137: Chapter 137 What kind of luck is this? A three-in-one question?
Zhao Yaqin watched his expression.
He said he didn't know, but his expression showed no fluctuation at all.
The competition continued.
Contestants number nine through fourteen performed within standard expectations, with the highest score being eighty-five and the lowest being seventy-one.
Contestant number fifteen, Lin Zhuo from Guangfu Hospital.
The scenario Lin Zhuo drew was emergency treatment for acute severe asthma complicated by respiratory failure.
His performance was indeed good; his choice of medication was accurate, airway management was on point, and his movements were clean and efficient.
The judges revealed the scores, and after dropping the highest and lowest, the average score was eighty-six point three.
He was currently ranked second, just behind Zhou Haoran.
Director Qian Fangxu, sitting in the back row of the observation area, nodded slightly.
Contestants sixteen through twenty-two.
Scores continued to fluctuate between seventy and eighty-five.
So far, Zhou Haoran's eighty-eight point seven remained the highest score.
"Contestant number twenty-three, please come on stage."
Lu Chen stood up.
The entire observation area went quiet again.
It wasn't out of anticipation.
It was out of curiosity.
Everyone knew he was the youngest contestant today, a Resident Physician who had been working in the Emergency Department for less than two months.
Several contestants who had muttered about him earlier glanced at each other.
The contestant from Jiangbei Affiliated Hospital whispered to the person next to him.
"A two-month Resident Physician? I doubt he'll even scrape a seventy."
The person next to him didn't respond, but their expression showed basic agreement.
Section Chief He Zhongfeng sat in the last row of the observation area with his legs crossed, looking quite relaxed.
Sitting next to him was a person in plain clothes—the same one who had spoken to him in the hallway earlier.
"Section Chief He, he's up."
"Hmm, watch."
At the judges' table, Jiang Weibang adjusted his glasses, his gaze landing on Lu Chen as he walked toward the operating table.
He lowered his head to write something on the scorecard, then looked up, staring at the stage with an expressionless face.
Lu Chen walked to the front of the operating table and stood still.
The chief examiner glanced at him.
"Contestant number twenty-three, Lu Chen, Jiangcheng City Central Hospital, please draw your assessment scenario."
Lu Chen reached out and pulled an envelope from the box.
He tore it open.
He glanced at the contents inside.
Then, he handed the envelope to the staff member.
The staff member took the envelope, opened it, and read the scenario aloud.
"Assessment scenario: Polytrauma patient from a car accident, open femoral fracture complicated by massive active hemorrhage, tension pneumothorax, GCS score of 6, full on-site emergency treatment process, time limit fifteen minutes."
After reading it, the staff member was stunned for a moment.
There was a collective gasp in the observation area.
This question...
It was too brutal.
Three fatal injuries appearing simultaneously.
Open femoral fracture with massive hemorrhage, tension pneumothorax, and impaired consciousness with a GCS of 6.
Any one of these alone would be a handful; having all three stacked together and needing to be treated within fifteen minutes?
This was the most difficult scenario of all the assessments today.
Without exception.
The contestant from Jiangbei Affiliated Hospital widened his eyes.
"What the hell kind of luck is this? A three-in-one question?"
The person next to him was also stunned.
"In previous years, this question would be the grand finale, usually only drawn by the most senior contestants."
Zhou Haoran's brows twitched slightly.
He looked at Lu Chen on the operating table, his eyes showing something new.
If he were to handle this question, he was confident in getting a high score, but fifteen minutes was indeed very tight.
Judging the priority of the three fatal injuries, the order of treatment, and the specific execution during the simulation—every step had to be perfect. If the order was messed up or any step exceeded the time limit, the score would drop significantly.
Zhao Yaqin's expression was somewhat grave.
She glanced at Lu Chen's back.
That back was straight, standing motionless in front of the operating table.
She turned her head to look at Jiang Weibang's expression on the judges' bench.
There was nothing unusual on Jiang Weibang's face.
But Zhao Yaqin felt like something was wrong.
Was this question drawn randomly?
Or was it...
She had no evidence; it was just an intuition.
Section Chief He Zhongfeng, in the back row, curled the corner of his mouth.
The person next to him whispered a question.
