture, got pinned between the seat and the car door," Wang Chao said.

"Brother Wu, get an X-ray, then you can take him straight to the OR," Liu Banxia said.

Wu Mingyu nodded. "Everyone, step back. We’re taking the X-ray now."

In fact, even without him saying so, everyone had already moved to the side. Even a portable X-ray involved radiation.

"Banxia, beautiful! The reduction is perfect. A simple internal fixation will do," Wu Mingyu couldn’t help but praise, looking at the displayed image.

DING! Patient admission complete.

Gained 100 Experience Points, 100 Diagnostic Skill Proficiency Points, 300 Bonesetting Skill Proficiency Points, 5 Glory Points.

Liu Banxia removed his gloves and went outside, happening to see Qi Wentai also coming out.

"That patient’s arms and legs are moving fine, and the initial cervical spine assessment showed no issues. But to be safe, we gave her some painkillers and sent her for cervical and thoracic CT scans," Qi Wentai said.

Liu Banxia nodded. "Good. Now we just wait for good news from Brother Wei’s side. Chao, you did well today. Your field treatment for all three patients was excellent."

"But next time you go out, don’t just think about yourself; take the interns with you. Let them get more field experience. You can all take turns."

Wang Chao nodded. "I’ll definitely keep that in mind next time. I need to rest for a bit first. I’m exhausted—mentally and physically. My heart is still pounding."

Liu Banxia chuckled. Truthfully, he was also quite worked up; that was the adrenaline.