Chapter Sixteen: The Doctor's Benevolent Heart

  Tang Xiaofeng had just come out of the director's office when he ran into Nurse Wang Hui, who was in a hurry. Tang Xiaofeng couldn't help but feel surprised. Without even greeting Tang Xiaofeng, Wang Hui pushed open the door to the director's office and said breathlessly: "Director Zhu, there are over ten injured patients from the emergency department, they're from a car accident, we need to deal with it quickly!"

  Director Zhu hastily stood up and said to the old man: "You sit down first, I'll go ahead and deal with the wounded."

  "You go and busy yourself, I'll wait here." The old man said with a smile. When Director Zhu arrived at the emergency hall with Tang Xiaofeng and nurse Wang Hui, he saw Director Sun directing the doctors to rescue the patients on site. Director Sun saw Director Zhu bringing Tang Xiaofeng over and hurriedly came forward to say: "The thirteen injured have all been settled in, you take command now, I'll go receive the patients." "No, I'll go receive the patients, you continue to dispatch and direct to avoid unnecessary chaos." "Alright, then it's the patient on bed eleven. The nurse has already arranged for an X-ray." "Got it," Director Zhu said as he led Tang Xiaofeng towards bed eleven.

  "Liu Yuanyuan, female, 31 years old, was sent to the emergency department at 9:20 this morning due to a car accident at 8:50. The patient was conscious and had normal breathing and blood pressure when she arrived. She had multiple soft tissue injuries all over her body... Preliminary diagnosis: soft tissue injury, rib fracture." A resident doctor who was on duty said hastily as Director Zhu came over.

  "Alright, I've taken over this patient. You go see Director Sun and check if there are any other wounded people that need attention." The doctor responded with a "yes" and hurried off to find Director Sun.

  Director Zhu looked at the film and gestured to Tang Xiaofeng to examine the patient. Just as Tang Xiaofeng was about to bend down to examine the patient, Liu Yuanyuan suddenly appeared short of breath, pale face, Tang Xiaofeng quickly picked up the stethoscope to listen, the breathing sound weakened, and then checked Liu Yuanyuan's pulse again, with her left hand pressing on Liu Yuanyuan's chest, her right hand gently tapping downwards, then changed to the side position and tapped again. While tapping, she shouted to Director Zhu: "The pulse is weak, the percussion of the upper chest shows a drum sound, the lateral chest shows a solid sound, these are signs of pleural effusion, and it's quite serious, requiring immediate drainage treatment."

  "Hemothorax?" Director Zhu was somewhat skeptical, Tang Xiao Feng had come to a conclusion so simply, although his palpation technique was correct, but he was after all just an intern.

  "En!" Tang Xiao Feng nodded affirmatively.

  "X-ray examination of the chest cavity is normal, and the ribs are only slightly fractured, not broken...... How can you determine it's a hemothorax?" Director Zhu asked while starting to examine Liu Yuanyuan. "It wasn't earlier, doesn't mean it isn't now, let's measure blood pressure to confirm," Tang Xiaofeng said after thinking for a moment.

  Director Zhu had already finished examining Liu Yuanyuan and came to the same conclusion as Tang Xiaofeng. He turned around, took the sphygmomanometer from the nurse, tied it around Liu's arm, and said to the nurse, "Arrange for an X-ray to confirm the diagnosis and prepare for a closed thoracic drainage surgery." "Okay, got it," Tang Xiaofeng hastily shouted: "The patient's condition is extremely bad. She had a normal chest X-ray before, but now she has developed hemothorax with a large amount of bleeding in a short time. With so many patients here, arranging for an X-ray will also delay us. She has already fallen into a coma, and if we don't perform the drainage soon, there may be life-threatening danger..." Doesn't he know that extraordinary times call for extraordinary measures? Tang Xiaofeng knew that Liu Yuanyuan was experiencing massive internal bleeding, and regardless of whether Director Zhu agreed or not, he would handle it promptly. He also knew what Director Zhu was worried about. "I know it's hemothorax, but without an X-ray to confirm the location of the fluid accumulation, how can we perform the drainage? Closed thoracic drainage surgery must be done with X-ray confirmation." "This doesn't necessarily require an X-ray to determine the position; percussion can also detect the location of the fluid accumulation. This requires experience to judge, and the previous percussion has already clearly indicated..." Tang Xiaofeng didn't want to continue arguing; he knew what Director Zhu was worried about.

  "Director Zhu, I've come to perform a closed thoracic drainage procedure." Tang Xiao Feng said calmly, looking at Director Zhu. "I won't let you take this risk." "In extraordinary times, doctors must be compassionate, and life is paramount." Tang Xiao Feng pleaded.

  Director Zhu looked at Tang Xiaofeng's determined eyes and instructed the nurse in charge of bed 11, "We need a closed thoracic drainage surgery here, prepare immediately."

  "Come right away."

  The nurse was only responsible for taking care of the patient and would always follow the doctor's instructions on treatment, even though Director Zhu had just disagreed with Tang Xiaofeng on the diagnosis. The nurse automatically filtered out their conversation, as Director Zhu was the highest authority in the emergency department and his orders were carried out without hesitation. The nurse turned to prepare, while Director Zhu continued to take Liu Yuanyuan's blood pressure, squeezing the balloon until the mercury column rose to 180 before slowly unscrewing the valve. As he watched the mercury column slowly drop, his heart was also at its highest point, and from that moment on, it would be clear whether Tang Xiaofeng was right or wrong.

  Tang Xiaofeng also paid attention to the readings on the blood pressure meter, although the stethoscope was in Director Zhu's ears, but from the decline of the mercury column, he could still see the approximate value of the blood pressure.

  Blood pressure readings consist of systolic and diastolic pressures. Systolic pressure is the highest value, with a normal adult range between 90-139. Diastolic pressure is the lowest value, with a normal adult range between 60-89. Exceeding this range indicates high blood pressure, while falling below it indicates low blood pressure.

  Generally, a mercury sphygmomanometer is used to measure blood pressure. During slow deflation, the pressure inside the cuff decreases, and when it equals or slightly drops below systolic pressure, the slowly falling mercury column will show oscillations, and the stethoscope will start to pick up pulse sounds. When the stethoscope first hears a "tapping" sound, the pressure reading on the manometer is the systolic pressure. Continue slow deflation until the sound suddenly becomes muffled and then disappears; take the pressure reading when the sound disappears as the diastolic pressure.

  After taking his blood pressure twice, Director Zhu finally loosened the cuff. His face turned somewhat unsightly and he didn't say another word.

  "How much? 80/50?" Tang Xiao Feng didn't dare to confirm the exact value, he only roughly distinguished that the blood pressure was around 80/50 from the start of the mercury column's movement and its final disappearance.

  "75 over 50, low blood pressure." Director Zhu replied. In this case, the patient is in danger. If no timely measures are taken, this hemothorax will threaten the patient's life safety.

  Perhaps Tang Xiaofeng is right, maybe I'm getting old and care too much about superficial reputation and honor. What Tang Xiaofeng said is correct, a doctor's heart should be benevolent, life is the most important thing.

  Collection, collection, seeking recommendation, recommendation, your collection and recommendation are the motivation for me to code, brothers and sisters give me motivation.

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