"Section Chief He, this question..."
"It was drawn randomly; it has nothing to do with me."
Section Chief He's tone was very flat.
But his expression said otherwise.
On the operating table.
Lu Chen stood in place, taking about three seconds to finish reading the scenario description.
The system notification sound rang in his mind.
"[Assessment scenario information detected]"
"[Scenario analysis: Three fatal injuries coexist. Recommended priority for treatment: Urgent decompression for tension pneumothorax → Temporary hemostasis and pressure bandaging for massive hemorrhage → Airway assessment and protection (GCS 6 suggests possible need for Tracheal intubation)]"
"[Current host skill coverage: 100%]"
"[All operations are within the host's skill panel range]"
Lu Chen glanced at the system's suggestion; it was completely consistent with his own judgment.
Tension pneumothorax was the most fatal; if not treated immediately, it would lead to cardiac arrest within minutes due to mediastinal shift.
Massive hemorrhage ranked second.
A GCS of 6 meant severe impairment of consciousness, requiring airway protection to prevent aspiration, but its priority was behind the first two.
He looked up at the equipment and the mannequin on the operating table.
The mannequin lay on the table; there was a clear subcutaneous emphysema marker on the right chest, and a simulated wound of an open fracture on the outer right thigh, with fake blood slowly oozing out.
Everything that should be there was there.
"Timer start."
The chief examiner pressed the timer.
Lu Chen moved.
His movements began the instant the timer started, without a millisecond of delay.
He didn't look at the mannequin first; instead, he shouted first.
"Simulated call: Requesting reinforcements, need a Nurse to assist, prepare large-bore indwelling needle, chest drainage kit, tourniquet, pressure bandaging materials, and Tracheal intubation equipment."
Many contestants forgot this step.
The first step of emergency treatment is not to act, but to call for help and allocate resources.
Someone on the judges' bench nodded.
Then Lu Chen walked to the right side of the mannequin and quickly completed the initial assessment.
"Airway obstructed, breath sounds absent on the right side, tracheal deviation, jugular vein distension—diagnosis: tension pneumothorax."
His voice was clear and calm; every judgment was quick and accurate.
"Immediate emergency needle decompression at the second intercostal space on the right midclavicular line."
Lu Chen picked up the thick needle from the operating table; positioning, disinfection, and needle insertion were all done in one smooth motion.
The angle, depth, and speed of the needle insertion were all within standard range.
From positioning to completing the puncture, it took fourteen seconds.
Someone in the observation area whispered.
"Fourteen seconds?"
"Isn't that speed a bit off?"
At the judges' bench, the judge sitting on the far left raised his eyebrows slightly and quickly wrote a few words on the scorecard.
After the needle decompression was completed, Lu Chen didn't pause and turned directly to the open wound on the right thigh.
"Open femoral fracture, active hemorrhage, stop bleeding immediately."
He picked up the tourniquet, quickly applied it to the proximal thigh, and then used pressure bandaging materials to temporarily treat the wound.
The position and tightness of the tourniquet, as well as the layers of the pressure bandage, were all standard.
It took twenty-eight seconds.
From the time he went on stage until now, it had taken less than a minute in total.
Two fatal injuries had already received temporary treatment.
The whispering in the observation area grew louder.
Zhou Haoran's body leaned forward slightly.
His eyes changed.
It was no longer the scrutinizing look with a hint of superiority from before, but a serious, focused observation.
This speed and quality of operation were not something a two-month Resident Physician should possess.
Next was airway management.
"GCS score 6, loss of airway protection ability, need Tracheal intubation."
Lu Chen picked up the laryngoscope and endotracheal tube.
His left hand held the laryngoscope, his right hand held the tube; exposing the glottis, inserting the tube, inflating the cuff, confirming the tube position, and securing it.
The entire sequence of actions was smooth and fluid.
From picking up the laryngoscope to securing the tube, it took twenty-two seconds.
At this moment, the observation area went completely quiet.
Twenty-two seconds to complete Tracheal intubation.
Achieving this speed on a mannequin wasn't too difficult, but the key was the quality of his actions.
Every step had no wasted movement, no repeated attempts, and no hesitation.
Success on the first try.