When the Doctor Uses A Hack

Chapter 305 - 306: Blindly Piercing through the Pericardium!

Chapter 305: Chapter 306: Blindly Piercing through the Pericardium!

Chen Cang hurried over to the group of directors and said, “Director, you’ve arrived.”

Li Baoshan nodded and asked in a grave tone, “How is it now?”

Chen Cang swallowed, “Still relatively stable, we’ve gone to do the relevant examinations, and should be returning shortly.”

Li Baoshan uttered an acknowledgment.

At this moment, Director Tao Zi from the Department of Cardiac Surgery, and Director Xu Tianfu from the Department of Cardiology walked over.

Tao Zi frowned and asked, “Chen? What is the patient’s condition?”

Chen Cang explained, “The patient’s examination results haven’t come out yet, but I suspect it might be a cardiac tamponade caused by traumatic hemopericardium!”

As soon as the words “cardiac tamponade” were mentioned, the expressions of all the directors changed dramatically!

Cardiac tamponade is a life-threatening condition!

Examinations can’t be conducted carelessly; at the very least there should be someone supervising!

With this thought, Li Baoshan asked anxiously, “What examination have they gone for?”

At this time, Chang Lina, who had taken the patient for the examination, approached with a trolley, accompanied by an on-duty radiologist.

The radiologist pulled out the MRI films, “Director, take a look, this is the chest film, this is the MRI.”

Upon hearing this, Tao Zi’s complexion changed drastically, “Why did you do an MRI?”

This question dumbfounded everyone!

The radiologist was surprised for a moment, “To ascertain the extent of blood accumulation inside the pericardial cavity…”

This response left the radiologist bewildered—could it be…they made a mistake?

But seeing the three directors staring at them with serious faces, the radiologist involuntarily shrank back, questioning if they had indeed made a mistake.

Li Baoshan quickly inquired, “Is the patient’s condition stable now?”

Chang Lina who had taken the patient for the examination nodded, “Stable! Blood pressure is 90/70, heart rate is 70 beats per minute… The patient’s vital signs are stable.”

Upon hearing this, the surrounding directors let out a sigh of relief.

Xu Tianfu said slowly, “It’s not that we don’t allow you to perform an MRI, but it should only be done when the patient’s condition is stable, otherwise a cardiac tamponade can easily be fatal.”

Indeed!

Xu Tianfu was not joking.

Every year, a significant number of cardiac patients die in CT and MRI rooms.

Therefore, many hospitals in the country don’t recommend cardiac MRI or CT for patients suspected with myocardial infarction or heart failure until their condition stabilizes.

The radiologist offered an awkward smile, “Director, the patient was stable when brought in.”

The three were taken aback!

Cardiac tamponade caused by hemopericardium…how could it stabilize without treatment?

At this time, Xu Tianfu holding the MRI films, suddenly paused, “This isn’t right… why is there no blood accumulation?”

Even Tao Zi felt surprised upon careful comparison, and after looking at the echocardiogram, became curious as well.

“It’s not right, look, the second and third ribs on the left side… There are clear signs of blunt trauma.”

“But the ultrasonic fluid level…”

At that moment, Old Liu hurried in, “Dr. Chen, I’ve brought the blood you asked me to fetch.”

At this point, everyone’s attention turned towards Chen Cang.

Li Baoshan’s eyes widened in shock, “What kind of blood is this?”

Chen Cang stated, “When I arrived at the scene with driver Old Liu, the patient was in poor condition, suffering from a very serious cardiac tamponade, blood pressure at only 60/30mmHg, and the classic triad of cardiac tamponade symptoms was very evident. This was my first time encountering a patient displaying a complete triad of symptoms. The patient’s heartbeat was extremely weak; worried that he might encounter problems on the way to the hospital, I made a snap decision to perform a pericardiocentesis on site.”

With this revelation—

Instantly, the expressions of the three directors changed again.

They all knew the severe consequences of cardiac tamponade.

But how do you perform pericardiocentesis outdoors?

Without ultrasound guidance on the one hand, and without monitoring on the other,

performing pericardiocentesis could only be a blind puncture.

Blind puncture… A single mishap could lead to problems.

After all, the pericardium is not the thoracic cavity with ample space available; its operable space is very limited.

As Tao Zi thought about this, he hesitated and asked, “Did you… ‘blindly puncture’ it?”

Chen Cang nodded, “I had no choice at that moment, the situation was special, and the patient was in extreme urgency, an emergency that couldn’t be delayed, so I did it.”

The three exchanged glances and couldn’t help but swallow… They could imagine the peril involved.

Nevertheless, the more they thought about it, the more relieved they were afterwards.

If things had gone wrong, the patient might not have made it to the hospital.

Li Baoshan sighed, “You took too much of a risk.”

Tao Zi shook his head, “There was no choice!”

When it came to this, the way the three looked at Chen Cang changed.

After all, among the dozens of people in the cardiology and cardiac surgery departments of the Second Provincial Hospital, there were probably only a few who could perform a blind pericardial puncture.

Even Tao Zi and the others were not sure if they would dare to do it!

Perhaps… in that situation, they too might have proceeded, right?

As Tao Zi pondered internally, whether he could actually succeed was really uncertain.

With this in mind, Tao Zi looked at Chen Cang with genuine admiration.

Brave and resourceful!

To rapidly diagnose cardiac tamponade and then boldly carry out field punctures was indeed a capability.

Sometimes, people really have no choice but to acknowledge their seniors.

Watching a new generation of talented youngsters gradually emerge, the directors felt both relief and a sense of loss.

Relieved, because there was someone to follow.

Regretful, because they were getting old…

However, after learning that the patient’s vital signs had stabilized following the pericardiocentesis and considering that there indeed was some blood remaining in the pericardial cavity,

but with no massive bleeding, it likely wasn’t a major vessel injury.

Nor was it an acute rupture of the heart.

The only concern now was the injury to the pericardium causing damage to the pericardial blood vessels.

At this moment, various test results came back.

The indicators were basically normal; hemoglobin was low, but not low enough to require transfusion; white blood cells were slightly elevated, which was also normal.

Having reviewed all the medical reports, Tao Zi said, “We now need to open the chest and explore to confirm whether there is damage to the heart or blood vessels. We should identify the source of bleeding and provide timely symptomatic treatment.”

“Moreover… look at the X-ray here, there is still pericardial effusion and clots, so next we should open the pericardium, clear out the pericardial effusion, and while identifying the source of the bleeding, repair any damage to the cardiac vessels!”

Xu Tianfu also nodded, “Luckily, the heart wasn’t penetrated, or it would not be so simple. Look at this broken rib; it probably injured the blood vessels of the pericardial tissue without causing damage to the heart. I estimate this is likely the main cause of the hemopericardium and cardiac tamponade!”

It must be said, Sun Sheng was quite fortunate, the fractured rib didn’t cause damage to his heart, otherwise… it would not be the situation we see now.

After discussing, the directors made a decision to quickly complete the surgery preparations.