122: Chapter 122 This is not the kind of hand a resident doctor should have.

Right at that moment.

The monitor suddenly beeped.

It wasn't a normal alarm sound.

It was that kind of urgent, piercing alarm.

Everyone's eyes turned to the screen at the same time.

The heart rate plummeted from 138.

120.

95.

62.

Then, a flat line.

"ventricular fibrillation!" Lu Chen's voice instantly drowned out the entire Resuscitation Room.

The patient's body convulsed violently, then went limp.

The heart had stopped.

Cardiac arrest caused by excessive blood loss came even faster than the system had estimated.

[System Hint: Patient in cardiac arrest!]

[Title effect activated: enemy of yama (Beginner), patient's vital signs' rate of decline slowed by 50%]

"Start Cardiopulmonary resuscitation!"

Without any hesitation, Lu Chen immediately placed his hands one over the other on the lower third of the patient's sternum and began compressions.

This was his first time using Master Level Cardiopulmonary Resuscitation in a real combat situation.

Yet his movements weren't jerky at all.

The depth, frequency, and force of the compressions were all precisely in place.

The depth of each compression was steady at 5.5 cm, and the frequency was steady at 112 times per minute.

The point of pressure on the heel of his palm hadn't shifted by even a millimeter.

"Epinephrine 1mg, IV push!"

Shen Xiaoning's hands were trembling slightly, but her movements weren't slow.

The needle pierced the IV line, and the drug was quickly pushed in.

Lu Chen continued compressions.

"Prepare the Defibrillator!"

Meng Yan had already pushed the Defibrillator to the bedside. Two electrode pads were coated with conductive paste and handed to Lu Chen.

Lu Chen glanced at the monitor.

The EKG waveform showed fine fibrillation.

"Biphasic 200 Joules, charge!"

"Charging complete!"

"Everyone clear the bed!"

Zhao Yaqin, Shen Xiaoning, and Meng Yan stepped back simultaneously.

Lu Chen placed the two electrode pads below the patient's right clavicle and at the fifth intercostal space on the left midaxillary line, respectively.

"Shock!"

The current passed through.

The patient's body jerked.

Everyone's eyes were fixed on the monitor.

One second.

Two seconds.

Three seconds.

The waveform moved.

The irregular quivering gradually turned into a rhythmic waveform.

Four seconds.

Five seconds.

Sinus Rhythm.

Heart rate 57, slowly climbing up.

62.

68.

75.

"Sinus Rhythm restored!" Meng Yan's voice carried obvious excitement.

Lu Chen stared at the monitor, not relaxing.

"Continue fluid resuscitation. Don't slack off until the blood pressure comes up. Monitor the rhythm closely and be ready for a second defibrillation at any time."

With the support of fluids and medication, the blood pressure slowly recovered.

78/50.

82/55.

88/58.

The patient's complexion gradually turned from deathly gray to having a bit of color.

"Blood pressure has stabilized for now." Zhao Yaqin looked at the monitor, her voice a bit tight. "But we can't wait too long. His arm is still bleeding, and the tourniquet can't be kept on for a long time. We must operate as soon as possible."

Lu Chen nodded.

"Push to the Operating Room."

Three minutes later.

The door to the Emergency Department's independent Operating Room closed.

On the operating table, the patient's right forearm was completely exposed.

The tourniquet was temporarily maintained, fluids and blood products were continuously infused, and blood pressure barely stabilized around 90/60.

The Anesthesiologist Zhao Ming was already in position, Tracheal intubation was complete, and general anesthesia had taken effect.

Zhao Yaqin stood opposite as the First assistant.

Shen Xiaoning was responsible for passing instruments at the instrument table.

Lu Chen stood at the lead surgeon's position and raised his hands.

"Release the tourniquet."

As soon as the tourniquet was released, blood immediately gushed out.

Lu Chen's left hand instantly reached deep into the wound, his fingers accurately feeling the broken end of the brachial artery, and clamped it firmly.

The amount of bleeding sharply decreased.

"Vascular Clamp."

Shen Xiaoning handed over the Vascular Clamp.

Lu Chen clamped the proximal and distal ends of the artery with the forceps, completely stopping the bleeding.

Then he began to clean the wound.

The mangled injury caused by the cutting machine was different from a normal incision; the range of tissue damage was larger, and the wound surface was more complex.

Torn muscles, broken fascia, and shattered subcutaneous fat all needed to be carefully cleaned.

Lu Chen's movements were fast but not rushed, each step clean and efficient.

Debridement took eight minutes.

