Surgery Godfather
Chapter 818 - 733 Another Roadblock

Chapter 818: Chapter 733 Another Roadblock

The challenges faced by the surgery were perfectly resolved, and Yang Ping planned to personally meet with Lu Jiangbei’s family to sign the informed consent for the surgery.

This was no ordinary surgery; as Chief Surgeon, he had to communicate face-to-face with the patient’s family, making sure they fully understood the risks and details of the procedure. Additionally, Doctor Zhou, the attending physician, and Director Pan from the Trauma ICU were also present.

In the Trauma ICU meeting room, Yang Ping met Lu Jiangbei’s mother, who was wheeled in by a relative.

At the time, all three family members were trapped in their car. Fortunately, the mother’s injuries were relatively minor, not requiring surgery; however, she was also hospitalized and now had to adopt the dual role of both family member and patient.

"Your husband is out of danger, but your child’s injuries are extremely severe, particularly the traumatic atlantoaxial dislocation combined with a comminuted fracture of the atlas. He now has high-level paraplegia, and whether he can recover after the surgery is uncertain, but we will do our utmost."

Yang Ping’s tone was very calm; when dealing with patients and illness, he always seemed very rational, which sometimes made him appear to lack a bit of warmth.

"Can he still take the College Entrance Examination?" the mother blurted out.

She knew that it was highly inappropriate to discuss this issue at the moment, that she should be more concerned about her child’s injuries. But somehow, the words about the exam had become so ingrained in her mind she couldn’t help but voice them out; it was not indifference but an almost instinctive reaction.

Over the years, all her energy revolved around a few words—her child’s College Entrance Examination, which had almost become the ultimate goal of her life.

"We will not discuss that issue now. Right now, we are only discussing the surgery. Without it, it’s still uncertain whether he can survive," said Yang Ping in still even tones.

He was a doctor, and he didn’t concern himself with the life destiny of his patients, only their immediate physical well-being.

The mother hesitated slightly, knowing that even if he could take the exam, a lot of time would be lost. Every minute of the senior year was precious and could translate into crucial points for the score.

Thinking that all her years of hard work might be for nothing, she felt a lot of reluctance.

"Doctor, he is a good student, please, help us. Make sure he doesn’t miss too much study time," the mother’s eyes wandered as she made a final plea. She herself didn’t want to dwell on this issue at such a time, but she couldn’t let it go.

Yang Ping had to remind her again, "My responsibility is to ensure that your child survives and then lives a better life. Nothing is more important than being alive."

Indeed, nothing was more important than being alive. The mother’s gaze became vacant as she repeated this phrase in her mind.

"Traumatic atlantoaxial dislocation, comminuted atlas fracture, high-level paraplegia—the mortality rate is very high. Most casualties die at the scene of the accident. His being able to make it to the hospital and onto the operating table is an immense fortune, so we must cherish it. We must strive to keep him alive, you understand? Only if he is alive is there everything, and if he is not, then everything is meaningless! You must understand, this is the Trauma ICU; leaving here alive is the ultimate goal of every patient, to be alive! That trumps everything."

Yang Ping’s words struck deep into the mother’s heart, and she gathered her distracted gaze, touching the corner of her eye, "Yes, being alive is more important than anything."

"Can we start discussing now?" Yang Ping took the medical records from the attending physician.

The mother nodded, struggling to adjust her emotions; at this moment, aside from life and death, everything else seemed insignificant.

---

Lu Jiangbei had a fever with the temperature spiking as high as 42 degrees Celsius!

Early the next morning, Yang Ping received a call from the Trauma ICU, which was made by Director Pan.

The sudden high fever was undeniably terrible news for the surgery, which had been scheduled and now had to be postponed.

Yang Ping hurried to the Trauma ICU where Lu Jiangbei was in bed, being physically cooled down with ice packs and ice blankets already in use.

"We’ve just checked the bedside chest X-rays, and there is an infection appearing in both lungs."

Doctor Zhou, the attending physician, looked somewhat anxious; the surgery could have proceeded now, but with the sudden fever, it had to be delayed.

"Let’s look at the X-rays!" Song Zimo suggested.

Doctor Zhou pulled up the chest images on the bedside electronic screen, which clearly showed that there was a significant infection in both lungs.

"He was fine during the day yesterday, and then he started having a fever in the middle of the night—I should have checked the chest X-rays earlier." Doctor Zhou felt ashamed, thinking he had not taken sufficient care of the patient and had inconvenienced everyone.

Yang Ping finished looking at the chest X-ray and said, "The condition of the patient is always changing, especially in these patients, it can vary from moment to moment, it’s not possible to do a chest X-ray every day."

