Surgery Godfather
Chapter 812 - 727: Dangerous Head and Neck Separation

Chapter 812: Chapter 727: Dangerous Head and Neck Separation

"Old Xu, you take over."

While listening to the phone call, Zhang Lin looked at Xu Zhiliang, seeking support; clearly, the situation on the other end of the line had exceeded Zhang Lin’s decision-making abilities.

In the emergency scene, on the brink of life and death, one judgment was tied to a life, and Zhang Lin dared not act rashly, dared not carelessly utter a word.

Xu Zhiliang took over the phone with calm composure, and as soon as he heard it was a rescue situation, he instantly transformed, speaking without a single stutter.

The emergency doctor on the other end was also well-trained, speaking clearly and calmly:

"Car accident, seventeen-year-old male, trapped in a deformed car, preliminary diagnosis: atlanto-occipital dislocation, disconnection between the skull and the cervical spine, no bony or ligamentous connections, only muscle and skin holding them together, hands and feet can still move, considering the spinal cord may not be severely damaged, the space inside the car is too small to fit a cervical collar, the rescue team is ready to cut the vehicle, what should I do?"

Facing such a case, the emergency doctor lacked experience; he had to seek assistance from surgeons skilled in cervical spine operations.

Atlanto-occipital dislocation, a fatal injury, is essentially the head losing its true connection with the cervical spine, with the remaining muscle and skin connection being meaningless.

For an emergency doctor, many never encounter it in their whole lives because patients with such injuries are often labeled black at the scene, leaving no chance for resuscitation.

"Listen carefully, throughout the entire cutting process, you can only rely on manually maintaining fixation and traction of the head and cervical spine, there absolutely must not be any secondary injury, absolutely not! Once the spinal cord is damaged, heartbeat and respiration will stop," Xu Zhiliang said confidently and steadily.

He enunciated clearly, without any stutter, making one doubt whether his usual speech impediment was an act.

"Understood!" the emergency doctor responded, taking a deep breath.

"Do you need us to come over?" Xu Zhiliang asked.

The other party firmly refused, "There’s no time, the patient is actively bleeding heavily, rescue will commence immediately; I will try to manually stabilize the head and cervical spine."

Aside from manual stabilization, there was no second option.

On the other end of the phone was Dr. Lv, who was very familiar with the surgeons of Comprehensive Surgery, often collaborating with them, but he had never encountered such a case in his career; this was the first time and possibly the last, he was uncertain if he could handle it well.

"There must be no rotation, keeping the head and cervical spine’s axis aligned; maintain proper traction, too much or too little are both extremely dangerous; everything can only rely on your sense of touch; both hands must be very stable, when moving---" Xu Zhiliang didn’t continue.

That’s because if Dr. Lv could succeed in getting the patient onto a stretcher alive, they would face a similarly tricky problem: how to stabilize the cervical spine for transport.

It was impossible to rely on manual support indefinitely; it was a choice made when there were no other options, and even short-term stabilization was extremely dangerous, not to mention long-term stabilization, yet a cervical collar couldn’t provide adequate stability.

Without reliable stabilization, any slight motion during transport might be fatal.

"How long will the cutting take?" Xu Zhiliang asked.

"We’re preparing to start now, it’s expected to take at least one hour," Dr. Lv breathed rather heavily.

"Can you wait for us to arrive before starting the cutting and rescue?" Song Zimo reminded from the side.

Xu Zhiliang shook his head, "We can’t wait, the patient has active, severe bleeding."

"Are there vital signs?" Song Zimo inquired with doubt.

"He’s still conscious!" Xu Zhiliang nodded.

It was extremely rare, and indeed fortunate; such cases of atlanto-occipital dislocation usually result in instant death, leaving no opportunity for resuscitation—yet now the patient was conscious.

