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Chapter 221: 222: Need a Commander!
Chapter 221: 222: Need a Commander!
Chapter 221: Chapter 222: Need a Commander!
The vehicle arrived at the Provincial People’s Emergency Department, and the stretcher was already prepared.
The patient was promptly taken into the resuscitation room!
Chen Cang did not hastily choose to learn the “Pulmonary Hydatid Cyst Excision.”
After all, this was not an ordinary surgery but a third-level procedure, infinitely close to fourth-level.
In the central and northern regions, it was generally treated as a fourth-level surgery, but the system clearly took the national situation into account.
After all, this disease is common in pastoral areas, especially during the seventies and eighties. Back then, there were many cases of pulmonary hydatid cysts, with hundreds of surgeries conducted annually in pastoral regions, and the treatment for these surgeries was quite mature.
At that time, a hospital in a certain pastoral autonomous region had achieved a surgical success rate that surpassed top tier hospitals such as Xiehe and West China, earning great acclaim.
Learning a third-level surgery required spending 4 skill points, and upgrading to advanced level required an additional 6 skill points, meaning that mastering advanced “Pulmonary Hydatid Cyst Excision” would need ten skill points.
Considering this, Chen Cang was somewhat reluctant.
After all, such surgeries were too rare. What if… the diagnosis was not this disease? Wouldn’t that be a waste?
However, once confirmed, Chen Cang would not hesitate at all!
After all, the rewards brought by this disease were either perfect-level chest imaging interpretation or perfect-level secretion testing, one could choose between the two.
At this moment, one could see the level and ability of the Provincial People’s Emergency team.
From receiving the patient to examination, starting monitoring, preparing drugs, and carrying out various tests, everything was done in an orderly and swift manner.
Chen Cang looked on with envy.
At this time, Wei Zhi and a man in his fifties had already come out. Upon seeing Qian Liang, they quickly approached.
Qian Liang said anxiously, “Thank you for your efforts, Director Wei, Director Zhang.”
Zhang Peiyi was the director of the Provincial People’s Emergency Department, a vigorous and robust man who at a distance didn’t look like a doctor because he had shaved his head completely bald, giving him a fierce aura.
Zhang Peiyi waved his hand, “Let’s save the patient first. By the way… who is Jing Ran?”
Jing Ran was taken aback for a moment, then stepped forward and said, “Hello, Director Zhang, I am Jing Ran.”
Zhang Peiyi asked, “You’ve been at Fuwai Hospital. How much do you know about pulmonary hydatid cysts?”
Jing Ran pondered for a moment, “If confirmed, surgery can be performed, but right now the priority is to stabilize the patient’s condition. I strongly suspect ruptured hydatid cysts entering the bronchi, causing severe coughing fits, chest pain, and then coughing up large amounts of water-like or membrane-like matter, and allergic reactions can occur. Severe cases can lead to anaphylactic shock, and large amounts of cyst fluid entering the bronchi can cause asphyxiation.”
“So currently, we should quickly administer anti-allergy treatment while conducting examinations to confirm the patient’s condition, and then strive to arrange for surgery as soon as possible.”
Chen Cang saw Jing Ran speak methodically and couldn’t help but glance sideways, because he had said what Chen Cang himself wanted to say.
Impressive!
Actually, Jing Ran admired Chen Cang greatly as well. He had witnessed Chen Cang’s emergency rescue process firsthand: rapid assistance, calm handling, composed analysis, quick disease assessment, and timely patient transport. The sequence of actions was like an emergency combo, which made Jing Ran feel genuinely moved and respectful!
Most crucially, he hadn’t expected Chen Cang to make such an accurate diagnosis of this extremely rare disease.
Because he was in the capital and close to Inner Mongolia, he had some understanding of the disease, but Chen Cang, working in such an environment, could still analyze and handle it, which definitely showed a level of competence!
At this time, a nurse hurriedly ran out.