"Should we send for further examination with a chest CT in the CT room?"

Lu Jiangbei only had a bedside chest X-ray done. To fully understand the state of the lung infection, a further chest CT scan was necessary, but in the current situation, it was best to move her as little as possible.

After thinking it over, Yang Ping said, "Forget it, try not to move her. Treat empirically with antibiotics and take sputum samples for bacterial culture and sensitivity tests."

The surgery would definitely have to be postponed. A severe lung infection could lead to reduced lung function. Although Lu Jiangbei was now assisted by a ventilator for breathing, it only helped with ventilation, not with gas exchange.

Ventilation refers to the exchange of gases between the lungs and the outside world, while gas exchange is between the alveoli and the capillaries. A serious lung infection damages not only ventilation but also gas exchange.

If a lung infection gets out of control, it could lead to respiratory failure, and ultimately, reliance on ECMO to support breathing, at which point the chances of survival are slim.

"According to the color of the phlegm, it’s very likely to be Staphylococcus aureus, so we’ll start with empirical medication," Director Pan decided on the spot.

As the director of the trauma ICU, frequently dealing with infections, Director Pan handled these situations with ease, but she also felt pressure given that this happened close to the surgery.

That night, Lu Jiangbei developed a fever. Director Pan rushed to the hospital herself to investigate the cause. Typically, infections following trauma come from several sources: wound infection, infection at the site of internal bleeding, lung infection, urinary tract infection, and so on.

After investigating these causes, they confirmed the infection came from the lungs.

Whether viral or bacterial, and if bacterial, which bacteria was causing the infection, typically required bacterial culture. However, this process took too long and could delay treatment.

Therefore, before the results of the bacterial culture were available, it was necessary to use empirical medication based on the color, texture, and viscosity of the phlegm, among other factors, to identify the microorganism involved.

Medicine is an evidence-based science, but at its root, it is also an experiential one. No matter what, it cannot escape the reliance on experience.

"Suctioning needs to be done more diligently, using a fiber optic bronchoscope to suction," Director Pan instructed the nurse who was performing the suction.

Lu Jiangbei now had muscle strength of grade one in her limbs and torso, or just slightly above grade one, so her respiratory muscles lacked strength, and even breathing was difficult, let alone coughing to expel sputum.

The ventilator could only assist with breathing and couldn’t help with expectorating sputum, and the accumulation of sputum could easily lead to infection.

Ordinary suction catheters only reach as far as the main bronchus, whereas a fiber optic bronchoscope can go into the tertiary and quaternary bronchi, or even deeper. Therefore, suctioning under the guidance of a bronchoscope is much better than ordinary suction.

The fiber optic bronchoscope is a technique from the Department of Pulmonary Medicine, usually operated by pulmonary doctors. Many doctors at Sanbo, influenced by the Comprehensive Surgery Department, began to delve into peripheral and interdisciplinary specialties, developing composite technical capabilities.

Dr. Zhou had mastered the basic techniques of various specialties, such as the fiber optic bronchoscope of pulmonary medicine, gastroscopes of gastroenterology, dialysis of nephrology, and closed thoracic drainage of thoracic surgery, among others.

These techniques were originally scattered among different specialties. If there was a need, a consult would be arranged to invite a specialist to operate. Now, with composite doctors like Dr. Zhou, it was no longer necessary to go through the hassle, as he could perform the procedures himself.

Dr. Zhou began suctioning under the bronchoscope, taking several samples to send to the laboratory for bacterial culture.

"Professor, do we continue the special assignment in the ICU?"

August, who had returned to the Comprehensive Surgery Department, volunteered proactively.

Robert wished he could punch the German, August, who was only responsible for the head during repositioning, while Robert, who was in charge of the trunk, exerted the most effort. Despite both wearing small-sized clothes, August’s remained intact, while the underarms of Robert’s had split open.

Hearing that Robert had volunteered, the Head Nurse, even before Yang Ping could speak, said happily, "The clothes have been prepared for you, it’ll be trouble, but we’ll need your help again."

The ICU had been at full capacity during this time, with the female nurses running off their feet and the few male nurses also stretched to their limits. If August and Robert were willing to continue helping, it would be a godsend.

The care for Lu Jiangbei was the most difficult among the patients, requiring several people to work together even for a simple repositioning, without allowing for the slightest relaxation.

During the few days August and Robert worked in the ICU, the overly large clothes didn’t arrive. Later, after they reverted to the Comprehensive Surgery Department, the clothes arrived too late to be of use.

But now, with Lu Jiangbei’s fever and the surgery delayed, those few sets of extra-large clothes could finally be put to good use.

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