196: Chapter 196 Chen Hao's Group: Patient Dies!
The Deputy Director from Tianjin waited for about fifteen seconds.
During these fifteen seconds, the blood pressure of the second patient continued to drop.
55/30.
The heart rate soared to 160.
He finally called out to Chen Hao.
"Chen Hao, the second patient's blood pressure is crashing, the retroperitoneal hemorrhage is worsening, and I'm not sure how to handle it."
Chen Hao's reaction was quick.
"External pelvic fixation! Use a bed sheet for circumferential compression!"
"At what position?"
"At the level from the greater trochanter to the pubic symphysis."
The Deputy Director from Tianjin began the procedure, but his technique for external pelvic fixation was clearly not proficient enough.
The position of the circumferential wrap was a bit too high, and the compression force was insufficient.
The blood pressure did not rise.
52/28.
"That's wrong! The position is too high!"
Chen Hao finally freed his hands and rushed to the side of the second patient.
But after he left the first patient, the ventilator for the first patient alarmed again.
The PEEP setting needed fine-tuning, and Li Minghui was unsure how much to adjust it.
He hesitated beside the ventilator.
Five seconds. Ten seconds.
The blood oxygen of the first patient began to drop.
"Li Minghui! Adjust PEEP to 10! Maintain FiO2 at 100%!"
Chen Hao shouted across the room while performing the pelvic circumferential wrap.
Li Minghui fumbled to adjust the parameters.
After the adjustment, the blood oxygen did indeed recover a little, but he did not notice another parameter on the ventilator.
The tidal volume setting was still at 8ml/kg.
Under conditions of ARDS, the tidal volume should be controlled below 6ml/kg.
Excessive tidal volume combined with high PEEP would further exacerbate lung injury.
This detailed error was not discovered by anyone in Team B1.
At forty minutes, the simulation system triggered the final deterioration event.
The second patient of Team B1 went into cardiac arrest.
The retroperitoneal hemorrhage ultimately led to irreversible hemorrhagic shock.
The Deputy Director from Tianjin and Chen Hao immediately began Cardiopulmonary resuscitation.
But in the simulation system's settings, this patient's blood loss had already exceeded 40% of their total blood volume.
Under the existing simulation conditions, the probability of successful resuscitation was zero.
Two minutes later.
The simulation system announced: Team B1's second patient has died.
Large red characters popped up on the screen. [Patient Death]
Chen Hao stopped the compression motion.
He knelt beside the mannequin, breathing rapidly, his forehead covered in sweat.
On the other side of the glass partition, the situation on Lu Chen's side was completely different.
All three patients survived.
The first patient's ARDS was controlled steadily under active treatment and close monitoring, and the pneumothorax drainage was effective.
The second patient also experienced a deterioration event of worsening retroperitoneal hemorrhage under Zhou Haoran's care, but Lu Chen had discovered the trend of falling blood pressure the moment it happened through the monitoring data from Fang Yuhang.
He had called out to Zhou Haoran fifteen seconds in advance.
"Zhou Haoran, the second patient's blood pressure is trending downward. Prepare for a pelvic circumferential wrap, use a bed sheet for compression, at the level from the greater trochanter to the pubic symphysis, and make sure the force is sufficient."
Upon receiving the order, Zhou Haoran executed it immediately; the position of the wrap was accurate, and the force was appropriate.
After a brief drop, the second patient's blood pressure returned to 80/48; although low, it did not crash.
The third patient's chemical poisoning was also gradually improving under Liu Dong's continuous detoxification treatment.
Forty-five minutes ended. Professor Han Zhiguo announced the end of the competition.
"All operators, hands off, return to the starting position."
Both groups stopped. The four people in Team A1 stood in a row. The four people in Team B1 stood in a row. They were separated by the glass in between.
The experts on the judging panel began to compare the scoresheet and grade item by item.
Lu Chen stood in place, his breathing steady, and his heart rate showed no obvious fluctuations.
The highest heart rate recorded by his wearable device during the forty-five-minute assessment was 92 beats per minute.