“Director, the patient’s blood pressure is only 80/50, do we administer anti-allergy now?”
Zhang Peiyi shook his head, “Give epinephrine to raise the blood pressure first, then administer dexamethasone once the blood pressure is up. How’s breathing? No respiratory failure, right?”
The nurse nodded, “No, not presently, but the blood oxygen saturation is a bit low.”
The group walked together toward the resuscitation room.
The bedside B-ultrasound examination was currently underway, and everyone was holding their breath, intently watching the images on the B-ultrasound monitor.
Although not very knowledgeable about B-ultrasound examinations, they could still generally understand what was on the screen.
The examining doctor suddenly took a snapshot, and had an approximate judgment in mind, “Echinococcal cysts can be definitely diagnosed, there’s no problem with that, but the key issue now is that we don’t know whether there have been any ruptures or how many hidden cysts that can’t be seen might exist. These are somewhat troublesome because if the echinococcal cysts are very small, we might still fail to detect them.”
Zhang Peiyi asked, “Can’t B-ultrasound provide a definite diagnosis?”
The B-ultrasound doctor shook his head, “There’s only a certain probability, perhaps more examinations are needed to complete the diagnosis.”
At this moment, Jing Ran suddenly said, “The accuracy of B-ultrasound in diagnosing echinococcal cysts is over 90%, but it is not as accurate for diagnosing cysts that have ruptured or are infected. Moreover, for suspected lung echinococcal cysts, abdominal ultrasound or CT scans are essential examinations. Such examinations are particularly important for preoperative assessments of right lung lesions, as surgery can treat right lung and liver echinococcal cysts simultaneously.”
“Now, we can definitely diagnose lung echinococcal cysts with B-ultrasound, but two things are not very clear: whether there are also echinococci in the liver and whether the lung echinococci are infected.”
After speaking, Jing Ran addressed the examining doctor, “Check the liver and see what you find.”
The examining doctor nodded and continued.
At this point, precise examinations were essential for making a definitive diagnosis, determining the exact location and number of cysts would allow better surgical planning!
One could say that examinations for surgery are as important as intelligence is for warfare!
One misstep could lead to total loss!
All present were senior department heads, each of whom carried significant clout. The group stood to the side with serious expressions in a tense atmosphere, all waiting for the B-ultrasound results.
The critical results of the examination were directly related to how the surgery should proceed.
Because the complexity of lung echinococcal cysts lies in the fact that the surgery isn’t as simple as just one cyst—there could be multiple cysts!
If the cyst is large, it’s indeed detectable, but what if the echinococcus is small?
Hidden in other parts of the lungs or possibly in areas like the abdominal liver, these were the most troublesome.
Undergoing multiple surgeries poses a significant risk to the human body, and everyone was very clear and understood this point.
Moreover, the most important thing was to assess the condition of the outer and inner layers of the lung echinococcal cysts—it was the key factor affecting surgery!
The biochemical tests would take at least another three to four hours, especially the complement fixation test and immunological examinations, which were relatively slow.
How to arrange for quick and effective examinations and targeted screening was thus extremely important!
Indeed, all tests could be conducted.
But what about time?
What about the patient’s condition?
They were currently managing hypertension and allergies, but what about later?
Therefore, a detailed plan was a must.
Put simply, with the complexity of the patient’s condition, who could take the helm?
Who could be the commander with the necessary skills, was especially critical.
It was like two armies on the verge of battle, there must be a commander with absolute authority.
At this time, everyone looked to Jing Ran, the postdoctoral fellow from the capital’s Fuwai Hospital.
Qian Liang couldn’t help asking, “Doctor Jing, have you encountered a similar patient before, and what should we do next?”
After pondering for a while, Jing Ran furrowed his brow, “Examinations are necessary, but we need the help of doctors who are very familiar with the imaging data to assist us in making judgments! After all, I’m not very professional when it comes to imaging data.”