The internal structures of the wound were completely exposed.

The distal end of the brachial artery was severed, the broken ends were jagged, and it had retracted about one centimeter.

There was a side wall tear about half a centimeter long in the proximal radial artery.

The Ulnar Nerve had some contusion, but the continuity was still there; it wasn't completely severed.

Looking at these injuries, Lu Chen already had a complete surgical plan in his mind.

First, repair the brachial artery to restore distal blood supply.

Then, repair the side wall injury of the radial artery.

Finally, handle the Suturing of soft tissues and skin.

"7-0 Prolene suture, Microvascular Forceps, move the Surgical Microscope over."

Shen Xiaoning handed them to him one by one.

The Surgical Microscope was pushed into place, and the focus was adjusted.

Lu Chen sat down.

The next operation was his first time using perfect level Vascular Anastomosis in a real combat situation.

But his hands were incredibly steady.

The two stumps of the brachial artery were carefully trimmed, removing all contused and non-viable tissue.

Then, Lu Chen began the End-to-end anastomosis.

The 7-0 Prolene suture passed through the entire thickness of the vascular wall.

The first stitch, entering at the six o'clock position of the posterior vascular wall.

The needle tip penetrated the adventitia, media, and intima, precisely exiting at the corresponding position on the opposite vascular wall.

The needle depth was consistent, and the margins were consistent.

Second stitch.

Third stitch.

The spacing of each stitch was steady at one millimeter.

Watching Lu Chen's operation from the opposite side, Zhao Yaqin's breathing gradually lightened.

She had seen Vascular Anastomosis.

During her advanced studies, she had observed surgeries performed by the director of the vascular surgery department at the Provincial Hospital.

That director was one of the top three vascular surgery experts in the province, having performed vascular surgeries for over twenty years.

But she had never seen anyone's hands be this steady while performing Vascular Anastomosis.

The speed at which Lu Chen's fingers moved under the microscope was extremely uniform.

It wasn't fast.

It was steady.

The range of every movement and the force of every needle insertion had no fluctuation whatsoever.

"These are not the hands a Resident Physician should have," Zhao Yaqin said to herself.

The continuous Suturing of the posterior wall was complete.

Lu Chen flipped the vessel and began Suturing the anterior wall.

Same rhythm, same precision.

Anterior wall Suturing complete.

"Release the proximal Vascular Clamp."

The clamp was released.

Blood flowed back into the anastomosis.

No leakage.

Not even a drop.

The vascular wall at the anastomosis was smooth and unobstructed, and the intima were perfectly aligned.

"Patent," Lu Chen's voice was calm.

Zhao Yaqin breathed a sigh of relief, but her heart was still racing.

The operations she had just seen had already far exceeded her estimation of Lu Chen's technical level.

Next was the side wall repair of the radial artery.

This was relatively simpler, just a half-centimeter-long side wall tear.

Using the same precise needle technique, Lu Chen repaired the tear with a few stitches.

Releasing the clamp, the blood flow was patent, with no leakage.

All vascular repairs were complete.

Time taken: seventeen minutes.

Zhao Ming watched the numbers on the monitor next to the anesthesia machine.

Blood pressure had already begun to rise.

92/62.

After blood flow was restored to the distal end, the color of the fingertips also began to change from pale to pale pink.

"Distal blood supply restored," Zhao Yaqin confirmed.

Lu Chen nodded.

Next was the Suturing of the soft tissue and skin layers.

This was the real highlight of today.

A fifteen-centimeter-long mangled wound, with multiple tears in the muscle layer, damaged fascia, and severe subcutaneous tissue loss.

It would be difficult for the post-operative results to be ideal if such a wound were handled with ordinary Suturing methods.

But in Lu Chen's hands now, what he held was not the Perfect-level Suturing Technique.

It was God-level.

He began Suturing the deep muscle.

When the first stitch went in, he himself felt the change.

The tactile sensation in his fingers was clearer than ever before.

As the needle tip passed through the muscle fibers, he could precisely perceive the direction of every bundle of muscle fibers and the thickness of every layer of fascia.

This perception wasn't a vague judgment; it was real tactile feedback.

The angle and depth of the needle insertion, and the position where the needle exited, all reached the optimal solution under the guidance of this tactile sense.

Every stitch was precise to the extreme.

Zhao Yaqin once again felt that indescribable shock.

She watched Lu Chen Suturing the muscle layer; after each stitch was placed, the muscle tissues on both sides aligned perfectly.

No excess tension.

There was no reversal.

The direction of the broken muscle fibers was perfectly restored.