For comparison, Chen Hao's highest heart rate reached 138 beats per minute. Zhou Haoran's highest heart rate was 105 beats per minute. Fang Yuhang's was 98 beats per minute. Liu Dong's was 110 beats per minute.
Ten minutes later. The evaluation results came out. Professor Han Zhiguo stood at the front of the observation platform.
"The results of the competition between Team A1 and Team B1 are as follows."
He first glanced at Team B1.
"Team B1, patient survival rate: two of the three patients survived, one died."
"SOP execution score: 71 points."
"Team collaboration score: 58 points."
"Emergency response score: 65 points."
"Weighted total score: 66.3 points."
Then he looked at Team A1.
"Team A1, patient survival rate: all three patients survived."
"SOP execution score: 94 points."
"Team collaboration score: 96 points."
"Emergency response score: 97 points."
"Weighted total score: 95.4 points."
The moment the numbers were revealed, the other groups of students watching on-site let out a low gasp.
95.4 points. An SOP execution score of 94 was already extremely high. A team collaboration score of 96 was almost impossible in such a high-pressure competitive environment. An emergency response score of 97 was the highest score among all competitive groups that day.
Chen Hao stood in Team B1's position, his face ashen.
His individual performance score was actually not low. But the team collaboration score of 58 dragged down the entire group's results. Fifty-eight points. A failing grade.
Professor Han Zhiguo was not in a hurry to announce the elimination list. He first provided some feedback.
"Team B1's problems stemmed from two areas."
"First, the communication of instructions was unclear. When the tension pneumothorax occurred, the core member only shouted to perform a puncture immediately without designating an operator, which led to three seconds of confusion in the division of labor."
"In real emergency rescue, three seconds is enough to turn a patient from savable to unsavable."
"Second, the prediction of the hemorrhage deterioration for the second patient was insufficient."
"Looking at the monitoring data, the trend of the second patient's blood pressure decline had already appeared thirty seconds before the deterioration was triggered."
"If the preparations for the pelvic circumferential wrap had been initiated at that time, there would not have been a timeout during the critical moment later."
"These two issues led to the death of one patient and a significant decline in the overall score."
He turned to Team A1.
"Team A1's performance can be summarized in four words."
He glanced at the four experts on the judging panel. The four experts did not seem to have any objections.
"Textbook level."
It was these four words again.
"From the initial triage to the institutionalized execution of reporting the status of all patients throughout the process."
"From the instant judgment in the double-hit scenario to the precise communication of team instructions."
"Team A1 did not have a single instance of confusion in the division of labor within forty-five minutes."
"Especially the core member, Lu Chen."
Professor Han Zhiguo looked at him.
"In the process of simultaneously dealing with the double hit of ARDS and pneumothorax for the first patient, you still had the capacity to discover the downward trend of the second patient's blood pressure in advance through the monitoring data from Fang Yuhang, and issued a preventive order fifteen seconds before the deterioration was triggered."
"This kind of situational awareness of the entire scene is not something accumulated simply by years of experience."
"The on-site command ability you demonstrated surpasses your professional title."
After the last sentence was finished, Instructor Sun Gubei added a remark.
"Far surpasses it."
Lu Chen's expression did not change. He stood there, his gaze calm.
Professor Han Zhiguo finally announced the elimination results.
"According to the rules, the member with the lowest individual score in Team B1 is Attending Physician Zhang from Lanzhou, with an individual comprehensive score of 52 points; he is eliminated."
The Attending Physician from Lanzhou turned pale, but he did not argue. He walked out of the simulation area with his head down.
Chen Hao stood in place without moving. His individual score was the highest in Team B1, so he would not be eliminated. But 66.3 against 95.4. This gap was too large.
Everyone in the room saw it. This was not luck. Nor was it a difference in scenarios. It was a gap in strength. It was a gap in the philosophy of team collaboration. It was a gap in the understanding of the essence of emergency rescue.
Chen Hao had fallen at the eighth stage of the airway challenge. Chen Hao lost by nearly thirty points in the team competition. The rumors circulating a few days ago about Lu Chen being a nepotism hire became laughable at this moment. A nepotism hire could not possibly achieve these things.