Surgery Godfather
Chapter 512 - 468: Two Choices

Chapter 512: Chapter 468: Two Choices

The last 8 units of AB type blood from the blood bank are being transported to Sanbo Hospital. Afterwards, an emergency procedure is initiated to gather relatives and volunteers for urgent on-site blood donation, which will take some time. For now, only these 8 units are available for rescue.

"This one is the driver, and there’s a student next door. Both have severe injuries. Director Han says you need to evaluate them."

Dr. Lv provides a brief overview of the patients’ conditions. Whether they can be saved or not depends solely on Yang Ping. No one else can act as quickly.

At the end of the emergency surgery corridor, two policemen stand at the large doorway. The female driver is suspect of drunk driving. She drove straight into a crowd without any attempt to brake. After her first collision with the crowd was blocked by an obstacle, she reversed and then accelerated, hitting another group of people. She intentionally targeted crowded places. This is considered a crime.

After understanding the situation, Yang Ping quickly glances at the CT images on the screen. The abdomen and pelvis are a mess; multiple large blood vessels must have ruptured. If she were to be treated conservatively for the time being, relying on blood transfusion and fluid replacement to resist shock, it would be impossible to maintain a blood volume balance. Even if a pelvic external fixation frame is temporarily installed to maintain pelvic volume, it still couldn’t balance the volume. There are bleeding points everywhere.

If intervention department is asked to perform embolization, it is impossible to embolize so many places, and there is no time.

The fastest and most effective method is the application of aortic balloon occlusion technology.

A puncture from one relatively intact femoral artery will deliver the balloon into the abdominal aorta. It can then expand within the abdominal aorta, blocking it and almost entirely stopping all bleeding below this plane, significantly reducing blood loss.

The balloon can even be delivered to a higher position to control bleeding, cooperating with blood transfusion and fluid replacement to temporarily stabilize blood pressure, buying time for surgery.

This operation can be completed in just one or two minutes.

A plan rapidly formed in Yang Ping’s mind, and he immediately ordered:

"Prepare for REBOA!"

REBOA, Resuscitative Endovascular Balloon Occlusion of the Aorta!

Dr. Lv, who had followed, immediately took out the REBOA kit from the surgery room’s storage cabinet as soon as he heard Yang Ping’s order.

This equipment is always ready in the emergency operating room, but no one can apply this technology as proficiently as Yang Ping.

Director Ouyang and Old Jin arrived at this time. Yang Ping handed over this patient to them and went to the next room with Song Zimo and others to see the student.

"You start with REBOA!"

Yang Ping gave an instruction and immediately went to the operating room No. 2 next door.

There are currently 6 operating rooms in the emergency department, all of which are integrated examination and operating multifunctional rooms.

"Hypovolemic shock, pelvic comminuted fracture, sacral comminuted fracture, bilateral femoral shaft fracture, multiple rib fractures, hemothorax, mediastinal hematoma, lung rupture, severe pelvic comminution, blood pressure cannot be maintained---"

The emergency doctor in charge of this patient reported the condition to Yang Ping.

"This female student, a high school student, has the most severe injuries, along with the driver we just saw."

Dr. Lv followed over again; he was in charge of on-site emergencies and needed to report the patients’ conditions to Yang Ping at all time.

Screen images flashing past, Yang Ping made an immediate diagnosis. This patient’s condition was extremely similar to the previous one; they were both on the brink of life and death.

"REBOA!"

Without waiting for the emergency doctor to act, Little Five directly took out the REBOA kit from the cabinet, opened it, and Yang Ping and Song Zimo put on gloves. Song Zimo acted as the assistant.

Puncture, insert the sheath, deliver the shrunken aortic occlusion balloon through the sheath.

Based on the patient’s height, CT scan images, image ratios, the amount of bleeding in each part, Yang Ping quickly judged the precise anatomical location of each segment of the patient’s aorta and the height at which the balloon needed to be delivered.

With swift actions, the balloon was delivered to the appropriate location and immediately inflated. The inflated balloon instantly blocked the aorta’s lumen, similar to closing the main valve of tap water, thereby controlling the majority of bleeding.

However, this is only a temporary measure to stop bleeding. If we want the patient to survive, we need to supplement blood to maintain the perfusion of important organs. The delivery of oxygen requires an adequate amount of blood.

During this window period, we have to seize the time to perform surgery and achieve long-term hemostasis. Only then will the patient have a chance to survive.

This kind of surgery is nothing more than a race against bleeding.

Stopping the bleeding and transfusing blood before massive blood loss causes organ failure can all be reversed; if we fail to stop the bleeding and transfuse blood before organ failure, vital organ ischemia and hypoxemia will cause a domino effect, leading to a state of exhaustion from which it is impossible to recover.

"Continue transfusing blood! Prepare for surgery, I’ll go check next door. I’ll be right back."

In the next room, Dr. Jin and Director Ouyang are performing a puncture and inserting the aortic balloon, but due to their less accurate judgment of the location, they are slowly pushing it up, correctly inflating the balloon.

"Too low! Go up, again, go up more!"

Yang Ping simply did it himself, pushing the balloon almost fifteen centimeters higher before inflating it.

"You continue with this one, I need to go back to the next room."

Yang Ping was only here to help insert the balloon, completing the emergency hemostasis.

When Yang Ping returned to operating room No. 2, Song Zimo had already completed the disinfection process and was preparing for thoracotomy. They both held full surgical privileges and didn’t need the assistance of the Thoracic Surgery Department.

The Department Director of Thoracic Surgery stood at the door, saw that the surgeons were Yang Ping and Song Zimo, did not say a word, and changed his consultation target.

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