"The patient is stuck in the back seat, Dr. Lv saw abnormal movement of the patient’s head, he reached out and felt something was wrong, suspecting that the upper cervical spine was nearly separated from the skull, with only the skin and muscles holding them together, no bony or ligamentous connections," Xu Zhiliang sat down next to the phone, his brow furrowed.

"I wonder if Dr. Lv can handle it?" Song Zimo expressed his concern.

Xu Zhiliang had his origins in emergency medicine and was very familiar with Dr. Lv, "It should be possible; this person is quite composed and meticulous in his work."

"A surviving traumatic atlanto-occipital dislocation?" August said, his eyes widening in surprise; he couldn’t believe it was true.

After all, at the scene of a car accident, a surviving patient with an atlanto-occipital dislocation is incredibly rare; doctors had only seen such cases in the literature.

The spine skeletal model was placed on the square table in the office, and Song Zimo, Xu Zhiliang, and August gathered around the model, beginning to study it, with Robert also joining in the bustle.

"The life of this patient is in Dr. Lv’s hands; I hope he can hold it steady. Whatever comes next, whether it’s a cervical collar or a halo vest, will not offer reliable fixation," Song Zimo expressed his concern.

Xu Zhiliang had also thought of this; it wasn’t just any cervical spine injury, but an atlanto-occipital dislocation. Even slightly poor fixation could be fatal due to minute movements.

"He’ll die right there at the scene!" August said frankly.

How to ensure that the patient wouldn’t experience any dislocation of the joint or injury to the cervical medulla during transport was a serious issue, a very serious issue.

"For such patients, the ordinary cervical collar is useless; it cannot provide reliable fixation," August said, his brows furrowed.

"Unless we can customize a fitting brace on-site, or create a perfect head-neck-chest plaster cast there."

Song Zimo, looking at the spine model and pondering, suddenly had a flash of inspiration.

"Can we have the brace department go to the accident scene to customize a protective brace? By rapidly forming it on-site, it could conform and fix the patient’s head and upper body temporarily to protect them?" Song Zimo suggested.

"Good idea, we would need to move the brace department’s equipment to the accident scene," Xu Zhiliang was awakened by Song Zimo’s suggestion.

In critical moments, creative thinking is really needed, breaking the mold of conventional thought.

"Should we call Old Wei from the brace department and go?" Xu Zhiliang stood up, "Zhang Lin, let Old Wei bring all their stuff and contact the emergency department to dispatch a vehicle."

"You all go quickly, I’ll immediately report to the professor and wait for you at home!" Song Zimo prepared to split efforts with Xu Zhiliang.

Old Wei of the brace department was in his fifties and held a specialized diploma. He used to be a plaster technician in the Orthopedics plaster room, skilled at casting plasters and creating braces. His craftsmanship was exceptional. Later, when the hospital established a dedicated brace department, Old Wei’s plaster room was upgraded to the brace department, becoming an independent section.

Moving the entire workshop to the accident scene was something Old Wei had never experienced before. When he received the call from Zhang Lin, he put out the cigarette in his hand.

"Check the equipment and materials, load them up, and go to the rescue scene to create braces."

Upon hearing that the task was to make a brace on-site, Old Wei’s eyes sparkled with excitement. He had been working with plaster and braces for half his life, and he felt he was the best in the world at it, unmatched by anyone.

Furthermore, hearing that this was a life-saving effort, Old Wei was even more thrilled. Working in the hospital for half his life and dealing with plasters and braces every day, he had never thought that these things could actually save lives.

"Bring a bucket of water!"

Old Wei directed his two apprentices while they were moving things.

"The constant temperature box needs a power source; where can we get power at the rescue scene?" one apprentice asked.

Old Wei cursed, "My BYD Tang can supply power, what’s there to be afraid of?"

"Move faster!"

Old Wei urged his two apprentices.

PS: Dear readers, thank you for waiting. Through hard work over this period, we’ve managed to expand from a two-person team to a three-person team, so I’ll have more time for writing. Thank you all for your unwavering support, let’s continue!